Ask Dr. Lam

I have traction alopecia and I would like to have some of the hairline replaced above the forehead, just enough to thicken the thinning areas and prevent people from looking at my receding hairline and not my eyes. Is it true that if your head is shining = no pores + no hair follicles = no hair growth that you cannot have a successful hairtransplant in that area? Secondly, I have listened to your YouTube on costs/grafts but can you please give a ballpark figure of what a restoration could costs? Cost is a big concern and would help me plan and budget for the procedure. Lastly, I live in Southern California and I know you've conducted seminars in San Diego and at Cedar Sinai Hospital in Los Angeles, can you recommend a physician in Southern California using your techinique? Thank you

hi,
1. the shining quality you are talking about is referenced in people with other kinds of scarring alopecia and they do not do well. surprisingly, traction alopecia works very well with hair restoration.
2. cost is about 9 to 10k. specifically, i would have to see you to decide absolutely the number but that is pretty close to being right.
3. i don't have recommendations for other surgeons, as i do not do that and also do not know of anyone to whom i can send you. i do very good with traction alopecia, as you can see in my work. if you do decide to come here, it can be very easy. you can fly and fly out the next day with a hotel that is like $69 a night. i can then set you up for someone to remove your sutures 10 days later in LA, Newport Beach, or San Diego area if you can't stay for me to remove them.
best,
dr. sam lam

Thank you for respondingly Dr. Lam, per the videos and photos posted on your website I'm very impressed with your work;I'm having two free consultations in Los Angeles but I am leaning towards making a trip to Dallas. The 9-10k procedure you describe could be done in one visit? Is it best to stay a couple of days to see how well the surgery was tolerated? How soon would I know the procedure didn't go well - not infections but if the hair doesn't transplant well? If all goes well with the surgery I know I would have to alter my hairstyle (wear my locs looser or another style period) would I be able to continue to have my hair dyed? Actually the donor site isn't gray and the hair is a softer texture does that mean that when transplanted to the front it would retain that texture/color or would it become like the hair in the front of my head - a bit coarser and gray? I think that my hair is filling in at the frontal hairline with fine hairs. If that's true could medication speed up the growth? Why does traction alopecia respond well to hair transplant? Lastly, after consult how soon would I be able to schedule an appointment; is there a waitlist? Thank you.

SINCE YOU HAD MULTIPLE QUESTIONS, I HAVE ANSWERED THEM IN ALL CAPS FOLLOWING EACH QUESTION:
Thank you for respondingly Dr. Lam, per the videos and photos posted on your website I'm very impressed with your work;I'm having two free consultations in Los Angeles but I am leaning towards making a trip to Dallas. The 9-10k procedure you describe could be done in one visit? YES, OBVIOUSLY NO GUARANTEES BUT THAT IS WHY 85% OF MY PHOTOS ARE ALL ONE SESSION IMAGES. Is it best to stay a couple of days to see how well the surgery was tolerated? YES, YOU SHOULD FLY IN THE DAY BEFORE FOR EVALUATION (IF I HAVE NOT SEEN YOU IN PERSON BEFORE THEN. WE CAN DO THINGS BY PHOTOS BUT THAT IS LESS THAN PERFECT. NEVERTHELESS, I CAN GET A GOOD IMPRESSION OF WHAT CAN OR CANNOT BE DONE AND EXACTLY HOW MUCH IT WOULD COST.) YOU THEN FLY OUT THE DAY AFTER THE PROCEDURE. HOTELS THAT ARE NEARBY WITH FREE SHUTTLES COST STARTING FROM $69 UPWARD. MOST OF MY PATIENTS CHOOSE THE $69 ONE. How soon would I know the procedure didn't go well - not infections but if the hair doesn't transplant well? I AM ABOUT TO SHOOT A VIDEO ON THAT NEXT WEEK SO LOOK OUT FOR IT. HOWEVER, IN GENERAL IT TAKES 6 TO 12 MONTHS TO SEE THE CHANGES. YOU CAN HAVE CHANGES AS EARLY AS 3 MONTHS BUT USUALLY NOT SUBSTANTIALLY. MOST TAKE 6 MONTHS TO START BEING HAPPY BUT 9 MONTHS FOR A MORE REAL RESULT AND 18 MONTHS FOR AN ALMOST FULL EXPRESSION. If all goes well with the surgery I know I would have to alter my hairstyle (wear my locs looser or another style period) would I be able to continue to have my hair dyed? YES. Actually the donor site isn't gray and the hair is a softer texture does that mean that when transplanted to the front it would retain that texture/color or would it become like the hair in the front of my head - a bit coarser and gray? TYPICALLY, HAIR RETAINS THE CHARACTERISTICS OF THE DONOR HAIR BUT SOMETIMES AFTER 1 TO 2 YEARS THERE CAN BE SOME CHARACTERISTICS THAT RESEMBLE THE RECIPIENT AREA. I think that my hair is filling in at the frontal hairline with fine hairs. If that's true could medication speed up the growth? NOT REALLY BUT ROGAINE IS A FANTASTIC IDEA TO START EVEN TODAY BECAUSE IT CAN MINIMIZE ANY SHEDDING AFTERWARD AND SUPPORT GROWTH OF THE GRAFTS. EVEN THE 5% WOULD BE FINE SO LONG AS YOU ARE NOT GETTING ANY SECONDARY SIDE EFFECTS. HOWEVER, THE 2% FEMALE DOSING IS FINE TOO. Why does traction alopecia respond well to hair transplant? BECAUSE THE PROCESS IS BURNED OUT UNLIKE OTHER TYPES OF SCARRING ALOPECIA THAT ARE ACTIVE PROCESSES OR CAN REACTIVATE. Lastly, after consult how soon would I be able to schedule an appointment; is there a waitlist? YES I AM BOOKED OUT A COUPLE OF MONTHS OR MORE SO PLEASE GIVE ME LEAD TIME. Thank you. YOU ARE WELCOME.

