Author: Dr. William Rassman

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A Bargain Hair Transplant? Not Quite! (with Photos)

The following comes from Dr Paul Cotterill in Toronto, Ontario, Canada:

Here is an example of why proper training and regional workshops are a pretty good idea:

I saw this patient in my office yesterday that was referred to me for assessment. This 38 year old fellow ( Class IV-V ), had a transplant 4 weeks ago in Ludhiana, India. He felt that the procedure didn’t go very well.

On examination the crown had been transplanted with 60 – 65 punch grafts that were 2-3 mm in diameter and the distance between grafts was 1 – 1.75 cm, very irregularly, across the crown. Peri-folliculitis was evident and residual crusting on some of the grafts. There was up to 7 hairs in some of the grafts. The grafts were removed via FUE from the occipital area. The procedure took 1 hour and he was told to return next month for a second session of the same. The cost – $500.00 for both sessions.

I have swabbed for C&S what I could, cleansed the scalp, started an antibiotic and suggested Propecia, with follow up in 1 week. He would like further sessions to the crown. He needed a proper consultation as to planning and the consequences of starting the crown in a 38 year old with certainly further thinning in the future. Further sessions at this point are unwise. I will be following up with him closely.

Dr. Cotterill has given me permission to repost these photos. It is unfortunate that people treat a hair transplant procedure as if they’re just getting a haircut. This is surgery! You want to do your research and know what you’re getting into. How could anyone recently get the old, ugly plugs of decades past? It’s disturbing on many levels. So he only spent $500 on 2 sessions to get this look. Now how much time and money will he have to spend to try to undo this foolish mistake? A bargain indeed.

Click the photos below to enlarge.

 

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96 Percent of Men on Propecia Have Persistent Side Effects?!

Hello Doc,

Please go through this ridiculous article in Yahoo.

Link: For Some Men, Propecia’s Sexual Side Effects May Be Long-lasting

Please tell me what you think.

Thanks

There are a great deal of claims that may accurately reflect the patient example, however, the documentation and balance of the presentation is poor and heavily biased. Read it accordingly.

It’s worth pointing out that this recent hysteria is just based on interviews with 54 men, where the participants reported their own issues after stopping the medication. Even more important is to note that these men were recruited from PropeciaHelp.com, an anonymous web forum where men post about problems (real or otherwise) they have from the medication.

The surprising 96% figure gives the media a good, scary headline to get people interested in watching or reading their report. For example, I just saw a quick 20 second segment on my local morning news that said “96% of men have persistent side effects”, but provided nothing else beyond that. It’s very alarmist and misleading.


2012-07-13 10:13:1596 Percent of Men on Propecia Have Persistent Side Effects?!

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A Good Hair Transplant Made Great (with Photos)

Once you have a follicular unit transplant (FUT), if the procedure was done with care, there is no question that the results can’t be detected in any casual encounter, or even on close inspection in most circumstances. Yet with that said, there is still a difference between patient results that go beyond the characteristics of (1) hair shaft thickness, (2) hair character, and (3) hair color.

Let’s take a look at a patient who had two hair transplant procedures. The patient is Dr. Jon Perlman, the well-known Beverly Hills plastic surgeon that has been featured on ABC’s television show, Extreme Makeover. After his first session, he had good results that nicely framed his face when his hair was groomed. But on close examination, his hair was somewhat see-through. Dr. Perlman has very fine hair, so the bulk of each hair shaft was lower than average. By undergoing a second procedure, the bulk was doubled and the results shown in the pictures below say a great deal about the change he experienced. He was more-than-satisfied after the first procedure and thrilled after the second one. A good transplant became a great transplant.

Sometimes patients will tell me something like, “I don’t want it too thick and I am afraid if I put too much hair there, it will look unnaturally thick.” In all of the years of doing this surgery, I have never, ever had a patient who told me that I had made the hair too thick in a single session. We have seen many of our patients (initially satisfied, but wanting more hair) receive another transplant and become transformed back in time to their youthful look. By performing NHI’s pioneering dense packing procedure, we can increase the density of hair in a single procedure, often reducing the number of procedures needed to obtain results like the one shown here, but when the hair is super fine (like the example below) then two sessions may be needed. For many people, hair is like money — the more you have, the better it is.

Click the photos to enlarge.

