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Disasterous Hair Transplant Horror Stories!

I saw two patients recently that are worthy of discussion here…

Patient #1:
He had a typical result from the hair transplant surgeries of the 70s, 80s and early 90s. He had hair transplant plugs in the early 90s which gave him a doll-like hairline in the frontal area. I have worked with him over a 10 year period with four surgeries to remove and thin out the 3 inch wide plugs, redistributing the hair from the plugs to other adjacent areas in an attempt to make them less detectable. He is about 80% closer to his goal over what he had when he first came to see me and now wears a crew cut, but he is still frustrated over the remaining plugs which still bother him when he looks into the mirror every morning. I will continue to work with him, thinning out more plugs until he is satisfied that he looks normal. He shared what it has been like over the past many years, as too much of his life focus revolved around his head and his freaky pluggy look. Fortunately he and I put together a Master Plan 10 years ago to get him back to a normal appearance, and even now, after a decade of my working on him, the process will continue.

Patient #2:
This man has a far worse story. This young man (in his 30s) has had hair transplant work by many doctors over 10 years. Unlike patient #1, he never had a Master Plan and always sought out the best doctor who promised him a quick fix and he believed what the doctors told him. In the midst of the process, he even had a brow lift to raise a hairline that was too low, leaving him scarred in the hairline area. A series of transplants to fix the hair loss from the brow lift in the frontal area failed, compounding the problem further. The donor strips that were taken in the back of his head were all taken in different areas of the scalp and they all stretched and widened substantially. It seemed that the doctors just kept on removing donor hair from different areas to avoid the wide scars previous doctors created.

This man paid tens of thousands of dollars and each successive surgery seemed to leave him worse off. The recent transplants apparently did not work and he asked me if there was something wrong with his skin and recipient areas. I asked him if he called the doctors who did the failed procedures and he said he did call them over and over again, but they never returned his calls. Now he is massively scarred in the back of his head with at least three wide scars each measuring over 1/2+ inch in width. He received body hair transplants into the scar, but the difference was marginal. Each “fix” addressed one problem in isolation of the other problems, resulting (at times) with him being left worse off in the total scheme of things. I don’t know what he will do, but I suggested that he consider working with just one doctor, and building a Master Plan to deal with his problems. One option might be balloon expansion of his scalp to remove the scars in the back of his head by stretching the normal scalp in the crown of his head. The use of balloons to stretch the scalp will take at least 8 weeks of constant inflation of the balloon. If he wanted us to do it in California, he would either have to move to California for the period that the balloon expansion was being done or find a local doctor willing to do the incremental expansion of the balloon in his home town. We have done similar patients with outstanding results, but the commitment of time is substantial. What I gave him was a Master Plan to get him back to a manageable state. Anything short of such a radical approach will just victimized him again and again by some of the doctors who see $$$ in each successive procedure that they can offer him. Too much of his life is being centered around his scalp and the various poor choices he made.

Conclusion:
I often end with the statement: “Let the Buyer Beware,” which is so appropriate in this situation. Doctors are not immune to being scummy. I unfortunately see horror stories like this almost every week, and I post these as a way to educate you (the consumer) so that you can make informed decisions and avoid being taken advantage of.

How do I end a post like this positively? Well, today’s hair transplants in the hands of good and honest doctors are spectacular. At last night’s Open House event in our LA office, Steve Hartman (CBS Sports announcer and radio show host) who is himself a hair transplant patient, told me that not only was his procedure undetectable, but that he and many of the patients who were there looked like they never lost a hair on their head. Those horror stories I wrote about above rarely happen today. There are rotten applies in every barrel, but there are many really great doctors also in that barrel. You just have to do your research before you jump.

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Propecia Effectiveness Statistics?

Hi Dr.,
I’m a 19 year old with a head full of thick hair. However, I have a slight recession that is following the pattern of my grandfathers. His hair receded into his early thirties and then stopped suddenly. I believe this is called a mature hairline, but it didn’t look like a mature hairline, it looked much worse. I really would prefer my hair not get like that. I think a hair transplant would be unwise this early, and getting one after the recession is finalized would kind of defeat the purpose of having one. Do you have any statistics on the effectiveness of Propecia, and would you recommend me taking this.

If it is a mature hairline, there isn’t much you can do. Medications may help, but I can’t say to what degree (each person is different and will react different to these drugs). At 19 years old and with very little (if any) male pattern baldness, you are definitely not a candidate for hair transplantation and any doctor that would do any surgery like that on you is taking you for a ride.

