Author: Dr. William Rassman

Posted on

My Hair Transplant Looked Great at 5 Months, Not As Great at 8 Months Post-Operative

My question is regarding post operative transplant shedding. For a little background, I’m a 26 year old male on Propecia for 2 years and exactly 8 months out of a 2000 graft hair transplant all in the frontal part of the scalp. At 5 months, my results were excellent, a very dense, even result with a natural looking appearance and texture. Since that time, however, I have noticed an increased thinning in my hairline; leaving a more see-through appearance. This has been coupled with a more “pluggy” texture. Furthermore, at 6 months, I noticed an increase in shedding but it has slowed down in the last 6 weeks.

My 8 month result is still great but there’s a visible difference in the last three months. Is this merely a part of the natural process for some patients and can’t be judge too quickly in my first year growth? Any help would be greatly appreciated! Also, let me know if you need extra information to answer my question.

Why don’t you follow up with your doctor with these issues? A pluggy texture is not good. Thinning may be related to continued (normal) genetic hair loss that may have happened without surgery. Shock loss is generally seen in the first month or two after the surgery.

In general, results of a hair transplant surgery can be seen in as early as the 2nd month all the way up to 12 months. Most see results in about 6-8 months. I couldn’t tell you why your results looked better at 5 months than they do at 8 months, though.

Posted on

My Hairline Is Diagonal

Hi, I am 19 years old and have a thick head of hair. There is no thinning present whatsoever. However, when i pull my hair back to look at my hairline, i notice that it goes in diagonally, not quite at 45 degrees but still noticeable diagonally (perhaps the mirror exaggerates how diagonal it is), the right side more so than the left as well. I have shown my mum, grandma and sister, and they have said that my hairline is normal and not receding. I know its hard to tell without seeing it, but are they right and is this type of hairline normal or is it a receding hairline. Like I said, when my hair is not pulled back, I have a thick head of hair and you would not notice that I had this type of hairline.

This clearly bothers you. I suspect that there is some maturing of your hairline at 19, which is common in men. You could send me pictures with your eyebrows lifted high (a good digital photograph) and I will give you an opinion. Please reference this blog posting when/if you send photos. Thanks.


2006-09-21 15:00:12My Hairline Is Diagonal

Posted on

My hair turned white

I’m in my mid 20s and I got a hair transplant done 6 weeks ago. I have started to notice a lot more white hair on my head after the transplant. Significantly more than before. Am I just aging? Or have the hairs temporarily turned white as a result of the physical trauma of the surgery?

We have performed over 17,000 surgeries over 31 years and I don’t remember anyone’s hair turning white immediately after a hair transplant. I have seen significant changes in hair texture, a few men developed kinky hair but not white hair.

Posted on

My Hair Transplant Made My Skin Cobblestoned!

Ive had a transplant 6 mnths ago.The hair that has been transplanted on the front top of my head has made the skin look bumpy cobble stoned appearance. I want to shave my hair short to blade 0 and not have the bumpy look. What procedures can be carried out to solve my problem. I do not wish to have another transplant so im looking on ways to make my linear scar fade away to. Is laser treatment good for the scar.

Of course, I will start by saying I want to see what your hair looks like and if you can visit California (we have two offices here) it would be best to let us examine you directly. The second option (and probably most convenient if you’re not local) is to send me good photographs of what you are referring to with good lighting. Be sure to include photos of the scar where the hair was taken from.

Cobble-stoning is usually the result of the larger grafts which have a reasonably sized skin disk with it. The skin from the graft does not align with the scalp skin around it so that it appears bumpy. If that is what you have, your doctor used an obsolete technique and these just can not be fixed by shaving down the scalp skin with dermabrasion, which only makes the visibility worse with depigmentation of the scalp skin. The only solution is to put more hair around these bumps to hide it in the ‘forest’ of normal hair (more hair transplants, but this time by a well skilled doctor using modern techniques). Laser treatments do not work either and the linear scars from the donor area can be difficult to fix, but again, I would need to see it to understand the problem.

Posted on

My Hair Transplant Scar is Wider Than My Surgeon Promised

I recieved a transplant of about 3,000 grafts from another doctor about 12 months ago. 720 are 1 hair and 2,140 are 2 and 3 hair grafts. I am 23 years old and I am not very satisfied with the results. Hair is not as thick as I would hope and the scar is wider than promised.

I was looking into doctors that could possible thicken up the front a little bit and try and reduce my scar as much as possible so I can keep my hair shorter. I was seeing what your thoughts would be on this. I am not able to make it into your office very soon but I can forward some pictures for now so you could give me some initial thoughts if possible before a consultation.

Before undergoing a hair transplant surgery, you must fully understand the limitations and have reasonable expectations. The scarring is also highly variable in each individual and there is no way anyone can predict how the scar will turn out with total accuracy. Everyone wants a great outcome and minimal scarring, but you must understand surgery is not an exact science and no matter how great your surgeon is there is always a variability.

