Dr. Rassman,
I wanted to ask you a question about hairlines but first, I wanted to personally thank the staff at NHI, Dr. Pak and you for the wonderful visit I had at NHI this past Friday. This is a bit long winded but please bear with me.
I am a 25 year old caucasian male with light brown hair and am in good health. I started noticing a little thinning at my temples over the last year. To be honest, I was very nervous. I then went from nervous to hysterical. I could not stop thinking about it. Nothing can be more vicious than your own imagination and mine was painting all kinds of horrible scenarios.
In lieu of this, I made several appointments to see various hair transplant doctors here in Southern California. Of course, I never ACTUALLY meet with a doctor. Instead, I ended up talking to a consultant. To be perfectly honest, I did not gain a great deal of insight from these visits. I wanted something empirical to measure my hair loss, a metric I could use to stay informed and make an intelligent decision about my hair loss. None of these visit’s gave me that information.
The balding blog has been a part of my daily routine for a little while now and I decided to do what you suggest in so many of your posts and get my hair mapped for miniaturization and start my master plan. I was looking forward to my visit but also fearing it a little as well. So many things over the last few months have convinced me that I was going to bald to a Norwood class 4, 5 or 6. Pictures I had taken in the last few months, the look of my hair when it is wet or under bright lights. Except for my temples, I looked normal but I felt awful.
Then I came to NHI this Friday and that all changed in about 5 minutes.
I can’t tell you how much better I feel after visiting your office. I made an appointment to see Dr. Pak and he was very informative and understanding. He magnified my donor area for me to show me what non-miniaturized hairs look like. He then moved the scope to various parts of my head. This is the part where I held my breath. However, when he zoomed in on my crown, he saw no miniaturization. The same was true for my vertex and other parts of my head. In fact, the only area that showed any miniaturization was my temples, something my paranoid imagination would not let me believe.
Words can not describe how relieved I was. Dr. Pak was very helpful and he answered all of my questions. However, on my drive home I though of one more question I wished I had asked him and it is this: If none of my hairs, other than my temples, displayed miniaturization then where does my fight against balding go from here?
In your Hair Loss for Dummies Book (page 12) you say the following; “If you’ve inherited this pattern (Class 7), it is usually evident by the time you are 30“. In my examination, Dr. Pak said that my fears about progression to a class 7, 6 or 5 were unwarranted. In fact, he didn’t assign a class at all. He said my hair was healthy all over and my density (2.0) was normal (only miniaturization at the temples).
Am I simply developing a mature hairline? In this post from your blog you say that the mature hairline develops from ages 17-29. I guess what I am trying to understand is the correlation between someone’s age and their degree of miniaturization. At 25, is it too early or difficult to diagnose what class I may (if ever) progress to? Could a Norwood 7 be a lot easier to spot at my age that say, a norwood 3 or 4? I only ask because if I don’t progress any further in the next 5 to 10 years, would some moderate temple restoration be out of line with FUE?
I am 25, but I am not so naive as to think that the battle is over. I do not intend to let anyone else touch my hair except NHI now that I have visited your office. Dr. Pak put me on finasteride and I fully intend to visit your office on an annual basis to check on my hair. Like you say, tenacity and diligence.
Sorry again for the long winded question and many, many thanks to Dr. Pak and you for keeping me informed about my hair loss and educating me before I gave into my fears and did something drastic and foolish.
Sincerely and respectfully
If at any point in the future you want to address only the front corner areas, you can always do so with a small hair transplant procedure using FUE.
You may have a maturing hairline… perhaps in combination with slight recession in the corners. It remains to be seen as you age, but take comfort that Dr. Pak did not see miniaturization beyond the front corners. Stick with the medication and we’ll see you again for your follow-up appointment.
Finally, thank you for the kind email and allowing us to publish it.
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The density has nothing to do with the harvesting method used, just the number of hairs per square mm that the grafts are placed in. Generally, depending upon hair/skin color and hair texture, the amount of hair needed to look full will reflect somewhere between 25-50% of your original density. One reason follicular unit extraction (FUE) might be best used for smaller cases has more to do with costs involved, since it is the more expensive procedure.
Neck hair is not considered “permanent” like the hair on the back of your scalp. There is a chance that as you get older your neck hair will fall out, so if neck hairs were used for a hair transplant it would also fall out. This is what makes neck hair not ideal for transplantation.
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