Yes, it is not unusual to thicken up the transplant with a second hair transplant, especially people with fine hair. Mechanically, there are limits to how close one can place grafts in a first surgery but on a second surgery, the surgeon goes between the previous grafts and this will double the density. After the next surgery, you should look good.
Finer Hairs at Hairline
Hello Dr.Rassman,
I am a 29yr old caucasian male who has over the last few years been dealing with questions of hairloss. Thus far there is nothing dramatic to speak of – no noticably thinning or balding areas. There is however one thing that has led to a good deal of concern – it can best be described as light or whispy hair around the frontal hairline (from temple to temple). My hair has always been quite fine in nature and until a few years ago a light brown color rather than the dark brown it has become. In recent years I have grown my hair out quite long – opting for the ‘rocker’ look as friends call it. If I pull my hair back I dont notice any loss at all – it looks like a regular hairline – but the hairs that make up the first cm (rough estimate) are lighter in pigment and fine in composition compared with hairs deeper in the scalp. Aside from the minor difficulties this phenomenon creates when attempting to style my hair I’ve been wondering if this is an example of the ‘miniaturization’ process that you have described. I have no signs anywhere else of this phenomenon – just the fringe of the frontal hairline. No crown thinning, no overall diffuse thinning, no temple thinning – and that is what is driving me crazy! If it were more extreme I would be prone to take some action be it drugs, topicals or other treatments. With this said however the lack of action kills me just as much because I wonder if I’m not acting when I should be – nipping my possible hairloss in the bud so to speak. Please let me know if you feel this is an example of ‘miniaturization’ or not and any course of action I should consider taking. Thank-you.
To really answer your question directly, you should be examined and have your scalp mapping of your hair for miniaturization, which is best done under magnification with a visualizing high power microscopic tool, like our densitometer. Fine hairs often exist in the very front of the hairline, but in regards to what you refer to, I am not sure if you mean the mature hairline that has probably evolved from your child hairline (age 10 or so), which is often lower and thicker. I would want to see pictures and possibly meet with you in person to make such assessments. If you’d like to send photos, you can email them to the address on the Contact page.
2005-12-07 15:01:072005-12-07 17:03:55Finer Hairs at Hairline
First Course of Action
I am 34 years old and I have a receding hairline. Now, I am getting a bald spot on the top of my head. What should be my first course of action to save my hair?
The first course of action should be to see a competent doctor who understands the male pattern balding (MPB) process. He will examine the hair on different parts of your scalp and look for the amount of miniaturization that you are showing in various locations. The things he will identify will not be the level that you can see with the naked eye as balding occurs slowly and insidiously and can not be picked up without high powered examination of the hair. Based upon a proper examination, he should develop a master plan for you that will cover your worst case scenario and probably include the use of medications for MPB if that is your diagnosis.
Finding a low cost hair transplant
I’ve been trying to get some sort of idea of about how much a hair transplant would cost to just fill in my temples. I’ve been on finasteride and minoxidil for over a year now with great results, but my temples are still thinner than i would like.
Anyone able to give a rough estimate of what the cost might be just to fill in thin temples? I think 500 grafts would be the absolute most I would need. And yes I am in the process of setting up a consultation but I would like to have an idea beforehand.
Hair transplant pricing is all over the place; however, think about what you are actually buying. If you needed a heart transplant or brain surgery, would you try to find the least expensive place to do it? I have seen many men find a cheap hair transplant and then, when either it failed or the doctor who performed it, didn’t bother to build a Master Plan for your future and then you find out that you lost a significant amount of your donor supply that is limited, the fee becomes ridiculously high regardless of how little that you think you paid for it. I have seen many hair transplant result where the doctor ruined the donor area or did it too soon just to get your money. Make sure that the doctor is reputable and if he employs a salesmen, don’t trust the consultation or possibly even the surgery. Try to find dirt on the doctor from Yelp, Realself, and Reddit. There are many potholes in selecting a doctor so don’t fall into one.
