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Case Study – Botched Hair Transplant Repaired By Dr. Yazdan

Poor Results after previous strip FUT surgery

Patient was young male experiencing hair loss.  He went to an “experienced surgeon” who performed an FUT/Strip surgery on him with a transplant of 5,000 grafts as the patient was told.  The strip surgery led to the damage of his existing hair causing diffuse hair loss and a poor strip scar in the donor zone. You can also see the poor graft survival rate of the FUT/Strip surgery that he had. Theres no way this patient had 5,000 grafts transplanted and it looks as though maybe 250 grafts survived from whatever was transplanted.  Aside from that, the patient lost all his hair due to the trauma created from his strip surgery.

The patient came in and saw Dr. Yazdan for consultation.  Dr. Yazdan recommended an FUE surgery for the patient.  Unfortunately the previous FUT surgery had caused damage to the donor zone and thus the density was low and thus was difficult to obtain grafts

During an 11 hour FUE hair transplant procedure Dr. Yazdan extracted and implanted 2051 hair grafts. After 6 months the patient had considerable results and after 1 year the patient had full results.  The pictures speak for themselves in regards to what kind of work is out there and what quality of work we do.

This shows the importance of choosing an experienced Hair Restoration Surgeon.

Case Study – 1582 FUE Hair Grafts – Diffuse Hair Loss

Patient was experiencing diffuse hair loss throughout the top. At age 40 he had been using Rogaine for the past 5 years. Hair density was approximately 60 hair follicles per cm2, which is slightly below average. Patient wanted the option to trim the donor region short so Dr Yazdan and the patient determined that Follicular Unit Extraction, FUE hair grafts would be the best option.

During a 6 hour FUE hair transplant procedure Dr. Yazdan extracted and implanted 1582 hair grafts. He has continued to utilize Rogaine to maintain his existing hair. Post-Op photos taken 9 months after surgery.

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Case Study – 1810 FUE Hair Grafts

The patient was a 39 year old male with Norwood Class 3 frontal hair loss. His hair line had been receding for the past 5 years along with thinning of the frontal forelock. Hair color was black with specs of grey. Hair density was approximately 80 follicles per cm2, ( average density is typically between 70-100 per cm2).

Since this patient preferred a short hair cut in the back, Follicular Unit Extraction (FUE) was recommended by Dr. Yazdan. On the procedure date 1,810 FUE hair grafts were transplanted over a 6.5 hour procedure. The patient elected not to utilize any hair loss medical management. After photos were taken 1 year post-op.

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1810_FUE_Grafts

Dr. Yazdan Discusses Hair Loss and Removal with Monsters & Critics

As one of the prominent hair replacement surgeons in Southern California Dr. Yazdan is often contacted by local and national media for his expertise on various topics relating to hair. Recently reporter April Neale from Monsters & Critics a popular news, entertainment and lifestyle web site interviewed Dr. Yazdan on a far reaching article about Hair Removal, Preservation And Hair Loss Repair
The following is the content from her interview with Dr. Yazdan:

There’s nothing more unnerving than realizing your hair is departing your scalp and not showing any signs of returning.

