Author: Dr. William Rassman

Women’s hair line lowering surgery has become popular in recent years. There are two methods: (1) Surgical forehead reduction, where an incision is made along the hair line to “pull down” the hair line. Think of it as a reverse face lift. A great method for the right candidate. Dr. Gal Aharonov is well known for this work. (2) Hair transplant procedure, where individual hair is implanted one by one to create the hair line. Each procedure has its drawbacks and benefits. One draw back of the forehead reduction surgery is the linear scar along the hair line. One draw back of the hair transplant procedure is that the results are not immediate (It can take 6 to 12 months to see complete results). One advantage of the forehead reduction surgery is that the results are immediate. One advantage of the hair transplant procedure is that you can create a soft rounded hair line.

CLICK on the images to see the HIGH RESOLUTION (close-up)

Before

After

I spent about an hour tonight on youtube reviewing a Denmark based hair stem cell clinic with other offices in Europe (https://www.youtube.com/watch?v=uu-pNdl7z38). I watched three videos about a half an hour each. What I saw was flamboyance with 8 star offices. One office was based in a castle, very impressive spokesperson, communicative in multiple languages including English, and lots of fluff. When it got down to the reality of what they were doing, it was FUE, plain and simple. It was a limited procedure that they demonstrated, and despite the claims that they were extracting stem cells and that one hair would produce two, and two would produce forr and so on, the reality of what my professional eye was seeing was nothing more than a limited FUE procedure with no stem cells other then those normally found in an FUE graft and no cloning. I am asked many times about Dr. Gho’s stem cell technique and heretofore, have not commented on it. I teach my patients a very basic principle about balding, that there is a limit to the amount of hair that one has. Short of an act of God, no doctor has yet gotten two healthy hairs from one, four hairs from two and so on. Somehow, Dr. Gho did not look like the God I know. People with advanced balding patterns must have limited goals. What I saw were a few patients who could never achieve any sense of reasonable results for the balding patterns they showed and with the number of grafts that were offered. I know that pomp and fluff sells and the dream of hair transplant patient world-wide is to have either stem cells or cloning solve their hair shortage problem, but I would suggest that readers of this blog follow the old adage that ‘let the the buyer beware’ and let it be a guiding principle for everyone looking into hair transplantation. I must be lucky because most of the patients I see, educate themselves about this hair restoration process and would never fall for scams. When patients just don’t know, I push them to get educated and this is why the editors write this blog, to educate our readership.

If you ever heard someone tell you to “get your head together’ I don’t think that they were tell you to get a new head as these researchers did here:

This is a technical challenge for the surgeons doing these head transplant, but it is a real ethical issue for me as we know monkeys are thinking, feeling beings.

I have heard from reliable sources that Donald Trump has had more than one scalp surgery to treat balding over 20 years ago. Many people who have had the older types of hair transplant procedures from the 1980s and 1990s often received deforming procedures that caused significant scarring on the scalp. Visible deformities can be covered up with good styling camouflage. In the 1980s and early 1990s, the hair transplants were created by pencil sized plugs and were often accompanied by hideous looking scalp reduction scars which, when the surgeon tried to cut out a bald scalp, left terrible deformities on the scalp. Today, hair transplants are created by moving hair in their natural growing groups of between 1-4 hairs each from the back and the sides of the head to where the balding problem exists.

I have heard that Donald Trump was a victim of these outdated techniques. Putting things together and relating it to my vast experience with patients who came to me to treat such deformities with ‘comb-overs’ or ‘comb-forward’ hair styles to hide these hideous deformities, I would guess that Donald Trump is a victim of these old surgical procedures and uses his now distinct hair style to cover it up. As long as he maintains this hair style and does not lose more hair, he will hold his iconic look.

The good news is that most people who were so victimized, have since come to be repaired with the more modern techniques developed over the past 20 years or so. Vice President Joe Biden is a good example of a politician who used to have a pluggy frontal hairline. Now, he proudly shows off a nice, frontal hairline with no evidence of any preexisting problems. I suspect, that Donald Trump is hiding something similar, using his dyed blonde hair and his ‘comb-forward’ hair style to hide his secret.

