Dr. William Rassman – Page 1365

January 8, 2009

Large FUE Case? – Hair Loss Information by Dr. William Rassman

Dr. Rassman

What is the largest number of grafts you recommend to be transplanted in one session using FUE? What is the maximum number you guys at NHI have done in one shot using this technique?

Thank you and Happy Holidays to you and your staff.

The largest case we did was 2,800 grafts. The large follicular unit extraction (FUE) cases require high densities of the hair in the donor area. Those individuals who have lower densities generally have from 20-40% less hairs per square inch, so one could expect that yields may be as low as 700 – 1,000 grafts for most — and that is generally people from Asia (like Indians), many from the middle east, and those with African hair. In a Caucasian with an average density, we have done 1300-1500 FUE grafts.

I think that many of you have seen comments made by me — comments of disbelief about the number of FUE grafts claimed to be performed by some dishonest doctors. I’d like to see some more honesty in the industry, but the almighty dollar is more important to some.

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January 7, 2009

What Percentage of Men Get to Norwood Class 6? – Hair Loss Information – Balding Blog

I’ve seen that you say only 7% of balding men will hit stage seven on the Norwood Scale. What about stage six? Theoretical if there were no treatments would most men (93%) be destined for stage six on the Norwood Scale? And is whether or not you reach seven on the Norwood scale genetic?
Thanks

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This is not an easy question to answer because of judgment problems in those that wrote the original charts. The best statistics I could find indicate that the Class 6 and 7 patterns in men over 50 years old are present between 23-30%. Assuming that the Class 7 pattern is 7%, then the Class 6 pattern is twice as common.

January 7, 2009

Hair Growing to the Edge of the Scar Where a Mole Was Removed – Hair Loss Information by Dr. William Rassman

I had a mole removed about a month ago, and the actual scar is healing very thin and good. The hair is growing right up to the edge of the scar from the top, and even at some points looks like it is growing through it. My concern is that underneath the scar, there is patches where the hair is scarcely coming in, and even patches where no stubble is visible. Can you shed some light as to how hair grows around scars, could the surgery have put the hairs beneath the incision into the resting phase. I have been worried about their growth and realize it’s way too soon to start thinking about FUE to fix the scar, although I realize it may be a solution if the hair doesn’t return to its normal growth. Any light you can shed would be greatly appreciated.

Yes, damage can be done when surgery is performed in the scalp. Sometimes, the hair follicles are amputated while the stubble remains and this may be a cause of hair loss from a local excision. The stitches that are placed can produce damage to the hair along the leading edge of the excised mole (as in your case). Wait it out a full 6 months and hopefully the hair will grow. If it is a problem, transplants work very well here.

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January 7, 2009

How Much Would a Hair Transplant Cost Me? – Hair Loss Information by Dr. William Rassman

Dear Doctor,
Im 23 and im a about 2 – 2A on the norwood scale (male pattern baldness on moms side, no balding on fathers). dark brown straight hair and my brother and cousins on my moms side all show signs of balding. I realize you are unable to make a proper evaluation of my hair characteristics with out photo’s and testing. But my question is this:

approximately what is the best, and all time worse case scenario on how much a hair transplant would cost me?

And I truly do realize it is hard for you to answer considering the circumstances so I will keep a very open mind on the subject. But there must be some rough numbers along with a brief description you could possibly throw at me to help get some idea on what a person like me should be expecting for the future. Thanks so much

Costs could range anywhere from $3000 to $10,000 on average depending on how much hair you need, but at this point you’re likely not to be a candidate. I couldn’t even begin to guess what an all time worst case scenario would be for you. If you’re worried about retaining your hair, I suppose the worst case would be that you develop alopecia universalis and lose all hair on your body, making hair transplantation impossible.

What you want to do is examine your scalp for miniaturization (here’s a handy guide to doing it yourself) and if it is present, you should try to prevent further loss by using medications. Surgery shouldn’t be the first solution you rush to, particularly as you are still young with very early hair loss. Finasteride (Propecia) is the drug of choice and requires a prescription by a doctor.

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January 7, 2009

Testosterone Therapy is Causing Hair Loss — Should I Stick it Out? – Hair Loss Information by Dr. William Rassman

I recently did a 3rd procedure with you and it turned out great. You did a scar revision which has reduced my scar width by at least 50%. In some places more.

Now the problem: My doctor has prescribed testosterone replacement therapy for me because of permanently low testosterone induced by the use of anabolics at a younger age. I have read in your posts where propecia or dutasteride might help negate the effects of hormone replacement therapy. Furthermore, the goal of the therapy is to reach ‘normal’ testosterone levels, not outrageous levels. I have been taking propecia for years, but when I started the testosterone gel (testim 1%) I started shedding like crazy. I understand that this can be one of the side effects.

