HAIR TRANSPLANT DALLAS: GRAFT PLACEMENT VIDEO 3 HAIR LOSS

[Trinder3467]

@samlammd I get it. If a patient refuses to take an anti-androgen, should he wash his hair everyday with a mild shampo or once a week with an anti-dandruff one. And also what type of hair transplant is considered to be a succesful transplant? There is FUE method, is there another one that involves no cutting of skin at all? I always wondered how some actors have perfect teenage hairlines. Tom Cruise, for example, even at the age of 50 managed to get a full head of hair and concealed it

[samlammd]

@Trinder3467 a type of hair transplant done by a qualified physician is really the key. FUE is ok but also strips the graft down and viability can in my opinion be compromised. i really have no idea what tom cruise had done. :)

[Trinder3467]

@samlammd I guess then we should assume that you also have a normal DHT level. I always wondered about people who don't go bald even by the age of 50 or 60. Does that say that all those people have lower DHTs including yourself? For example, if patients who didn't inherit the balding gene, then the DHT won't affect them, right? Or for some reason that patient suddenly in his life experiences hormone problems he still will see loss?

[samlammd]

@Trinder3467 it is not a question of normal DHT. it is a question of having DHT sensitive follicles. some people's follicles are not sensitive to loss.

[Trinder3467]

@samlammd Hi, it's me again. How much would you say Tom Cruise's transplant set him back. I'm talking from a positjon of hair line. Just round numbers in your clinic.

[samlammd]

@Trinder3467 hi, i really do not know. i appreciate all the questions but really please be fair to my personal life. i am spending an inordinate amount of my personal time answering your questions. i do appreciate some questions but really cannot handle the load.

[Trinder3467]

@samlammd Hey, I only asked because you answered. In the future I will assume your silence as a "busy signal". Thank You.

[samlammd]

@Trinder3467 no worries. i always try to be responsive but that can kill me sometimes. :)

[Trinder3467]

@samlammd No, harm done. But , as a surgeon, I would suggest you to look into the Tom Cruise's hair. He claims that it's his but I have my doubts.

[samlammd]

@Trinder3467 ok, will do. :)

[Trinder3467]

@samlammd I see. I've noticed that most, if not all, hair transplant surgeons share great head of hair. What is your secret?) Besides maybe taking Propecia or Rogaine. Or it just happens that you guys don't have MPB and you have no balding gene in your family?

[samlammd]

@Trinder3467 i am lucky. my mom's dad was completely bald. somehow i was spared the gene. but honestly, there are tons of balding surgeons out there. just go to the annual hair transplant meeting. you will see them there plus a lot of really bad work unfortunately, probably from the plug era.

[Trinder3467]

@samlammd Yeah, but still I'm sceptical and a bit frightened by the side effect. My parents won't even allow me to touch it. Other than that I understand that hormones are greatest factor in hair loss. What is your position on future cloning process? If it gets approved, what are the chances of it being succesful compared to today's transplants? I want to be excited about it, but still nothing can be compared to your original natural born hair I guess. Just a thought.

[Trinder3467]

@samlammd So, we come to a conclusion that MPB is the same as Diabetes. They're both inherited, but the only problem is that, as you say, DHT rise is not always a factor since even if you push it down by Propecia you may still experience some loss. While with Diabetes you have too much sugar in your blood and blood tests are the proof. That's why if Propecia was really that effective then I bet that it would cost a lot more than it does now. I wish there were a natural way to lower DHT

[Trinder3467]

@samlammd Okay. But is there a hope for a person in my state of thinning to regain thickness and keep hair, without the use of Proscar or Saw Palmetto? My Trichologist says that a "Mezotherapy" is also a DHT-killer. Basially what it does is it kills off DHT presence in the scalp and stimulates faster hair growth. While on the topic, is Rogaine a trusted product. If once used, and then stopped, will more thinning occur as a result?

