February 2007 – Page 8

February 15, 2007

I Think My Hair Transplant Was Placed Too Low – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman, I recently had a HT with a “top doc” but I’m concerned that my hairline may have been placed too low. I’m 32 years old. My hairline sits 3 inches above my eyebrows and recedes about a 1/2 inch higher than that as it goes back. Where is the right stop for an adult hairline? any comments will be greatly appreciated.

If you look at the post Maturation of a Hairline, you will see where the adult hairline belongs. It should be one finger breadth above the highest crease of the wrinkled brow. There is not a fixed size for distance between the hairline and eyebrows; instead there are guidelines that could be used to determine where your natural hairline used to be and where it should be after a hair transplant.

One method is to measure the distance between the tip of the nose and the chin (let’s say in ‘Fred’ the distance is 7cm) and compare it to the distance between the upper bridge of the nose — Fred’s mature hairline should be found 7cm above the upper bridge of the nose. The other method is to use the highest crease of your forehead when you are looking upward and go about one finger breadth above it to determine where your natural mature hairline should start. I personally think that the second method is the best way to know where the mature hairline belongs.

Some patients do not follow these rules and may have a wide forehead or a bigger chin to start with. In these cases, old pictures from patients could be used as a guide. Nevertheless, the judgment of the surgeon and his/her artistic view is always crucial for the design of the most natural looking hairline. If you ended up with a too-low hairline, it can be a real problem, since as I’m sure you’re aware, hair transplants are permanent. Send me a photo with your eyebrows lifted high up and I will venture an opinion and keep your identity confidential, of course. Please reference this blog post when sending your photos.

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February 15, 2007

Does Brushing Prevent Hair Loss? – Hair Loss Information by Dr. William Rassman

does brushing help prevent hairloss?

Brushing will not prevent hair loss, but it will cause hair loss if you pull your hair while doing it. Use a brush with tongs that do not dig into the scalp and be gentle. Hair that is miniaturized or near the end of its life, will come out and not return with little coaxing.

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February 15, 2007

Can I Take Avodart, Then Switch to Propecia to Maintain the Benefits? – Hair Loss Information by Dr. William Rassman

Hi doc.. Im a male aged 22years.. Im having thinning and falling of hair in the crown area since last two years. i Still have a significant amount of hair left. I’ve started taking generic 1mg finasteride called Finax mfgd by reddy’s laboratories. i’ve been taking it since last 5 months. Im still losing around 50 hairs a day. while taking shower, combing etc… I have a doubt regarding Avodart! Its a known fact that avodart increases hair count significantly while using it for six months but it’s long term use and side effects are not known. so i have a plan. wat If i start taking avodart for six months and after i get a good result from using it, i switch back to propecia and maintain the benefits i got from avodart(duasteride). is that a good plan? will be waiting to hear from u.. thanks in advance doc… by the way ur site is simply Amazing!!!

Loss of 50 hairs per day is normal. Propecia may very well sustain the benefits you got from dutasteride or Propecia (finasteride) may give you benefits without evening needing dutasteride. You sound like a person who wants to experiment on your head. It is your head, but I ask you why you’d want to be a guinea pig? What you said makes no sense to me, but if it makes sense to you, then so be it. It has been said that a person who treats himself has a fool for a doctor.

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February 15, 2007

Am I Experiencing New Hair Growth on the Crown? – Hair Loss Information by Dr. William Rassman

Dr Rassman,

thanks for all your blog has done, its really a great resource and place for answers. Its been a great help for me.

I am turning 25 soon, and for the past year have been driving myself crazy because my hair has thinned. I did catch it very early, its far from noticable to the naked eye, and ive been on propecia for almost 10 months.

Heres my question, I recently noticed what feels like short spikey hairs on my scalp, my hair is long so i cant see them, only feel them.

would this be considered new hair growth? I know all about miniaturization (thanks to this blog) but these hairs feel very hard and spikey. And im sure they werent there a few months ago. The spikey hairs are only on the crown and other areas my hair has thinned.

any comments you have to help answer my question are greatly appreciated

You could be experiencing new hair growth. Follow it over the next few months and get some good photographs if you can ASAP and then more later on to compare.

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February 14, 2007

High Hairline on Nicolas Cage – Hair Loss Information – Balding Blog

Would it make sense to get me “only” back to a higher NW 3 instead of a mature hairline (a forelock with partially receding sides), so as to preserve more hair for a possible follow up hair restoration in the future, or is that not the way it is done? I look at pictures of actor Nicholas Cage, for instance, who was clearly balding 10 years ago into what appears to be my current hairline, but who now has a decent hairline that looks like a NW3. It looks quite natural and very subtle.

