Month: January 2023

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You shouldn’t see the grafts!

A good transplanted hairline will have a transition zone created in front of the larger grafts (2-3 hairs each) so that there is an easy gradation from forehead to thicker hair. This picture shows the absence of a transition zone and hair lined up like soldiers, not a random normal placement of the grafts. In addition, the transplant is not aligned to the forelock so it was poorly planned. This surgery was done recently by another clinic.


2020-09-25 10:11:35You shouldn’t see the grafts!

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You Say Norwood 2 is Just a Mature Hairline, But Can It Be Treated Surgically?

Hi Docs, thanks for the great site, it really helped me figure out my options. I finally got a check on what I thought was a receding hairline after seeing my brothers lose their hair and after a couple of checks with a hair specialist in the UK I was told I have a matured hairline but no apparent signs of real balding, recession or minituarisation. I was told that there was no apparent need for me to use Propecia or Minoxidil. I am aged 32 now and my hairline looked to have matured by around 21 and hasn’t moved noticeably since then.

My question is that you tend to mention on this blog that a Norwood 2 is approximately a mature hairline and you don’t consider this male pattern balding from a surgical standpoint – but on your New Hair Institute site you show Norwood Class II patients and count that as hairloss that could be treated surgically? Would this be strictly for a cosmetic adjustment of the hairline? (I realise it’s all cosmetic surgery but as in there’s no balding to cover, just a hairline change). Although I’m happy with my hair more or less, I’d still prefer a slightly straighter (closer to juvenile) hairline as I have quite a high, thin forehead and I’d be interested in surgery simply as a cosmetic adjustment.

Thanks for any clarification.

Norwood 2Hair loss is not a medical illness. Hair transplant surgery is considered cosmetic surgery. If you want to enhance your appearance, it is your choice. So for those with a Norwood class 2 or a mature hairline which is more like an early Class 3 pattern, we can certainly treat it.

The point I generally make in my medical practice and here on BaldingBlog is to have open communication between the patient and doctor. We give our opinions on what may be too low of a hairline and how it may not be age appropriate, but in the end each and every patient has a right to choose their own “look” and hairline.

There is nothing wrong with, as you put it, a cosmetic adjustment.

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You say get a doctor to manage hair loss?

not to sound ignorant, but what benefit do I get from seeing a doctor, other than getting the receipt for finasteride, which I‘ve already done? Or are you thinking about transplants? Different question: I wanna try topical fin, but I‘m not sure where I can get it in Germany, I saw that some people mix it themselves, I don‘t think thats a good idea…I could order it from the US, but that would be too expensive for me in the long run.

A good doctor will give you a Personalized Master Plan for your short and long term hair loss management. It doesn’t necessarily mean a hair transplant. I am a hair transplant surgeon yet I manage many men for hair loss even though I never do a hair transplant on them. I show the patient caring, empathy and bring my expertise to the situation at hand.


2021-07-06 08:07:38You say get a doctor to manage hair loss?

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You Only Want to Sell Hair Transplants to the Fruits and Nuts in California!

Sir,

I am 58 and starting to lose my hair front and top.

I have never used any product other than Nioxin, (for 20 years) but not for hair loss, I simply like the products.

I am having a very hard time, not only believing in the infomercial hair loss products like Provillus but also your negativity towards all these products. I find your foot print, disclaiming most of the infomercial hair loss products and this includes Rogaine…

Should I believe that all these products are completely bogus OR are you degrading them because you charge an insane amount of money for your hair transplants, especially in Calif where the fruits, nuts and very vain people live! I seem to feel that you are bias towards these products because you need to buy another million dollar mansion some where in the fruit and nut state? Am I correct?

By the way, I have many friends that live in Calif and I consider them to be fruits and nuts also!

Sincerely,
– Name removed
New York

I’ll just assume you were making a very poor attempt at humor with all your “fruits and nuts” comments, so I won’t take offense. Considering our fees for hair transplants are lower than many physicians in your own state, you’re pretty narrow-sighted to think pricing is outrageous because we’re in California. But let’s get to the real meat of your oh-so-insightful email…

Most of the hair loss products you read about on the web are bogus and the makers prey on desperate people trying to retain their hair. The products that do work (and are proven to do so) are finasteride and minoxidil. And even then, I post plenty of reports from readers about side effects and concerns for those medications. I like to think I’m pretty balanced when it comes to this stuff. If you like a particular hair product then by all means continue using it. I never said these products were unhealthy or would hurt or kill you. A product like Provillus just contains minoxidil, so it works like minoxidil does. If you want to spend more on a boutique minoxidil with vitamins that I feel won’t aid in regrowth, that’s your call to make. If you want to buy a shampoo because you like the way it makes your hair feel, then please go for it.

It sounds like your biggest gripe is that I’m not writing positive things about unproven treatments. I’m asked about nearly every hair treatment product under the sun, and all I can do with most of these is review the ingredients listed and give my 2 cents. Recently I was asked about a product that lists rosemary as some kind of hair growth treatment. Simon and Garfunkel might’ve had a hit with Parsley, Sage, Rosemary and Thyme, but it doesn’t mean those same ingredients will work to grow hair (otherwise I’m sure Garfunkel wouldn’t have had his infamously bad hairline). My point is that there are hundreds of products around that claim to work — and they simply don’t. There’s no proof that they are effective… and it seems people don’t tend to care if there’s proof, as long as the website looks slick and they’re offered a “guarantee” that may or may not be worth anything.

You’re free to believe what you want to believe about me, but you couldn’t be more wrong. If I was going to try to persuade people into getting surgery, I wouldn’t bother recommending any medication (which I don’t make money on). If I was trying to buy a “million dollar mansion” (actually, it would be my first), I wouldn’t offer my services, time, and support for free through this website. Why would I bother educating people about how to be a better consumer if I was trying to take advantage of them? Give me a break. As for the so-called “fruits and nuts” in California, this state has some of the most normal, driven and brightest people in the world. If you want more information on what this state has to offer, you can visit the California Tourism site. I found that site by using Google… which incidentally was founded in *surprise, surprise* California.

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You Changed My Life By Repairing My Plugs — But Can I Remove a Donor Scar Completely?

Dr. Rassman,

I had many strip procedures in the early 1990’s that left my hair looking very “pluggy”. People would immediately look and my forehead at first meeting and continue to stare as though I was not even present. I wore a baseball cap everyday to cover up my hair everyday for 9 years (all the way through college, graduate, and PHD school). Luckily, I took a chance and made an appointment with you. You completely changed my life and helped rebuild my self-esteem.

After many corrective surgeries and reaching an amazing result due to you experience and craftsmanship, I have one last question regarding “reducing donor scar left from the strip harvesting.” Are there any other new options out there that could eliminate the donor scar through Trichophytic closures coupled with FUE, laser surgery, or tissue expansion that would allow me to shave my head if needed?

Thank you for the kind words and I’m glad I was able to help.

With respect to the donor scar, there are scar revision surgeries and even Scalp MicroPigmentation (SMP) to disguise the scar. I don’t know that you’ll be able to completely eliminate the scarring, but masking it or revising it would possibly be doable. With that said, everybody’s situation and needs are different, and I cannot give you a detailed personal consultation over the Internet without an examination.

Please call my office at (800) NEW-HAIR or (310) 553-9113 and we can set up an appointment to discuss your options.

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Yesterday, this man had 4090 grafts

This man had his hair wash this morning. There was no crusting on his head. I recreated his natural swirl which doesn’t show up well in these photos. The tape was placed to minimize any swelling that would follow a procedure of this size (which would otherwise produce swelling in the forehead and possibly the eyes within 3 days of the surgery). He slept well and drove in this morning feeling completely normal and pain free. He will now starting doing his own washing. That is not blood you are looking at below his head but a flower on his shirt. I told him that he could begin exercising in two more days.

The third picture was taken a day 6 and as you can see he looks much better. He is having no difficulty washing his own hair and has resumed full activities

 

 

 

 

 

 

 

 

 

 

 


2020-02-25 16:07:25Yesterday, this man had 4090 grafts

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Yeast and Seborrheic Dermatitis

Hi Doc,

I have been suffering from seborrheic dermatitis for the last 1.5 years. I read somewhere that yeast containing food aggravate the problem. Is it true? Are there any specific food items that I should avoid?

Thanks!

There appears to be an association between yeast and seborrheic dermatitis. There’s a great article on the American Academy of Family Physicians website that says:

“Pityrosporum ovale, a lipophilic yeast of the Malassezia genus, has been implicated in the development of this condition. It has been suggested that seborrheic dermatitis is an inflammatory response to this organism, but this remains to be proved. P. ovale is present on all persons. Why some persons develop seborrheic dermatitis and others do not is unclear. The colonization rate of involved skin by this organism may be lower than that of uninvolved skin. Nonetheless, the fact that seborrheic dermatitis responds to antifungal medications is strongly suggestive of the role of yeast in this disorder.”

Read the rest of the text at American Academy of Family Physicians

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Years After Hair Transplant, I Still Get Scabby Growths in Recipient Area

At least 5-10 years ago I had multiple sessions of hair transplants. All these years later, I am still getting scabby type growths at up to dozens of the implant recipient sites.They dont hurt ,but they feel annoying-as they feel like small crusty raised bumps that I have to kind of pick and tease off since hair is growing up threw the center of them.I am fair skinned Irish so I am very careful not to get a sunburn on my scalp or it makes this problem MUCH worse .Any advice/product or Rx recommended?? Thank You

I would have to see you and look at your skin to understand the problem. Flaky skin (dandruff) can be something brought on by a scalp surgery. Zinc and tar based shampoos will work to control this. You can buy this in any neighborhood drugstore.