Author: Dr. William Rassman

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Doctor Charges Per Procedure, Not Per Graft

Thank you for taking the time to maintain this website. I met with a hair loss consultant last week for the first time. He recommended that I have 2500 grafs on my forehead area and a second transplant a year from now on the top of my head. Why not just have it all done at once? He claims that they dont charge per graf, but a flat fee regardless of how many transplants they do. Is this just a opportunity to make more money for a second procedure?

If the consultant you spoke with was not a doctor who does the surgery him/herself and is trained in hair transplantation as a specialty, then he/she is practicing medicine without a license and I would run for the hills. There are some clinics that promote consultants to recruit patients and I have seen some people get recommendations that are way out of line with their need. Doing more than 2500 grafts depends upon:

  1. The size of the bald area being treated
  2. The donor density
  3. The looseness of the donor area skin (laxity)
  4. The skill of the surgical team (only some teams are capable of performing 5000 grafts at one session)

Fees are generally priced per graft, but that is not a hard and fast rule. Whatever the basis for the charge, it should be both competitive to what a quality medical group would charge and show value for what you are going to receive (result focused of course). Selecting a doctor should follow the science I have outlined in How to Tell if You’ve Found the Right Hair Transplant Doctor.

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Do you think that microneedling daily is better?

I’ve read about someone microneedling daily, with a dermastamp I think, at 1.5mm, with great results. Do you think this is unreasonable or even risky? Or just ineffective or suboptimal? It did seem to work for that person.

There is no reason to microneedle daily. There is a wound healing cycle that microneedling invokes and this can be stimulated once a week reasonably well.

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Is Dupa caused by classic genetic balding?

Maybe. There is no obvious genetic link to the Classic DUPA (Diffuse Unpatterned Alopecia) we originally reported in the Journals. I have, in some patients, seen genetic balding also present (not that common) and when I do, I warn these patient never to have a hair transplant because it will fail.


2020-04-19 09:23:35Is Dupa caused by classic genetic balding?

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Doctor Gave Me Betamethasone for My Hair Loss

Hi I am 26 years old and I recently moved to a new country for the 6 months but I noticed that I have been gradually losing hair for the past year or so(even while I was still in my home country). I’ve seen a local dermatologist here in Taiwan but I am having some reservations about him. He did a hasty (literally) 2 min. check-up, where he just casually looked over my scalp and he didn’t bother to ask me any questions about my family history or my lifestyle hair. He just immediately related my condition to the stress of moving to a new country. Afterwards, he sprayed nitrogen of some sort into my hair, he told me to come back once a week and then gave me a prescription for betamethasone (apply 4 times a day) and polytar liquid to wash my hair once a day. I am wondering if it’s time to find a new doctor? What kinds of procedures should I expect in my first meeting with my doctor? How should I go about finding a good one? Thanks in advance

I believe that you are right to consider getting another doctor. You actually know what to look for in a doctor by your description:

  • One that gives you the time for him to ask questions about you and your family history of hair loss
  • One that does a thorough hair and scalp examination including a study of the hair for miniaturization analysis
  • One that answers your questions and engages you enough to give you the trust you need

Sounds like his treatments are everything (including the kitchen sink), but I think that you know that the kitchen sink will not bring your hair back. If you were my patient, I would advise you to stay away from betamethasone, as it is a steroid which might hurt you with regard to producing even more hair loss. Good luck.

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My Doctor Told Me I Have Extensive Alopecia Areata

I am a 26 year old women with what my doctor called Alopecia Areata and it has left me with many holes on my head. He said it may go away on its own, or it may last years. I want to know if a hair transplant will solve my problem.

Hair Transplants are contraindicated in alopecia areata because any hair that is put into the bare areas, may get rejected by the disease and even cause further hair loss. You can, of course, wear a wig as so many women do with this condition. The winner of the Miss Delaware contest had Alopecia Areata and you can see how she managed her hair HERE and: HERE

Bald is definitely beautiful.


2014-12-10 12:26:34My Doctor Told Me I Have Extensive Alopecia Areata

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Do young men respond to finasteride better than older men?

I remember you saying that younger men tend to respond to finasteride well. Is that true? If so, how?

Yes, that is true: When hair is recently lost, reducing the impact of DHT which suppress hair growth can be block by this drug in younger men. The longer the hairs are either miniaturized or have disappeared from your scalp, the harder it is to bring it back.


2020-12-04 11:30:31Do young men respond to finasteride better than older men?