Episode 17:
Are Long Hair Transplants Possible?

long hair transplants

The following is a transcript of Episode 17 of the Hair Restoration With Dr. Daniel A. Danyo podcast. In this episode, Dr. Danyo breaks down the difference between long hair transplants and the other procedures he offers. He explains some of the unique advantages of a long hair transplant, and he discusses why it’s a great option for individuals looking for maximum concealment and same-day results.

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Dr. Danyo: Long hair transplant is the highest level of FUE transplantation around that we take the entire follicle and the entire length of the hair and move it. And it has the advantage of having near full results immediately. So you can really get perfect density. And the key is that we can use the curl of the hair to perfectly position that so that it’s curling in the right direction along with the right angulation to get the best results.

Clark: That was the voice of Daniel A. Danyo, MD, founder and physician at North Atlanta Hair Restoration, a boutique medical practice solely dedicated to the diagnosis and treatment of male and female hair loss. And you’re listening to Hair Restoration with Dr. Daniel A. Danyo. I’m your host Clark, and all season long we’re speaking with Dr. Danyo about how he and his team at North Atlanta Hair Restoration are helping his patients transform their everyday lives for the better. In this episode, Dr. Danyo explains the advantages of a long hair transplant. It’s a procedure where the entire hair follicle is moved for full concealment, and same day results. He also breaks down the different types of transplants he offers. There’s so much to talk about. So let’s dive right in. Dr. Danyo, we are back. It’s so great to be connected to you again, I can’t wait to jump into today’s topic. But first, how are you doing?

Dr. Danyo: I’m doing great. Yeah, things have been busy at the office. And…

Clark: You’re so busy.

Dr. Danyo: I know.

Clark: We’ve been very busy.

Dr. Danyo: You know, we’ve been averaging about seven cases a week, I’m having more and more days where we’re doing two large cases in one day. Just because, you know, I’m doing a lot of consults, we have a great way for people to do online consults. So I have people coming from all over the country, the problem is just getting people on the schedule. And so we’ve just had to turn it up and get people in.

Clark: You know, we’ve talked previously on this show, I mean, this is really a great way to get to know you to get to know this boutique practice, the approach you have, the intentionality you have. And you are the person doing all of this meaning, you know, it’s got to be tempting I would imagine to introduce other people to help pack in more people. But it sounds like once you hit your max, you’re kind of at that max because of how you’ve built the practice. Because what I’m saying is you do everything from the start to the finish working with each patient. So I know you’ve been busy. And we’ve also talked about how you try to keep it all together. Because that’s pretty strenuous to do this kind of work.

Dr. Danyo: It is. And the problem is because we’re so unique, I do all the extractions and placements and just the training to get to the level that I am it’s not something that I would feel comfortable even farming it out to, say a physician’s assistant at this point or even another physician unless they’re just extremely trained. So the problem is it can cap me out as far as what I can do physically. And just what I can do with my staff in a week’s time.

Clark: Well, I know we’ve talked about some of the big races you trained for, and the fitness and all the exercising you do, the good health, nutrition, all that because it is you’re sitting there standing there in specific positions trying to do these procedures. And it’s challenging. So you got to keep taking care of yourself because I know there’s a lot of people who are still on the schedule and wanna get these kinds of results. And it’s been so great hearing the feedback that you’ve been hearing from people listening to not just one or two episodes, but oftentimes listening to several. Because I guess this is a close up look into the work you do, why it matters, why you love it so much. And we also answer some common questions that you get.

So anyway, I’m excited to be back for another episode. So today’s topic, this is all about long hair transplants. Now, we have often talked about hair transplants and you teach me a lot because I’m learning a lot as we go through this. So the most obvious question is why is this different? Why is this one called long hair transplants? Is it for men? Is it for women? Does it not matter? What? Let’s just dive straight into that and then talk a little about the how, and the why, behind it?

Dr. Danyo: Sure. So long hair transplant means that you’re taking the follicle and most hair transplants with FUE the hair is actually cut either before or during the extraction. So when you move it the hair is short. So you kind of have to imagine what it’s gonna look like with short hair, and I’m talking like a zero guard short. Now, the long hair is, you’re gonna get close to a full result when you leave the day of the procedure. So, for some people, especially with concealment, I mean, there’s no other way to better conceal that a hair transplant’s been done, than doing a long hair transplant. Because let’s say you’re working on the frontal hairline, you’re just moving that hairline forward with hair. And it looks natural, and you can’t actually see individual grafts.