Here is a review sent into Realself for me this morning about the consultation I gave him yesterday and that I told him not to do a hair transplant, which is why he came in to see me:
As the years have gone by, I have started to notice some thinning up top. After doing some research, I decided to setup a hair loss consultation with Dr. Rassman.
I chose to setup my appointment via an online form, and was surprised when I received a phone call from Dr. Rassman himself within 15 minutes! Turns out, he happened to see my consultation request while relaxing on his deck, and decided to give me a call! He was very friendly and personable on the phone, which made me feel better about my upcoming in-person consultation.
I arrived on the day of my consultation and was seen very promptly. Dr. Rassman was as friendly and jovial in-person as he was on the phone. He did a quick visual examination, and then performed an inspection using a device called the Haircheck. This devices takes measurement of hair density per square inch at different sites on the scalp, using the back of the head as a baseline to compare with other locations on the scalp. I had never seen this type of device used before, and I was impressed by Dr. Rassman’s objective and data-based approach to evaluating hair loss.
After the Haircheck inspection, he informed me that there was some thinning, but not enough to recommend a hair transplant. He then gave me a thorough description of my options and talked through the potential side effects, while interjecting some lighthearted humor, which made me feel at ease. He was very knowledgeable, and was up to date on the latest research. In addition, he answered all of my questions and promised to email me additional info. I was surprised and delighted to find that Dr. Rassman followed-through on his promise quickly, emailing the additional info in about an hour.
I suspect that many other surgeons would have simply taken my money and performed a hair transplant, but I respect Dr. Rassman for his candor and honesty in recommending against a hair transplant. If you are thinking about seeing someone about your hair loss, I would definitely recommend seeing Dr. Rassman for a consultation!
2019-09-18 12:47:062019-09-18 12:47:06Finding a low cost hair transplant
Fine blonde hair and I can see my scalp
Fine blonde hair is often produces a see-through hair. Most people with very fine hair can see their scalps
Fish Oil and Hair Loss in Asian Populations?
Great site. I have always thought that large amounts of fish oil can cause diffuse hair loss. The reason I think this is because of observing Asian woman and men. I have notice a LARGE amount of this population have diffuse hair loss, on the sides and back. I’m actually surprised of how many. I live in a major city and live in the ChinaTown section. I understand they have different hair characteristics ect…like skin color and dark hair but am convinced that this group of the population suffer from more diffuse than any other. I am convinced large amounts of Omega 3 can cause diffuse hair loss. It is interesting that GSK’s new prescription fish oil also list hair loss(Alopecia) as a possible side effect.
Just thought I would get your view.
I do not think large amounts of fish oil cause diffuse hair loss. Are you implying Asians consume large amount of fish oil because they eat more fish and fish products than non-Asians? If we were to entertain your argument, I would think the Eskimos have a very high Omega 3 fish oil diet. I do know that they have less balding than the general population of Caucasians and American Indians. I can not address any suggestions by some manufacturers of fish oil supplements that hair loss is a known side effect, because I have no personal or professional experience one way or the other. The information PDF you sent (linked above) doesn’t have an actual percentage of those that experienced it. It could’ve been 2 people out of hundreds, but I have no way to know.
Asians (non-balding) generally have less hair than their Caucasian counterpart and also have less balding than their Caucasian counterparts according to studies I have researched in the past. Asians also have straight black hair which contrasts with their light colored skin and may look thinner. These factors can sometimes make non-balding Asians look as if they have thinning hair.
Finpecia Worked Great for Years, Then Suddenly Stopped
Hi Doctor,
At age 23, I started taking Propecia. I soon switched to Finpecia made by Cipla to save on costs. For three years things were great. I regrew hair on my crown, no more small baldspot and no noticable hair falling out whatsoever. It was everything I hoped for.
This January, after aproximately 3 years on Finpecia, I noticed my hair thinning out and everyday I see that I am losing hairs. I still have decent coverage on the crown but my hairline is receeding and it’s definitely thinner coverage all over.