Again Dr. Lam thank you for responding so quickly and for answering all of my questions; I know you are very, very busy. As for the Rogaine the 2% and 5% are available over the counter or by prescription? I will research the secondary effects. I'm really hoping for a fall 2010 appointment so I should start the Rogaine now? I would like to send some photos of my current and former hairline but what will happen to the pictures? By sending the photos to you I am agreeing only to a cyber consult not allowing you to publish the pics for any reason without my permission correct? What angles should I shoot the affected area(s) from? I didn't quite understand this answer:
Why does traction alopecia respond well to hair transplant?
BECAUSE THE PROCESS IS BURNED OUT UNLIKE OTHER TYPES OF SCARRING ALOPECIA THAT ARE ACTIVE PROCESSES OR CAN REACTIVATE.

Do you have a video or any other material in your archive that addresses this subject further? Thank you

Again Dr. Lam thank you for responding so quickly and for answering all of my questions; I know you are very, very busy. As for the Rogaine the 2% and 5% are available over the counter or by prescription? OVER THE COUNTER. I will research the secondary effects. READ MY WEBSITE: http://www.hairtx.com/non-surgical-options/propecia-and-rogaine/minoxidil-rogaine-white-paper/ I'm really hoping for a fall 2010 appointment so I should start the Rogaine now? YES, I WOULD RECOMMEND IT. IT STARTS TO STABILIZE AREAS BETWEEN 6 WEEKS TO 3 MONTHS BUT LONGER IS NOT WORSE BUT CAN BE BETTER. I would like to send some photos of my current and former hairline but what will happen to the pictures? By sending the photos to you I am agreeing only to a cyber consult not allowing you to publish the pics for any reason without my permission correct? THAT IS CORRECT. What angles should I shoot the affected area(s) from? BALDNESS EXPOSED. IF THEY ARE TEMPLE AREA THEN FRONTAL AND 3/4 OBLIQUE VIEWS, LIKE HEAD SEMI-TURNED. I ALSO WANT TO SEE THE BACK OF YOUR HEAD WHERE I WOULD TAKE THE HAIR FROM. I didn't quite understand this answer:
Why does traction alopecia respond well to hair transplant?
BECAUSE THE PROCESS IS BURNED OUT UNLIKE OTHER TYPES OF SCARRING ALOPECIA THAT ARE ACTIVE PROCESSES OR CAN REACTIVATE. THIS IS HARD TO EXPLAIN TO A LAY PERSON. HOWEVER, THE OXYGEN AND NUTRIENTS THAT DEPRIVED THE HAIR FOLLICLE THAT ULTIMATELY KILLED IT SHOULD NOT HAVE GREATLY AFFECTED THE UNDERLYING SKIN TISSUE. THIS IS IN CONTRAST TO LUPUS AND LICHEN PLANOPILARIS, WHICH ARE ACTIVE SCARRING HAIR LOSSES THAT CAN ACTIVATE AND REACTIVATE.

Do you have a video or any other material in your archive that addresses this subject further? I THINK THAT I PROBABLY SHOULD SHOOT A VIDEO ON IT. HAVE YOU WATCHED MY ETHNIC HAIR TRANSPLANT TALK (http://www.hairtx.com/gallery2/v/videos/hair-transplant-lectures/ethnic-hair-restoration.flv.html)? THAT SUMMARIZES SOME ELEMENTS THAT MAY BE OF INTEREST BESIDES MY TRACTION ALOPECIA PAGE (http://www.hairtx.com/hair-loss-disorders/traction-alopecia/ SORRY BROKEN LINK. WILL FIX IT SOON.) OR MY AFRICAN AMERICAN DISORDERS PAGE (http://www.hairtx.com/hair-loss-disorders/african-hair-disorders/ WHOOPS I SEE THERE IS AN ERROR. I HAVE TO GET MY WEBMASTER TO FIX THIS).
Thank you

Hello, I have watched the videos you recommended and also read the information you suggested; that includes information on Minoxidil-Rogaine. A couple of questions; the photos of the African American woman, age 50 - I believe she had hair transplant all along the hairline, what was the cost of her one session? I thought you did a fine job restoring her hairline. In one of your videos you mentioned that you rarely performed the procedure whereby the scalp is basically pulled forward to cover the missing hair in clients of African descent because of the high potential for keloiding. How do you select the clients that would tolerate this surgery better than transplanting? Thank you

1. for cost, you can email constanze@lamfacialplastics.com or call 888-866-3388. i am guessing that it would be around a stage 3, which you can ask for. however, remember that it depends on how much donor hair you have and how much area of baldness. of course, i have no idea how much hair you have to move or will need to move until i see you. i am estimating the cost is around 10k ish. my estimate should be about right give or take a thousand.
2. the surgical type of procedure is not good for any race in my opinion. i think it leaves scars and an unnatural hairline.
best,
sml

Okay, I'm trying to upload some photos but I am not having any success. I put 10/11 folders in a folder but I can't upload the folder. Will keep trying - prefer to send them privately to EMINA@HAIRTX.COM is the that correct address? Thanks

send it to me directly drlam@lamfacialplastics.com. just send me a frontal view, two oblique views (or side views) and one of the back of your head, all with hair out of the way.
best,
sml