Author: Dr. William Rassman

“The waiting is the hardest part.” – Tom Petty and…

“The waiting is the hardest part.” – Tom Petty and the Heartbreakers

If my chronicle of hair had a theme song, that 1985 hit would be it. But let’s go back in time and set the stage.

When I first met Dr. Rassman, I had $2500 saved up to populate the barren wasteland known as my forehead. “If I could just lower my hairline 3 inches, all would be right with the world,” I thought. I had everything in place prior to my first consultation with NHI. I knew the day of the week I’d want my procedure, what movie I’d watch during the procedure, and what lunch — an egg salad sandwich — I’d be enjoying during the procedure. The stage was set. And then…

“I’m not going to do $2500 worth of work on you.”

“I’m sorry, what?”

“Your goals require approximately four times that much hair, and I’m not going to put you in a position where you MUST come back for more work. You must approach each procedure as a stand-alone procedure, not something that will leave you incomplete and dissatisfied.”

“Dr. Rassman, the other three places I met with said I could move forward and have a procedure with $2500.”

“If they can show you one patient, just one, who lowered his hairline that much with $2500 worth of work, then proceed with them. My experience tells me the math doesn’t add up.”

I walked out of the NHI office that day thinking, “That’s the most interesting and somewhat irritating business model I’ve ever encountered. He won’t take my money?”

So began my true follicular education. I read all the peer-reviewed journals published by NHI. I visited the office again to watch a procedure being done. I went to three NHI Open House events to meet as many patients as possible. They clearly had nothing to hide. It was then that I fully respected Dr. Rassman’s decision not to perform my surgery right away. He encouraged me to approach my hair restoration as a lifelong plan. After all, we’re not dealing with an infinite supply of donor hair here! Every graft is critical!

The morning of my first surgery, Dr. Rassman, being acutely aware of my financial situation back then, took a moment to inquire as to how I saved up the money in such a short period of time.

“That was easy, doc. I moved out of my apartment, put my belongings in storage, and slept in my car for a few months. That dedication is deserving of two egg salad sandwiches and a hot fudge sundae, right?”

“You’re serious?”

“Yep!”

After three months of checking the mirror for any sign of hair growth, the first evidence was revealed! I was told to basically forget that I had surgery for the first few months since it typically takes that long for the new hair to begin growing. Yeah right. I was in front of the mirror every day without fail. The waiting definitely was the hardest part!

Ten years, two surgeries and approximately 5500 grafts later, I’m happy to say that I no longer think about my hair loss. The hairline has been lowered and the temple regions have been moved forward, resulting in a completely natural looking frame to my face. The barren wasteland is now a thriving metropolis thanks to the New Hair Institute!

NHI is family. They don’t sugar coat anything, and they ensure your expectations are realistic. For that I am forever grateful.

I wrote the original article on Diffuse Unpatterned Alopecia (DUPA) and yes, a hair transplant should never be done if you have this condition. However, too many young men assume that they have DUPA, and that is wrong. Get the diagnosis confirmed by an expert like me with microscopic examination of the donor area and a metric on the degree of miniaturization present in the donor area. The picture below cannot, without such a miniaturization analysis, arrive at a DUPA diagnosis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691938/

Conclusions of article: Minoxidil is a common medication prescribed for treating hair loss-related problems. It provides remarkable benefits to patients with hair disorders. To date, the FDA has approved minoxidil only for AGA. However, minoxidil is used off-label for treating several hair disorders as well as increasing body hair growth. Although topical minoxidil is considered an effective and safe treatment option for various hair disorders, additional evidence-based data are needed for some applications.

Other mention: Salicylate and aspirin can inhibit sulfotransferase. A recent study showed that the follicular enzymatic activity decreased following 14 days of low-dose aspirin use. Thus, prior or concomitant use of aspirin decreases the clinical response to topical minoxidil.

Just want to preface this by saying that I’m all for fighting hair loss in any way you want if it’s what you wanna do. I’m genuinely not here trying to sway anyone one way or the other. That’s why I’m not even gonna mention what I’m doing/not doing for my hair loss. Just wanted to comment on how some people in the hair loss community might have a bit of an unhealthy relationship towards balding and I think we all torture ourselves more then we need to.

