Category: Photos

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Hair Loss InformationHair Plugs in the Modern Era (with Photos) – Hair Loss Information – Balding Blog

ToothpicksThis patient received 250 grafts just a few years ago (not from me, obviously). He knew things were going wrong when the doctor put wooden toothpicks (which could leave behind splinters) into the recipient sites which were made on his head. He overheard the staff chuckling at how he looked. He told me that before selecting his original doctor, he researched the field over the internet and had a few doctor consultations. He selected the original doctor because he was promised a great result and he believed that promise. As the hair started to grow, he became very self conscious and progressively depressed. Going out into social situations made him uncomfortable, even just going out of his house (something he rarely did once the grafts started to grow).

Cosmetic surgery of any type reflects people and their innermost feelings about themselves. I wonder if doctors understand how substandard cosmetic surgery like this can impact a person’s life. This nice young man’s life was in ruins and his fear of going to still another doctor who could possibly do even more harm, did not drive him to learn how to correct the problem until very recently when he ran into us on the internet. First, we spoke over the phone and then he set up a surgery with me and flew in. When I saw him this week, he was frightened with flashbacks of his original horrific experience

Just to be sure everyone is clear — the photos that are shown below are of this man’s substandard work and an example of what a doctor could do if he/she does not use state of the art hair transplantation technology. The term “hair plugs” is still incorrectly used for the modern technology we invented, but the lingering images (reinforced by patients such as this) are hard to abandon. Looking at the results that were once commonplace, one can clearly see that referring to this old technique as “plugs” is not out of line. Fortunately, I took steps to correct the appearance of these plugs by coring some of them out and transplanting more hair to fill in the entire frontal area. All of the plugs that were removed were cut into follicular units, and then re-transplanted into the scalp. I expect that he’ll be much, much better off after this first procedure with me of 2600 grafts grows in, which was done this week.

Here are the photos of his pluggy look referenced here (click to enlarge):

 

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Receding Hairline Corners – Is It Just a Mature Hairline? (with Photos) – Hair Loss Information – Balding Blog

Dear Mr Rassman,

First of all thank you for your very informative and helpful site.

I am 30 years old and lately I started worrying about my temples. I have a feeling that I have rececing temples and want to take action in case this is the case. Unfortunately I do not have old photos taken from the right angle to compare. Could you please tell me what you think and my Norwood class according to the attached photos. I do not have any balding or thinning on top.

By the way, you can use my photos on your blog if you please.

Kind regards

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Click the photos to enlarge:

 

First of all, thanks for allowing me to publish these. What I believe you’re talking about are the corners of the hairline, not the temples. The temples are below the corners (above the ear) and those look fine in the photos you provided. People seem to get the temples and corners confused all the time when labeling them.

It appears that your hairline is now convex in shape and the central area does meet the side areas, suggesting that the maturing hairline is locking into place. If there is no miniaturization present, I would do nothing other than observe your hairline yearly. This is a Norwood Class I or II.

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Transplanting Conservative Hairlines – Hair Loss Information – Balding Blog

On the NHI patient photos site, patient DTA has had a significantly improved hairline from his previous norwood 3 hairline. I was under the impression (from reading this blog) that your clinic took a more conservative approach to hairlines than other clinics but from the results it appears the hairline was significantly improved.

Could you please inform me on what type of method was used (FUE, strip or both), how many sessions such a hairline took to complete and how many grafts?

Thanks

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Before
Before		 After
After

This patient had 4 procedures totaling 7390 grafts, all using the strip technique. The lack of graft and procedure count was an error on the NHI site that has since been corrected. He started getting transplanted before the FUE technique was available. Many times the patient just wants more fullness, so the graft count goes up.

As for the conservative hairlines, we create hairlines for men that frame the face and look masculine, like the patient above. I don’t understand why some doctors will transplant a straight line of hair for a 40 year old man (for example), when that type of hairline is usually seen only in children and women. See also: If I Get Transplants, I Want a Perfectly Straight Hairline.

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Hair Loss InformationBalding 22 Year Old Woman (with Photos) – Hair Loss Information – Balding Blog

This 22 year old patient came to see me for hair loss she’s been experiencing for the past 2 years. She did all of the right things, saw two dermatologists, and received a complete medical work-up for a variety of disease entities and vitamin deficiencies and was found to be normal. What I told her is as follows:

  1. Obtain a new test for androgen sensitivity of her hair based upon a genetic test
  2. If she is sensitive to androgen, we might try her on an androgen blocker such as finasteride or dutasteride in the hope that this will block enough of the androgen to allow better hair growth.

The science is minimal that support this thesis, but it is better to try to block the androgens on women who are positive to the genetic test for androgen sensitivity than to put all women on the drugs.

In addition, as we could not offer her an immediate benefit with drugs, we used a concealer treatment on her hair and showed her how to do this herself. Her comment after the application of DermMatch was, “I have been reborn”.