I’ve been taking some supplements such as saw palmetto and been using 2% Nizoral. I’m wondering if adding Rogaine Foam may be to some benefit.
Also wondering, if in your experience, you think I should get back on the name brand propecia. I’ve been getting the Finpecia from a reliable online pharmacy that requires a prescription and is “certified”, but I wonder if the quality of drug is different.
Thanks for your help and I appreciate this blog.
For those readers not familiar, Finpecia is a generic Propecia (1mg finasteride) made in India by Cipla — the generic 1mg isn’t available legally in the US yet due to patent laws. And just like Propecia, it does not continuously work for everyone. Many men on finasteride will see results for 5-10 years (or beyond), but each case is different. You need to see your prescribing doctor about the reduced impact of this drug. I think you should still stay on the medication, because if you stop it you will likely lose a great deal of hair.
Cipla is a huge pharmaceutical company and I doubt there’s a difference between the generic and the name brand finasteride.
As for adding Rogaine Foam, I suppose it’s worth a shot. You might see some benefit, but I can’t say for sure.
First new drug for hair loss released in South Korea
http://www.koreabiomed.com/news/articleView.html?idxno=10914
The focus on the drug is to create or enhance collagen production. I was able to find some articles in support of hair growth claims, they are:
https://pubmed.ncbi.nlm.nih.gov/32255530/
https://onlinelibrary.wiley.com/doi/abs/10.1111/jocd.13729 (medication delivered by injection)
https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/dexpanthenol (a review of more articles)
https://www.webmd.com/vitamins/ai/ingredientmono-853/pantothenic-acid-vitamin-b5
2021-04-16 01:29:062021-04-16 06:31:56First new drug for hair loss released in South Korea
First Ever Skull & Scalp Transplant Performed In Texas
Opening a new frontier in transplant surgery, Texas doctors have done the world’s first partial skull and scalp transplant to help a man who suffered a large head wound from cancer treatment.
In this photo taken on Wednesday, June 3, 2015, James Boysen is interviewed in his hospital bed at Houston Methodist Hospital in Houston. Texas doctors say he received the world’s first skull and scalp transplant from a human donor to help heal a large head wound from cancer treatment. (AP Photo/Pat Sullivan)
I would guess that he received radiation for a brain cancer and that his scalp and skull had necrosis (death) that left him with no or a poor cover for the top of his head, leaving the skull and brain potentially exposed. This can be onerous. Assuming that I am correct, something like this would be lifesaving. This would not be a substitute for a hair transplant so for our readers, I wouldn’t rush to Texas to have this done. It is, nevertheless, interesting to read about.
First Step for Teen with Thinning Hair
Hi doctor, I have been recently been encountering certain problems with my hair over the past 5 months, I am 16 years old (male) and currently starting my first year of college. First signs of change were with the texture and build of the hair, as it started to become much drier and thinner. Then the amount of hair that started to fall out naturally started to drastically increase, although I have naturally thick hair the changes that I am experiencing seem too unnatural, one example is the fact that I never really used to be able to see my scalp, now I am really feeling concious about it. I have great foundations of friendship in the school that I go to and the worry of acceptance isn’t preying on my mind too much. I have asked my best friend about it and she seems to see no difference in the appearance of my hair, but I still believe there is something wrong.
My grandfather had troubles with baldness as a teenager and was completely bald on the top of his head at age 20. Confident self image is something that I always like to pursue, I style my hair using straightening irons and using gel based products, which I have been widely recognised at school for, for the past two years. A balding head it something that is not really seen around my social groups, and I’m not quite sure how my friends would react. I haven’t consulted my doctor about it and I would really like some impartial, friendly advice on what to do next, whether I should consult my family or keep it quiet and hope it will go away. I would really appreciate your help in this matter as I have only spoken to one person about this and I haven’t been able to research it myself much. Thank you
Go get your head mapped out for miniaturization, which will show if you are in the early phases of genetic balding. Especially at your age, it is too important to guess or work the answer blindly through the internet.