Author: Dr. William Rassman

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I had a beard transplant 5 days ago. I am concerned that my herpes is acting up on my recipient scabbing area?

At 5 days, you have far too many crusts on your beard. What you are seeing is probably the crusting not the Herpes. You should nevertheless start taking your acyclovir because wounds like this tend to bring on the Herpes, possibly in the recipient wounds themselves.Many doctors would have put you on the acyclovir just for having a beard and mustache hair transplant. You need proper washing of your crusts to get them off. See your doctor as you shouldn’t look like this at 5 days, it is poor post-operative management.


2020-08-23 16:07:21I had a beard transplant 5 days ago. I am concerned that my herpes is acting up on my recipient scabbing area?

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I Had a Hair Transplant 7 Months Ago and It Still Doesn’t Grow Right

I had a hair transplant about seven months ago. It was performed April 5 2009. I had been cutting my hair all this time because I am in the military. but started to grow it out the last two weeks. but it still looks funny. What I mean by that is when it grows it doesn’t match the rest of the hair. the back hair is more full, and the front looks like stitches. Is this normal after seven months? How long do I have to let it grow to make it match the rest of my hair?

I do not know about your hair transplants or how the procedure was performed. I do not know what your expectations were or if you were given realistic expectations. So I really cannot comment on what you are experiencing. Keep in mind that not all hair transplant procedures are the same. The doctor and the team you chose can either produce great results or substandard results, depending upon their experience and skills. It is not like shopping for a car.

The best advice is to follow up with your doctor. Sometimes it can take a full year for 95% of the growth to be evident. At 7 months, I would expect 60-80% growth.


2009-10-13 11:13:32I Had a Hair Transplant 7 Months Ago and It Still Doesn’t Grow Right

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I had a hair transplant and I have numbness in the front for the past 4 months

There are always small nerves cut during the making of the recipient sites which cover a wide area of the frontal hairline. These nerves usually stop bothering most people within the first month, but sometime people feel the numbness for many months. These nerves will eventually heal and stop bothering you, just be patient.


2020-02-11 08:19:13I had a hair transplant and I have numbness in the front for the past 4 months

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Failed hair transplant one year ago (photo)

What does that mean in terms of my donor area as I had 2000 grafts?

The grafts used from the donor area are lost forever. There is no regeneration of the donor area Most people do not deplete the donor area in a single hair transplant. I would certainly go back to speak with your doctor and ask your doctor why it failed. I can’t give you any explanation other than to say that most failed hair transplants, in the absence of dermatological autoimmune diseases, are technical in nature. A 2,000 graft FUE procedure can be 30 percent of the average Caucasian’s donor supply and 40% percent for Asians as they tend to have less overall hair. From the picture below, it looks like your donor area has been maxed-out and FUE would not be possible going forward based upon what is seen in this picture showing very significant donor site depletion. To me, this reflects that you had a significantly lower than normal donor hair density before this process was started. Your surgeon should have told you this before he recommended FUE. Now with your donor area so depleted and a failed hair transplant and a see-through donor area which will not go away, you don’t have many options. Any more FUEs will only make it worse and this donor area can’t possibly yield enough hair to give you any reasonable transplant result. The only solution to this problem is the use of Scalp Micropigmentation which will make your donor area ‘look’ normal and it also might help the recipient area but you would have to see an expert in this area to fond out more about your options. See here for the limits for FUE surgery defined in one of my previous post in the Hair Transplant Forum: https://baldingblog.com/2017/07/21/many-fue-grafts-many-fues-grafts-one-know-safe-limits/ and here for information on Scalp Micropigmentation: https://scalpmicropigmentation.com/


2020-09-01 09:48:16Failed hair transplant one year ago (photo)

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I had a failed 5000 graft FUE, can I have another FUE surgery?

You can have a second hair transplant if the donor area has a reasonable amount of hair left. Failures are usually the result of technical problems at the time of the surgery. If the first surgery was with FUE, the second surgery should not use FUE or you will have balding in the donor area. Your available donor area depends upon your original donor density that you had prior to the first hair transplant. Did your doctor measure it?


2019-03-09 10:24:49I had a failed 5000 graft FUE, can I have another FUE surgery?

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I Had a Propecia Shed Within a Few Months of Starting The Drug, But It Never Regrew!

Hi Doc,

I have been taking Finasteride for about a year and a half now and within a few months of starting the drug I noticed that the hair on top of my head was getting thinner. I am 37 and have extremely slow hair loss since the age of nineteen, so after research I figured it was the “propecia shed” amd that it would grow back within a few months. Well, that was eleven months ago, and it still has not been restored to what it was before starting finasteride.

Anyways, I was hoping you could give me some advice on what to do. My doctor just basically said that all I can do is try Rogaine, but there are many reasons I don’t want to use it. Is there anything you could recommend by chance?

Thank-you

The only medicinal treatments I recommend for treating hair loss are minoxidil and finasteride, as they are the only ones proven to work.

I’m not sure what I can offer you advise-wise, considering you’re already under the care of a doctor and I don’t know anything about your medical history. You took finasteride because your hair was thinning — so is it possible that you were just a non-responder and your hair loss would’ve been progressing to this point even if you hadn’t taken finasteride? Did you have any additional stress in your life that could’ve caused it to occur?

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I Had a Procedure with You in 1994, But Wasn’t Satisfied

Dear Dr. Rassman:

I don’t know whether or not you’d be interested in this message. Nevertheless, I would be interested in your reaction to it …

I was a patient (age 34 at the time) of yours in August of ’94. You transplanted about 2,000 grafts from the back of my scalp to the top of my head. My overall reaction was that the density wasn’t near enough. And there was no way I could afford a second trip through the mill.

