I am considering a hair transplant. I am 30 year old female. My husband and I have also decided on trying to get pregnant. I am not sure if it is better to do the surgery first or wait till after the baby. My concern with after the baby is I am aware that during pregnancy my hair will be temporarily thicker- so if I do the surgery before post pardum shedding then my hair will be abnormally thicker for the surgery, in turn getting a smaller surgery than needed, and after the normal post pregnancy shedding I will not be happy with results. In addition, if I do the surgery immediately after the shedding stops I will be temporarily thinner than usual (because of the shedding) and have a larger surgery than needed and kill off “good” hairs just because they were shed. On the flip side if I have the surgery before pregnancy how long after the surgery should I wait till becoming pregnant? Will becoming pregnant after the surgery affect the results in anyway? — T.L.

You can have a hair restoration procedure before getting pregnant and up to the first trimester of pregnancy. If you are not able to have surgery before the pregnancy, you can have surgery four months or later after delivery. The changes in density and amount of hair lost during pregnancy will not affect the overall long term result of the hair transplant regardless of which option you choose.

— Victor Hasson, MD

I have had a hair transplant with a local clinic about 1 1/2 years ago and I am not that satisfied with their work. I can conceal it pretty well and Finasterid is currently stopping my hair loss. However, there are two or three bumps in the temple area where the clinic transplanted hair. You can barely see them because of the hair covering it but I can feel them. Will they go away over time? Are they dangerous? — J.

Thanks for the question, J. The bumps could be a few things. Since they are not very noticeable, they are probably of no concern and almost certainly would pose no danger. If a graft was not properly trimmed and excess tissue was left, the area may be raised or a small bump can result. Larger incisions can also create a little scarring which could also be the case. In either of these scenarios, it is not likely to diminish over time at this stage. If there is an ingrown hair, the spots would likely continue to get bigger over time and some inflammation may be present. In this case, the ingrown hair would need to be freed. This may solve the problem but once in a while when the new growth cycle occurs and a new hair comes in, it could possibly get trapped under the skin again.

It is difficult to be accurate without being able to see the area. For a little better diagnosis, send good clear photos of the areas in question via our hair transplant consultation form. I hope this helps. Good luck.

— Jerry Wong, MD

I’m in Los Angeles and would like a hair transplant consultation. Is it true you have an office in Los Angeles? I’ve done a Google search for “Los Angeles Hair Transplants” but can’t find a Hasson & Wong office listed. — S.J.

The Los Angeles hair transplant consultant has a new website at losangeleshairtransplants.net. Mike is also our Seattle and Portland consultant. He is now booking hair loss consultations in Los Angeles as needed. If you’d like a free consultation, visit his website, or email mike {at} hassonandwong(.)com

There is much debate about hair transplants in men under 25 but I think it is an important topic. I have hair loss and I am 24; are there programs your clinic provides to help #1 prevent further loss, and #2 create a plan for multiple transplants with respect to our donor areas. — C. Y.

As a general rule, we like to wait until a patient is 24 years old to perform surgery. This applies to patients with typical male pattern baldness. Every individual situation can differ. When a clear pattern of loss has developed at an earlier stage and it is easy to predict the final hair loss pattern, exceptions can be made.

In most case involving young patients with male pattern loss, a careful approach to the surgery with a conservative hairline is usually the best option. Other types of loss due to traction or an accident can also determine if a patient can have surgery before the age of 24. Preventing further hair loss for a young patients is often the number 1 priority. Your use of Propecia is a general recommendation to most patients with hair loss.

Creating a plan for surgery for young patients is basically the same for any patient. We access the donor area and final hair loss pattern to determine what can be accomplished to provide the best cosmetic result for now while taking into account this result must stand the test of time and will look good many years down the road. When using Propecia combined with our technology and skill, often times one surgery may be enough. Many patients today have 1 or 2 surgeries as opposed to several in years past.