My question is: In the past, every time I have used something like testosterone, after I stop much of the hair that I lose grows back. Furthermore, I have read that any kind of abrupt change to the body’s hormone level (such as starting Propecia for the first time) can cause hair loss. So, is it possible that I should just stick with the therapy and that I will shed, but that these hairs will grow back? Were they just induced to go into a dormant phase early, but will return? In other words, after my levels normalize and are not abnormally high, with propecia in the mix, can I expect to return to normal? Or is it that I basically have a choice – low testosterone for ever or bald?

I will talk to my doctor and I will see an endocrinologist about this, but I was wondering if you had any anecdotes about this particular kind of treatment.

Thanks

I agree that you should discuss this issue with an endocrinologist, as the problem is a bit complex. Unfortunately, I do not have any anecdote to share with you. At the least your transplanted hair will not be affected with testosterone. In theory Propecia should counter the DHT effects.

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January 6, 2009

Hair Loss InformationIs Finasteride Evenly Distributed in a Proscar Tablet? – Hair Loss Information – Balding Blog

I would like to thank you for this very useful resource, and your consideration of submmited questions. I have a question about Proscar- since Proscar tablets are not scored four ways- is the finasteride distributed equally throughout the pill, in other words could their be more potent peices of the pill. This was a concern I had about switching to proscar. Are you aware if the pills have an equall distribution of finasteride? It seems like they may not since they are designed to be halved not quartered.

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Proscar I can not imagine why Merck would weight the active ingredients in a tablet of Proscar (finasteride 5mg). I can’t say with 100% certainty, but I’d believe the distribution is fairly even throughout, particularly since the pill is likely homogenized. If it’s not perfect, it would probably be within a very small fraction of a percent difference. The Proscar isn’t scored, so you will likely get a little more of less each day anyway unless you somehow manage to get a perfect cut on an odd-shaped pill (see image at right). It’s a good question and although I did a little bit of research on it, I couldn’t find the absolute answer for you.

There’s an interesting thread at Drugs-Forum.com about splitting pills and ingredient distribution that you might find useful.

January 6, 2009

Gastrointestinal Problems and Propecia – Hair Loss Information by Dr. William Rassman

Hello Doctor,

I’m thinking of taking Propecia to combat my hair loss dilemma, but I have gastrointestinal issues that prevent me from taking certain medications. Even just taking a garlic supplement results in some intestinal pains. Would taking propecia be an option for me? Does Propecia have any recommendations for patients with other health issues to refrain from taking the drug?

The best way to find out is to try it yourself for a few weeks. Most doctors have professional samples in their offices which will allow you to try it. I would doubt significant GI problems would appear, but try it and find out.

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January 6, 2009

In Case of Emergency, Ration Propecia – Hair Loss Information by Dr. William Rassman

I recently went hiking/camping on the Appalachian trail for 9 days, and only managed to bring 3 days of propecia medication. My poor packing skills brought up the question: What is the best way to ration/use propecia medication in this situation? – Once a day for the first 3 days? Once every 2 days? Cut the pills in half?

thanks for your time

I would have taken the Propecia every other day and cut the pills to spread it out. 6 days may not matter in the grand scheme of things, though. There is no right answer in a situation like that where you made a mistake. Do your best to spread the medication out so there’s not too much time in between dosings.

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January 6, 2009

Hair Loss Information » Indian Finasteride – Balding Blog

I am taking Propecia for the past 4 months.However being a student, I find it very costly and would like to take the generic Popecia.On talking with my family doctor in INDIA ,I got to know that the generic Propecia made by Dr Reddys Pharmaceuticals is FDA approved and also much cheaper. FDA.gov

The Doctor who gave me a prescription for Propecia in Boston says that the medicines from India do not contain Finasteride at all and should not be taken.Also I read in an earlier question about the same issue u had answered that the Propecia from India is not FDA approved and is of Poor quality.But Dr Reddys Pharma Claim that their Product has been FDA approved. Should I ask my Parents to send me the Generic Dose from INDIA or continue using the Brand Propecia as cost is a major issue.Also wanna know if using the Generic Propecia will give the same results. (Dr Reddys Pharma is considered amongst the best Pharmaceuticals in INDIA.)

Dr. Reddy’s Pharmaceutical Company is well-known and I believe that their generic Propecia is FDA approved. I wrote about it before. To get approved by the FDA, the company must show that it contains what it stated on the packaging.

The distribution of finasteride should be equal throughout the tablet (1mg or 5mg tablet), but I conclude that by using my common sense. I can not tell you what to do, but many people who use the Dr. Reddy’s finasteride products say that it is the same as what is sold as Propecia or Proscar. You should know that getting the generic 1mg pill into the US violates Merck’s patent, which is why it is illegal to sell the medication in the United States.

January 6, 2009

Oily Scalp and DHT? – Hair Loss Information by Dr. William Rassman

Does oily scalp causes DHT to bind with the follicle?

Does thyroid problems has anything to do with hair loss?

An oily scalp has nothing to do with DHT. DHT is associated with the presence of testosterone and if you are balding, the DHT is probably responsible for it.

Thyroid problems can cause hair thinning and hair loss, but it is generally not a problem for most men.

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