HairLossGuy2The term “alopecia” refers simply to any kind of hair loss, such as male pattern baldness. It happens to both men and women, and commonly the culprit can be alopecia areata, an immune condition often times brought on by a severe emotional stressor that leads to coin-size bare patches.
It can happen anywhere you have hair and can be even more dramatic such as in cases of alopecia universalis, where all hair including eyelashes and brows are shed permanently. Many people experience hair loss exhibited by common male pattern balding, as the hairline recedes in a u-shape, or the crown is exposed with the hair surrounding it intact.
It goes without saying and pardon the pun, but most people are attached to their hair. Monsters and Critics spoke to world recognized hair expert Dr. Amir Yazdan, who specializes in hair disorders, hair restoration, and unwanted hair removal.
He says, “About 90% of hair loss is genetically driven. In most cases, hair loss is inherited, which means it’s passed down from one or both of your parents. This is called male-pattern or female-pattern hair loss. If your hair is thinning, it happens slowly over time, so you may not notice the hairs falling out. If your hair is shedding, then clumps of hair fall out.”
Aging and issues with the thyroid gland, such as hypothyroidism and hyperthyroidism combines with decreasing hormone production all factor too according to Dr. Yazdan. Diet, overall health and mental and emotional stability are factors as well.
Hair preservation for men and women comes with common sense fixes and avoidance.
Dr. Yazdan tells us today’s hipster hairstyle for men – the ubiquitous “man bun” – is tomorrow’s patient in his hair loss clinic.
“Wearing a man bun will create hair follicles damage. Why this hairstyle for men became popular I really don’t know. It puts extra tension on hair follicles and over time can lead to what’s called traction alopecia,” says Dr. Yazdan.
Other things Dr. Yazdan points out that will do a scalp harm are men wearing tight-fitting hats, do-rags, beanies and baseball caps that are not properly fitted. All of these habits, Dr. Yazdan points out, can lead to traction alopecia as well.
Women also hasten hair loss with wearing wigs, overdoing chignon styles or tight braids, adding extensions, and excessive coloring, chemical straightening will all damage the hair and the scalp. Anything that pulls on the hair repeatedly damages follicles over time. “Hair dyes, chemical straightening can cause damage to the scalp as well as the hair follicles if used incorrectly or frequently,” says Dr. Yazdan.
Using products that are useless, wrong or harmful will also harm follicles according to Dr. Yazdan. “Guys will use anything on their scalp if their hair starts to thin. From a solution that their aunt gave them to some product that they read about online. Lots of times, these products can damage the scalp and increase their hair loss. It seems that when men are desperate for hair, their number one choice isn’t to see a doctor who specializes in hair loss, it’s to search the internet for answers, and this is where they can get in trouble.”
Dr. Yazdan also cautions people into buying the hype about PRP therapy that news outlets are talking about currently. There are caveats. “This is not a Lazarus therapy,” cautions Dr. Yazdan. “It’s along the lines of the ‘vampire facial’ that became popular a few years back. PRP therapy is good for the under 30-year-old who is just starting to lose his hair. They still have hair follicles that are alive that can be rejuvenated with this procedure. If your lawn grass is brown and dry, you can water and fertilize and bring it back.”
Who is not a candidate for PRP? “The 45-year-old who has been losing his or her hair for the past 10 years. Their hair follicles are dead and cannot be rejuvenated by this procedure. If your lawn grass is dead, there is no reviving it,” says Dr. Yazdan.
“This is not a one-time procedure. It must be kept up year after year or your hair will just go back to the way it was. Like Botox treatments. If you stop, wrinkles eventually come back,” adds Dr. Yazdan.
Dr. Yazdan was called upon by CBS’ “The Doctors” team as an expert to help with a special case, an 8 year-old girl who lost a large portion of hair from her hair extension being yanked on by bullies.
Lastly, hair transplant surgery is the most effective way to deal with bald areas on the scalp. But not all hair transplant surgery is equal.
“In the last two years, there has been a huge influx of doctors with little to no training advertising hair transplant surgery and hair transplant procedures. Just as you wouldn’t go to a doctor who learned eye surgery over a weekend course or learned laser eye surgery from the representative that sold him the laser eye machine, you shouldn’t go to a doctor or clinic that does not primarily focus on hair restoration procedures. The doctor needs to have adequate training and experience in this field of medicine,” cautions Dr. Yazdan.
“Many doctors are buying machines and devices praised at being the latest and greatest for hair transplant, however, they have no idea how to use them. They generally bring in assistants to perform the procedures and this puts patients at harm and at risk. So the number one thing I see men do to harm their hair follicles is having a procedure done with an inexperienced doctor.”
Dr. Yazdan also deals with people trying to manage their body hair situation and gave us his “laser hair removal 101” which is invaluable advice for people seeking this procedure out.
Sometimes excessive hair can be a huge problem, and people will go to drastic measures to rid their bodies of it. Men (rarer in women) can suffer terribly painful pilonidal cysts (pictured above) in their gluteal folds from problematic ingrown body hair, and women do everything under the sun to rid their bodies of hair for cosmetic reasons
“Generally the treatments are tolerated pretty well. Women, of course, have a much higher pain tolerance than men. If the areas being treated are too sensitive, they can always be pre-treated with a topical numbing cream which helps make the procedure more comfortable,” says Dr. Yazdan.
Safety is an utmost concern for patients when it comes to lasers, and using the right tool for the job is key. “Laser hair removal is safe if it is being performed by licensed, and qualified staff,” says Dr. Yazdan. “The legalities of laser hair removal vary between states. Some states require nothing more than a lay person purchasing a laser and setting up shop while some states require that only a physician perform laser hair removal. Then you have everything else in-between. It’s important to note that this is a medical procedure. Patients should be evaluated by a physician who can assess whether the patients are a good candidate or not and discuss the risks and benefits with the patients. In general, the lighter your skin color, the safer laser hair removal is. In African American patients, laser hair removal can be extremely dangerous in the hands of the wrong operator.”
For those who are tired of repeated waxing, lasering can be a cost-effective permanent solution. “With laser hair removal, patients can expect to receive on average about a 70% reduction in hair after 6-8 treatments,” says Dr. Yazdan.
A doctor’s office is always better. As with any medical procedure, there can be complications and it is important to have a physician available to manage those complications. “Many times in my practice we get patients who were treated at a spa and have suffered burns or other reactions to the laser and they are left without any medical care or follow-up because the spa does not have the appropriate knowledge to treat the patients,” says Dr. Yazdan.
Avoid going cheap with any cosmetic procedure, especially the temptation to go “Groupon” shopping for any medical procedure. “Generally, I say no. At the end of the day, you get what you pay for,” says Dr. Yazdan. “Would you board an airplane with a pilot that has no idea what they are doing? This is your body and your skin. There are those that will receive no results and waste their time and money. Then there are those that will have permanent burns and scarring and need to see a plastic surgeon and a dermatologist to have their burns treated and their scars minimized. Generally, if you are receiving treatments at a Board Certified Physician’s Office you can expect that they know what they are doing. I would be cautious with spas and salons offering laser hair removal services with no physician supervision. This is where the majority of problems, and Groupon deals, happen.”
Source: monstersandcritics.com

