Author: Dr. William Rassman

I was wondering if balding is common, or am I just singled out to be bald while most men are not?

The incidence of balding varies with age, according to an article published by Dr. O’Tar Norwood in his 1975 male pattern baldness article in the Southern Medical Journal. This is reflected in the below diagram (and quoted text), borrowed from the textbook titled Hair Transplantation, by Dr. Walter Unger.

“(A) Incidence of different degrees of male pattern baldness compared by age. (B) Differences in incidence of male pattern baldness between Hamilton’s and Norwood’s studies, with Hamilton’s findings being consistently 20% to 30% higher.”

The frequency of balding is dependent upon age. Dr. Norwood reported it at about 35% in the 50 year old male, Dr. James Hamilton reported it at about 55% in the 50 year old male. As age goes up, the frequency of balding is higher, peaking in both authors studies at about 65 years old (55% and 85% incidence of balding in Norwood and Hamilton, respectively). It should be noted that Dr. Hamilton introduced his hair loss classification scale in the early 1950s, and Dr. Norwood revised this some 20 years later.

You have a pattern of balding that indicates that you will probably lose all of the hair on the top of your head, maybe the frontal forelock will remain, maybe not. Based upon your skin color, I suspect that you may have an Indian heritage which means to me that your donor supply will be lower than the donor supply of the typical Caucasian. Your doctor needs to build a Master Plan with you, measure your donor hair density and donor supply for the long term. This will determine not only what you need now but what you will need in the future as well. I suspect the first surgery will take at least 2,000 grafts and further surgeries in the next few years may be required as you lose the rest of the hair on your head. I also suggest that you consider taking the drug Finasteride to protect the hair that you have left for both the short and long term.

Plan on getting a HT I have an autoimmune disorder called LPP & the top of my head started thinning really bad about a year ago hair falling out in clumps flaky I’ve tried meds and everything there’s not much they can really do . It’s killed my confidence but I’m looking at getting a hair transplant to correct my hairline how many grafts would I need? Its just the top of my head thats needs to be filled in I have a really good donor area and I’ve been thinking about a HT for awhile now if anyone could give advice thanks

Having LLP (Lichen planopilaris) is generally a contraindication for a hair transplant, as the odds are that the disease will kill the grafts.

To answer the question of how many grafts it will take, I will have to know the thickness of your hair (fine, medium or coarse). The range therefore would be 2,700 for fine, 2,300 for medium, and possibly 2,000 for coarse hair. From the photo, it is evident that you are balding behind the line you drew, so extra grafts should be considered for this area depending on how far back it goes.

Both sides have identical recession as shown here.

Assuming that you just want to fill in the corners and create a normal mature hairline, and assuming that your hair is at least medium in thickness in the back of your head, it would take about 1500-1700 grafts, depending upon where you and your surgeon place the exact location and shape of the hairline. A coarse, hair will drop the numbers while fine hair will increase the numbers. I have been doing hair transplants for 32 years and adjust the graft numbers to the donor supply, the balding pattern, the donor density the donor hair thickness and getting to know the patient and his expectations, so even the above estimate may change.

Hi there,

I live in Canada, and unfortunately no one here provides miniaturization tests or hair bulk analysis. I understand Dr Rassman has offices in California and NY? Would it be possible to have these done if I came to one of his offices? Also, how much would I be looking at in terms of charge to have this done? I really have been trying any way I can to get a professional opinion with my hair, if I am over reacting or if there is something more going on. I would just like to know for sure, so I can determine my best plan of action, or if I need to be concerned at all. Any help would be much appreciated.

Thanks for your time.

We do this as part of a free consultation in appropriate young men. Our office is in Los Angeles, California. If you’d like to travel from Canada to see me or Dr. Pak, you can request a consultation via our website here. You might wish to send photos in advance of making any travel plans so that we can have an idea of what your loss is prior to your appointment.

If you decide to go to someone more local, just make sure that any doctor you see has the HairCheck instrument to measure your hair bulk.