Author: Dr. William Rassman

Hair system for someone who still has hair but diffused thinning like me, will they work well?

Hair systems work well, but they almost always accelerate the hair loss because of the various attachments that are used. Men who use hair systems find that they get balder by the number of years they use them.

How fussy do you have to be with placement of it though? If you have a hair system or only applying in certain spots you can’t be too consistent?

You have to be fussy! If you apply the hair system, make sure that the clips are never in the same place or you will end up with traction alopecia.

I’m 23 and it’s happening. I’ve always had a poor hairline but now it’s thinning. And quickly (6 months and it’s gotten worse). Money is no object. Are these crappy hairpieces or are they indiscernible from the real deal? Do you shave the rest of your head for them? How do they work? How do you clean them? I want to do it early enough with my current hairstyle so no one can tell. I’m not keen on the medication or rolling.

Be aware that hair systems need to be attached, so most use glues to hold them to your shaved scalp. This causes traction alopecia and more hair loss so most men who make the switch to hair system end up on them for life as their hair loss always gets worse, often from the hair systems themselves.

I’m 23 years old, male. I was concerned about my thinning hair and my forehead is also very high. I was wondering if my forehead could be lowered along with hair transplant in one session and also a general estimate of what it might cost. Could the surgery be financed?

Another concern that I have is whether my transplant area and donor area would be red and swollen for various number of days. How many days are we talking about here? Since I am a college student I am concerned if people will be able to tell I had a hair transplant surgery after I come home from the procedure. Will the transplanted hair and the hair from donor area shed very badly and leave me looking like I have thinner hair than I used to and how much pain should I expect?

Thanks for addressing my concerns.

Thinning hair in a 23 year old man is usually caused by genetic balding. You should see a good doctor to have your hair mapped for miniaturization and have your hair bulk analyzed to be sure that you have genetic balding. If this is the case, then the use of medications like Propecia will be critical to stopping or slowing the balding process from progressing.

The redness after a surgery depends on two factors — the color of your skin (white skin is more likely to turn red), and the general way your body reacts to a wound (scratch your forehead with your fingernail and then wait 5 minutes to see if it turns red). If and when you become a candidate for a hair transplant by presenting with a clear balding pattern, then you can at the time of the transplant, lower your hairline. Costs vary depending upon what has to be done. Financing is available.

When estimating the number of grafts a person needs, I always want to know the hair thickness (hair bulk) of the donor area. Hair bulk is not hair or graft density. I initially saw the graphic at the bottom of this post on Reddit.com. For a visual representation, the graphic artist kept the number of hairs the same and changed the thickness of the hair shafts to show the value of hair thickness in producing coverage. Dr. Sharon Keene nicely demonstrated this with real hairs and got the same result as the graphic demo below. So you see, if your hair is fine, it will take a lot more hair to get the fullness of a person with medium-weight or coarse hair. This is why people with fine hair often get a second hair transplant. Fine hair is clearly better than no hair, but when a person with fine hair gets a hair transplant, they should accept that they will never have the look of Brad Pitt’s hair, while a person with thicker hair shafts, a Brad Pitt expectation may be realistic. The chart below shows the value of thicker hair shafts very nicely.

Let’s drill down on an example: Look at the chart below; let’s suppose that a balding man has medium hair (50microns thick). His friend had a hair transplant and had fine hair in his donor area, with a hair thickness of 30 microns. His friend had a hair transplant, and it doesn’t look like he has a full head of hair after the transplant despite getting 4000 grafts. He is concerned that he might not be happy with the type of results his friend had. If he does the analysis, he will find that he has 7.1 times the hair bulk as his friend with fine hair whose donor hair thickness had 30-micron hair shafts (50/0.7 = 7.1). I would tell him that if I were his surgeon, he would get much fuller-looking results than his friend, not because I am a better surgeon than his friend’s surgeon but because his hair thickness will produce more hair bulk than his friend’s fine hair gave him. The amount of hair bulk is a simple math calculation reflecting the area of a circle [ Pie (r)² ]. If you want to run the calculations, you will know the value of your hair thickness, and everyone having a hair transplant should do this to establish realistic expectations.

In my 35 years performing hair transplants, I have transplanted many men with fine hair. They were generally pleased because they got back the hair they always had, which was fine hair. A fine-haired man getting a hair transplant for balding doesn’t have the expectation that his hair would look like Antonio Banderas’s hair because they never had it.

In the late 1980’s. Dr. Manny Marritt had a light-skinned Caucasian human volunteer with black, medium-weight hair (~50-micron hair thickness) agree to have half the hairs on one side of his head plucked out. Then, Dr. Marritt brought in independent observers and photographers to see if the lower-density side could be detected. The answer was NO! That told me that in the worst situation possible (black, medium-weight hair on white skin), 50% density produced the same fullness as 100% density. With that being the case, a person with medium-weight hair that is blonde with a blondish skin color or a brown-haired, brown-skin colored man would require less than 50% of their original density to get a full look from a hair transplant. I have found that to be true, and that is the art of what a good hair transplant surgeon offers. When the hair transplant surgeon combines this knowledge with proper hair distribution, the best results are produced with the least amount of hair and cost to the patient.

For those readers who want to know where they stand about hair thickness, to get some realistic expectations for a hair transplant, you can purchase a micrometer for under $25 on Amazon, cut 10 of your donor area (back of your head), and measure the thickness by averaging their width of those 10 hairs. Use the chart below to understand the measurement and consider Dr. Marritt’s simple experiment. The micrometer can be purchased here: https://www.amazon.com/dp/B09964YBMF?ref=ppx_yo2ov_dt_b_product_details&th=1

 

 

The illustrations below show the same number of hairs, but the hairs are thicker. Please note the HUGE visual difference between fine, medium, and coarse hairs regarding the fullness each group produces.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

You can contact me at williamrassman33@gmail.com