26 months using minoxidil, finasteride and microneedling

This is a wonderful result and shows the power of microneeding at maximizing the results of medication and cause such good growth. A microneedling maintenance program should be continued at least once a month and if you see hair loss, then increase the frequency of the microneedling. Stay on the finasteride and the minoxidil.

[If you have any questions, you can reach me at williamrassman33@gmail.com]

2500 grafts second procedure (photo)

When you have an advanced balding pattern as you do, transplanting the frontal half is a great starting point because the man in the mirror will look hairy. Make sure that your doctor and you discuss your residual donor supply to see if you can address the crown at a future time. I have written articles on transplanting men with advanced balding patterns when they don’t have the donor supply to meet their needs. If your surgeon follows my published articles, you can work your way to the back of your head, regardless of your donor supply. I like what you are doing!

I had 2500 grafts one year ago and am still thin, what shall I do? (photo)

No one ever gets back their normal density. The question that should be answered is did you meet the expectations that you are your doctor set at the time of the surgery?. . Maybe your hair was fine or that the number of grafts were insufficient or you had less than good growth. In any event, you must o back and meet with your surgeon if you are unhappy


2017-12-27 17:23:01I had 2500 grafts one year ago and am still thin, what shall I do? (photo)

25 and want to have a second hair transplant

I am 25 years old suffering from hair loss . I had a FUE Hair transplantation of 2000 grafts for the hair line but the results was not full and I believe now that I need more hair in the top and the vertex area. Can I do another hair transplant?

Your surgeon should have made a Master Plan for you knowing your donor density so that your surgeon could then know if your donor density is adequate to support a second hair transplant. Sometimes a strip surgery may be better for the second hair transplant if the donor density appears to be thin from the first surgery?

I am a 24 years old and am thin throughout my scalp (photo)

My mother and aunt have a similar problem. What should I do?

Clearly you are very thin and have a see through appearance. If this is in the female side of your family, it is most likely genetic. First, you want to make sure that it is not caused by some medical condition.

Female hair loss is a difficult analysis and requires many tests, not just thyroid testing. I simply can not write a textbook on the subject on this site, but here’s a list of past posts that may help you understand what you’ve got going on:

  1. Female Genetic Hair Loss Is Different From Male Genetic Hair Loss
  2. Birth Control Pills and Hair Loss
  3. Woman With Thinning Hair After Family Tragedy
  4. Diseases Causing Women’s Hair Loss
  5. Female Hair Loss

The first step in evaluating hair loss in women, after a detailed history and physical exam, is to rule out any underlying medical causes of hair loss which can be treated. If clinically appropriate, the following disease processes should be considered: anemia, thyroid disease, connective tissue disease, gynecological conditions and emotional stress. Furthermore, over 50% of women going through change of life hormone fluctuations (menopause) experience significant hair loss. It is also important to review the use of medications that may cause hair loss, such as (but not limited to) oral contraceptives, beta-blockers, Vitamin A, thyroid drugs, coumadin, and prednisone. The following laboratory tests have been recommended to rule out the aforementioned medical conditions:

Some common blood tests for female hair loss:

  • Sex Hormone tests
  • SHBG (Sex Hormone Binding Globulin) used to test status of male hormones
  • Estradiol is a sex hormone
  • FSH (Follicle Stimulating Hormone) *not hair follicle but follicle in the ovary*
  • LH (Luteinizing Hormone) is a sex hormone
  • Free Testosterone
  • Total Testosterone
  • ANA (Anti Nuclear Antibody) used to test for Lupus or other autoimmune diseases
  • TSH (Thyroid Stimulating Hormone) used to test for hyper or hypo-thyroid disease
  • Test Iron status
  • TIBC (Total Iron Binding Capacity)
  • Ferritin
  • Iron

Assuming that you do not have a medical cause and it is genetic female hair loss as seen in your aunt and mother, then one of the better cosmetic treatments for this is Scalp Micropigmentation: https://scalpmicropigmentation.com/smp-for-women/


2017-11-06 17:43:46I am a 24 years old and am thin throughout my scalp (photo)

24 Year Old Male with Receding Hairline and No Change in His Hair Loss over the past Year on Haircheck Test

I have performed a HAIRCHECK test on this now 24 year old male with a receding hairline last year and then again today. His hair has shown stability and very little loss as the drug finasteride seems to be helping him hold onto his hair. I told him to return in a year for another HAIRCHECK test and to see if his corner frontal recession bothers him. A hair transplant is a viable option.


2019-02-20 08:04:4124 Year Old Male with Receding Hairline and No Change in His Hair Loss over the past Year on Haircheck Test

24 year old male with advanced balding in the family (father)

This young man (Joe) believed that he was starting the balding process that his dad had (a Class 7 pattern of balding). His father was with him today and he told me that he started balding when he was in his very late 30s. That was unusual for a man with a Class 7 pattern of balding (just a rim of hair around the head) as most men achieved that pattern in their 20s. Joe had early recession in the corners of his hairline.

This is what I told him and what I did: “You were concerned about the balding in the family with your father developing his advanced balding pattern in his late 30s (unusual). We performed bulk measurements on your hair today and much to my surprise, the balding you are experiencing is very mild and early with less than 9% hair loss behind the frontal hairline and in the top of your head. At the age of 24, you might be able to hold on to your hair for years if you use the drug finasteride. We discussed the potential side effects of this drug and I told you to call me if you should develop any of these.”

This shows the value of the HAIRCHECK test for hair bulk measurements. Although he thought that shaving his head was a good option and receiving Scalp Micropigmentation rather than face his fading hairline every year, month by month, I felt that he had a good chance to keep his hair and postpone any more thinking about his balding. This is very important for any young man. At his age, thinking too much about his hair replaces the real important things in life. Hair may not be important for him to worry about for years to come.

24 year old female with corner hair loss and some hairline early elevation

This is a common finding in some women, although it is more common as women get older. I have treated many of these women with a hair transplant to put back the rounded hairlines typical of the female hairline. You should be look at my an expert to make sure that you don’t have an autoimmune disease like Frontal Fibrosing Alopecia. a diagnosis that is easy to make when your doctor is skilled in the examination of a female hairline


2019-05-10 12:38:4324 year old female with corner hair loss and some hairline early elevation

24 year man old wants a hair transplant at all costs (social and $$)

The hair loss behind what is still a strong hairline. In some Indian men, these strong hairlines can persist for many years even if the hair behind it goes. His pattern from other photos not shown here, is almost certainly going to develop into a Class 6 pattern so I told him to postpone surgery at this time. He should try the drug Finpecia (available in India) as this drug might reverse the hair loss especially when used in conjunction with minoxidil.

Too many young men want to rush hair transplants and too many doctors are happy to take their money and do it; however, hair transplants done too early, may leave the man with a balding pattern that the doctor and the patient never planned for (and that would be bad for the patient but the doctor has already pocked the money and I am sure it cleared his bank account)