Do you think that my 800 grafts were an adequate number?

Can you give me an analysis of what you see?

Ask yourself: How many hair would have been in this area had you not lost the hair? Normal hair density ranges between 1000-1250 hairs/square inch depending upon your race. To get a reasonable density from a hair transplant when you hair is brown, skin is fair, and hair is of a medium thickness, you need to restore about 20-40% of the original hair density. There are many gaps in your hair transplant and the frontal hairline is a straight line when it should be soft, non-linear and the grafts random and to make matters worse, your doctor put another straight line of hair grafts behind the frontal line. I am worried about the nature of your frontal line grafts, as they must be single hair grafts or your hairline will look pluggy. You will, I am sure, need another transplant but I wouldn’t go back to that doctor again


2019-03-09 10:21:51Do you think that my 800 grafts were an adequate number?

Question about Class 7 pattern of balding

I have read a few articles stating that for most norwood 7 men they would display that pattern by the time they reach 26. Would you have a reference picture of what that would look like? Im assuming they generally would not be fully bald by that age.

Two scenarios point to a Class 7 pattern of balding.
1- The aggressive balding pattern fully appears by the age of 26-

2- The balding pattern is evident with thinning and miniaturization down to the rim of permanent hair around the top and back of your head which suggests that your pattern will eventually become a Class 7 pattern.

You need a good doctor to manage your balding and if you want a hair transplant, to help you get realistic expectations for what you can achieve as determined by your donor density and your hair bulk.

Doctor Says After 10 Years on Propecia It Looks Like How You Were Before Starting

I read an article written by a Hair Specialist from Saratoga Hair Transplant Center that Propecia works great for the first 4-5 years for most men, and then slightly each year the hair gets worse again and by the time you been on the drug for 10 years you are back to where you were 10 years ago, this sounds really good to me! But is it really true?

I always believed that after 2-3 years you will start going downhill.

I don’t agree that after 10 years on Propecia, you end up right back where you started. Some men fully maintain the benefits from Propecia in the long term, and others just do not. Everyone is different and will react differently to medication. I have patients that have been taking the drug each day for over a decade and are still seeing the benefits from it.

Think of this as a war between balding and the drug holding onto your hair. May the better side win!

Post Finasteride Syndrome (PFS) Questions

So basically what I learned is that people who don’t recover from sides after quitting fin are bound to get them regardless, propecia just accelerated the what will happen to them. Because of that how tf do I know if I’m getting ED or whatever in the future ? The doctor said that people who have low testosterone or diabeties have that chance but I have no idea if I have low t levels. I mean I have lots of body hair and some facial hair and I’m south Asian sooo

I don’t know if your doctor knows what he/she is talking about. There is no association between diabetes and PFS. I don’t believe that anyone knows what causes it, but I know that we don’t see it in our practices because we don’t maintain young men on finasteride who have ED, especially if it doesn’t respond to time and/or a reduced dosage.


2019-12-11 09:44:49Post Finasteride Syndrome (PFS) Questions

Doctors Promising Unattainable Hair Transplant Results

Norwood 7We just spoke with a patient who had a full Norwood class 7 balding pattern with an approximate 2 1/2 inch height to the posterior rim. His donor density was very low from the pictures he sent prior to our phone consultation.

He had been making rounds with various doctors showing his picture and wanting a full head of hair. One doctor he spoke with quoted a certain dollar figure and told him that he could get a full head of hair from transplantation. I think he wanted to believe what he was told by this other doctor, and he was basically price checking with us. We told him that what he wanted was impossible, though. His goal was unrealistic and another doctor was about to take advantage of him.

Again and again, I hear of promises about bringing back hair from a hair transplant with goals that are not possible to attain. The promises from doctors who need the income seem to never stop. So as we always say — “Let the Buyer Beware”.

Rare Genetic Vulnerability to Minoxidil?

I’m a hairy 22yr old guy. I over-plucked my eyebrows and wanted them to grow back quickly so I applied Rogaine to them just once. In 1 hour, I felt extreme dizziness and heart palpitations, so I washed off the Rogaine. 2 days later, my eyebrows started falling out. 2 weeks after that, I started losing substantial amounts of hair from my scalp, arms, legs and even pubic area. This enormous amount of hair shedding has been going on for 3 months now. My eyebrows and scalp are starting to look like total crap because the hair isn’t really growing back anymore. All my blood tests have come back normal. I’m positive that the Rogaine set off some kind of systemic reaction in my body. You once answered a question entitled “Rogaine Destroyed My Hair!” I got in contact with the individual who posted that question. He also used Rogaine just once. After speaking with him, I learned that the progression/symptoms of our hair-loss have been almost identical.

Doctor, is it possible that we have some rare genetic vulnerability to Rogaine? And why has it continued to affect our bodies for so long? Shouldn’t any effect be temporary? The other guy is still losing hair and eyebrows, even though he applied the Rogaine 2 years ago. Both he and I notice that when new hair does grow in, it quickly falls out within a week or 2. Thanks doc. I hope you can offer a glimmer of hope.

I have noted your history, but I have no experience with this. As you may know, minoxidil is a drug that was originally made for use in high blood pressure and it produces a drop in blood pressure, which would explain your initial symptoms. With regard to the longer term side effect, I really don’t know, but would strongly suggest that you get your hair examined by an expert with (at the least) mapping and miniaturization studies done.

