Doctors on Hair Loss & Hair Transplant surgery.

My mother had esophageal band surgery a couple of years ago due to her excessive weight problem. Following this she has noted progressive hair loss and a change in her personality. I’ve read that band surgery and stomach stapling can cause hair loss. Is this true?

Bariatric (Weight Loss) Surgery: Metabolic, nutritional, psychological and physiological Consequences Bariatric or weight loss surgeries have become commonplace in the USA and in other countries, in part due to an ever increasing incidence of obesity in the context of a societal standard of beauty that emphasizes a thin, shapely physique. Lobbying by various organizations, as well as medical studies detailing the present and future consequences of untreated obesity, has led to insurance coverage for these surgeries, which were previously deemed “cosmetic”. This article will detail some of the physical and mental aspects of the often rapid weight loss which occurs after bariatric surgery.
The bariatric surgery community utilizes a number of procedures to promote rapid and hopefully permanent weight loss. Some of the earlier methods have been abandoned or modified due to unacceptable morbidity in the post-operative period, both immediate and long-term. Currently used techniques most often decrease absorption of calories or promote early satiety (feeling of fullness), or some combination of the two.

Unfortunately, the decreased absorption of calories is accompanied by decreased absorption of macro- and micro-nutrients. This often leads to nutritional deficiencies of varying degrees of severity. Sometimes these deficiencies may go undetected for some time, until they have had a profound effect on the patient. Many of these deficiencies can be very difficult to treat (refractory) once established. They may cause significant derangement in the patient’s physical, mental and emotional health.

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Tags: anxieties, bariatric surgery, calcium, caloric, calories, cosmetic surgery, depression, emotional distress, endocrine system, hair follicles, hair loss, hyperparathyroidism, iron, magnesium, medical therapy, metabolic, nutritional, obesity, patients, physiological, protein, psychological, psychotherapy, surgery, vitamin, weight loss, zinc

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I had hair transplant procedure a week ago and I’ve note that the hair is still growing in the grafts. Does this mean the hair has been accepted and that it will continue to grow?

Following hair transplantation hair in the grafts will continue to elongate for about 10 days. Some of this may be continued hair growth, but it also reflects a move toward anagen effluvium. In anagen effluvium the dermal sheath begins to contract and move toward the surface of the skin much like an accordion. This shortening of the dermal sheath will push the bulb of the hair shaft toward the surface of the skin. Therefore, some of the elongation of the hairs is not due to growing, but rather due to a contraction of the dermal sheath toward the skin surface.

Once the dermal sheath contracts, the hairs will either begin to shed on their own beginning in two to three weeks after the transplant. Some of the hairs will continue to rest on the surface of the skin for a prolonged period of time. Eventually the scalp skin will either begin to form a wall around the resting, non-growing hair, or the scalp will form a pustule or pimple like reaction that will eventually burst and the non-growing hair will exit the skin with the exudate from the pimple or cyst like structure.

It is probably a good idea to minimize the number of the cyst like structures that you get because they represent unnecessary inflammation. Inflammation may not always be a good thing. In theory inflammation might sometimes lead to an autoimmune response toward one’s own hair and this in turn may compromise future graft growth.

In order to minimize inflammation, we generally recommend that patients begin removing non-growing hair fragments beginning three weeks after the hair restoration procedure. The best way to manage this is to aggressively wash the scalp with soap and a wash cloth. Non-growing hair will come out easily like removing a pin from a soft stick of butter. Growing hairs on the other hand must be plucked and it takes a good bit of force to accomplish this.

Sometimes hairs do continue to grow following a hair transplant without ever going into the resting phase, but it is unlikely that you will see more than 10% go into the resting phase. It is far more likely that the hairs will shed. Occasionally hairs almost shed, but then continue to grow. We can easily recognize these hairs because they have a dark tip that is coarse followed by a narrow constriction that is of lighter color. This is followed by a gradual darkening of the hair shaft and increase in hair diameter once again. We call these hairs that exhibit signs of this trauma pol pinkus hairs and they are a sure sign of recently transplanted hairs that have continued to grow.

