Do you feel that staples or sutures are better for closing of the donor area after hair transplant surgery.  Which one produces a better scar?

This hair loss question was answered by Dr. William Lindsey of Reston, VA who is one of our recommended hair restoration physicians.

I see this question a lot on the hair loss forum and have put my 2 cents in a few times.  To summarize, I don’t think there is any difference between sutures and staples if placed with the same amount of skill.

I place staples about 25% of the time and it really depends on how the skin comes together for me. The hair restoration patient who is shown in this hair transplant photo album was listening to my assistant and me discussing this very topic. In the last 8 years I conservatively guess that I have placed 300,000 sutures; so I am very comfortable sewing. If there is any tension on the scalp after deep closure I do sutures. On the other hand, I think staples are more comfortable for the patient during that initial 10 days, and if the scalp comes together easily I will use staples for patient comfort. But if I have to trade a bit of comfort for a worse potential scar in my hands, I will suture and explain it to the patient.

Good question.

William Lindsey, M.D.

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Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

This insightful hair loss information was posted on our hair restoration forum by Dr. Jerry Cooley of Charlotte, NC who is a member of the Coalition of Independent Hair Restoration Physicians.

Propecia is approved by the US FDA for once a day use for hair loss. This does not mean it is the best dosage, only the one that was studied and approved. The average serum “half-life” of finasteride 1mg is about 5 hours in young men and 8 hours in older men. This does not mean that half of the medicine is out of your body in that time period though. The finasteride molecule is distributed throughout the body where it binds to the type II 5-alpha-reductase enzyme, thereby inhibiting conversion of testosterone to dihydrotesterone (DHT). Serum DHT is reduced about 65%, and less DHT means less balding. But several studies show that a single dose of finasteride suppresses serum DHT for 7 days or more (Eur J Drug Metab Pharmacokinet. 1991 Jan-Mar;16(1):15-21, J Clin Endocrinol Metab. 1990 Apr;70(4):1136-41, Prostate. 1989;14(1):45-53). So the finasteride is leaving the bloodstream, entering the tissue throughout the body, and binding to the type II 5AR (5-alpha-reductase) enzyme, resulting in long lasting DHT suppression.

I do not “recommend” my patients take finasteride daily, every other day, twice weekly, etc. Rather I feel it is my duty as their doctor to advise them of the known facts about this medication. Most of my hair loss patients choose to take it on a Mon-Wed-Fri schedule, which is rational from my point of view. Many of my younger patients take it daily ‘just to be sure’ while my older patients are happy to take it two or three times a week. There are no clinical studies showing that less than daily dosing is as effective to treat baldness as daily dosing and for obvious financial reasons, the pharmaceutical company making finasteride has no incentive to fund such a study.

I hope this information is helpful. It is up to each patient to make an informed decision about which dosage is right for them. 

Dr. Jerry Cooley

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Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

In our hair loss forum community, we spend a lot of time discussing hair transplant surgeons who perform only the best work. And though these physicians deserve the online accolades they receive, the experience and hard work of the medical technicians and office staff plays a significant role in the success of the surgery.

These “unsung heroes” are largely responsible for regularly performing the important but tedious tasks of carefully trimming follicular unit grafts under microscopes and placing delicate grafts into recipient sites without damaging them.

Each member of the hair restoration surgical team must be on their game in order for the hair transplant procedure to be a success. One technician improperly trimming or placing grafts could amount to a significant amount of wasted follicles and a much lower hair growth yield.

Surgeons are often more publicly recognized because they are ultimately responsible for the work of the entire surgical team and the end result. However, each member of the hair restoration team plays a significant role in the final outcome of the surgery. Large ultra refined hair transplant megasessions are only possible today because quality surgeons employ a large and experienced staff who can handle grafts quickly, accurately, and safely.

Kudos to the dedicated medical technicians and office assistants who work hard alongside elite surgeons to ensure the end result is as good as it gets.

Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

In response to your suggestions on our hair loss forum, we created a new forum category to give you a specific place to interact with other members on a more personal level.

Here you can interact with other balding men and women by sharing your experiences with baldness and how it has impacted you. Relate to others more intimately and offer and receive helpful encouragement in our “Support Group – Discuss personal issues due to Hair Loss”

Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

With your involvement, our hair loss discussion forum has brought a whole new level of transparency and accountability to the hair transplant profession. Today clinics must share impressive patient results on a regular basis if they hope to earn the respect and patronage of the patient members of our forum.

However, over the past few years, only a handful of hair restoration physicians were presenting their work on our forum on a regular basis. This small handful of hair transplant clinics typically got all the online accolades. This created the false impression that only a small handful of surgeons were doing world class hair restoration surgery. This is understandable since those who are “out of sight” are often “out of mind”.

Although each surgeon recommended on the Hair Transplant Network has been privately and publicly evaluated by our community, patients deserve to see their ongoing patient results. To get virtually all recommended clinics to share their work on our forum each month, rather than just a handful, we recently provided all recommended physicians with strong incentives to get active. See Recommended Clinics Required to Present their Patient Results on this Forum.

So far this month, we have had great success in getting virtually all physicians recommended on the Hair Transplant Network to agree to post at least one photo album monthly showing patient results. You may have already noticed a big increase in hair transplant photos posted by a much wider range of leading clinics on the Patient Results Posted by Leading Hair Restoration Clinics forum. There will be many more to come!

We expect that getting all clinics to actively share their results will be a healthy improvement for this community.

We want to thank the members of our hair loss forum community who have generously shared their experiences and advice on our forum over the years. Without you, there would be no patient movement and no Hair Transplant Network.

Long live this collaboration between active and educated patients and ethical and committed physicians and their staff.

Onwards and Upwards,

Patrick Hennessey and Bill Seemiller, Publishers of the Hair Transplant Network, Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog