Category: Hairlines

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I Want Even More Hair (with Photos) – Hair Loss Information – Balding Blog

I have wonderful results from the transplants you have given me, but now I want more hair in the crown. Can I do it one more time?

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This is not an uncommon question. I have shown his before and after pictures here, with permission. He has received 3,218 grafts in three procedures. The first procedure was a limited FUE surgery placed into the corners with 484 grafts. This gave him a nice result, but he wanted more fullness so another procedure was performed in the front to finish out the hairline reconstruction. Had he elected to allow me to dense pack the frontal hairline and use a more traditional approach (strip harvesting), I would have done the entire procedure in the front (1391 grafts) in a single procedure, but the FUE limited the harvesting in the early days (2001) when this was considered a large FUE procedure for me. He elected to come back a third time now to address the top and back of his head. His third procedure had 1,827 grafts and it achieved wonderful, natural results. Now he wants a tighter swirl in the crown and a second procedure into the crown (a 4th procedure overall) will finish the job.

A good Master Plan might have reduced his entire process to two procedures (front and back), but sometimes it takes a slower approach to make the patient feel comfortable with the process. He now has 3,218 grafts total and will receive another 1000 in the crown in the very near future.

Before (click photos to enlarge):


After:


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From Bowling Ball to Gorilla (with Photos) – Hair Loss Information – Balding Blog

Patient ZU is in his mid 60’s and he is what we call a Class 7 Norwood scale balding person (click name to see his before picture). He came to an open house last week and he has now filled out nicely. He told every person at the open house that he looked like a ‘bowling ball’ before his hair restoration, smiling as he made that reference. I talked about him before on this site (and posted some photos), but when last I spoke of this patient, I had said I’d post updated photos of results from his last procedure when I got the pictures. Well, now I have them. He had a total of 8,300 grafts. Would you believe that he still wants more hair? The crown area needs more fill and his comb-back styling is now working well for him, but he believes that with more hair it will work better. I guess when you have been deprived of hair for 40 years, you may over-react. Patients continuously tell me that when it come to hair, like money, more is better.


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Wide Temples and Balding – Hair Loss Information by Dr. William Rassman

Hello Dr. Rassman,

I have always had a big forehead and relatively wide temples. I am 29 and my head looks kind of like the second stage of hair loss diagram. I think my hair may be a bit thinner than say 5 years ago, but not too sure.

My question is, do men with wide temples always end up balding? or is it possible that some men just have a large forhead and big temples without ever balding…

Size and shape of the head are not indicative of future hair loss, as there is no relationship between the two. Some men do have large foreheads or an abnormal shape of the head accentuating the detectability of receding hairlines. Some of those men more sensitive to the impact of hair loss on their ‘look’.

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Asymmetrical Hairline – Balding Blog

Dear Doc, is it normal to develope a very asymmetric hairline at the age of 18-19 ?
I have the right part of my hairline very regular, but the left side is extremely high… it seems that I losed hair only on the lef temple region. In the other areas of my head I have a full density of hair. Is it a normal thing? Could my stress have caused this recession, or was this something impossibile to avoid anyway?
Thanks for your help Sir

Hair loss from genetic causes, can start on one side and then eventually the other side will catch up. Get a diagnosis by mapping out your scalp for miniaturization to determine if you have genetic hair loss. Then tackle it with a good doctor and the appropriate medications that work really well in young men.


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I Don’t Like Having a Mature Hairline – Hair Loss Information by Dr. William Rassman

I am 23 and notice I have a mature hairline. its a 2 on the scale. I dont like my hairline though and would like to get the hair around my temples back. Is there any procedure that can fix this? If so please tell me

I have transplanted the juvenile hairline back in some men, but I do so only under certain conditions:

  1. There is no evidence of advanced balding either on examination or in the family line.
  2. I want to get to know the patient and he must be mature and able to understand the ‘worst case’ scenario that could happen (in your age the worst case thing is advanced balding).
  3. I look at the value of the various elements of hair quality, skin color, hair density, and overall donor supply characteristics and connect it with potential demand considerations.

I have clearly done this more than once, but in my present memory the only ones I have done under 25 years old were professional actors, television soap opera sexy men, or models whose livelihood depends upon that ‘youthful’ look.

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Hairline Regrew with Meds – Hair Loss Information by Dr. William Rassman

I’m a 27 year old with recession to a NW2 pattern, but thinning over a NW5 area. I’ve been using Propecia, Minoxidil and Spiro for roughly 1 year, and I’m noticing pigmented hair starting to sprout around my original NW1 hairline. However, the density on the top of my head appears to have gotten slightly worse. Maybe it’s a shed, I don’t know.

With success continuing on the hairline regrowth standpoint, do you think the thinning on top is just taking longer to grow in — or could it be possible I’ll end up with a NW1 hairline, but with a thin NW5 pattern? I understand that hairlines usually come back in (if at all) AFTER the crown and vertex have filled in…? It just seems odd to me to be having regrowth success in the one area people have a lot of trouble with, but be lagging behind in the areas that are meant to respond best to treatments.

My father has a NW4 recession/NW6 thinning pattern at 55, and my hair loss seems to be following the same pace and pattern as his did at my age. In the scenario that I don’t achieve desirable density on treatments in the next 12 months, is FUE an option to fill in the density of the thinning pattern? On that same note, if I were to have FUE done in the next 1-2 years, would it still be possible to pursuse Hair Multiplication when it became available? I can’t remember where I read it, but someone mentioned that previous HT patients would not be suitable candidates for HM for some reason. Or maybe I misunderstood/misread…?