For Propecia stats, I’d say one of the the best places would be this page at the official site — Propecia.com – See the Proof — which is setup by the manufacturer, Merck. Although you may think that would be a terrible place for unbiased info, I should point out that Merck is heavily scrutinized by the FDA to make sure any claims, statistics, or other information provided is accurate.

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Do Blondes Have More Hair Than Brown or Red Heads?

What do you think of the comment in the side box, “Do blonds have more fun ? No – but they do have more hair. People with blond hair have more hair on their head than people with brown or red hair“.

Link: KidsHealth.org – Taking Care of Your Hair

That’s wrong, Isnt it?

Blonde hairI don’t know that there is a significant difference in hair densities between blondes and those with darker hair, even though it is recorded in various places on the web. I’ve seen pages like this one, but can’t find a source for their information. I have made a point to check the hair densities of the blondes who have come into the office to see me over the years since I started the hair practice nearly 20 years ago, and I couldn’t find any real difference.

However, there is a difference in hair densities between different ethnic/racial groups. Caucasians have the most hairs on their head. African/black hair types have the least amount of hair on their head. Asians fit somewhere in the middle. The reason for this difference is not clear, but Caucasians probably need the most hair on their head because their hairs are the finest. This fine character requires more hair to look like the equivalent of say, Africans, who have the least amount of hair, but their curly hair makes up the volumes. Asian hairs are often coarse, so they may make up for the less numbers that way.

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Propecia Patient Results (with Photos)

Dr. Rassman, I saw one of your comments on Propecia on the balding blog. You are welcome to use my pictures to show your bloggers what the drug can do. As you remember, I am 39 years old and I got these results in just 8 months on the drug. Contrary to what some say about the sex drive, the drug did nothing to suppress it. Sometimes I wish it did. I saw a couple of other doctors before I started Propecia and one had a salesman who tried to sell me 1500 grafts. He said Propecia would not work. Glad I did not have the surgery and listened to you guys.

Thanks for coming forward on this very important issue. The young man can get an outstanding response from Propecia, especially the ones under 30. You are an exception to the rule and a lucky one at that. Although sometimes I feel like a Merck salesman, because I suggest this medication for many of my patients, it is because of people like you that I have become an enthusiast for Propecia. Although the corners did not return, the fullness you wanted was achieved and you are happy. That is what this is all about. You were wise to seek out other opinions and I applaud you for such persistence. There is no “A” given in school for such decisions, and in the real world, the hairy guy you look at in the mirror every day is better than that “A” on a report card.

The below photo on the left is before Propecia use (scanned from a Polaroid, so please forgive the quality); below photo on the right was taken about 21 months after continued Propecia use. He’s had no hair transplant surgery. Click the photos below to enlarge.

 

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Do hard drugs promote hair growth

I just watched the Andy Irons documentary (A Pro surfer) with Andy and his brother who are known to have used hardcore drugs and are perfect Norwood 0’s. David Bowie, Bob Dylan, Robert Plant, Comedians like Richard Pryor, Joey Diaz. Do you think hardcore drugs lower your Testosterone and DHT levels? When ever I hear people saying hair is a diet thing I think absolute bullshit. David bowie lived off of cocaine in the 80s with like a can of tuna fish and some peanut butter or some shit and had perfect hair.

These guys are public. I doubt that their hair has anything to do with hard drug use.

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Propecia, the FDA, and High Grade Prostate Cancer

Dear Dr. Rassman:

I am a bit concerned about continuing with Propecia in light of the recent finding on the risk of high grade prostate cancer. At the FDA hearing in June of last year, the FDA statistician estimated that the risk of getting high grade prostate cancer using 5mg of Finasteride over a 7 year period was 1 in 200. I realize that Propecia is one fifth that, but even a 1 in 1,000 risk when it comes to an aggressive cancer seems, well, risky. If you told me that there was a 1 in 200 or 1 in 1,000 chance the plane I was about to board would crash, I would not board. So, my question is this: is there anything in the study you see that makes you think it’s safe to keep going with this drug?

I believe you are reading things out of context. The FDA site states:

“The labels of all 5-alpha reductase inhibitors (5-ARIs) are being revised based on FDA’s review of two large studies examining whether these drug products (Proscar, Avodart) reduce the risk of prostate cancer. The studies did find an overall reduction in the risk of lower-grade forms of prostate cancer, but both studies also showed an increased risk of high-grade prostate cancer.