Clark: And the significance of being able to leave that same day. I don’t know, oftentimes, you say someone might come in, you know, they might take a day off of work, but they really don’t have to, and they’ve been able to go in pretty much the next day, after a procedure. These procedures take several hours depending on how much work you’re doing. But that’s a…I don’t wanna just gloss over that because that’s a really big deal.

Dr. Danyo: No, it’s huge. And it’s really been a quest of mine. You know, early on in my practice, I recognized that this is such a kind of a quiet procedure for people, they just don’t wanna broadcast that it’s been done. And they also don’t wanna have to take off a week or two of work, and just kind of sit around and a lot of people don’t even take a vacation, they just take that time off to heal. So, we’ve talked about the shaveless procedure before, which is great, because the donor sites concealed. And if there’s enough hair up top, you can conceal that the grafts were being done.

And we’ve talked about the art of concealment, where we limit the amount of medications we’re using, that we use pen implantation, where we don’t have to add medicine to kind of lift the scalp of the skin off the head to do surgical slits. And we’ve just made it very clean so that people don’t get swelling, they don’t have a lot of pain. And they can get back into the swing of things quickly. And that’s really just been through determination, trial and error, and just perfecting what we do.

Clark: It’s taken a long time to get to where you’re at. So that’s a great reminder. Now, I think you just said, concealment, right?

Dr. Danyo: Yes.

Clark: That’s one of the big parts of all this, and can we kind of get into the details of what do you mean by that? And how does that connect to the actual procedure? Like what’s actually happening? So the way I’m envisioning it long hair transplant, you’re actually preserving that hair. And in that case, it’s actually grown out pretty long. And you’re kind of replanting it, I think of it as like replanting a tree. And we’ve talked about before.

Dr. Danyo: Yeah. So the analogy would be if you’re replanting a tree, the traditional FUE would be you’re cutting it down to essentially the base of the trunk, and then moving it waiting for the plant to grow. But we’re taking the entire plant, so…

Clark: Do you get better results that way? I mean, I guess success means different things to different people. But if you’re trying to conceal, that’s got to be better, you’re not shaving down.

Dr. Danyo: Well, one of the key elements of long hair that makes it actually more accurate is the fact that the hair has a natural curl to it, as well as angulation. So when you extract hair from the head, the hair is angled down, but the curl is angled down, you want that curl when you place it, especially in the frontal hairline, you want the curl to be down as well, you don’t want hairs going down and up and to the left and to the right.

And with the long hair transplant, you can take that curl and put it perfectly in position. If you look at like a telescope, say a submarine telescope, if you move, say 5 or 10 degrees to the left or to the right, that can have a huge impact on where that View-Master is. So when you have a long hair, you’re able to take that curl and just completely match it with almost 100% perfection, so that it creates a very natural look probably even more accurately than the shaveless procedure, although I do this under loop magnification. So as I’m placing the grafts, I’m looking at the angulation but I’m also looking at the curl of each hair. But just having that fine tuning of say 5,10 degrees, it’s more accurate,

Clark: Yeah. I just still can’t get over how you have to do this literally hair by hair and you’re zoomed in I know you use the telescope, you know, example here where some submarine scope, but you’re wearing a lot of…like the zoom magnification that you’re wearing those small details. That’s significant.

Dr. Danyo: Yeah, it’s 5x, I’ve had a lot of patient…or a lot of the physicians that have come into the office and that have actually been experienced surgeons that have used loops. But when I give him the 5x loops, because you’re really looking through a very small hole, the higher the magnification, the smaller the field of vision is, it’s very hard for them to kind of get used to it. It actually takes months to possibly even longer until your brain adapts to being able to look into that viewfinder, and then look out and then back in and back out. Because that’s what the hair transplant requires. So it just adds to the accuracy when you’re placing.

Clark: That’s really cool. And certainly I’ve never done this, I don’t think I’ll ever be in your position. So I don’t really know how to compare, but what do you think is harder for you, or maybe harder for the patient, if it is long hair transplant work for the you know, how you can do the shaveless FUE on other things?

