Author: Dr. William Rassman

Posted on

Patients That Opt for a Transplant That Still Shows Hairline Recession?

Hey doc, I noticed your blog here presents us with numerous demonstrations of surgeries, where a receding hair line is being restored to a full-blown NW1. However, the impact of surgery on donor area (whether FUT or FUE) has drawn me to weigh the benefits of smaller improvements.

But I don’t remember seeing here any pictures of patients who could easily (graft-wise) afford a Norwood 1 transformation, but have chosen a minimalistic path (for example, going from a Norwood 3 to a 2 or simply increasing the width of the forelock a bit to eliminate the steepness of its shape). Such visual representations will surely educate us about our options with surgery.

I’m sure we’ve posted examples of patients that didn’t want a fully restored hairline on this site in the past, and I know there have been plenty of men who have had surgery for a “minimalistic” path. A patient must give us permission before publishing their pictures, so we’re only able to post those that have given their consent. Not every patient wants their photos shown to others.

There are comprehensive before / after pictures in our NHI photo galleries that will show various examples of hairline restoration.

Posted on

Penis Structure and Finasteride

I was thinking of going on Propecia but found this article: Effect of androgen deprivation on penile ultrastructure

I was wondering why Merck hasn’t mentioned this as a side effect. Is this claim true in humans?

This may occur in humans at doses of finasteride much higher than the 1mg dose level that is the therapeutic dose for hair loss. The study doesn’t say how much finasteride was administered or the frequency of dosing, but as the study is in rats, I wouldn’t know how it could apply to humans. Merck likely hasn’t mentioned it as a side effect, because it hasn’t been proven to be a side effect in humans. I don’t know how else to comment on this question.

Posted on

Paying the Price for Hair Plugs from 25 Years Ago (with Photo)

As a young man 25 years ago, he had a hair transplant with the old fashion plugs. After seeing what it looked like (it was partly hidden with some hair at the time), he came to the conclusion that he made a mistake and immediately went to using a wig. Between his wig and a baseball cap, he had hidden his secret. About a year ago, he realized that maybe he could undo his plugs and after a year doing internet research, he came to my office to ask me an important question I’ve heard quite a few times before — “Can you just remove these plugs and make me bald so I can shave my head?”

Remember, this is NOT the standard of care today. Click the photo to enlarge.

 

To see the deformity, he lifted up his wig, which was tightly held to the scalp with tape. Although he is a Norwood Class 5A pattern with high density in the donor area, he never really wants to do hair transplants again, and just wants to be a normal bald man. This is a common finding in people who lived with the horror of the plug deformities of the old transplant work. Unfortunately, this type of problem is what so many people believe is today’s standard of care. Nothing could be farther from the truth as today’s hair transplants can not be told apart from a normal natural head of hair in a non-balding patient.

We agreed that I would remove each plug one-by-one and sew him up, making him a normal bald man. Removing these plugs may leave some minimal scarring. He wants me to transplant the hair extracted from these plugs and put them into the place they came from, to hide two obvious small neck scars. This should easily be done in one surgical session.

Posted on

Pearl I got from ISHRS meeting last week

Dr. Christine Shaver and other dermatologists are picking up diseases of the scalp in young balding men. These men present with itching, inflammation and hair loss. Upon biopsies taken by Dr Shaver, she identifies about one young male patient each week with a condition called Lichen Planopilaris or Frontal Fibrosing Alopecia, both autoimmune diseases of the scalp. In some men who eventually get a hair transplant, the hair transplant is likely to be rejected by the body. It may also reduce the growth or prevent growth in a hair transplant. If you have itching and inflammation, seek out a dermatologist and have two biopsies, one in the frontal where the inflammation and the itchiness is most prevalent and then a second biopsy from the Donor area in the back of the head. A biopsy read by an expert, will make the diagnosis and then special treatments are required. Catching it early is critical for everyone who has these diseases.

Posted on

Penis Dysfunction- What To Do?

Thank You doctor for the advice on Propecia. I have started taking it now and within days my hair has improved. Yes, i do get proper erections but when i think of my penis….i dont…so i guess psychology is playing a part in not getting erection.

Anyways, can you please suggest some tests which i need to keep doing to check if my testeterone levels are normal (what i mean to say is tests which can check if my sexual organs are normal).

Thank You

There are doctors that specialize in sexual problems in men. If you are penis-focused, you may be causing your own sexual dysfunction, that is why a doctor who specializes in sexual problems may be a good starting point. They will be able to help differentiate between physical and emotional causes. You can have your doctor measure your testosterone levels to see if they are normal.

I am glad to hear that Propecia is helping, but I would expect that the benefits of it will take months, rather than days.

Posted on

People on Forums Swear by RU58841

I hear about a substance called RU in a bunch of the forums on the internet.Many of the people using it swear it helps the hairline. Do you have any on this at all?

I assume you’re referring to RU58841, which I still don’t know much about besides that it is an experimental anti-androgen out of Europe. I mentioned it earlier this year in a post, but I can’t comment on forum members swearing something works or doesn’t work. I prefer published proof in peer-reviewed medical literature, which I haven’t seen yet.

Posted on

People that had FUT

What does your scar look like and what length can you hide it under? Like I usually get cut 3 on the sides and back, I have dark hair.

I had three hair transplants with strip surgeries. I can cut my hair to a one cut, and have no visible scar. Most people get just a line scar but 5% do get wider scars easily treated with Scalp Micropigmentation or wearing your hair slightly longer. Half of the hair transplants we do are with strip and the other half is with FUE and few patients complain of the scar as we are now using staples for the closures and they remain in for 3 weeks until the wound is healed. A minor inconvenience, I am told.


2020-09-15 12:15:44People that had FUT

Posted on

People Wonder What a Hair System (Wig) Looks like (Video from Reddit)

Reading the comments are about as interesting as the video. Most men don’t understand how a hair system works and this picture shows it well. Good hair systems are not inexpensive. Over the years, the cost for such hair replacements can run over $15,000. That is why so many people offer hair systems. The glue that attaches to the hair system you see here pulls out hair, so many people who use then become more bald over time from the traction of the glue that pulls out hair.

r/all Hair. from interestingasfuck


2018-06-26 13:16:59People Wonder What a Hair System (Wig) Looks like (Video from Reddit)