Before and After 2 procedures (2890 grafts total):

 

For more photos, click “read more” —

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Before (left) and immediately after surgery (right):

 

After 1st procedure (1529 grafts):

 

After 2nd procedure (1361 grafts):

 


2011-02-03 13:24:30A Good Hair Transplant Made Great (with Photos)

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A Few Weeks After Switching from Finasteride to Avodart, I Saw Major Shedding

Hello Doctor,

My question is: Ive been taking proscar 2.5 mg for a while with good results, after some time i felt that it wasnt working that good anymore. Regardless, one day i visited a local hair surgeon and after a brief talk about surgery the discussion moved on to hair medications, which he told me that i should switch to avodart (which he’s taking as well) so i did.

The first few weeks was awesome, after that i am experiencing major shedding which continued for the past 2 months (i’ve been on it for 2 1/2 months) so i dont know whether to switch back to finasteride or wait to see what happens with the avodart?

Honestly, you need to ask your doctor. This is a prescription medication that I did not prescribe to you. I can’t tell you whether you should switch between medications. Sorry.

avodart, dutasteride, finasteride, propecia, hairloss, hair loss

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A Doctor Told Me Trichology Was a Hoax

Dear Dr Rassman,

Hi, i am a 20 year-old Asian male serving my country’s conscription policy and i am suffering from male-pattern balding. My receding hairline is most obvious at my temples. I have realised that this spurt in receding is particularlly so during my service, which i blame the constant wearing of the helmet for. Moreover, my hair is rather greasy. Is there any tips to stunt the hair loss or is there any products recommended to cause hair regrowth?

I have also heard from a medical doctor that such thing as trichology is a medical hoax. Companies masquerading as the solution of hair regrowth lack any proof of medical and scientific evidence for their claims. Is this true? Last but not least, my twin brother is also suffering from a similar fate and i strongly suspect that this is highly hereditary given my father’s current look.Looking forward to your reply. Thanks.

To practice trichology, you do not have to have any medical qualification. If you are interested in learning about hair and helping people with their hair problems, you can focus on this field and get licensed in most states in the same licensing branch as cosmetology. On surfing the net, I found The Institute of Trichologists (based on the UK, but with offices all over the world), which is just one of many such sites pushing for trichologist training.

Hair loss is genetic — wearing a helmet or having greasy hair/scalp will not cause more hair loss. If your twin is identical he will have the same hair loss pattern you have, if your hair loss is genetic.


2008-10-02 15:00:13A Doctor Told Me Trichology Was a Hoax

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A Few Hairs Are Weak and Wavy in My Otherwise Straight Hair

Hi,

I’ve noticed that a few of the hairs at my hairline have become ‘wavy’ where as most of my hairs stand straight. Is it the case that these hairs are miniaturising?

They don’t appear to be thinner in diameter than the hairs next to them…but also don’t seem to grow as strong (i.e. they ‘fall down’ rather than grow straight up).

Thanks in advance.

The weaker hairs you’re seeing could be miniaturizing, or it could just be that you’re seeing hairs in different parts of the hair cycle. Without seeing you, I have no way to know.

If you want to know if you have started the balding process, looking at one hair at a time is not the way to go. See a doctor who will measure your hair bulk in different parts of the scalp. Balding people (even in the early part of the process where you can not see any thinning) will always show a reduction in hair bulk.

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A Chemical May Help Cure Alzheimer’s Disease

Resveratrol, found in wine, actually in the grape skin, might help in the fight against Alzheimer’s Disease The skin of the grape is a potential treatment for a variety of age related disorders, reported from the Georgetown University Medical Center in Washington DC. In the disease, amyloid-beta protein is deposited in the brain and is associated with this disease, but in a study of 119 people with mild to moderate disease, taking 1 gm of resveratrol twice a day for a year, researchers did not see a significant accumulation of these amyloid-beta deposits. The study is small, so few conclusions can be drawn from this, but there seems to be no harm in taking this drug in these doses, so maybe it is worth a try in those who think that it might help their brain function, particularly if they or a member of their family may have this awful disease.

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A Few Years Ago a Bald Spot Appeared at My Hairline…

A few years back I lost hair in a small area on the front of my scalp. My hair has not thinned anymore or anywhere else. Just this one spot on the front on my scalp, almost like a receding hairline but only one one side? What could it be?

You need to get a good doctor to look at it. There are many things that can cause a single spot of hair loss and a good dermatologist should be able to make that diagnosis for you.