Author: Dr. William Rassman

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Touch-Up Hair Transplants – Hair Loss Information by Dr. William Rassman

What are your thoughts on “touch up” transplants? I am currently 27 yrs old and have had thinning in my front forelock since I was 18. When I was 24 I started Propecia and although it has progressed (from the size of a dime to a quarter) It has been slow.. This makes me think that my problem could be solved with 800 or so grafts. The rest of my head has good thickness. I realize you’re going to recomend a “master plan” and “hair mapping”, but if you could include your thoughts on touch up’s. It would be appreciated. Most importantly on what criteria you would recomend them, if any.

thank you.

It is impossible for me to tell you about your hair loss and treatment plans from a simple blog posting. You seem to know about the importance of a Master Plan and miniaturization mapping and with any transplant work that you are considering, anticipating the future direction of the hair loss is critical to balance things like:

  1. Supply/demand of donor hair use
  2. The rate of hair loss for following your progressive hair loss over time
  3. Budgeting appropriately to follow-through with what you start

If you are concerned about your hair loss, your next step is to see a good, honest hair transplant doctor. If you saying that you already had a hair transplant or two or three, and this is a touch-up (meaning another small hair transplant procedure) you should ask your doctor how many more of these are needed to make sure that you know where it will all end sometime.

Sometimes patients come to me with a preconceived number of grafts they need. Often times these numbers do not match their expectations and the real needs to achieve the goals. Everyone’s needs and the criteria for choosing the numbers of grafts are different based on hair color, skin color, hair texture, head shape, etc, etc. See Patient’s Guide — How Many Grafts Will I Need?

I do not understand what you mean by a “touch up” transplant. You should either have a hair transplant to meet your goals or you should not have a transplant at all. There are some patients who may come back a year later for more fullness or address other areas and as there may be a risk of shock loss, you need to prepare a worst case scenario. You may see this as a “touch up”, but as you can see, it is related to the goals and expectations of a hair transplant program.

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Will Propecia Ruin My Chances of Using Stem Cells In the Future for Hair Loss Treatment? – Hair Loss Information by Dr. William Rassman

Hi Dr!

I am 21 years old and I am struggling with hair loss. I spent a lot of money on laser treatment, but it is now a year later and my hair is back to looking terrible! should i begin propecia? if a cure for baldness ever comes along with propecia ruin my chances of using it? (stem cell) thanks! i need help bad!

(I am also afraid of the side effect of propecia)

The simple answer to your question is probably no! The medication (Propecia) is gone from your blood stream in a day or two and probably out of your body in under a week or so. If you are genetically balding and take Propecia and experience side effects, you can stop the medication and the side effects will go away.

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Why Does the Back and Sides of the Head Not Lose Hair? – Hair Loss Information – Balding Blog

Hi,
lately we were discussing baldness, and we ended up with a couple of unanswered questions. A lot of people lose their hair, only on top of the head, but we couldn’t find out why. A friend of mine told me that the hair on the side and the back of your head belongs to the bodyhair, and therefore you don’t lose it. Is this true?

Thanks in advance!

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Most cells in our body have a ‘death’ time programmed into them. For reasons unknown, part of the hair on the scalp in about 45% of the male population may have programmed earlier death (the balding pattern seen in balding men). This patterned hair loss does not impact the hair around the sides and back of the head, the 3 inch wreath of hair we call permanent hair. Men generally do not lose hair on the sides and the back part of their scalp, because it is a genetically programmed trait not to lose the hair. This fact allows hair to be transplanted from the back and side of the head (permanent hair) to the balding areas. Furthermore, hairs on the side or the back of the female scalp are not generally considered permanent and when they have female genetic hair loss, it is usually a more diffuse type of hair loss impacting the hair all over the head. This is why most women are poor candidates for hair transplantation as they do not have this permanent wreath of hair around the sides and back of the head.

There has not been a good explanation that I’ve heard for this permanent rim. There was an interesting book I recall titled Sex, Time and Power: How Women’s Sexuality Shaped Human Evolution by Leonard Shlain, who had proposed a connection that might explain male patterned balding. He postulates that man’s history really goes back to tribal living when we had 150 people in a tribe (no large civilization existed at that time). He noted that 7% of men had extreme balding, and the same number of men were left-handed, color blind, and gay. He postulated that in the days when men hunted, there were left-handed spear tossers, men who could see through the camouflage of animals (color blind), men whose heads would go above the bush to spot game animals would not frighten the animals (animals knew to run from men and balding men did not look like men to these animals). The same number of men had to stay ‘back at the camp’ and protect the women (gay men). Not a bad guess, eh?

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Hair Loss InformationI Found this List of What I Can and Can’t Do After Surgery… – Hair Loss Information – Balding Blog

Hi Dr. R!

Captain Forehead here. I’m one week post-op. Staples are good so far. Not too much discomfort.

Wow, there is SO much different info online about what you can and can’t do after surgery. I found this elsewhere on baldingblog.com, a very helpful guide.