If you have other questions or would like a free hair transplant consultation, please submit a hair loss consultation form.

Jerry Wong, MD

Dear Dr Hasson, I am a black person who needs a hair transplant, but I don’t see any black men who have had your procedure. I would like to volunteer my self to let black men know that they can have a hair transplant, too.

— G.F.

Thank you for your interest and offer. We have had many black men as patients. Most have come from other parts of the world and have not been back to the clinic for follow-up photos to put on the website. If you are a good candidate for hair restoration surgery, we would be happy to have you as a patient and potentially post your before and after photos on the website for other black patients to see. You can upload photos from our free hair loss consultation form and you will receive a free evaluation and a recommendation.

Victor Hasson, MD

Good afternoon Dr. Hasson and Dr. Wong, I have a doubts about a hair transplant. I have diffuse alopecia in the upper part of the head. With long hair, I can cover the entire surface with an acceptable result. My question is, I have always read that the diffuse alopecia is more difficult to transplant, because is easy to damage the healthy hairs.

Is that true? Is possible to do? — I.P.

As you describe in your case, you have a diffused thinning throughout the top of your scalp. This type pattern of hair loss can be more difficult to transplant and cause damage to existing hair, especially for a lesser skilled clinic or doctor who is not using the right technology. In our clinic we routinely transplant amongst existing hairs and expect that with our innovations and level of skill, no viable native hair will be damaged. It is possible for Hasson & Wong to safely and effectively transplant a patient with your hair loss pattern.

— Jerry Wong, MD

Here is my case: I am 30 years old, I have been on Propecia for almost 10 years and have a moderate hair loss. I would like to get more density on the crown though. I have tried Rogaine which coupled with Propecia really worked but Rogaine was giving me headaches, so I was forced to stop.

My question: if I get a hair transplantation to get more crown density, the newly implanted hairs will remain on my head while the non-transplanted hairs will keep on vanishing: the result might look poor in 5 years post surgery. What do you think? — S.W.

Thanks for question, S.W. Likely the Propecia has been effective in reducing or stopping your hair loss. If your donor hair is sufficient and it would not put you at risk down the road, a transplant to the crown would be an option. The grafts would be blended into the existing hair to provide a bit of a buffer zone should you continue to lose existing hair around the transplanted hair. If your loss continues, there would be the possibility that another procedure would be required to add hair to the areas exposed around the transplanted area.

For the most part, patients on Propecia usually don’t lose enough hair around the transplants to warrant another surgery in that area. An important factor in the equation is your donor supply and final hair loss pattern. These two variables will ultimately play an important role in determining what is safe to do in your case. If the overall donor supply will meet any potential future demands, grafting in any areas is safe. If the supply may not ultimately meet potential future demand, then we must be careful how we distribute the grafts.

In some cases, a transplant to the frontal zone and mid scalp will provide an excellent cosmetic result, but work for the crown must be avoided when limited donor supply exists. In the end, a careful evaluation of your donor supply and final hairless pattern will determine whether crown work would be a good idea in your case.

You can submit photos for a free hair loss consultation.

— Victor Hasson, MD

How effective is propecia in halting hair loss if taken early in the process? Will it stop working after a certain number of years or does it usually stop all hair loss in the crown and mid scalp areas once the patient has started taking it? If I am on propecia to maintain my mid scalp and crown, but have already lost my temples and frontal regions of hair, is a transplant possible or is there to much of a risk that I will lose hair in the other areas if the propecia losses its potency? — M.

Propecia is very effective in halting hair loss if started early in the process. We have many patients who have been taking it for over a decade with no noticeable decline in effectiveness. We do not expect that one day the medication will all of a sudden stop working. If you are taking Propecia and it has effectively stopped or slowed the hair loss in the mid scalp and crown it should continue to do so indefinitely. To what degree your frontal zone and temples can be restored will also depend on your donor area and final hair loss pattern. In almost all cases if the patient is a surgical candidate, it is safe to restore the front and let the medication work on the mid scalp and crown.