 

Click on photo for LARGER SIZE

Click on photo for LARGER SIZE

This patient is not going bald. He may be classified as a Norwood 2 or as having a mature hair line. He had the surgery because he did not like his raised corner hair line. He wanted a lower, relatively straight juvenile hair line (he once had). He was old enough (over 30 years old) where chances of him losing more hair or shock hair loss was minimal. He understood this is a cosmetic procedure and was made aware he may need more than one surgery to achieve the density he was looking for.

He chose the FUE method of graft harvesting since he wanted the flexibility to keep his hair buzzed or kept short.

The total number of grafts he received was 1600 grafts. He had two separate FUE procedures of 800 grafts with each surgery spaced out about 1 year apart. The final result you see is after 2 years. If you click on the photos for a close up ZOOM you can see that the density achieved was close to normal (non-balding) hair density. The reason he needed TWO (2) separate surgeries was because you cannot fit 1600 grafts in such a tight space. Each graft can be about the size of a rice grain. After the hairs have grown out, you can fit another graft in between the spaces.

He occasionally attends our monthly Open House events if anyone would like to meet him in person.

My question relates to wind exposure. I’ve read on this blog (and elsewhere) that there is no correlation between exposure to high wind gusts and hair loss.

However, I’ve also read here that most of the hairs shed daily “blow out in the wind,” and from showering, styling, etc.

I live in Chicago where I have been exposed to wind gusts in excess of 30 mph. Can this cause hair loss or would I only be losing what was already bound to be lost?

Thanks Doc!

Wind does not cause hair loss other than the fact it may blow away falling hair. Hair loss in men in most cases is due to genetic male pattern balding. Hair loss occurs in a pattern (thus the term). If your theory of the windy city (Chicago) is true, you would see more bald men and women in Chicago. I don’t believe Donald Trump is from Chicago.

I am a 20 year old boy I have been noticing hair fall eveyday. I have read on the website progesterone cream for hair fall. Is this safe? What about PRP

While progesterone is generally considered a natural female hormone, biochemically it is an indirect precursor to testosterone much like testosterone is a a precursor to DHT. (Men produce progesterone naturally just like women produce testosterone in their body)

If you follow this logic you can argue that you should be taking more cholesterol for male pattern balding and all hormonal deficiencies (since cholesterol is a precursor to testosterone/ progesterone/ etc)

Without going into detailed biochemical / medical logic, there may be an academic reasoning behind the use of progesterone (of how progesterone can counter DHT levels) but it is not a standard treatment for male pattern balding.

Keep in mind, male pattern balding is a genetic condition for which there is no definite cure. Drugs such as Propecia and Rogaine can help but over the long run the genetic predisposition will manifest. The only FDA approved medication for the treatment of male pattern balding is Propecia and Rogaine.

There is nothing wrong with doctors promoting off label treatments such as progesterone, PRP, low level laser light therapy as they have a right to practice medicine within the bounds of their Hippocratic Oath. Likewise the consumers (patients) have a right to choose their doctors and treatment options based on their own research and free will. However, it is my opinion that the consumer take a “buyer beware” approach. For every success story behind these treatments, there are many disappointed consumers who have spent thousands of dollars with no benefit. I may be biased because in my 23+ years in the hair restoration field, I have met with thousands of these disappointed consumers.

College-aged rugby players taking creatine monohydrate supplementation for three weeks had their Testosterone and DHT measured. The results of these tests indicated a rise in DHT levels when using this supplement in their diet. A rise in DHT levels can accelerate, at least in theory, the hair loss seen in genetically balding patients.

http://www.ncbi.nlm.nih.gov/m/pubmed/19741313/

The following is taken from MSN Lifestyle:

1. HOW HAIR TURNS GREY

Hair grows in a follicle, a bulb-like tube on your scalp. The average head has 100,000 to 150,000 follicles, each operating independently from the others. Hair in its basic, unpigmented state is white. It gets its color from melanin, a pigment that also determines skin color. Two types of melanin, eumelanin (dark brown or black) and phaeo-melanin (reddish yellow), combine to make all the hair colors. One hypothesis for why hair goes grey is that aging slows or stops the hair from accessing the melanin, so it comes out grey, silver, or white instead.