I had to say that I had a very enlightening talk with my therapist and also spoke with some of the good people on the r/bald sub and it was quite enlightening for me. I’d realized that it was super unhealthy to obsess about image and my hair to the extent that I was doing it (in the back of my head at all times, sucking all joy out of my life at the worst moments)

realized that a key for me was to not catastrophiez hair loss more then it needed to be and to realize that even the one thing I was fearing most in the whole world (being bald) is not something that’s that bad.

If we wake up bald tomorrow our family will still love us, our friends will still be there, we will still enjoy every hobby, tv show, movie, video game, book, interest that we had prior. It will be an adjustment period sure, it’ll be weird to look in the mirror and you’ll have to relearn to like how look the same as when you had hair and also for a little while after our loved ones will have to get used to the new look. But then after a few months at most, life will go on just how it was before. Having that mentality of ‘whatever happens it’ll be ok’ is so important in this situation.

I think most people who lose hair young torture themselves much more then they need to by making the stakes in their head so high. If you think being bald is a death sentence then of course you are going to stress over it 24/7 and drive yourself mad. If you think balding is just a natural part of life that happens to many people, just like wrinkles or skin sagging or any other changes our body goes through over the course of our entire life. If you convince yourself that if it happens to you it won’t be a huge deal, then you will have a much healthier perspective and be much more comfortable, whether you decide to fight your hair loss or accept it. Bring down the stakes a little, it’ll be a weight off your shoulders:).

So yah I think this sub is great and that if you want to fight your hair loss then by all means, more power to you. I just think that some people on here could tone down the animosity and negativity regarding certain topics and I know that if people had a healthier perspective and relationship with their hair loss and overall body changes then they might be a lot happier and more calm with whatever they decided to do. Even the worse case scenario for us would be ok so we don’t need to be as terrified as we think.

Wanted to get this off my chest because I recognize a lot of myself in the people on here with how I see them stressing so much with this all or nothing mentality and making the stakes so high in their heads that they spiral into bouts of depression.

Again nothing wrong with taking finasteride or whatever other method if that’s what you want and you’ve balanced the sacrifice/reward in your head. Just want people to know that they should do this because it’s something they want that would bring them pleasure, not because they should feel like they absolutely have to or else their life will be over because that can lead to being in a bit of an unhealthy place mentally.

This is all, thanks to anyone who read this far, wish you the best

If at the 8 month mark I desire more density, would another operation be appropriate or should I wait until 1 year?

Since 95% of the growth (possibly not length but growth) occurs within the first 8 months, a second surgery can then be done if the desired goals are not met. By the 8th month, you will have a good idea what the value of the first transplant is.

I’m a 22 year old male with androgenic alopecia and diffuse thinning. I’ve been balding since I was 18 years old.

Recently, I’ve been experiencing very rapid shedding all over my scalp (top of the scalp, donor area, and both sides of the head). I went to my dermatologist and had a scalp biopsy (4mm, punch) done to make sure it wasn’t alopecia areata. Turns out, it’s telogen effluvium due to various stressors. 12 days later, I got the stitches removed from the area.

BUT

The hair that is currently growing out and closely around the biopsy site are probably the thickest that they have been in YEARS.

I currently use a topical minoxidil 7%, finasteride 0.1% compound solution ((been using for 1 month), stopped taking finasteride tablets due to sides (used for 2 months)) and I use a microneedling pen (1mm, once per month). Although I’ve had very subtle hair regrowth on my hairline and slight thickening on my temples, the hair from the biopsy site feels and looks thicker than most of the hair on my scalp at the moment.

I’m aware that it may seem like an “illusion” due to my current TE condition, but it honestly feels much more thicker than before the initial shedding started. It almost nearly resembles the texture that it was from when I was a teenager.

If anyone is familiar with the biological components of hair loss and hair regrowth, I would love to hear from you about this matter.

Wounds sometime stimulate hair growth much like microneedling does