— Jerry Wong, MD

I have had 2 transplants (3800 and 1500). The first left my recipient area pitted and looking like a golf ball or a pin cushion. I had the second one recently (Jan 2010) with the intent to conceal the pitting in the hailine. First procedure was with NHI (Oct 08) in Melbourne Australia the second with Dr Knudsen in Sydney. When I see your photos (and others) I almost begin to cry cause my recipient area is such that I cannot leave the house without a cap. I fear that the recent procedure will not be enough to conceal the damage. My only hope is to have another procedure (around 4000, donor area permitting) to get as much density as possible to conceal the mess as I am painfully aware that scars are for life. How long do I need to wait between procedures and is donor hair supply the only constraint on density or is there a physical limit at which you cannot place grafts together? Please help me. — S.H.

It would be best to wait until at least 8 months post-op to determine the result and plan for another procedure. If the recipient area is not able to be improved to the desired degree by the second procedure, a couple questions need to be addressed:

1. will another procedure adequately conceal the old work and create a natural enough result ?
2. will removing the old work be necessary before the next procedure to achieve the desired result ?

In many cases where the recipient area is scarred and damaged, the removal of the tissue and then later reconstruction will create the most natural hairline. There are several factors that need to be taken into consideration to determine the best approach if any for another procedure. There are too many factors to discuss here which would determine that. A clear set of photos, or better, a physical examination would be required to correctly assess the situation. For a free consultation and to upload photos, please submit a free hair loss consultation form.

While donor supply does factor into what density would be best to try and achieve, there is a physical limit as to how dense the grafts can be packed. If given a sufficient amount of raw materials (donor) to work with, many patients with otherwise obvious unnatural hairlines from previous surgeries can in the end have normal looking natural results.

— Victor Hasson, MD

I have a question. I have already been in contact with your very help staff but I have a question for you: I had a previous hair transplant and had 1200 grafts removed. I live in the UK but want to come over for a mega session and I would like to know without seeing me, typically what is the most amount of follicles the average person has spare? Also I have no desire to take minoxidal or propeccia. Are there any clinically approved herbal remedies that I can use? I want to get going on this as soon as possible. I am looking at 6000 grafts and have available resources from now on.Can you tell me how quickly I can get in and what I need to do? — T.W.

Hello T.W. Thanks for writing. There are no clinically proven herbal remedies that stop hair loss. There is nothing in the natural supplements market that will halt hair loss or regrow hair. If these worked, there would be no need for hair transplant clinics. So far, the only permanent solution to hair loss is hair transplantation, and the only drugs that halt and/or regrow to some extent are Finasteride (Propecia, Avodart), and Minoxidil (Rogaine). We do not recommend Rogaine generally as it is not as effective or convenient as Finasteride, and patients must stop it prior to hair transplant as it is a blood thinner. Blood thinners must be stopped in the months prior to surgery to avoid excessive bleeding during the procedure.

The clinic is usually booking surgeries about 6-8 weeks or later from the time you are approved as a candidate for surgery. First, you must submit a consultation form and receive a recommendation from the doctor.

The consultation form is a two part form. In the first part, you provide contact information, describe your hair loss, and answer questions about your situation. In the second part, you upload digital photos.

As for average number of available grafts, 6000 grafts, in most cases over 2 surgeries would be fairly typical. 3000-4000 grafts is a typical good sized surgery at Hasson & Wong, and for patients with excellent density and scalp laxity, 4000-5000 is quite possible. In rare cases does one surgery exceed 6000, though it certainly does happen at this clinic.

Visit the following page to see our photo guidelines:
http://www.hassonandwong.com/consultation/hair-transplant-consultation-online.php

Then, submit this form and upload your photos:
http://www.hassonandwong.com/consultation/consultation_form.php

— Victor Hasson, MD