[samlammd]

@Trinder3467 if it is male pattern baldness, that is a progressive disease. it does not improve by itself. if it is not MPB, then obviously it could improve but depending on what is causing things. rogaine and propecia slows down and somewhat reverses things but once you stop you will lose everything you would have lost during the time you are on it. you will not lose more than if you were not on it.

[Trinder3467]

@samlammd So, we come to a conclusion that MPB is the same as Diabetes. They're both inherited, but the only problem is that, as you say, DHT rise is not always a factor since even if you push it down by Propecia you may still experience some loss. While with Diabetes you have too much sugar in your blood and blood tests are the proof. That's why if Propecia was really that effective then I bet that it would cost a lot more than it does now. I wish there were a natural way to lower DHT

[samlammd]

@Trinder3467 yes in a way. propecia is very effective. it just does not stop the process. there are natural dht blockers supposedly but i just don't think they are effective. btw, propecia is very expensive. 60 to 70 a month. next year it will be off patent and become a lot cheaper.

[Trinder3467]

@samlammd Yeah, but still I'm sceptical and a bit frightened by the side effect. My parents won't even allow me to touch it. Other than that I understand that hormones are greatest factor in hair loss. What is your position on future cloning process? If it gets approved, what are the chances of it being succesful compared to today's transplants? I want to be excited about it, but still nothing can be compared to your original natural born hair I guess. Just a thought.

[samlammd]

@Trinder3467 no real idea about cloning. we could be close or we could be far. every year i hear something about it but we are not quite there yet. :)

[Trinder3467]

@samlammd I was prescribed to take a "Saw Palmetto" instead. Would you recommend this as an alternative? My urologist and endocrinologist would not let me take Proscar or any anti-androgens because I'm in perfect health and my DHT level is only 130 units above the normal. And also the fact that I'm 24 years old. I'm not really balding, but my hair is thinning since April. On the crown area moslty, but it seems to have stopped. The growth of hair in at a normal rate. The quality isn't.

[samlammd]

@Trinder3467 saw palmetto has had ambivalent studies. some look promising, other say it is bunk. i am in the latter camp but don't have a lot of experience with it. no matter what your DHT is, if you are having MPB, you should consider propecia. that is something you can speak with your doctor about. that is my opinion.

[Trinder3467]

@samlammd Okay. But is there a hope for a person in my state of thinning to regain thickness and keep hair, without the use of Proscar or Saw Palmetto? My Trichologist says that a "Mezotherapy" is also a DHT-killer. Basially what it does is it kills off DHT presence in the scalp and stimulates faster hair growth. While on the topic, is Rogaine a trusted product. If once used, and then stopped, will more thinning occur as a result?

[Trinder3467]

@samlammd Okay. So, more hair transplant procedures mean more donor scars, right? Did you have any situations where you had to take hair from other parts of the body? Like worst case scenario - pubic hair. As a doctor, do you recommend to take Properica/Proscar to your patients. I'm afraid to take it because of the side effects and not to mention that it literally shrinks your prostate.

[samlammd]

@Trinder3467 yes, more HTs mean more incisions. however, if they are closed well you should have a hard time seeing them. i have not had to go to body hair yet because i plan as well as i can that i don't run out of scalp hair. i recommend propecia to all my male patients because it really helps slow the process down and even reverse it to a certain extent. i really believe the side effects are overstated, as i have only had 1 patient out of thousands that complained of permanent issues.

[Trinder3467]

@samlammd I was prescribed to take a "Saw Palmetto" instead. Would you recommend this as an alternative? My urologist and endocrinologist would not let me take Proscar or any anti-androgens because I'm in perfect health and my DHT level is only 130 units above the normal. And also the fact that I'm 24 years old. I'm not really balding, but my hair is thinning since April. On the crown area moslty, but it seems to have stopped. The growth of hair in at a normal rate. The quality isn't.

