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Male Eyebrow Transplants (with Photos)

Hello Doctors
I am a 39 year old man and had a problem with my eyebrows since I was probably in my 20s. My eyebrows aren’t very thick. I never plucked them and do not know why they appear thin around the edges or when it exactly happened ,but I wanted to talk to you about what a transplant looks like in that area for men. My hair is otherwise great on the scalp and I have a strong hairline. Have you done any man eyebrow transplants? Thanks

Here’s a male patient we haven’t shown before, with some beautiful eyebrow transplant results. I placed 189 grafts into his eyebrows with almost all single hair grafts taken from the scalp using follicular unit extraction (FUE).

In general, eyebrows are difficult to get control of the direction of the hair as it exits the skin, but these results turned out great! The after photo was taken about 7 months following his hair transplant.

Before photo on left // After photo on right. Click to enlarge.

 

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Are Antibiotics That We are Taking, Slowly Killing Us?

In a Denmark Study, people who “redeemed five or more antibiotic prescriptions over the course of a 15 year period were much more likely to develop type 2 diabetes compared with those who took antibiotics’ only noe or two times. Other diseases were also appearing that may be the result of altering the bacteria in our intestine finding associations with “obesity, inflammatory and autoimmune disorders and even depression”.

Since the 1940s with the discovery of antibiotics, the focus was to kill all of the bad ‘germs’ in our body, but maybe we just killed off the good ‘germs’ in the process and without these good ‘germs’, we found ourselves with many other diseases. Children may have been over-treated causing more asthma and a tendency to obesity.

I have read much about the value of our ‘gut’ to help our immune system function properly. The learning curve is very steep at this time and it seems that in almost every medical journal now appearing, we are learning that our intestine is really a functioning part of our immune system, something I never learned in medical school.

I found myself being asked many times by patients to give them an antibiotic for a flu. I know it did not work against a virus, but the patients would demand antibiotics and although I may have been one of the few doctors who resisted such calls for antibiotics, I could not always stand my ground. So what I am telling you here is not to demand Antibiotics when you are not feeling well, as you might be harming yourself if you took them unnecessarily.

This was discussed in New Scientist, April 8-13, Pages 39-41.


2017-04-09 20:32:36Are Antibiotics That We are Taking, Slowly Killing Us?

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Man had problems with his SMP (From Reddit) – with photos

If you have no idea what SMP is then you’re probably not going to find this interesting but I wanted to start a thread chronicling my experience of lightening/removing my scalp micro-pigmentation (hair tattoo). I had my first laser session yesterday.

My hair story is a bit of a long one but I’ll try and explain it as best as I can. Pretty much been bald since my early 20’s, always had a high forehead and it really shook my confidence (and still does unfortunately).

My GP put me on Finasteride and after trying it for a few weeks and dealing with bad sides I stopped it. In my early 20’s I went to see numerous transplant doctors who all told me that I need to wait a few years to see where the balding would end up. They also said that I probably wouldnt be too happy with the outcome of a transplant because of how much hair I had lost and having a so-so doner area. I then started to look for other solutions. I came across Scalp Micropigmentation (hair tattoo) and researched it heavily. This was 5 years ago. I had heard of ‘Tricopigmentation‘ which was branded as a semi permanent SMP option. At the time Milena Lardi in Italy was the best clinician in this field so I travelled to Milan and had 3 sessions done (after shaving my head all over for the first time).

The tricopigmentation gave me a nice shadow but I wanted more so I decided to go down the ‘permanent’ SMP route with a UK company. Again I had 3 sessions but this time it was much darker and overall I was pretty happy with it. I was not as self conscious about my shaved head as I thought it looked like I was shaving out of choice and not out of need. It was high maintenance though as I had to shave everyday and also use alot of anti-shine. Some people noticed and others didn’t. In hindsight Im not sure I was fooling anyone as I do think that many people can spot a ‘too perfect’ hairline. The eyes are naturally drawn to it, which isnt good.