ISHRS Meeting in Chicago Sets Record Attendance.

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Dr. Yazdan, second from right, with colleagues.

Dr. Yazdan recently attended the 23rd Annual Scientific Meeting in Chicago for the International Society of Hair Restoration Surgery. This was the most well attended conference ever by the ISHRS, with over 500 hair surgeons worldwide participating. With workshops and discussions on the latest technology and trends and the opportunity to meet and collaborate with colleagues around the world Dr. Yazdan returned to his offices recharged and excited at the state of today’s advanced hair restoration techniques and the efforts by the ISHRS to assure the highest standards of care for the patient.
Below is a infographic of the latest worldwide trends in hair restoration as compiled by the ISHRS.
 
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Case Study – 1568 FUE Hair Grafts

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31 year old male with blonde hair. He was losing hair for the past 5 years and was very self conscious about his thinning hair. He used the hair camouflage powder called Toppik to try and conceal his hair loss. Dr. Yazdan (with offices in Orange County and Las Vegas) performed 1,568 FUE hair grafts in one session to fill in his frontal forelock. After results were photographed 9 months post op.

Patient Profile – 3,800 Grafts – 1 Hair Transplant Session

This 42 year old male came to our Ocean County, Ca offices with Norwood Class IV hair loss. He had been experiencing hair loss since his mid twenties and the entire top of his scalp had begun thinning noticeably. He had not used any hair loss treatments. With good overall density and hair quality in the donor area Dr. Yazdan was able to perform a 3,800 graft FUT hair transplant in one session. After results are one year post-op and patient is managing future hair loss with Finasteride.

3,800 Graft Transplant Session - Front View

3,800 Graft Transplant Session - Top View

2500 FUE Hair Transplant Grafts – 6 Month Follow Up

This is a before and 6 month after 2500 FUE hair grafts were performed in one session by Dr. Yazdan . Patient is a 33 year old male with Norwood Class 6 hair loss. His hair is black, fine texture with average density.  His results will continue to improve over the next 6 months.  Patient sent in his own followup picture as he lives out of state in New York and has not returned for a formal followup evaluation.

Before and 6 months after 2500 FUE hair grafts.

Poor Donor Closure – Corrected

Fig. 1 - Poor donor closure technique.
Fig. 1 – Poor donor closure technique.

For many hair transplant patients, traditional FUT using strip excision is still the best method to transplant the most hair in a given hair transplant session efficiently.