[Trinder3467]

@samlammd So, what would you suggest to a patient who is old enough for a transplant procedure but he still has most of his hair on some parts? Should he wait until he loses all his androgenic zone hair and start then? Or start the transplant as he loses it. In other words, what stage is appropriate to achieve the fullest look

[samlammd]

@Trinder3467 that is a hard one. if you want the fullest result possible start sooner than later. however, that depends on if you are willing to accept more transplants in the future, which you will most likely need. also, i need to see your donor density and how much loss you have to make that prediction. i give people better estimates when i see you in person, look at the loss, look at the hair caliber, look at the density, age, etc. all these need to be combined for a good recommendation.

[Trinder3467]

@samlammd Okay. So, more hair transplant procedures mean more donor scars, right? Did you have any situations where you had to take hair from other parts of the body? Like worst case scenario - pubic hair. As a doctor, do you recommend to take Properica/Proscar to your patients. I'm afraid to take it because of the side effects and not to mention that it literally shrinks your prostate.

[abhilash910]

If i get one when i am 35 or something, what are the odds that it will look when i am 50? What if i loose more hair , i will end up with hair in sporadic places. The transplanted hair will stay, but others will fall away eventually. So does that mean @ 50 i have to return for another transplant?

[samlammd]

@abhilash910 it depends on how the transplant is done. if you blend back the area where you have lost hair and go back toward areas where there is no hair loss then it should not be as much issue. but at 35 most likely you will lose more hair and you will need to back up your previous transplant over time.

[brunovalentim1982]

wow, but that most of cost you a fortune :/

[princeslade]

How many hairs did you use per graft in the hairline compared to the central part?

[samlammd]

@princeslade the hairline is mainly made up of 2 hair grafts. plus a row of 1 hair grafts in the front. the area behind that would be a combination of grafts that contain 3, 4, 5, 6, and 7 hairs. :)

best,

sml

[princeslade]

@samlammd won't grafts with 7, 6 or 3v3n 5 hairs create a "plug" look? That can't be natural.

[samlammd]

@princeslade not at all. plugs are 16 to 20 hair grafts that are round. when you pair two follicular units that are already very close together, the spacing between the grafts is maintained and you can get more grafts in a tighter arrangement than is otherwise possible. this is the concept of di-follicular unit grafting. you can only do this with high density donor area, i.e., the follicle units are so close already that you don't need to separate 2 of them. this is only for central density

[Trinder3467]

@samlammd My question is for the ages. But I would still give it a shot. Why do ALL the hair transplants create a TRIANGLE-shaped hair-line? Every transplant that I've reviewed on youtube I see the same problem. If I want a transplant I want my full head of hair back.

[samlammd]

@Trinder3467 triangle shaped hairlines are terrible. no one should create triangles. they should be a gentle curved arc but you can have a small widow's peak in the center. remember that when we start to see hair loss, we have already lost 50% of our hairs. we are born with 100,000 hairs. with each transplant we move about 5,000 hairs so it is hard to have 5,000 hairs equal 50,000 loss. that is why good artistry is so critical.

[Trinder3467]

@samlammd I have to be honest though. Most of these hair transplants lack temple hair. Why? Also what happens when he loses the rest of his hair on top? Would he still have donor hair left?

[samlammd]

@Trinder3467 temple hairs are important to transplant. i have been doing more and more of them over the years. when i teach how to teach hair restoration course i always advise docs to be careful to do temples because they are hard to do naturally if you are inexperienced. also, you need to estimate how much donor hair you have left to do big temples. i always predict based on supply and demand (degree of loss, donor density, and age) if i have enough future donor to be used.

[Trinder3467]

@samlammd So, what would you suggest to a patient who is old enough for a transplant procedure but he still has most of his hair on some parts? Should he wait until he loses all his androgenic zone hair and start then? Or start the transplant as he loses it. In other words, what stage is appropriate to achieve the fullest look?

[princeslade]

How many grafts were used in this procedure?

[samlammd]

@princeslade i can't recall but probably about 6000 hairs and that divided into a couple thousand grafts. remember that "grafts" is not a good way to describe things because if you use primarily 4 to 5 hair grafts versus 1 to 2 hair grafts the results are entirely different. i know clinics that chop up grafts into useless 1 to 2 hair grafts to build up central density so they can charge you for "grafts". see my video on graft cost philosophy to understand this better.