As a result of these two studies, the labels of all FDA-approved 5-ARIs will be revised to include new information that these drug products may increase the risk of high-grade prostate cancer. The product labeling will also state that 5-ARIs are not approved for the prevention of prostate cancer.” [Source]

I did a quick Google search and found prostate cancer statistics, unrelated to finasteride use. “Based on rates from 2006-2008, 16.48% of men born today will be diagnosed with cancer of the prostate at some time during their lifetime.” That is about 16 in a 100 or 1 in 6 men.

My point is: Propecia does not cause cancer. The studies that the FDA quotes and the media has latched on to point to how those men who ended up with prostate cancer while on finasteride had a higher grade prostate cancer than men who did not take finasteride… but the controversy of why this is, was not clear from the studies.

A final point is that if you are concerned about the medication, you do not have to take it. It is an option I give to all my patients. This is one of the many reasons why a doctor should prescribe you the medication, because each and every patient is different and the prescribing doctor should be there to address all of these issues one on one with the patient.

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Do I need a doctor for taking oral minoxidil?

I’m going to start the Big 3 to at least TRY for some regrowth. As a 33 year old NW6 I don’t have much to lose. I do have a ton of minituarized hairs on my crown, so it’s worth a shot I suppose. My results over time would be connected with a hair transplant. Unfortunately, topical minoxidil doesn’t work for my lifestyle, so I want to try Oral Minoxidil, and switch to topical down the line. I’ve heard of some potentially dangerous cardiovascular risks associated with oral Minoxidil. I consider myself relatively healthy, with normal BP levels, although I haven’t had a physical in several years. Should I consult with a doctor prior to ordering oral minox? Or would a low dose (0.25-0.50 per day) be OK to start?

Get a good doctor and don’t be your own doctor here.

 


2020-11-04 08:18:39Do I need a doctor for taking oral minoxidil?

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Proscar Has Gone Generic in the US

Dr. Rassman,

It says here that Proscar has gone generic. Do you believe it, and what does it mean to american customers of Finasteride? I am particularly confused about the 180 days bit? Does it mean that generics of proscar will only be available for a 180 day window.

Thanks Doc

See Dr. Reddy’s launches generic Proscar in U.S..

Yes, Proscar (brand name of 5mg finasteride) has gone generic. Propecia (brand name of 1mg finasteride) is still not available in the generic form in the US. Some patients take Proscar and break the pill in 1/5 or 1/4 in place of Propecia because it costs less. This does not mean Proscar is available without a prescription in the US, but it now that it is to be available in the generic form, it should cost even less to take finasteride in 1mg doses (as long as you break the pill).


2006-07-05 15:51:00Proscar Has Gone Generic in the US

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Do Older Women Lose Hair Due to the Length?

Long hairI am 58 years old (female) and have been letting my hair grow long – it is now past my shoulders – I have noticed a lot of hair loss when I wash my hair – is this due to the length of my and age? Thank you for your response

We generally lose about 100 hairs per day and if the hair cycle goes about 3 years, then the calculation of a 100 hairs per day is arrived at. The longer the hair is, the more detectable the hair will be as they will stick to your fingers in the shampooing process and in the drain. This goes for any age.

One lost hair on you could clog a drain and look like a handful if it is as coarse as it looks in the picture. As you know hair cycles and grows about a half inch a month. If you are 5ft tall and your hair is 5 ft long (example) then you have a ten year hair cycle and than means that all of your hair should fall out and be replaced in 10 years, one hair at a time. My great grandmother had hair length like yours when she was 110 years old, but she wore it in a bun and washed it a few times a year. It was evident that her length was far shorter than it appeared as the hair tangled and much of it never fell out.

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PRP Is High Cost, Low Value for the Treatment of Hair Loss

I called this one place in Vienna, VA that says they have the “Best” Centerfuse and the Harvesting Kit known as “Terumo, which she also said is the top of the line and the best of the best for PRP hair loss. She said it’s $1,500 for PRP w/out A-Cell and $2K for PRP w/A-Cell. Expensive per treatment because of the top quality they use. Is it true because everywhere else in Northern VA and Washington, D.C they have packages of 3 or 4 treatments for $2K or $2,500.

My title page says it all: PRP is High Cost, Low Value for the treatment of Hair Loss.


2019-12-09 16:18:11PRP Is High Cost, Low Value for the Treatment of Hair Loss