This is especially true for the hair transplant patient that has good hair density and has no desire to ever keep his/her hair extremely short in the back where the donor scar could be visible.

Most experienced hair transplant surgeons like Dr. Yazdan are proficient in advanced surgical techniques that the donor scar is barely visible to the eye even on close inspection. What was unusual about this case (Fig. 1) is that the patient had just had a strip excision hair transplant by another surgeon and was experiencing a lot of pain. His wife felt that the donor closure did not look right and seemed crude and the scalp was buckling.

Fig. 2 - Proper Trichophytic Donor Closure Technique by Dr. Yazdan.
Fig. 2 – Proper Trichophytic Donor Closure Technique by Dr. Yazdan.

Dr. Yazdan immediately noted the poor closure technique and recommend that he  re-excise the area and close the wound using proper trycophitic donor closure technique (Fig. 2). The procedure went well and the patient left with little discomfort. the sutures were removed in 10 days and upon follow up 6 months later the donor scar line was virtually invisible (Fig. 3).

Fig. 3 - 6 months after closure and wound is barely visible.
Fig. 3 – 6 months after closure and wound is barely visible.

Female Hair Transplant – Post Menopause

This female patient was 50 years old and had some frontal hair loss after menopause. She was upset her that she could see scalp. She had tried styling and cosmetic cover-up options as well as Rogaine with little success. Dr. Yazdan performed a strip procedure with 1296 grafts in the hairline and going back 3 inches. The after photo (Right) is 9 months post operative.

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Hair Transplant Repair with Beard & Chest Hair

The before and after photos are of a 58 Year old male from Hawaii.  The patient came to Dr. Yazdan’s Orange County CA office. He had multiple hair transplant procedures prior, that left him with major scarring on his scalp from another physician. He had no donor zone hair left on the sides and back of his scalp.  The after photo (right) is 1 year after he underwent 1 FUE procedure by Dr. Yazdan utilizing Beard & Chest hair to transplant 1884 FUE hair grafts to the scalp.  The chest hairs were used in the hairline to mask the previous “plug” grafts giving a softer appearance and the beard hair was mixed in for better density.

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Recent FUE Hair Transplant Results – Case Studies

The first hair transplant patient was a 31 year old male with blonde hair. He was losing hair for the past 5 years and was very self conscious about his thinning hair. He used the hair camouflage powder called Toppik to try and conceal his hair loss. Dr. Yazdan (with offices in Orange County and Las Vegas) performed 1,568 FUE hair grafts to fill in his frontal forelock. After results were photographed 9 months post op.

fue hair transplant Before and After FUE Hair Transplant – 1568 grafts in one procedure.

The next patient – age 44 – had more extensive hair loss (Norwood Class V) and had been noticeably losing his hair for the past 7 years. He had used Rogaine but had little success. Dr. Yazdan performed 1,922 grafts in one session with the FUE technique in the hairline to the crown. Post op results after 1 year.

fue hair transplant 2000 grafts

Is FUE Hair Transplant Scarless?

There has been a lot of conversation online and in advertising about FUE being a scarless hair transplant procedure. The answer is both Yes and No. Part of the reason for our answer is that it depends on the execution and experience of the surgeon. Recently Dr. Yazdan consulted with a patient in his Las Vegas hair transplant office who said he had 2000 FUE grafts at a local office that performed an FUE procedure with the NeoGraft Automated Hair Transplant System. He decided on NeoGraft because was told the procedure would be scarless. He also assumed that the Doctor would be performing the procedure. In both cases he was unfortunately wrong. The day of the procedure he discovered that medical technicians performed the procedure and he quickly learned that the donor area had significant scarring.
The issue of technicians performing hair transplant procedures has be addressed by the International Society of Hair Restoration Surgeons (ISHRS.org) in their highly publicized consumer alert.
The reason for his scarring was because of poor technique. In this patient’s case the donor area was too small for 2000 grafts (although it appeared that less than 2000 grafts were performed.) so that the incisions were run together and were too deep. In addition the circular scalpel that extracted the grafts was too large – 1mm or larger. By running the incisions together the patient experienced both scarring and poor hair growth because many of the hair grafts were transected. The donor area was also high on the back of is head and could potentially be exposed if he continued to experience hair loss over time.
In order to improve the naturalness and density in the transplanted area Dr. Yazdan personally performed 1250 additional FUE grafts using his custom instrumentation and a .7mm diameter scalpel. The photo below shows the previous NeoGraft harvested donor area (Top) and the FUE grafts harvested by Dr. Yazdan (Below – day of surgery) which will appear virtually scarless because or the tiny incisions and proper spacing technique.