[thebadestnozzo]

WHY WOULD YOU PUT YOURSELF THROUGH THIS

[samlammd]

@thebadestnozzo so that you can go from bald to a full head of hair for the rest of your life! it is worth a week of not looking so good IMHO.

[AngeloR674]

@thebadestnozzo becuase people care enough about them selves to look better!!! to bad youre not one of them!!! keep your stupid comments to your self!

[Kalm1ty]

could you show me what a donor scar would look like with your work?

[samlammd]

@Kalm1ty absolutely, not only do i have photos but i have macro lens comb through videos of my work on my web site (and on youtube). easiest thing to do is to go to hairtx [dot] com and go to videos tab then go to the very first box called "technique" then go to the "closures" videos and watch them.

[Kalm1ty]

@samlammd I can't really see anything on the videos but it sounds like it would be hard to see the scar.

Would you recommend donor transplantation for short hair cuts?

[samlammd]

@Kalm1ty that's the point. it should be hard to detect. however, worst case scenario you can have a 1 to 2 mm spread back that should only be detectable with close inspection. a short hair cut is also something that makes a hair transplant result not look good because you simply do not get enough travel distance with the transplanted hairs. plus, your transplanted hairs can look unnatural when they are trimmed close. plus FUE does not guarantee nothing visible in the donor.

[samlammd]

@Kalm1ty in summary, short hairstyle is bad for ALL types of hair restoration as indicated in my above answer.

[Sal1675]

Was this using FUE system or did you take a strip of skin from back of head?

[samlammd]

@Sal1675 strip harvesting, as i believe the graft quality is 1000x better; and donor incision is almost impossible to detect if done well.

[Sal1675]

@samlammd - dont you like FUE system at all? The troulbe with strip harvesting is that I cant get my hair cut short as the incision is obvious. Is stem cell technology not yet available?

[samlammd]

@Sal1675 no, i don't. most FUE systems truly damage the hairs during harvesting and growth is poor. go to hairtx [dot] com and click on the FUE link and read my two page description of why I think FUE is not a great thing right now. if you are talking about very short hair, yes, that is true. but read what i have written before you judge. we are still not there with stem cell technology yet. thanks.

[GAMINDORE]

@Sal1675 The stem cell is getting very slow... We hear this here and there, but, actually, when we finally will have access to this technology ????Or maybe this is just an outcry... ??????

[samlammd]

@GAMINDORE yes, you are right. i don't know???

[seekperfection]

I recently receieved the hair restoration procedure and will be posting updates as the days progress.

[MsGreatHair]

OMG ... this procedure looks painful !!! Think i'll have baldness over pain, thank you.

[samlammd]

@MsGreatHair it is not painful in my clinic. i am one of very very very very few clinics that can provide level 2 conscious sedation, i.e., iv sedation, so there is ZERO pain during the procedure. most places cannot do that because they do not have an accredited surgical facility within which they work so it can be painful. no pain at my clinic. :)

[hellophoenix]

@MsGreatHair No Not at all,,,I just did mine and it was not bad at alll

[AJBurtonOperator]

How much did this operation cost? I have the same frontal hairloss and would love something this dense.

[samlammd]

@AJBurtonOperator you can call my office 972-312-8188 for a quote but figure around 11k for an estimate.

[HattoriGalford]

After the surgery, wouldn't ppl be embarrassed to go to work while it is healing? How long to the redness and the scar around the donor area last?

[samlammd]

@HattoriGalford that is why people take a week off from work. it is much less visible after a week. however, it can have a light red hue for another 1 to 2 weeks but typically it is not very noticeable. the scar is covered with your hair so you should not even see it during recovery. in a few months when things are healed it should be hard to see it.