3. GREYING IS CAUSED BY HEREDITY

When you’re born, your genes are already hardwired for when and how your hair will turn grey. This includes premature greying—people who grey before age 30 usually do so because it runs in the family. For most of us, greying starts in middle age. Dermatologists go by the 50/50/50 rule of thumb: by age 50, half the population will have at least 50 percent grey hair—although a worldwide survey showed that number was much lower, with only 6 to 23 percent of people half grey by age 50.

4. RACE IS ALSO A FACTOR

In a related matter, race also determines when you’re likely to grey. In general, Caucasians gray in their mid-30s, Asians in their late-30s, and African Americans in their 40s.

5. PLUCKING ONE GREY HAIR WILL NOT CAUSE THREE TO GROW IN ITS PLACE

This old wives’ tale is a myth. Each follicle can contain only one hair, and plucking it won’t make it able to produce multiple hairs. Furthermore, what you do to one follicle has no effect on the ones around it. That said, excessive plucking isn’t a good idea—it can damage the follicles and even stop hair production in that area altogether.

6. STRESS PROBABLY PLAYS A ROLE IN GREYING

When President Obama went grey his first term in office, was it stress, age, or a combination of both? Scientists aren’t sure. While some researchers say that your genes alone are responsible for grey hair, others say that there seems to be a connection between greying and stress, just no direct link to prove it. In 2011, a study by Nobel Prize winner Robert Lefkowitz discovered that long-term productions of the body’s fight or flight response—the instinctive ability to mobilize energy in response to a threatening situation—can damage your DNA and cause premature aging, including greying hair.

7. TRAUMA WON’T MAKE YOU GO GREY OVERNIGHT

Another myth is that a major shock will cause your hair to suddenly turn grey. This is sometimes called the Marie Antoinette Syndrome because the French queen’s hair supposedly turned white the night before she was beheaded. But hair, once grown, doesn’t change color, so waking up with a head of white hair isn’t going to happen. Although there is a very rare condition where all of the colored hairs can fall out, leaving only white hairs behind, the simpler answer is that Marie Antoinette probably just took off her wig.

8. SMOKING MAY CAUSE YOU TO PREMATURELY GREY

Multiple studies have linked smoking with premature aging, which includes early greying. In 2013, a study found that there is a significant relationship between smoking and grey hair in people under 30. In fact, “smokers were two and half times more prone to develop PHG” or premature hair greying.

9. BODY HAIR ALSO TURNS GREY

All your body hair—chest, nose, pubic, etc.—can turn grey. Body hair tends to grey at a different rate than the hair on your head, which is why some men can have grey beards and brown hair, or vice versa. By the way, dyeing grey pubic hair is a thing.

10. SOMEDAY, RESEARCH MAY LEAD TO A GREY HAIR CURE

Scientists in Europe discovered a breakthrough with vitiligo, a disease where skin loses pigment and develops white patches. Like hair, vitiligo is caused by “massive oxidative stress via accumulation of hydrogen peroxide,” causing the skin to bleach itself from the inside out. Researchers have successfully treated the discolored skin and eyelashes of vitiligo patients, which has led some to predict a potential cure for grey hair. But while the idea sounds promising, history is full of tonics and creams claiming to cure grey hair. As far as we know, none of them have worked yet.

http://www.foxnews.com/health/2015/12/08/fda-clears-cold-cap-to-save-hair-during-breast-cancer-chemo.html

A number of times we wrote about the use of the Cold Cap for people who have cancer and did not want to lose their hair during chemotherapy. The stories I followed included a relative of mine who was able to hold on to 80% of her hair under chemotherapy for breast cancer. Another patient held on to his hair with chemotherapy for lung cancer. The value of this technology is absolutely clear and now the FDA has formally cleared the technology for clinical use. It was interesting to hear the stories from some of the patients I followed. Their doctors were somewhat resistant to this technology but because the patients insisted on it, they allow its use in their Chemotherapy Centers. Keeping ones hair during chemotherapy gives dignity to many such patients and helps reduce the stigma associated with these horrible diseases.