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Poor NeoGraft donor technique above. Proper follicular unit extraction below by Dr. Amir Yazdan.

Below is the donor area of a FUE patient 30 days post-op.
Donor area 30 days post FUE Hair Transplant by Dr. Yazdan.
Donor area 30 days post FUE Hair Transplant by Dr. Yazdan.

Am I a Candidate for a FUE or FUT Hair Transplant?


If you are pursuing a hair replacement surgery, you’ve likely considered a FUE or FUT hair transplant. But how do you know which is right for you?
Dr. Amir Yazdan discusses who is a better candidate for follicular unit extraction (FUE) vs strip (FUT) hair transplant harvesting when performing hair transplant surgery. Both procedures can be very effective but there are issues that determine if a patient is better for one procedure versus another.
With FUE hair transplantation the follicular units of 1-4 hairs are excised one at a time using a very small (.7-.9mm), precise circular scalpel. The incision is so tiny that when the wound heals there is virtually no visible scar. This is particularly popular for patients who have less hair loss and want to keep their hair very short.
Patient’s with more hair loss and desire more hair transplanted in a single session may prefer the FUT strip excision method. With a narrow strip a large amount of hair can be extracted at one time and with microscopic graft dissection the hair grafts are prepared by size. With modern tricophytic donor closure the scar is very fine and easily covered by the existing donor hair.

NeoGraft, Artas and Other FUE Hair Transplant Systems

FOLLICULAR UNIT EXTRACTION (FUE) HAIR TRANSPLANT DEVICES

There has been a great deal of conversation online about the most effective procedure for performing a hair transplant procedure. In our Orange County & Las Vegas hair transplant offices we have had many patients come in for consultation that are confused by FUE, AlphaGraft, NeoGraft, Artas and other FUE hair transplant devices. That is correct, these are devices and not a surgical procedure.
In many cases patients believe that a NeoGraft hair transplant is a surgical technique when it is only a mechanized devices for performing FUE hair transplants. Simply put, follicular unit extraction involves removing tiny follicular bundles from the back of the scalp with a tiny .7-1mm circular punch. The incision is typically so small that there is no visible scar after the wound heals.

WHAT IS THE NEOGRAFT HAIR TRANSPLANT SYSTEM?

According to the company – NeoGraft is the first and only FDA cleared follicular unit harvesting and implantation system. The NeoGraft system delivers automation of the FUE technique. The above statement is true. the device, originally developed in Europe is combination electrical hand engine the powers a hollow circular punch and then sucks the hair graft into a container where the grafts are gathered and then implanted. Although the company has developed a device to also insert that grafts it is rarely used. The concern of many experienced hair surgeons including Dr. Yazdan is that the suction tears the tiny graft from the connecting fat tissue at the bottom and can tear or transact the graft which can significantly impact graft hair growth. There have also been concerns that in some cases the procedure with these devices is actually performed by unlicensed technicians for surgeons with little or no hair restoration experience. (Read more)

ARTAS ROBOTIC HAIR TRANSPLANT SYSTEM

Artas was launched in 2011 as the first robotic hair transplant system. The system is sophisticated, utilizing computer assistance to harvest hair follicles during the actual process of hair replacement. ARTAS incorporates a number of elements in its operation, including an image-guided robotic arm and special imaging technologies that co-ordinate together for the purpose of implementing the “follicular unit extraction (FUE)” technique upon the recipient of the system. The system is very expensive – approximately $200,000, cost more for physicians to use and to date has shown no superiority in hair graft quality from those of experienced hair surgeons using hand operated mechanized FUE devices. In FDA trials ARTAS showed no superiority to hand held follicular unit extraction by an experienced hair transplant surgeon.

IN OUR PRACTICE

Dr. Yazdan has developed his own instrumentation to assure the most precise results possible. He will modify his instrumentation to adapt to a specific patients hair type and angle of hair growth. The important issue for patients to understand is that follicular unit extraction (FUE) is a procedure and that everything else is a reference to a device that helps the physician extract the follicular units. Many surgeons use different devices to perform excellent FUE results and the important part is the surgical expertise and care of the grafts once harvested that assures optimal results for the patient.
Below is a video of Dr. Yazdan performing the procedure.