[Haroldrod]

need your phono number please

[samlammd]

@Haroldrod 972-312-8188. :)

[PowerRedBull]

What I mean is that the usual hairtransplants I see on youtube just seem to be 'too perfect'. Like they have a very straight hard line wher they begin, they're very even and the line 'too perfect' in my opinion. For example if you take a look at the (non balding guys) pictures in google image search from 'justin timberlake' or 'christian bale', their hairlines are not really straight lines,but instead go up and down a little bit , which gives it that "natural vibe", instead of a ultra sharp line

[samlammd]

ok, to understand that i agree with you type in "hairline coastline" in the youtube search window then click the first video that comes up after you do the search on youtube. that video will explain my thoughts.

[PowerRedBull]

Well yes that is kinda how i think howlines should look (especially the idea) since the pictures a bit small. But yes, hairlines have shapes like coastlines..going up and down. Well then you are the one doing good natural hairlines..my gratts to you!.

Don't remember fully why i said the hairline thing on this video, as you seem to know what i mean. I guess I just saw the little implanted hairs with blood on the video and assumed it would create that 'fake'looking hairline

[samlammd]

No problem. Thanks!

[kdksad]

@samlammd : what happen with the donor area since the follicle is remove from that area to the recipient side? will the donor area become bald or its regrow again?

[samlammd]

@kdksad since you have so much hair back there if you take less than 1 cm out and close it you will never know it is gone.

[PowerRedBull]

Overal I'm not really impressed by the shapes of hairlines that are created by hair transplants. (I'm not talking about this one specificly).

It always seems to me they try to create forehead shapes which are none of the "natural" balding scales of norwood. hairline shapes in norwood always have these ' curvy' lines. Like it's always a tad 'roundish'. With hair transplants, They often create hairlines which are really M shaped and make you think "oh , that doesn't look natural". ..why?

[samlammd]

i don't know why hairlines are not designed well. i fix a ton of them.

[PowerRedBull]

Well i would not call the usual (i'm really speaking about the usual hairlines from transplants - not all) are very 'straight' and 'neat'....they have a very hard line, while most 'natural' hairlines are not really even, have a bit of bows in them,(if that's the word for it in english), like they're not perfect harsh lines..but go up and down a bit along the forehead. (do a google image search for 'justin timberlake' or 'christian bale'. Their hairlines have 'flawns' wich make them look natural

[quang9876]

please, if you could tell me the cost of your hair transplant costs.

[samlammd]

the cost ranges between 8 to 12 k. we do not charge per graft since no one can guarantee an exact graft count. for example, how does a 6 hair graft equal a 1 hair graft? it doesn't. how does a 3 hair graft equal a 2 hair graft? it doesn't. just our philosophy. if you are interested in more info, just contact info at lamfacialplastics [dot com].

thanks,

sml

[quang9876]

i would like to know the costs for each graft... thx

[pt171]

Is it possible that the donor be somebody other than the person undergoing the procedure?

[samlammd]

no, you will suffer rejection and all the hair grafts will spit out. good question though.

[drac0nyx]

taking a strip from the back is nothing like a scalp reduction surgery.

[samlammd]

that is correct. you will not have any scalp reduction benefits with strip harvesting.

[drac0nyx]

i cant see any benefits from scalp reduction

[samlammd]

that is why i do not perform it. however, i hate to be negative about a procedure i don't do just because i don't do it.

[penyupenang]

Hey what will happened to the donor area after the folicle was taken? Will it re growth again?

[samlammd]

no, actually taking a centimeter of skin and hair out in the back won't be noticeable after you close it.

[penyupenang]

i see, so what you mean is.. the donor area skin will undergo a scalp reduce procedure...

[samlammd]

well, that is confusing way to put it only because when someone says the term "scalp reduction", they are specifically referring to a procedure to reduce bald scalp by cutting tissue away. however, in short, yes, i am reducing the scalp in effect but that is not the intention but the byproduct. hope that is clear.

[penyupenang]

Yeap i get it... also rumors said that the transplanted hair will grow for a life time due to its genetic resistance to baldness... thats a good news or rumors..