Dr. Danyo: Well, I mean, the long hair transplant is by far, the highest level of the follicular unit excision, where we take individual follicles. Also it’s harder for my technicians who are pulling the grafts, because all the hair is long, and all you’re gonna see is just a small circle around the follicle. And they also have to be wearing loops to find the follicles to pull them. And if it’s really long hair, a lot of times with women, I mean, it can be 12,18-inches long, we extract a little, place a little, extract a little, place a little. It’s just because when you have a lot of long hairs it just becomes kind of a management issue. And so we have to position a little bit differently more upright. So we’ll generally extract maybe 20, and then place 20, which ultimately is probably a better way to go anyway, you know, to get them out, get them in. But it’s definitely more tedious. And more time consuming.

Clark: Right on. And when you’re taking a little putting a little, is it kind of like when an artist is painting kind of like you kind of close up? And then you might walk a few steps back to see, how’s it looking? Is that sort of what your describing?

Dr. Danyo: Oh, absolutely. Absolutely. And we can really interact with the patient and give them the mirror and, “What do you think?” And they can say, “Oh, I love it? Or do you mind adding a little bit more right here?” You know, because in my mind working together with the patient, and getting exactly what they want is key. It doesn’t take a lot of extra time. In fact, it kind of makes my job easier if we work together.

Clark: Right. I dig it. Okay, so you mentioned the patient just now if you’re interacting with the patient, how does this kind of outcome from the patient perspective? What kind of outcomes are they normally expecting? What kind of results? What kind of success? Do you see…is this different than most of the procedures you’re doing? Is it similar?

Dr. Danyo: No, I mean, the outcomes are similar. I mean, if not better, just because, you know, we talked about that angulation issue, I mean, we can get really fine tune it and perfectly place the curl in the angulation we really get a good look, as well. I mean, from a density standpoint, when you’re putting in short hairs, there’s…I’ve done it enough that I know what certain areas require and how to place them. But when you have the hair and especially if there’s really coarse hair, you may not have to put as much density in a certain area. And you can use it in other areas. So that makes things much easier.

Clark: I mean, this all makes sense. It’s just one of the methods that you’ve got in your tool belt. And for someone if they have not listened to other episodes yet would you wanna take a quick moment just to explain, zoomed out kind of the different ways that you can do this. Because not all patients are looking for the same thing right?

Dr. Danyo: Sure.

Clark: Sometimes people need different things. So how does long hair transplants sort of measure up to the rest of what you’re doing?

Dr. Danyo: Well, again, it all depends what the needs are. If there’s a huge need to conceal….recently, we did an actor and he wanted total concealment and was gonna be doing some shoots probably in the next week. You know after the procedure.

Clark: Like video shoot or?

Dr. Danyo: I’m talking like doing a Netflix series.

Clark: What?

Dr. Danyo: Yes.

Clark: Well, you got to remember you’re in Georgia, right?

Dr. Danyo: Yes.

Clark: So you got…that is like made in Georgia, you got a lot of activity there for that. I didn’t think of that.

Dr. Danyo: Oh, yeah. So he had a very small window, when he could do it and…

Clark: No pressure.

Dr. Danyo: Yeah. And so, in talking in the consultation, he was very much…he didn’t want anyone to know, but also didn’t want a huge amount of time off, because it was a small window that we were working in. So, I offered, long hair transplant, we did 1500 grafts, his donor site hair was about maybe an inch long. So we placed it all in and just extremely happy with the results. And…

Clark: Wow.

Dr. Danyo: He was able to go very stealth. Nobody knew anything.

Clark: Stealth mode.

Dr. Danyo: Yeah.

Clark: It’s important. I mean, this is his career. I mean, a lot of times people are doing this, maybe it’s for personal reasons. And someone, they don’t come to you just to get this procedure done. They’re coming to you, because of the way they wanna feel later.

Dr. Danyo: Yes. And we’ve talked about other instances where you have, maybe somebody is on a board of a large company, where they have emergency meetings, or they just have to be present, and they’re really unable to take time off going as stealth as possible. for them. It’s just really important. It’s just another option. It’s another tool. I would say, it’s easier, obviously, to do men that have shorter hair. And it’s more difficult with women. And one of the big concerns is you have long hair, and you could potentially dislodge the graft.

Clark: What do you mean by that? What do you mean by that?

