Category: Photos

Dear Dr. Rassman,

Excellent blog. It’s great to be able to find straight forward information on hair loss which isn’t over hyped (like much hair info on the web) and isn’t afraid to point out pitfalls.

I’ve consulted with a Clinic who offer a technique which appears to be an advancement of FUE . They suggested I need one session and have 2,000 follicles transplanted on the day.

From looking at the photo of me today, aged 31, does it look like I need 2,000 transplanted? (I know a photo isn’t sufficient for you to diagnose and you could easily guess 15% too high or too low from looking at it) Also, how am I to know that I wasn’t charged for 2,000 while 1,500 are transplanted?

As I’ve found your blog useful I’m sure others have too and I’m more than happy for you to publish the photos attached.

Thanks in advance

Firstly, thanks for sending and allowing me to publish your photos. Even if I know the clinic you mention, it would be unprofessional of me to give a comment. The graft recommendation of 2000 grafts appears reasonable based upon the photos you sent and projecting the building of a mature hair line which is lower than the high exposed forelock the photo shows. Viewing the hairline proposed by the doctor would give me a better way to determine the appropriateness of the estimate.

In the end, it is still a “buyer beware” market. You really need to do your research, meet with the doctor, and meet with patients from the clinic to judge the results — don’t just settle for seeing photos of results. Most important, you need to be comfortable with your ultimate decision to trust the doctor performing your surgery. Yes… its a hard process. Speaking with patients who have had the work done there before you came on the scene, will tell you much about the doctor. Speaking with the patient that has had the work done by that clinic should get you the inside scoop. I remember a clinic that offered potential clients a list of over 1,000 satisfied customers, but when I personally called the first 20 on the list, 100% of them told me of horror stories about their experiences with that clinic. The trust issue sometime is relatively easy to flush out from former patients.

If you trust the doctor, you shouldn’t have to worry if you indeed got the grafts you were promised. And yes, there are clinics that can deceive you on the number of grafts you received. We developed count sheets and for FUE we even recorded the amount of damage to the hairs in the follicular units, but damage from the FUE technique is now virtually eliminated with our new breakthrough (but we still keep a written track record of what we do every time, even with FUE². Ask the clinic you ultimately decide to have surgery with, to show you their count sheet paperwork, not only for your own surgery (as this is something you should have in your possession when you leave the surgery), but also in other patients (with the name blanked out so you can verify they actually even make count sheets and record their damaged grafts). If the clinic will not give it to you, or they do not exist, then I would probe the situation more.

Paid advertisements (not an endorsement):

Many of you hopefully know (or at least have read) about the Norwood Classifications for male pattern baldness. I wrote the question in the title of this post, because there is no such thing as a Class 8 patient. Norwood Class 7 is the highest balding pattern defined, but I want to discuss a patient that has an extremely advanced Class 7, so to get my point across I’ve defined the Class 8 term here. He has white skin and black hair with a very, very fine hair character. I had great trepidations when he came to me three years ago to get a transplant, because he had no good quality hair and the worst color contrast possible. One thing running in his favor was a donor density 25% higher than normal. He’s had three procedures with me over the years. First one was 3908 grafts, then 3177 grafts, then 1525 grafts… for a total of 8610 grafts, and as the density dropped with each procedure, the yield also dropped. Of interest, his scar was minimal and the rest of the donor fringe area maintained its height to reflect the dropping density of the fringe hair with each successive hair transplant. He is tickled over the results and could not be happier. The fine hair is see-through, but he loves to comb it and keep it styled.

Click the photos below to enlarge.

Before:

After 8610 grafts:

A few weeks ago he came in and we tried an experiment. We applied concealers (Toppik) to try to manage the see-through hair. The results of this experiment can be seen in 3rd set of photos below. What we concluded was that the concealers made him appear too thick and if he dyed his hair a light brown and then used Toppik, his overall look might be better. His eyebrows are light brown, so that would fit.

After 8610 grafts (and Toppik):

This is a very important piece for BaldingBlog and the first time this patient has agreed to show his results on the Internet. In my opinion, this is one of the best “miracles” we have pulled off in this practice. It took courage for him (see his before picture) to trust me to make this happen and I was honored with his faith in me. With good doctor/patient communication, almost anything is possible. This man is soft spoken and often comes to our open house events to speak with patients and show off his results in person.

Here’s the side-by-side of his before and after (8610 grafts over 3 hair transplant procedures and Toppik), and you can see the results are just amazing!