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There is a long story where patients were polled to find out if they would have a preference with hairlines that are high. Those with a normal mature hairline looked better and the patients themselves prefer that look. The mature hairline has a slight corner recession as its natural look — it gives a convex look to the hairline.

Disclaimer: I have no direct knowledge of Nicolas Cage’s hair.

This is purely speculation based on photographs that I have seen, but I am under the belief that actor Nicolas Cage has had hair transplant or uses some scalp coloring agent to make his hairline very strong. In his case, it seems to me that the hairline is clearly not in the correct position and it is very straight without a good transition zone. I disagree with you that it is “quite natural” and if you look carefully at the picture, you will see what I mean. Hair in the high position should be a finer quality of hair, reflecting the thinning process that goes with genetic balding as the hairline rises. His high hairline does not have finer hairs, which draws the attention when looking at his face — my eyes go directly to his hairline, which for its position is far too strong. There is a negative connotation in the minds of many people when they they can detect a transplant. Saving hair for future transplants just to go to a higher than a normal location does not frame the face well. It draws the eye to the hairline. My goals always include having a hairline that no one pays any attention to. I personally think that a thinner, lower hairline looks more natural that a high, stronger hairline.

February 14, 2007

Where Can I Buy Apple Polyphenols and Procyanidin? – Balding Blog

Hi Dr. Rassman,
Could you please suggest places that someone could find apple polyphenols and procyanidin capsules and topical solutions? I have only been able to identify one supplier and I cannot tell if their prices are reasonable. Thank you!

There appears to be a complete listing here: HairSite – Where to buy apple polyphenols or procyanidin B2?

February 14, 2007

Transplanting Hair from Neck to Beard? – Hair Loss Information by Dr. William Rassman

Hi – I’ve been bumping around your website and I see where jerks must’ve emailed you a million false emails – this is not one of them : )

I’ve got minimal hair in my beard on the sides of my chin, and I would love to find a solution for it so that I can grow a full beard. My little brother had hair transplants from the back of his head to his hairline (receding hairline) – but he shaves his hair closely and the line in the back looks really silly.

I also shave my head closely (not bald, like a 1 level crew cut) – so I’m hoping to find a solution for my beard (have full head of hair on top, so only looking at the beard). I’m wondering if it’s possible to either get the hair from my neck below a normal beard line (that low neck hair 3 inches below the chin where you have whiskers but everybody shaves it off anyway) grafted up into the cheeks/chin area – or if it’s possible to get the hair below my normal hairline in the back and put that in the cheeks near the chin area? I just don’t want that silly line in the back of my head (I call it a “scalp zipper” (privately I don’t make fun of him obviously).

Also, I know it’s a specific cost to the individual based on how many grafts and sessions are required – but if I assumed about 1,000 grafts in 1 session, how much would I be looking at (high and low range)?

Lastly, I didn’t see very many photos on your website of successful beard transplants. Any good websites out there? I’d also love to hear about horror stories from recent years and how to avoid them.

This is a serious email and I am looking to do something in the next few months if I find a good solution – would love to hear back from you.

The procedure known as follicular unit extraction (FUE) was first published by me in 2002 and it discusses minimally invasive hair transplants where individual follicular units are removed one at a time. There is no linear scar with this technique and you can clip your hair short as you want. I would not take it from the neck, because neck hair is not permanent. See:

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February 14, 2007

Should I Take More Finasteride After a Few Years of Use? – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman, thank you for your blog. It’s really a big help.

My question is regarding the effectiveness of Propecia. Why does Propecia’s benefits diminish as time progresses? Is this situation similar to antibiotics, where the body eventually becomes immune to the drug? If, after 3-5 years or so, the effects of the drug die off, can we boost our dosage of Propecia to compensate for its ineffectiveness?

Propecia does not become less effective, but the progressive nature of genetic hair loss is on-going. The drug is about 80% effective, which means that the 20% that continues to be impacted, builds with time. More Propecia does not make for a better DHT block.

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February 14, 2007

Losing Arm Hair – Hair Loss Information by Dr. William Rassman

i am losing hair on my arm. i do not have none. my hair on my head is getting thin also. could you give me some idea of what i can do. they aint no were i can go out here. please help me out.

Without examining you I can not tell you very much. Are you taking medications? If so, these must be looked at as a cause. Arm hair? Well, I just do not know.

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February 14, 2007

Hair Restoration Doctor Specializing in African Americans? – Balding Blog

Is there a hair restoration doctor that specializes in african americans. The reason that I ask is that I see that alot can go wrong. And I would really like to find someone that specializes. Thanks.

As far as I am aware, there is no hair restoration doctor who specializes in African American patients. Hair (without regard to race) is hair. Transplants can be more difficult when transplanting African American patients, but any good doctor who does hair transplantation should be able to address your needs. Go to ISHRS.org to locate a doctor near you.

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