I apologize for the blurriness of the before photo. Click the photos below to enlarge. Before (left); After (right)

 

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Even Today, The Quality of Hair Transplant Work Can Be Less Than Marginal (with Photos) – Hair Loss Information – Balding Blog

I am not against capitalism, but last week I met with a young man who took advantage of “special pricing” for hair transplants at just $0.99 cents a graft by a clinic here in Southern California. Yes, you read that price correctly. This is the same facility where a man had died during his transplant procedure a couple of years ago (the only death I know of in the history of this business). This is unlike a 99 cent store that might sell some quality products. This was, of course, a cosmetic procedure that is presented front and center right there on your scalp… and he went with the lowest price he could find.

The patient I met just had a surgery at this clinic and was thrilled at the bargain price he got, but when I saw him (just a day out from his surgery) I was shocked by what I saw! He looked like a victim of a shotgun blast, with blood all over his head and wounds big enough to drive a truck through. Well, maybe not a truck, but you get the idea. This is absolutely NOT the normal look for a person the day after surgery (this is an example of what you should look like a day after surgery). Many of the grafts were hanging out of his head, either partially or fully, and they were embedded in the clots that lay on top of the skin. The patient also reported that the facility was not clean and it was crawling with ants. A real bargain, indeed!

This is one of the more shocking cases I’ve seen in a while and he agreed to let me share his story. I washed off most of the caked clots from his recipient area before these photos were taken. Once again, these photos were taken the day after his surgery at another clinic and I only saw this patient after he came into my office for help. Click to enlarge.

A “bargain” hair transplant

 

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Female Balding and Steps Taken to Fix It (with Photos) – Balding Blog

This is a 60 year old woman who had 2700 grafts to fill in the area where she was very thin. She uses a combination of Toppik in the first inch of the hairline only, a good solid perm for the rest of her head and a reddish hair coloring that works to minimize her hair color contrast. Red coloring at times gives wonderful results and this lady was very careful to style her hair to maximize coverage. The curly nature of her hair changes the characteristics of her hair, which is normally straight.

She could have done it all with transplants alone, but it might have taken twice the amount of hair transplants than she got with the three step approach she used. Click the photos to enlarge.

After

 

Before

 




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Hair Loss InformationCase of 5000+ Grafts Immediately After Surgery (with Photo) – Hair Loss Information – Balding Blog

There have been concerns expressed that people that have had a hair transplant look like a bloody mess right after the surgery. When I recently posted a photo of a typical post-op case to another website, some forum members there expressed surprise and disbelief that a patient could not have blood on their scalp as they left our office immediately after the surgery.

To handle any concerns over whether it is actually possible to leave an operating room without having your scalp dotted with blood, I am presenting a case done just last week where the patient received 5,019 grafts in a single session. These photos are not retouched and are typical of 90+% of our patients at the time they leave our office after surgery. The technique that produces this result reflects the instrument we use for site creation. The recipient sites that are made will tighten around the graft to create a mechanical seal around the site and minimizes any post operative bleeding. With good daily washing, the wounds usually do not form any crusts (scabs). If there is any hair present, the patient can often walk around without a hat and be virtually undetectable with regard to the hair transplant visibility.

Immediately after one session of 5019 grafts. Click to enlarge:

 

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Remarkable Result from 2 Years on Propecia (with Photos) – Hair Loss Information – Balding Blog

This patient has been taking Propecia for 2 years and not only did the hair growth fill in the crown, but even the miniaturization study showed significant microscopic benefit. This is what I keep talking about in this blog, there is the measurements of science behind what the eye sees.

Miniaturization mapping (captured with video microscope):

Propecia - Before / After

 

Before photo on the left / After photo on the right (2 years on Propecia — no surgery). Click to enlarge:

 

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Great American Dream Vote Winner, Follow Up (with Photos) – Hair Loss Information – Balding Blog

I’m very curious on the progress of the TV show contestant, Russ Jowell, that you transplanted in April of 2007. How is his progress? how was it compared to the photoshop projection that was shown the day of the show prior to the transplant?

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For those that missed it, ABC ran a special called The Great American Dream Vote where this young man with a Norwood Class 6/7 hair loss pattern (pretty extreme for a 22 year old) won his dream of getting a head of hair. Unfortunately, the show was canceled before his results could be shown… so here we are.

Russ’s results came out well, but he’s not at that Photoshop projection the producers of the show asked us to make. He has very fine hair, and the projection was made by taking the results of another patient’s hair transplant (who had a medium weight hair), so that will account for the difference in fullness from the frontal view. A coarser hair will have three or four times the volume (visual effect) than a fine hair with less bulk to it. Russ had another surgery after that 1st one for a total of 5816 grafts (photos below) and he just recently had yet another procedure (2856 grafts), this time to the top and crown to give him more coverage. We heavily weighted the transplants in the front on the 1st and 2nd time around, and it’ll take some time before we get photos of his 3rd procedure results, since that surgery was recent. Russ is very happy with the results thus far and can’t wait for the top and crown to grow in. Click the photos to enlarge.

After two procedures totaling 5816 grafts

 

Before