Dr. Danyo: Well, you know, you kind of comb your hair or pull it back, and you pull the graft out. And I actually have not had anybody pull a graft out, even with long hair, which is pretty awesome. Obviously, they’re careful. But you would imagine having long hair you could easily tug on the graft and pull it out now, but that really hasn’t been an issue. And even there’s a doctor in Uruguay, Dr. Travaglini, [SP] he’s gone almost exclusively to long hair, because of the accuracy with that curl that we were talking about. And they really don’t have people pulling grafts out, even with different hair lengths.

Clark: Wow. Man, that’s…but you know, what you’re working towards though, is that feeling someone gets whether that’s like the person you’re talking about the actor that had to get this done stealth mode, though, to feel more confident, to be better for the role be, better for job, work, all that. But you’ve also got the people who are enjoying the other side of this and they’re lives are impacted…

Dr. Danyo: Sure. Lighter 45. It’s left lot to learn.

Clark: Any thing you wanna add on that?

Dr. Danyo: Well, the way we do the long hair, we have a actually a long hair transplant machine. And it has a special punch that it actually has a groove in the hair. So when you’re grafting, you can set the, you know, that little groove to be down, which is what you want. And you can set how much oscillation because it doesn’t spin it oscillates. And I generally like to do about 120 max, maybe 90 degrees of oscillation. So it’s going 60 degrees to the left and to the right, or 45 to the left and right. And what that groove will actually kind of capture the long hair and keep it from getting cut as it oscillates back and forth. And so you can go deep to the follicle and then you have this long hair that’s left over.

Clark: So it’s like a high tech scooper?

Dr. Danyo: Yeah.

Clark: It’s how I’m thinking about it. It’s just a really sensitive way to pull that. Well, it’s not like you’re pulling your hair…we can all like you know, put your hand in your hair and then like kind of pluck out a single hair. But in order to go in and do what you’re doing. You’re going a little bit beneath that surface, getting the actual follicule.

Dr. Danyo: Yeah, and the nice thing is the actual way like when I do a shaveless procedure, I cut and color the hair at the same time with the punch, you know the punches that we use are trumpeted so it kind of cuts away, so I can cut the hair as I’m coring. So I don’t pre-cut the hair when I do a shaveless procedure, but my punch will cut the hair, and then we leave everything else long to conceal the donor site. So there really aren’t short hairs left in the donor site when we’re done. When I used to pre-trim with scissors for one, it was just exhausting. And I cut a lot more hair than what I was taking in the donor site wasn’t quite as concealed. So the nice thing is the actual motion, the depth, everything is the same as when I do a shaveless procedure which I do all the time.

Clark: What do you think the pie chart looks like of how much shaveless FUE work you’re doing compared to the long hair?

Dr. Danyo: Well, the long hair is still small. You know, we started out with very small cases doing like 250 grafts, and we really didn’t have much of an issue. And then we went to 500. And the most that we’ve done is 1500 with long hair. So it’s still probably less than 5% of what I do. But it’s something that we’re in the process of, kind of actively marketing. And I also had to develop a comfort level, you know, obviously, there’s kind of a higher risk of pulling the grafts out. But again, I haven’t had anybody have that as an issue, even with really long hair. So, I’m at a level now, like we’re doing this podcast, to kind of present it to people to say that this is a total option, if you want full concealment, and you really want total accuracy in the placement of the grafts.

Clark: And part of the advantage of that is you can see how that curl is coming out. You can see I mean, there’s…

Dr. Danyo: Well the curl, the density.

Clark: I love the analogy.

Dr. Danyo: Yeah. Now some of the hairs do get cut, I’ll be honest with you. So it’s probably, I mean, it can vary. Some people, there aren’t a lot of hairs that get cut. And then others it might be 25%. There are also some dormant hairs in the follicles. So I tell people, I mean expect to have probably 25% more visible hair than what you see now. And they’re always happy with that.

Clark: I love it. Anything else you wanna touch on those results? And okay, what you’re working towards, and your team is working towards is that checkup of when they come back and you can see this difference right?

Dr. Danyo: Yes, and you see it immediately. Which is great.

Clark: You know, people have like an aura and energy field. I think, and I don’t wanna get too deep on this. But I feel like if you’re taking care of that, people can sense it.

