Author: Dr. William Rassman

The hair loss behind what is still a strong hairline. In some Indian men, these strong hairlines can persist for many years even if the hair behind it goes. His pattern from other photos not shown here, is almost certainly going to develop into a Class 6 pattern so I told him to postpone surgery at this time. He should try the drug Finpecia (available in India) as this drug might reverse the hair loss especially when used in conjunction with minoxidil.

Too many young men want to rush hair transplants and too many doctors are happy to take their money and do it; however, hair transplants done too early, may leave the man with a balding pattern that the doctor and the patient never planned for (and that would be bad for the patient but the doctor has already pocked the money and I am sure it cleared his bank account)

I am 25 years old suffering from hair loss . I had a FUE Hair transplantation of 2000 grafts for the hair line but the results was not full and I believe now that I need more hair in the top and the vertex area. Can I do another hair transplant?

Your surgeon should have made a Master Plan for you knowing your donor density so that your surgeon could then know if your donor density is adequate to support a second hair transplant. Sometimes a strip surgery may be better for the second hair transplant if the donor density appears to be thin from the first surgery?

You need to sit down with a good doctor and get an examination that might predict your hair loss pattern. If that can be predicted (I often do this with the HAIRCHECK test), then your course after a single hair transplant might be anticipated. There is never certainty as I use the tools I have to give people the best assessment of their course over time. At our Monthly Open House events we have patients who had one or two hair transplant sessions and did not need anything after. If you come to one of these events, you can meet these patients one-on-one. The older you are when you start, the more predictable the risks, but if you wait, then you will learn to live with balding while you are younger, something most men who see me don’t want to do.

Considering a hair transplant but thinking about long-term commitments post-op from tressless

Should I get a HT ? Im 23 i used minoxidil for 2 years and did nothing just stopped the shedding so what you advice me to do ?

This is a wonderful result and shows the power of microneeding at maximizing the results of medication and cause such good growth. A microneedling maintenance program should be continued at least once a month and if you see hair loss, then increase the frequency of the microneedling. Stay on the finasteride and the minoxidil.

[If you have any questions, you can reach me at williamrassman33@gmail.com]

This young man (Joe) believed that he was starting the balding process that his dad had (a Class 7 pattern of balding). His father was with him today and he told me that he started balding when he was in his very late 30s. That was unusual for a man with a Class 7 pattern of balding (just a rim of hair around the head) as most men achieved that pattern in their 20s. Joe had early recession in the corners of his hairline.

This is what I told him and what I did: “You were concerned about the balding in the family with your father developing his advanced balding pattern in his late 30s (unusual). We performed bulk measurements on your hair today and much to my surprise, the balding you are experiencing is very mild and early with less than 9% hair loss behind the frontal hairline and in the top of your head. At the age of 24, you might be able to hold on to your hair for years if you use the drug finasteride. We discussed the potential side effects of this drug and I told you to call me if you should develop any of these.”

This shows the value of the HAIRCHECK test for hair bulk measurements. Although he thought that shaving his head was a good option and receiving Scalp Micropigmentation rather than face his fading hairline every year, month by month, I felt that he had a good chance to keep his hair and postpone any more thinking about his balding. This is very important for any young man. At his age, thinking too much about his hair replaces the real important things in life. Hair may not be important for him to worry about for years to come.

I can now see through to the scalp in the back of my head, which looks like it is balding now. Will the hair grow back in the donor area?

After an FUE, the hair that was removed is gone forever and will never regrow. In African hair, the donor supply is numerically lower than both Asians and Caucasians by as much as 10% to 40% respectively. As a result, the limits for FUE are much more restricted in people of African decent. If you are a typical African American, then the limit for FUE should have been 1,400 grafts (see this link which explains this: https://newhair.com/donor-area/). You have what we call donor site depletion. Since you now have donor area depletion, the only thing that you can do, which works very effectively, is Scalp MicroPigmentation (see here: https://scalpmicropigmentation.com/scar-covering/).

You should get a HAIRCHECK test to find out if there is any loss that you can’t see in the top and crown area of your head. You need to know there is the possibility that you might develop hair loss elsewhere. I call this a Master Plan which every male having a hair transplant should have. You look, on the surface, to be a great candidate, but if the HAIRCHECK test reveals hair loss behind the hairline, it is something you MUST know (See: https://baldingblog.com/value-haircheck-bulk-measurements-two-patients-seen-today/)