While I thought the newly transplanted hairs themselves looked okay, I concluded that your procedure fell far short of my expectation. To be blunt, my head resembled a coconut. So I ended up going to a company that provides rather costly “hair systems” (the gentle term for wigs). They look great – full and natural. It’s an ongoing “expense” that’s become a part of my life. But I thought of you the other day.

The idea of finally just shaving my head and being done with the high cost of masking my hair loss crossed my mind again. So when I took another good look at the white scar that traverses the back of my head from ear to ear, I dropped the shaven head idea.

Maybe when head tattoos are commonplace, I’ll put one right over the scar; a picture of a “bald eagle” or something.

Your reaction to this would be appreciated.
Thank you, sir.

Thank you for contacting me. I had the opportunity to review your photographs and your medical record. Hair loss is a progressive process and it is clear that the communication between us failed. I care about my patients meeting their expectations (first being sure that these expectations are realistic) and following up with a good Master Plan to follow the hair loss over time. I did this in 1994 as well. A single hair transplant procedure of 2000 grafts may have filled in some of your thinning, but it was not enough to cover the complete hair loss pattern that probably evolved. As hair loss is a progressive process and your pictures showed that you were in the process of losing hair at the time of the transplant, clearly you were a moving target. I must have failed to explain that process to you. Drugs like Propecia (finasteride) were not around in 1994, so unfortunately, in those days, I worked with a handicap watching helplessly as people lost their valuable hair over time. As you may know by experience, hair transplants (without the protective effects of drugs like Propecia) can accelerate the hair loss and even produce shock loss, which means that the hair loss process probably accelerated.

I can suggest that you arrange a visit with me and let’s discuss your present status and your goals. There have been many advances in managing scars if that is your main focus today. Nevertheless, I do care and the best I can do is offer my advice and reconnect with you again after all of this time. My office can be reached at 800-NEW-HAIR. Please do give us a call so that my staff will be able to get your next visit arranged.


2007-09-24 15:33:51I Had a Procedure with You in 1994, But Wasn’t Satisfied

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I Had a Hair Transplant, But I Have DUPA!

This is my story. I went to Dr. [name removed] because my front was thinning more than the rest of my hair. The doctor recommended 2489 grafts in the frontal 1 inch. He lowered my hairline because he said it was the sexy look and at 26 years old, that was a good look. After 9 months, the hair in the front was still very thin so the doctor told me to have another transplant. I purchased another 1804 grafts which did not appear to have grown out after another 10 months. I went back to the doctor and he told me that I needed more grafts. The area that he took the grafts from was very, very thin after the second transplant. I did not feel comfortable with this recommendation, so I went to another doctor to get a second opinion. He told me that I have DUPA and that the entire hair on my scalp was thin and see through. My scar is very visible. This second doctor told me that I should not have had the surgery and that I was in a bad place to do anything but wear a wig. So I went to a wig place and the wig was totally unnatural. The hair on the top was thick, the side hair was not covered by the wig and looked transparent. What do I do? Is there a place to complain about my surgical care? Do I go to a lawyer and if so, how do I find a good lawyer?

It sounds pretty clear that by having Diffuse Unpatterned Alopecia (DUPA), you were never a candidate for surgery. Hair transplant surgery in men such as yourself is a disaster and no you will probably always show this deformity. It seemed that the doctor must have needed your money and did not care about your welfare. First of all, I would like to see you, possibly get pictures from you so that I could ascertain for myself if you had DUPA. I would try the use of dutasteride (only if you really have DUPA), which would be an off-label use of this drug. I have seen some men with DUPA get a response from finasteride, but high doses of dutasteride may have value. The problem with this drug is the issue of sexual drive and low sperm counts from its use. These would be things we would have to talk about and you certainly should not consider having children anytime soon if you try this route.

Your recourse includes:

  1. Complaint to the medical board of your state.
  2. Seek out a lawyer by going to the state bar for assistance in finding one.

The courts are generally not victim-friendly when dealing with hair transplants, because they do not see significant damages so the monies collected in the few cases that went to court have been pretty low. For the readers out there, please keep in mind that the doctor you choose should be ethical, honest, and competent. Try to identify the larceny in the doctors before you bet your appearance on someone you don’t know and can’t research.

I would be happy to help you, but we must first somehow meet.


2007-11-08 15:54:44I Had a Hair Transplant, But I Have DUPA!

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I Had a Microscopic Exam of My Scalp, Followed By Sales Tactics

Hi i notice my hair is ” kind of ” thin in the crown area. I went to a hair therapist “hair club” and the guy showed me a micrograph of me scalp and on the crown it shows a grey picture with little dark circle surrounding my hair. then he showed me a pinkish picture of the hair in the back without the dark circle. He is saying the dark circle is causing my hair to thin. He keep claiming it is genetic but no one on either side of my family or whoever has thining hair. All i heard from him the whole time the moment i step in the store before any analysis, is that im thining. And toss me those hair loss solution for 3000 a year. I have a feeling he just trying to make me buy his product see that im only 20. I dont wanna judge him but he dont look like a honest guy from how he talks.

PLz give me some advice thx.

I am going to assume he did a miniaturization study and if he did, he should know how to read it. You are young and may have male pattern baldness (MPB), but this question should have been answered by the miniaturization study. I would recommend that you see another physician for a second opinion.

If you are having early thinning in the crown due to MPB, then you would likely be an excellent candidate for Propecia. This is the only FDA approved oral medication for treating hair loss. There are thousands of products out there touting hair restoring capabilities, but outside of the ones that contain minoxidil (marketed as Rogaine), none of them really work. Minoxidil is a non-prescription item and many fancy sounding hair loss treatments you see on store shelves or television infomercials will contain this. Save your money and see your doctor about a prescription of Propecia if you are truly experiencing MPB. Good luck.