Does a Maturing Hairline Also Decrease the Total Volume of Scalp Hair?

hi doc

i’ve got a general question about maturing hairline. while a hairline is maturing, can the total volume of scalp hair diminish? is that possible?

If the hairline and the hair that disappears reflects 2% of your total hair count, then the reduction will be 2% of your hair (total volume measurement). While it is maturing, the impact (if you do not have genetic balding) will not affect you anywhere other than the first 1/2 inch of hairline. In other words, if you’re losing hair beyond the hairline it isn’t just a mature hairline.


2009-10-15 10:33:07Does a Maturing Hairline Also Decrease the Total Volume of Scalp Hair?

Reader Shares His Daily Hair Routine

Dear sir,

I first of all thank you for taking your time out to answer this question. I’m sure you’re quite busy…I’ve seen more balding heads on the streets than ever.

I’ve been losing my hair since I was 17. I just turned 21.

I went through all the usual stages. Denial, loss of confidence, etc. I still have as much left as many men RECIEVE in their procedures, but it will only get worse. I had a solution in Spring 2006, while I still had enough that no one knew – Propecia. My (completely bald) doctor recommended it for me.

But I was an idiot.

In December 2006, I stopped taking it. I felt it hadn’t made any difference. No further thickening, no regrowth. Everything seemed fine until summer 2007, when it started becoming frighteningly apparent that it HAD kept some hairs in (I washed many long, luxurious strands of Marc Bolan-style hair down the shower drain). I didn’t know why this was happening all of the sudden – I did not know that stopping Propecia not only stopped the positive effects of Finaesteride on DHT, but also allowed the MPB held back to return with a vengeance.

Within six months, my hair loss had become worse and more apparent than it had since it began. It happened quite quickly.

I went to the barber’s in October 2007 and cut my long hair off. I could tell where the hair loss was hitting hard; the hair cut from the sides and back was thick and Roman, while the hair cut from the top and front was lighter and frizzy. Not enough hair was growing to create curls or waves, so it looked like it was damaged.

Immediately I began a plan of action. This time, I wasn’t going to hit MPB with just one drug. I was going to have an armory full.

In November, I began a treatment which gathered supplements, drugs, and shampoos over the course of those following months. It has come to finally include the following daily routine:

Propecia (1X)
Rogaine Foam (2X applications)
Saw Palmetto (supplement, 400 mg each; 2X)
Nioxin 3-part System (no.2; in the shower)
Neutrogena T-Gel (1X; shower)
Nizoral (1x; shower)

The anti-MPB effects of Propecia and Rogaine are known to you. Saw Palmetto is reputed to have anti-androgen effects, as is coal tar (1% found in the T-Gel) and ketoconazole (1% in the Nizoral). Nioxin is proven only to thicken the APPEARANCE of the hair, but claims to clean away “environmental residues like DHT” on the box. Reviews and hearsay seem to back this up, so I’ve been trying it.

Why go through all the bother, you ask? Simple.

I am a musician. A player, a writer, a performer. Not just a musician, either. A damn good one, with artistic vision and a damn good shot at making it.

But this is the one thing holding me back.

1: Toupee/Wig – Will not. Don’t want to be playing a windy outdoor show or find myself in the throes of lust with someone I fancy when the proverbial “rug” falls off.

2: Shave – The aesthetics of being a performer on stage in the rock/pop medium require a youthful, attractive appearance. This I know firsthand; people who knew me when I had a large rockabilly pompadour or a healthy tangle of curls suddenly looked at me with sad shock when my receding hairline and thinning temples were revealed. I have an odd-shaped head, and that doesn’t help either. So nix the Telly Savalas look for me.

3: Hair Transplant – This is the most promising option. I have read all sorts of “breaking news” regarding WNT proteins and new solutions for this age-old bastard curse, and they may eventually pan out. But not in the next five years, and certainly not soon enough to take advantage of my youth and hit the big time. But I do not have tens of thousands of dollars to spare (especially in the midst of the economic recession), and I know that (sparing a new cure) my situation is only going to get worse.

I have read on many forums that Propecia (or finaesteride at all) loses it’s effectiveness on most men after 5 years of use. This rumor is widespread and greatly troubling; if true, the backbone of my (and many other men’s) MPB treatments will be null and void in 5 years or less, leaving us to lose all the remaining hair in a fast, depressing way (as I did much of my hair last summer).

I am at ends. While one’s self-worth should not be based on looks alone, appearance is crucial to the formation of identity. And when that tool, that weapon of good looks is taken away from a hopeful star, what is there to do?

Again, your time is most sincerely appreciated and I truly thank you for reading this.

You are incorrect with regard to Propecia (finasteride). It continues to work for years and does not simply stop at the end of the 5th year. What usually happens is that hair loss continues to progress and eventually (around the 5th year), you may go back to your baseline hair loss pattern — but if you stop the Propecia altogether, you will be far worse.

You need to get a good doctor to build a Master Plan for you. It is said that the person who treats himself may have a fool for a doctor. You’re throwing everything at your hair loss, and while it may not be a bad thing (unless you count the expense of money and time involved), it might be excessive and unnecessary. Please, discuss this with a doctor — the physician that prescribed your Propecia is probably a good place to start. Thinning hair can be devastating to one’s self esteem, and many people will do whatever it takes to not let that happen.

I wish you good luck and thank you for sharing your story with us.


2008-03-18 10:01:57Reader Shares His Daily Hair Routine