[samlammd]

that is truth.

[WTF1920]

That looks kind of painful...But I bet it's worth the wait when it grows back.

[samlammd]

surprisingly, it really is not that painful.  it is achy on the back side of the head for about 7 to 10 days but if proper tumescent technique is used (see my site hairtx), true short and long term discomfort is greatly minimized.

[beezwaldo]

sammyland i just had my transplant about 1 month ago 1230 follicles im waiting on the results now they say 1yr for full hair restoration how long for you ? b4 you saw your hair coming in? and i was not bald just little receeding will it all the tranplanted hair come in? or will it rest forever...the doctor says it goes in a resting phase ..just thought ide ask someone who is far ahead than me thanks

[samlammd]

hi, i've made it a policy not to comment on another surgeon's work or thoughts. that is not fair or ethical. i maintain the same standards in my forum on my website. best wishes for your beautiful hair to grow in!

[arashmets]

Sam can someone lose the new donor hair they get transplanted from the back, or is it a guarantee that new donor hair never falls out or recede?

[samlammd]

no, there is no guarantee. you can have some thinning back there but i have never seen that as permanent. in less than 5% of the case, i see temporary thinning around the donor hair but i have never seen donor hair loss that i can remember. it is theoretically possible as anything as possible.

[LuminousWorld]

So how much does it cost?

[fredgotti]

After getting a hair transplant, do you still need to take drugs such as Rogaine or Propecia, or is it a done deal?

Also, how much does this procedure typically cost? I understand it probably varies widely, but let's say to replace your hairline for instance?

[samlammd]

rogaine and propecia are not necessary to affect the transplanted hair, which is permanent. they are to limit further loss of your non-transplanted hair so they do help a lot. cost is between 8 to 11 thousand depending on the loss.

[7ayyouta]

does ist hurt?

[7ayyouta]

does it hurt?

[samlammd]

no. it really shouldn't. we use a very gentle iv anesthetic.

[javoman13]

were you bald?

[Bfolks84]

What about Laser Hair Restoration? What do you know about that?

[samlammd]

you only get very minimal results with that. NOTHING like a transplant.

[samlammd]

his results can be seen on hairtx dot com under the hairline and central density gallery if you go down 21 patients to the individual labeled "57 year old, stage 4, one session, 7 months after transplant"

[vimarauz28]

Where are you located at??

[samlammd]

no, you can have any degree of loss to have hair restoration, even just hairline or just some thinning.

[BoycottCCrocker]

I would like to see this guy's hair now.

[samlammd]

I just posted the 1 year views of his result as a video response. Check it out.

[alchomy666]

Hiya. I am a guy who is 24 years of age. I have a terrible receding hairline, i would like to have a hair transplant done, but simply dont have the funds at the moment. I am using 4% Minoxidil lotion, to try and keep my existing hair. But i am still slightly thinning. Dont get me wrong, it has helped slow down the baldness a little. But i have not really gained any pleasing results. Also Finasteride did not work at all. Can you take anything else with the lotion to increase its effectiveness???

[samlammd]

first, you probably mean 5% minoxidil since there is no 4% only 2 and 5. second, finasteride over the long-term is the single most important treatment and especially when combined with minoxidil. oftentimes when it does not work is due to the fact that you are still going to lose hair and significantly so at your age if you are losing it already. you most likely truly need finasteride (propecia). consult a dermatologist/hair tx specialist.

[amberbonitama]

was it so necessary to correct him on a 1% difference???????????????

[samlammd]

yes, because 4% does not exist. i do not want someone to go ask for a product in the store (since it is over the counter) that does not exist on the market. there is only 2% for women and 5% for men. that's it. this is an important distinction. only 3% difference can cause hair growth on the face in a woman, and only 3% difference can cause a poor result in a man. and a 1% difference does not even exist on the market.

[amberbonitama]

o ok :)

[michellefarry]

do you have to be bald to have a hair transplant?