Patients…

* Can lie flat
* Can have full aerobic exercise in 1 week (even run a marathon if they want)
* Should limit weightlifting greater than 25 lbs for 4 weeks and keep the back straight
* No sit-ups or pull-ups for 4 weeks
* May play with pets in 1 day (but no licking the transplants by your dog until the crusts are off – it had to be said)
* Smoke and dust in the environment are not a problem unless you are not clean
* Passive sex is ok for the first 2 nights, then everything after is a go

It’s just weird ’cause sometimes I feel more tension while yawning than I do after the pushup I just tried, of course while keeping my head totally back!

I guess I’m just writing to say, I wish I knew for sure how “zombie-like” I have to remain after surgery and how much of my history of widened scars is due to junky genetics.

Thoughts?

P.S. See ya at the Open House in L.A. this Saturday!

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You don’t have to be a zombie after a hair transplant surgery. The precautions are so that it protects and minimized the donor area scarring and most of the rules are to protect the people who are not generally careful and do unsafe things. I am generally open to shortening all of the time lines with more careful people. To simply think about it, the more tension you put (sit-ups, etc), the more there is a risk of widened scarring when your neck muscles are pulled. You will know that if you put your hand on the back of the neck and see how much pull you get from what you are doing.

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Hair Regrew After Chemotherapy — Now It’s Falling Out Again! – Hair Loss Information by Dr. William Rassman

i lost my hair from chemo. it all grew back, but my problem is now it seems to be falling out again and i’m not sure what to do or if it will all fall out again. could you please help me

Hair will generally regrow after chemotherapy. Your new hair loss problem may not be due to chemotherapy. There are many causes of hair loss and the chemotherapy may have had something to do with other organ system, the general state of your health, etc. There may be other medical issues that you are not aware of so the hair problem may reflect some other systemic problem. Be sure to get your doctors involved in your problem.

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Hairline is Thinning, Face is Aging — Stress? – Hair Loss Information by Dr. William Rassman

Hi,
I began noticing a very slight loss on my front right side at about 29yo, though everyone told me I was crazy. Since then, I have moved to NY and have remarkably increased stress level. After being here 2 years now, I’m 32 and have noticed my hairline thinning more and my face aging. Is this all due to stress, or is it just the aging process coincidentally starting at the same time my stress level increased? Btw, I’m a male; my father was not bald until he had chemo at 50; my uncles all have their hair; my grandfather on my mom’s side was bald. Since graduating college at 28, I have been through a lot and my diet has gone downhill for lack of money. I was a vegetarian for 8 yrs until about 28.
Thanks.

We have seen aging differences in twins where one is more stressed than the other so, yes, stress changes the rate at which we age. Male pattern balding is a genetic process that is certainly accelerated by stress. If you can barely see it, then you should get your hair mapped out for miniaturization so that a diagnosis can be made.

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How Much Time Should There Be In Between Transplant Procedures? – Hair Loss Information by Dr. William Rassman

Dear doctor,

last week i underwent a 2500 grafts transplant to my front and sides of the head, however i still need another 2000 grafts to cover the
crown.

my question is – what is the average time gap between two transplant operations ?? when should i go in for the second tranplant?

Also is it necessary that i take medication after these transplants.

The spacing of hair transplant procedures should be at least 8 months apart to allow the grafts to grow from the first session. I always tell my patients that when they see the growth, they will know:

  1. If another hair transplant is needed, and…
  2. Where these grafts are needed in the second session

The only medication I recommend after a transplant is Propecia to arrest or slow the progressive nature of genetic hair loss. I suggest taking the medication before the transplant as well.

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Perfectil Supplement for Hair – Hair Loss Information by Dr. William Rassman

I know taking too many vitamins can cause hair loss, but do you think taking (perfectil) which is a beauty supplement for hair and skin,would be ok while I am still having a balanced and good diet?

Best

While I doubt it will hurt you, I do not know what effect it will have on your health and hair. All supplements in the U.S. are relatively unregulated since they are marketed under the guise of a natural food product. I do not endorse any such products. It is a buyers beware market. Use at your own risk.

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Avodart vs Hair Transplant – Hair Loss Information – Balding Blog

I was wondering if you give prescriptions for avodart. I had some frontal transplants in early 90’s but continued to lose behind transplant..i now wear a hair system and Have learned to live with it…i need to keep what hair i have in the back and on the crown so my systems do not have to be made any larger..I have been doing alot of research about avaodart..i was able to get a sample pack (2 weeks) from a dr friend..but need prescription to get more…

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Avodart (dutasteride) should not be the first line for you unless you are sure that Propecia (finasteride) is not working. I would be happy to evaluate you, but the few times I have prescribed Avodart, I had good reason to do it. The side effects on Avodart are more than the side effects of Propecia. If you have a void now developing behind the old transplants, have you considered fixing this (it is relatively easy)? It may allow you to get rid of your hair system. In any event, you need to have miniaturization analysis before any treatment to know what is happening to you.