Dr. Danyo: Yes. Yeah. I’ve always tried to, in my practice, you know, figure out what are the needs that people have. I was in pain management before and my practice, I did it so that, let’s say you were coming in for an epidural, I could do it in a very painless manner where you didn’t need sedation, you could drive yourself and then drive back to work that day. Versus having to go to a surgery center. Having somebody drive you, you know, you’re getting all these monitors and IVs, and you’re kind of laying on a gurney taking up your whole day. And that’s two people out of work that day. And for me, that was unacceptable. So I came up with a better way. And, I was busy doing that part of my physician work because of what we did. And people appreciated it.

Clark: When someone gets this kind of procedure, the long hair transplant compared to some of the other procedures you do. Is the recovery different? Do you need to care for the hair differently? Is it the same?

Dr. Danyo: You just have to be more careful. Yeah, it’s the same. I mean, we want people to wash the hair, and I think it’s very important to immediately wash even the night of the procedure.

Clark: Really?

Dr. Danyo: Yes.

Clark: Why is that? Why immediately like that?

Dr. Danyo: Well, because there’s you know, whenever you ever you’re…let’s say you had a cut, you would wash it, if you didn’t, it would get very crusty. So let’s say you’re doing 1500 grafts…

Clark: Oh, I see.

Dr. Danyo: …you’re gonna get…

Clark: Fifteen little pokes, almost right?

Dr. Danyo: Well you’re gonna get right, you’re gonna get crusting around each graft.

Clark: Wow.

Dr. Danyo: And if you don’t wash it off in the first two to three days, because it’ll accumulate. It’s just kind of part of natural healing, then it’s very crusty and you get itching and you lose that concealability So, it’s very important to wash I don’t have people washing grafts out. You know, I always tell people I have a spray bottle that when I clean the grafts, I’m spraying as hard as I can about a centimeter from the graft and it still doesn’t wash out so.

Clark: Wow, so you’re saying…do you clean as you go?

Dr. Danyo: As we go and before people leave. But even so because there’s gonna be drainage you just have to stay on top of that. You just have to keep it clean. You know the long hair especially that you know women that are doing it you just have to be extremely careful when you’re washing

Clark: I think I’ve asked you this before this will probably be my final question for now. And then we’ll touch base again in the future. But with washing your hair. Does it matter the shampoo..? I feel like you hear and you see so many commercials about all that kind of stuff. Does that matter? How much does that matter specially, you know, right after a procedure like this the type of shampoo you’re using?

Dr. Danyo: Well, we give people a little bottle of baby shampoo. And we want them to use that until it’s gone. I mean, it’s probably a couple ounces. It’s not a big bottle.

Clark: Like an airplane travel size kind of?

Dr. Danyo: . Exactly, exactly. And once that’s gone, just use regular shampoo. As far as like growth, enhancing shampoos, there’s really no evidence. I have people that have tried all different shampoos, I haven’t had a single patient say, “Oh, this is the best.” Now some of the thickening shampoos can thicken your hair in thickening conditioners, especially some of the leave-in thickening conditioners are great to cosmetically thicken the hair. But as far as like DHT, blocking shampoos, growth, supporting shampoos, there’s just not a lot of evidence. I don’t sell any products here, if people wanna use them. Great. But it’s probably a multi-billion dollar industry with really minimal evidence to support the use.

Clark: Right. Makes sense. Hey, I’ve enjoyed this. As always, I’m always learning so much. I really appreciate the way you make it simple to describe. I know there’s a lot that you do to make the magic happen. But you’ve been doing it a long time, you know how to communicate this. So…

Dr. Danyo: Well, I appreciate it.

Clark: …that being said, Is there anything else that you wanna share on this or you feel good?

Dr. Danyo: I think that’s it, we’re gonna be coming out with some videos, showing the long hair transplant process and get more people information to see if that fits, what their needs are. And really the biggest need is the concealability aspect and really long hair transplant is by far the highest level for concealment.

Clark: Fantastic. Dr. Danyo, as always really enjoyed it. Looking forward to our next podcast session.

Dr. Danyo: All right. Thank you, Clark.

Clark: Thanks for listening to “Hair Restoration,” with Dr. Daniel A. Danyo. Book your consultation today with Dr. Danyo by simply calling 678-845-7521 or visit them online at nahairrestoration.com. And be sure to subscribe, rate, and review the podcast wherever you listen to your favorite podcasts.