FUE vs FUT Hair Transplant Procedures – What’s the Difference?


Many patients are confused by the various hair transplant techniques and who is a good candidate for which procedure.
Orange County hair transplant surgeon Dr. Amir Yazdan explains who is the best candidate for FUE vs FUT. Although there are many specific reasons a patient will have one procedure versus another the decision is typically based on two criteria.
A patient who is best qualified for follicular unit extraction (FUE) #1 wants to keep their hair very short in the back and doesn’t want even a very thin scar to be visible and #2 needs usually 2000 grafts or less.
A patient that typically has strip FUT hair transplantation #1 does not keep his/her hair short in the back and #2 needs more than 2000 hair grafts in a single session.
In Dr. Yazdan’s Orange County and Las Vegas offices he will review all options including medical treatments during your consultation and together you will make a decision based on multiple factors prior to hair transplant surgery.

Regenerative FUE Hair Transplant by Dr. Amir Yazdan M.D. Orange County & Las Vegas Using ACell & PRP

Dr. Amir Yazdan M.D. of Modena Hair Transplant Institute introduced a new technique of FUE Hair Transplant surgery that allows regeneration of the Donor zone with subsequent use of Acell & PRP. He calls this Minimal Depth FUE and he offers this procedure in both Orange County and Las Vegas.

FUE Hair Transplant procedures have grown exponentially in the past few years. Many clinics use large diameter punches greater than 1.0mm with deep extraction techniques such as seen with the Neograft or Artas Robot. Although this may make the FUE procedure easier for the surgeon, it can create long-term complications for the patient. The use of bigger punches and deep extraction removes the surrounding adipose tissue/fat associated with the hair follicle. This adipose tissue contains essential stem cells which can help regenerate hair follicles in the donor zone. Furthermore, when these fatty grafts are transplanted, a lot of times we see lumps and ridging which can be felt and seen by the patient. Dr. Yazdan says, “In a Hair Transplant procedure the goal is to transplant hair, not fat. With my new minimally invasive FUE technique, it ensures that only the hair is extracted leaving the regenerating stem cells behind.”
With Dr. Yazdan’s new technique of Minimal Depth FUE with micro diameter punch sizes, the surrounding adipose tissue is left intact leaving the stem cells behind which can help regenerate hair growth in the donor zone.
“This development is huge in terms of FUE hair transplant procedures. Quite frequently, I see patients that have had poor FUE procedures done in the past which have left scarring and depletion in the donor zone. With my new techniques and the use of Acell and PRP (Platelet Rich Plasma), I have seen greater than a 50% regeneration of extracted follicles in the donor zone,” says Dr. Yazdan.
ACell is an FDA approved cellular regeneration product used in wound healing that has recently been combined with a patient’s own stem cells and has shown to improve hair regrowth for both men and women. ACell activates follicular progenitor cells (adult stem cells) and this is used in the Donor zone following an FUE extraction procedure.
PRP (Platelet Rich Plasma) is a procedure in which a small amount of blood is taken from your arm. This blood is processed and from that, Platelet Rich Plasma (PRP) is extracted and activated. This is then injected into the recipient site. PRP is loaded with growth factors that promote rapid angiogenesis, localized cell growth, decrease inflammation, and decrease healing time. Quick healing time is important for Dr. Yazdan’s patients in both Orange County and Las vegas because it allows them to return to work and their daily activities in a shorter period of time.
Dr. Yazdan states, “With the use of Acell and PRP, I have seen accelerated healing, reduced swelling, and excellent graft survival rate. I use this in every hair restoration surgery because it gives patients the absolute best results.”

Case Study – Eyebrow Hair Restoration

Female patient had damaged her eyebrows from tears of plucking. 8 years prior she had her eyebrows tattooed but the tattoo had begun to fade. She wanted a more natural and permanent solution.

With an abundant amount of hair and hair length to cover the donor area, Dr. Yazadan suggested Follicular Unit Extraction which would be a more comfortable procedure than donor strip extraction and would heal faster. Dr. Yazdan transplanted 400 grafts to each eyebrow. Follow up photos were taken one year post-op.

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