You stated that the results are thinner than you expected. The 3000 grafts that you received was spread over your balding area, so if your balding area was large (Norwood Class 4,5 6, or 7) then I might expect thinner results than if your balding pattern was a Class 3 or less. Also, the thickness of the hair shafts (fine vs coarse hair) will reflect the fullness that you received. The growth of the transplants (100% or 50% growth) may play a role as well. If I was able to see you, I would have an appreciation of these factors and then give you an opinion.

You can always email us or call us at (800) NEW-HAIR to set up a phone consultation. We usually request photos in advance and you can arrange a time to speak to one of the physicians to facilitate the consultation.

Posted on

My Hair Was Pulled Out and the Bald Patch Keeps Increasing

hi. I would be most grateful if you could help me…My hair was pulled out 4 weeks ago. It hurt and bled a tiny bit. The bald area pretty much immediately grew (sparse) stubble, so I am assuming this will eventually regrow. However, the bald patch has increased in size (about half an inch forward and back), and the hair surrounding it still falls very easily.

Is it possible these hairs were disturbed in the follicle (a big handful of hair was pulled) or could there be an underlying problem? Or could this be a localised anagen effluvium (if this even exists). In the beginning the area and whole scalp ‘burned’ intermittently for about 3 wks although now just the ‘patch’ burns occasionally. I find if the surrounding area itches and I scratch thats normally when the hair comes out (1-8 hairs at a time). I have looked all over for an answer but I think this must be unusual which I find worrying.

Thank you for your time.

If you are really worried, I’d have a doctor examine your scalp. I would expect, however, that if you wait up to 8 months, the problem will take care of itself. Generally, a one time hair pull will not result in permanent loss.

Perhaps the surrounding hairs became weakened after the hair was yanked out and that’s why you see loss in that area. Without seeing what you’re talking about, I am having a hard time understanding what you are describing.


2010-08-24 13:03:16My Hair Was Pulled Out and the Bald Patch Keeps Increasing

Posted on

My Hair Was Transplanted with Micrografts Lower than My Juvenile Hairline!

Hello Dr. Rassman,

I had a couple of HT procedures in the late 90’s that placed several hundred “micrografts” and “minigrafts” into my hairline. While the result is not as bad as some of the super-pluggy transplants I’ve seen, I now know that an FUE procedure could produce much better results. The issue is that the surgeon placed my hairline too low – it was lower than my juvenile hairline, but still along the forehead muscle. Due to this, I have no room to have a “transition zone” transplanted in front of it.

Would it be possible to have my hairline taken back a centimeter or so over a few sessions by individual graft excision and then have some refinement with FUE? I have spoken to one doctor who wants to bring my hairline down further, but I am completely opposed to this (I would like it to be a little higher at the end of any repairs).

Without examining you, I wouldn’t be able to define your options (particularly based on your unique case, which might be very difficult to correct). Generally, a brow lift may essentially bring the hairline up to a level that can be worked with, but it’s really not a sure thing. There will always be some risk of scarring when you take out old grafts in the front, but with a brow lift and a surgery to bring up the hairline you might be able to have follicular unit extraction (FUE) to thin it out some. People have entertained using laser hair removal which may expose the micrograft scarring (I personally have not seen a successful one yet) and even with FUE there are issues of scarring and a risk of an unnatural appearance.

You need to find a surgeon that will work with you, and assess the risks and benefits. You have limited options, but you need an expert to analyze your problem.

Posted on

My Hairline is Receding and I’m 20. Please Help

Well from the last year i think my hairline has been receding. I am 20 years old and i just have a strange feeling that it has started receding from the sides.. Please help..

You should see a doctor who offers ‘bulk analysis’ with the instrument called Haircheck. This will tell you fairly definitively, if you are starting to lose your hair. Some doctors have not acquired the instrument, so as you check the doctors in your area, call them and ask their office in advance if they have the instrument. You can also have a doctor look at your under a microscope for a Minaturization test. This can give you some objective (measurable) perspective on your hair status. In general most common cause of hairline receding for a 20 year old is genetic male pattern balding (MPB).

Posted on

My Hairline is Receding on One Corner — Should I Consider a Transplant at 18 Years Old?

Hello, im an 18 year old male and was unlucky enough to be born with not a great hairline to begin with. Now however i notice that my hairline has become a lot worse on one side than the other. Is this natural? And also what would you recommend for treatment? i am already on regaine at the moment which seems to have help a bit and stopped hairloss for now. But would you consider a hair transplant?

it wouldn’t take many hairs being transplanted to have a huge effect on my self-esteem, how many do you reckon?

Please help, it can be really depressing at times, thanks!

You need an evaluation and a Master Plan. At this point, you really don’t know what type of hair loss pattern you have or if you will bald further than the frontal corners. If were to have surgery without a Master Plan with everything under consideration, you could end up with two patchy corner areas of hair and a bald head some years down the line.

You might just be developing a mature hairline or it could be early genetic loss. There’s no way for me to know what you’re seeing or what your treatment options are without an examination. At 18 years old with some hairline corner recession, I wouldn’t anticipate surgery being the recommended path at this time.

Address your depression and self-esteem by educating yourself and seeing a doctor for an examination and a Master Plan of your options.