Month: January 2023

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What If I Want a Hair Transplant, But Don’t Want to Take Propecia?

First off, thanks for everything you guys do! Doc I am 26 yrs old and I had several questions. I apologize in advance if any of them are stupid questions! I am closest to Norwood III Vertex, but not completely there yet. I actually have a fair amount of hair on the top, problem is it’s really thin. The back and sides of my hair are complete opposite, they are very thick. I want to do a hair transplant, but is there any point to doing so if I do NOT want to take Propecia? I am open to taking Rogaine. Everybody keeps telling me to wait till my 30’s to get a transplant, since if I do 1 so early now, I will still lose other hair. If this does happen, I just get a 2nd transplant, correct?

The problem with a 26 year old experiencing hair loss is that your balding pattern is in transition. Will you become more advanced in your hair loss? You can try to predict it by performing a miniaturization analysis and see how far back this process goes (see Mapping Your Own Scalp).

Having a hair transplant at age 26 without Propecia on board will just accelerate the hair loss you are likely going to see in the years ahead. Not taking the medication will allow what nature has planned for you to happen. The choice is yours. Rogaine will not offer the same degree of protection. Why keep putting yourself through more hair transplant surgeries as your hair loss progresses if a daily pill could be the solution?

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What If I Try Rogaine and Propecia, Then Phase Out Rogaine Gradually?

Dear Doctor Rassman:

I’m 28 and have noticed a rather rapid hair loss on top, behind the hairline. I’m scheduled for a miniaturization study next week. I’m afraid of the 6 month gamble on Propecia only-the one you recommend, particularly because hair loss seems so sudden and fast. What if I use Rogaine and Propecia simultaneously and if and when hair loss is reversed-say a year from now-gradually phase out Rogaine? Would my body be able to tell which hairs owe their existence specifically to Monoxidil and I lose the benefit I gained from it and keep only the hair supported by Propecia? Thanks.

The mechanism of action is different for finasteride and minoxidil. If you use both and receive benefits, then stop using Rogaine, you will lose any benefits from the Rogaine. It isn’t possible to tell which drug gave which benefits, which is why I recommend starting with one and then adding the other if necessary. Propecia does not keep hair grown by minoxidil and vice versa.

In other words, what you’re suggesting is not a good idea.


2007-10-08 13:35:48What If I Try Rogaine and Propecia, Then Phase Out Rogaine Gradually?

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What If I Take Propecia, But Don’t Need It Yet?

If you take proscar 5mg tabs & cut it into 4’s, will it work the same as propecia ? That’s what i’ve been doing. It’s cheaper. Also, if you take this & don’t need it, could it make you lose your hair ??

Proscar is the same medication as Propecia — finasteride. They just come in different dosages.

Never take a drug that you do not need. Get your hair mapped out for miniaturization to find out if you need it and if you have genetic balding that needs to be treated. Taking Propecia when you do not need it may have some long term problem that was heretofore not discovered yet. Why take any risks?


2006-12-08 10:18:57What If I Take Propecia, But Don’t Need It Yet?

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What If I Stop Using Chemicals and Grow Out My Afro?

Hi, I’m a 17-year-old african male who’s experiencing hair thinning at both the left and right frontal areas of my head. I’m sure it isn’t hereditary as my older brother of 19-years still has a head full of healthy hair. I think this may be due to the numerous products I’ve used in recent years to maintain a wavy texture in my short hair. Now that I wish to grow an afro, the thinning is more visible than if I have short hair. I was wondering if growing an afro could disguise the thinning or if it could allow the thinning hair to strengthen again?

Thanks

Let your hair grow out and you should see that it will take on its natural appearance. The new hair that grows out from the scalp never had product or chemicals on it, so this hair will curl/kink if that is your normal character. I am assuming that the chemicals you used did not damage the hair below the skin.

That being said, you might have a maturing hairline or early genetic loss. Unless you used excessive chemicals in just the hairline, it sounds like it could be genetic (which could skip generations). You might not necessarily follow the exact timetable as your older brother if there is hair loss in your family history. I wouldn’t be able to make that determination without an examination, so you should talk to a doctor if you’re concerned.

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What If I Shave My Head After a Transplant?

What is the average total cost of a hair transplant and what if I decide to shave my head, will there be noticible scars?

I’m sorry to tell you this, but there is no “average total cost” of a hair transplant. It varies from patient to patient and from doctor to doctor. However, you can usually count on a good hair transplant costing several thousand dollars because it is (or should be) a very detailed and labor intensive process with a highly trained staff.

As for shaving your head, any time the skin is cut, you will have a scar. The degree of your scar will depend both on the skill of your surgeon and how your body heals, but scars can be minimized through multiple techniques. If you plan to “go Marine” you might consider the FUE/FOX Procedure if you are a candidate (see FUE category ). This, too, will leave scars but they will be little white dots versus a thin line which will draw the eye and be more obvious with a shaved head.