Tags: anagen effluvium, cyst, dermal sheath, dr. john p. cole, Grafts, hair diameter, hair growth, hair restoration, hair shaft, hair transplant, hair transplant surgery, hair transplantation, inflammation, non growing hair, patients, pimple, resting phase, scalp

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Now that there is a genetic test to predict your hair loss, is it possible to simply wipe out this gene and thus put a halt to hair loss?

The genetic test is a test for a marker on the X chromosome that predicts hair loss. We do not know if this gene has anything to do with the cause of hair loss. Hair loss is multifactorial. This is probably why you see a few people who respond favorably to certain topical or oral medications while others don’t seem to respond at all. It is more probable that hair loss results from the interaction of multiple genes. It remain unknown what would happen should we alter a single gene. The consequences might actually be negative.

Tags: future, genes, hair loss, hair loss pattern, hair loss solutions, predict, x-chromosome

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I see on your website that you offer a Hairdx test, what is it and how is it helpful to prevent hair loss?

Hairdx is a genetic marker test to determine your risk for hair loss and to determine whether you might not loose your hair. The test evaluates a specific marker on the X chromosome. As you know, the X chromosome arises from the mother of the male. The marker is on the androgen receptor gene located on the X chromosome. Men who carry this gene variant are at a 60% risk of loosing their hair by age 40. Men with the less common genetic variant have a greater than 85% probability of not going bald before age 40. Ninety-five percent of bald men have the high risk androgen receptor variant.

It is known, however that androgenetic hair loss is polygenic in inheritance. One receives genes from both the mother and the father and it is felt that hair loss is not sex linked. This means that you can receive the risk for hair loss from either the mother or the father, but the specifics are still poorly understood. To date there are 4 major genes that determine your risk for hair loss, age of onset, eventual hair loss pattern, and rate of hair loss progression.

This test is only a prediction of future hair loss. It does not rule in or rule out the probability of future hair loss entirely. If you test positive, you should be evaluated for other signs of hair loss. These include miniaturization of the hair follicles and loss of hair shaft pigment. If you show signs at any point after testing positive for the marker, you might want to consider medical therapy such as Propecia or Minoxidil. You might also want to begin using Haircycle shampoo and conditioner to prolong the anagen duration, which is known to slow down the rate of hair loss progression. Instituting medical therapy at an earlier stage in life may limit the rate of your progression and the ultimate degree of loss you will suffer from.

We are happy to send a test kit to you if you like. The cost of the test is 149.00. This is the first diagnostic test to help you determine if hair loss may be in your future.

Tags: genes, hair follicles, hair loss, hair loss pattern, hairdx, medical therapy, minoxidil, pigment, Propecia, x-chromosome

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Dr. Cole, what is the C2G stand for?

C2G stands for the Cole Isolation technique to go or CIT to go. CIT is a proprietary method of harvesting individual follicular units one at a time such that there is no need for a strip harvest. Strip harvests leave linear scars and no one can predict how wide the scar will be or whether it will be pale white in color or red in color. Either way the strip harvest leaves you will a linear scar that obviates your capacity to wear your hair short and leaves you vulnerable to others suspecting you’ve had a hair transplant previously. Often patients are so concerned about their strip scar that they cease going to a barber or hair stylist for fear of exposure.

In an effort to overcome this social stigma we developed the CIT procedure. The single negative to this procedure has been the requirement for patients to shave the donor area. This can result in problems blending back into society or into one’s work place. The goal of C2G was to develop a procedure that allows patients to keep their hair long so that they can return to their normal social environment within a few days.

C2G is a procedure where only individual follicular units are trimmed and the resulting individual follicular units are then transferred to the top of the scalp after harvesting them via CIT. Only the individual follicular units are trimmed so that you have a normal appearing donor area from day one and you also have the advantage of avoiding the strip scar altogether. Now there is no reason to avoid taking advantage of all the long term benefits of CIT. This includes no linear strip scar, no prolonged strip scar pain, no prolonged strip scar tightness or numbness in the donor area, more hair per graft (more bang for you buck), and a lower follicular injury rate (transaction rate).

There was once a draw back to CIT. Now there is none. C2G is the future of hair restoration surgery.

Tags: c2g, cole isolation technique, donor area, hair restoration, hair transplant, hair transplant surgery, strip, strip scar

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