Call it vanity or risk, but I’d rather have decent hair in my 20s and 30s, and the confidence that goes with it, and worry about my 40s onward if/when I get to them. What can I do NOW to achieve my goals, even if they’re temporary fixes until the next great drugs/procedures come along?

Thanks

Norwood Class 2

Norwood Class 1

I am very impressed with your questions, particularly the way you distinguish the difference between the way to classify recession and thinning patterns of hair loss. You are correct to assume that the impact of medication is different between the front and the top/back of your head. I do not understand why the treatments you are having are impacting the juvenile hairline (Norwood Class 2 pattern moving to a Norwood Class 1 pattern).

With regard to filling in a thinning pattern — that would depend upon many things. There are many doctors who would gladly sell you hair to fill in a thinning pattern, but there is always the really important question to ask: Will the gain off-set any loss from the transplant? Many unscrupulous doctors would like to tell you that this is preventive hair transplantation to stop the balding. When I hear that statemen (preventive hair transplants) I know that the doctor has ethical problems and $$$ are getting in the way of his/her judgment for good patient care. To get a proper answer to that question, you MUST find an ethical doctor who will answer it from your perspective. Judging that you are focusing upon a Norwood Class 1 pattern, I might think that you are overly worried. If you choose to have an FUE or a conventional strip procedure, that is an independent decision to having a transplant in the first place.

Any transplant you *or any person having them) might have will not interfere with the advances in hair cloning or hair multiplication that may come up in the future. You are worried about what you will look like in 13 years, but I would ask you to have you scalp mapped for miniaturization and if you really are thinning in the patterns you discussed above, then the drug of choice is Propecia/finasteride and that could do more to fix the thinning problem than any hair transplant you can do.

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Hair Loss InformationUnnatural Looking Balding Pattern (with Photos) – Hair Loss Information – Balding Blog

This appears like a hair transplant that did not grow, but it is actually a natural balding pattern in a 50 year old man with frontal balding. So why does it look so unnatural? The reason is that the hairs that remain are all healthy hairs, and the surrounding healthy hairs have disappeared (died). Most people develop miniaturized hairs, which is when the hair shafts become finer (front to back), and they just get thinner and thinner in appearance. That is what normally happens in most men. Sometimes, men have mosaic type genetic balding patterns, where some hair in the front remains for the lifetime and looks healthy (hair by hair), but the overall appearance on this type of balding pattern is particularly ‘shaggy’ and has a less-than-healthy look.




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Propecia and Body Hair (with Photos of Hair Transplant) – Hair Loss Information by Dr. William Rassman

This patient had a very nice result from one hair transplant procedure. An interesting item to me was that he reported that when he started to take Propecia, the hair from his chest and back (which was very heavy) returned to his barely hairy 18 year old body’s hairless appearance. In addition, he also reported a reduction of nose and ear hair. So this patient shows not only the benefits of a good hair transplant, but also a rare but good side effect of Propecia (I have rarely seen been made aware of this loss of body hair). I only have photos of his head, as I didn’t think people needed to see photos of the inside of his nose or ears (and so I didn’t take any).

The first set shows his before photos. Click the images to enlarge.

And this set shows his results after one hair transplant procedure of 2,073 grafts.

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I Had a Hair Transplant, But I Want the Corners Lower Than “Normal” – Hair Loss Information by Dr. William Rassman

Hello, I had 1200 grafts last year, and they have done well, but the hairline is too far back in the corners. It is probably just fine for most men, but I wanted a more rounded hairline. I think that I got the male “template.” I have a widows peak, it does not, nor the area of about 1 inch to either side, need to be lowered, just the area in the corners. I have heard of hair line advancement, could this help? Most literature says that all men should look the same, as it comes to hairlines, its just not what I want. I travel to Sacramento and San Jose frequently. Hope to hear from you.

Picking a hairline is a negotiation between you and your surgeon. I have restored the original hairline in men and if this is part of your Master Plan, then it can be done. Be sure to get a great doctor, because these rounded corners can be a difficult part of the art of hair restoration.

Here’s Patient NU, whom I have featured on this site previously. The corners of his hairline were lowered dramatically and the patient wanted his central frontal hairline to look like actor Andy Garcia. Each of us has a different look and different taste, thank God. If we did not, then the world would be farily dull. The patient shown below had let his hair grow out to shoulder length for a number of years, and then recently cut it to crew cut length. He clearly enjoys the freedom of having his hair just the way he wants. Also, it is worth noting that he had temple transplants many years ago, and his results are available here and here.

Other examples include patients EO, KB, and IU.

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Hair Loss InformationTransplanted Hairline at 3 Months (with Photos) – Hair Loss Information – Balding Blog

I am concerned about transplants in the front of my existing hairline. Will they be noticable if I lower my hairline 2/3rds of an inch?

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Here are some 3 month follow-up photos of a patient with dark hair. He had received about 700 grafts in front of an existing hairline. Since it is only a few months after the transplant, only some of the hair is growing and I expect much more to grow out in the subsequent months.

What is important to note is that the patient styles his hair forward so there is no way to tell that these little hairs are growing. Even if he did not do that, it was not clearly evident that these transplants are even there. The point is, it is easy to ‘hide’ transplants even in the front of the existing hairline, because these hairs grow from nothing (bald forehead) to something (fine hairs) very slowly. Most men are very sensitive to having their hair transplants seen by anyone, so I thought that these pictures would show a ‘worst case’ where the hair is growing directly from the forehead (its future home).




Please click the photos to enlarge.