For more information about Follicular Unit Extraction (FUE), please take a look at:

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What If I Need Chemotherapy After I Have a Hair Transplant?

If you get a hair transplant and later get diagnosed with cancer, need chemotherapy and lose your hair, what do you do about the scarring and dots where the transplanted hair previously was?

I would think that if you have cancer, a hair transplant or its scar would be one of the last things on your mind. If you do end up going through chemotherapy and lose all your hair, you will see the scarring.

But while most of us do not plan on having cancer or chemo in our lifetime, if it happens to you and you are worried about the scar, you can wear a hat or a wig as most chemo patients do.


2010-11-09 12:16:12What If I Need Chemotherapy After I Have a Hair Transplant?

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What If I Haven’t Seen Regrowth Results from Propecia At 9 Months?

You always say at the 8th – 9th month mark you should see Propecia’s regrowth/thickening of hairs. If you haven’t seen anything by then does it mean there is no possibility of thickening of miniaturized hairs or regrowth after that? I read that Propecia can take up to 1 year to see it’s benefits, so what’s the deal here?

I do not believe I said Propecia will make your hair thicker or regrow new hair all the time. Medication works differently for each person, so I couldn’t guarantee that. You must understand that there is no magic cure for hair loss and all drugs have limitations. As such if you are not noticing growth, you may notice less hair falling out. Less hair falling out still means it is working.


2008-12-15 09:00:27What If I Haven’t Seen Regrowth Results from Propecia At 9 Months?

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What If Dr Rassman Retires Before I’m Old Enough for a Hair Transplant?

Dr.Rassman are you the only person who performs transplant. If not i would rather have you do it as you are well respected, i wouldnt feel as happy if anouther surgeon at NHI did my surgery. Also can you see anytime in the future were you may retire and if so will NHI still be in buisness, if so how could you replace yourself with someone as good as you. If you left i probbaly wouldnt get surgery at NHI. Im 18 and have a receding hairline, im worried that by the time im 25 and want a transplant you may not be doing transplants any more.

Just to make this perfectly clear — I’m not retiring anytime soon!

Yes, even if/when I do retire, NHI will be in business. Dr. Jae Pak (whom I’ve known and worked with for over 10+ years) was personally trained by me and is a great transplant surgeon. He and I both do hair transplant surgeries at New Hair Institute. You will be in good hands with Dr Pak.


2008-05-21 10:48:12What If Dr Rassman Retires Before I’m Old Enough for a Hair Transplant?

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What Happens When a Class 7 Patient Has No Master Plan?

Without a Master Plan, a Norwood Class 7 patient can be exposed to the worst of the problems in planning. An unfortunate example of this is a patient with a complex surgical history that I just saw who had three procedures with three different doctors over the past 10 years. His balding pattern was heading to a Class 7 and none of his doctors seemed to understand where he was going with his hair loss problem. This man had transplants that were spread all over in a most unnatural look, with areas left completely untouched. Some hair was placed in areas that should not have received transplants (they weren’t beneficial to the appearance), and he now has a massive scar in the donor area with no significant donor hair left. He asked I not post his photos here, but what are the options for a case like this?

  1. Use beard and body hair transplants to fill in the areas that do not look normal. Fill in the scar with beard hair transplants as well. Learn to use transplants as an aide to styling and hair length needs to be planned. I’m not a fan of body hair transplants (BHT) in the great majority of cases, but his options are extremely limited.
  2. Use cosmetic camouflaging such as Toppik or DermMatch.
  3. Consider scalp tattoos.
  4. Get a wig.

Some people still don’t get why a Master Plan is even important, so think of it as a surgical blueprint that plans for the worst case scenario of your hair loss progression. I can not stress the importance of a good Master Plan. Some doctors made a lot of money from this man, but did him no favors. And as I sound like a broken record, never forget — let the buyer beware!

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What Happens to Surrounding Skin After the Strip is Removed?

Dr. Rassman,

I know that this question is probably answered in many FAQs, but I’ve been watching your blog for two years straight and do not recall seeing it:

What happens to the surrounding skin when you cut out the donor area? I’m particularly concerned with knowing exactly which areas of skin are going to get “stretched” to make up for the missing skin. For example, does my face get tighter? Does my neck feel tighter? Does the skin regenerate to compensate? Can this lead to minor sagging/stretch marks in areas behind the head? More importantly, can it shift parts of your face slightly out of line?

This is a great question, one that I am asked when I do consultations. Your face doesn’t get tight, your neck isn’t stiff. You don’t even get tighter buns. The stretch that occurs is so uniform that most of the time there’s nothing that can be detected. Some people who have good laxity will notice a slight decrease in the looseness of their scalp.

I only wished that my own strip excision would’ve produced even a small face lift, but the answer is that there is really no shift of anything. I dream of doing a hair transplant and giving a person a facelift, which would allow me to increase my fees and offer more value, but alas this does not happen.


2009-10-13 12:04:28What Happens to Surrounding Skin After the Strip is Removed?