Once I got to my late 20’s I decided to get a transplant to compliment the SMP. Again I researched this for quite sometime and ended up having a 4300 graft hair transplant in Turkey. This gave me texture on the scalp and also massively reduced shine (which I was delighted about) but its way too thin to grow long. The recovery was horrific and dont think id ever get another one. While the idea was that the transplant would compliment the SMP (and vica vearsa), I was left with transplant hair I cant grow very long because it makes the SMP on the scalp stand out like a sore thumb! Furthermore it really made the hairline look even more fake.

Fast forward to 2019 and I was left feeling really self conscious about my head. I do notice when people talk to me they linger just a second too long on the hairline and scalp, plus i do see some people do a double take on the street. In the end I decided my only option was either to live with it (not happening) or get the SMP lasered off (without damaging the hair). After a few months of research I went with a laser removal technician who has alot of experience with SMP.

I had my first session yesterday and so far Im pleased with the results — although it was really f***ing sore. It will take a number of weeks for the fading to happen (it doesnt happen right away) but already I’ve noticed the hairline looks a little more natural and while its still red (it looks worse in photos) I think I will be happier with it gone or faded. Less really is more.The actual hair stands out now rather than the SMP dots.

Happy to answer any questions you guys might have. 3 words of advice if you’re thinking of SMP or lasering it off for that matter:

  1. If you’re thinking of getting SMP go with someone who has ALOT of experience and can show you photos of their work. This is very important.

  2. LESS is more when it comes to SMP. Try and keep things as natural as possible (broken and receding hairline) — not a lego man hairline. Its really difficult to get a natural hairline, especially for lighter skin tones.

  3. If you’re thinking of getting SMP or indeed removing SMP — Research, research, research and ask questions before committing.

Photos:

Upper left photo = SMP + Transplant hair a little longer than buzzed (before laser)

Upper right photo = 1 day post laser and buzzcut (today!)

Bottom Left = SMP before laser and transplant hair buzzed

Bottom right = 1 day post laser and buzzcut (today)

 

This man offers good advice. I keep mentioning the idea of a Master Plan and that is something that is critical. Had he found the right doctor at the onset, he would have been able to tackle a hair transplant when and if he wanted one. Here is a man who had the worst balding pattern possible with hair transplants followed by SMP. The photos speak to the result: https://baldingblog.com/72-year-old-surfer-still-surfing-and-he-has-hair-photo/


2019-11-04 10:41:27Man had problems with his SMP (From Reddit) – with photos

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Any Radiation from Robot FUE Systems?

Hi. I’m a bit of a hypochondriac, but do the robotic FUE hair transplant systems like ARTAS and others emit radiation?

Thanks

I believe all electronic equipment, such as the computer monitor you are staring at and the microwave oven you cook your meals in, emit radiation. These aren’t hazardous levels of radiation, though.

The ARTAS FUE robot likely emits some level of radiation like any other electronic equipment, but it isn’t anything to be concerned about. The FDA’s Center for Devices and Radiological Health was likely involved at some level before the robot was made commercially available.

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Why do so many hair transplants look terrible?

Thanks for the further performance pointers! Is (1) primarily avoided by trimming off as much of the skins as possible (without damaging the follicles) and (2) by inserting them so that the hairs grow out closer to perpendicular to the scalp (rather than tangential). I speculate there is a lot of room for automation during the “filtering” the grafts based on follicle counts. I’ve read that in some areas of visual-diagnostic medicine, computer models are able to classify images more accurately than medical professionals (on a nonmedical image classification task, a convolutional neural net I built was more accurate than me in a small labeled test sample). But perhaps even more important is that it can reduce the time needed for the procedure, and therefore, also reduce the costs (which allows more people to get a transplant).

WE have monthly open hose events where our former patients come in to talk about their experience. Most people like you who come are skeptical thinking that can tell who had a transplant and they are always pleasantly surprised that they can’t tell. Good transplants can’t be detected. Look at Elan Musk before and after his transplant, a good example of a good job with actor Joe Penny (https://baldingblog.com/actor-joe-penny-shows-off-his-repaired-hairline-with-photos/).


2020-04-16 10:24:03Why do so many hair transplants look terrible?

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Appropriate Amount of Grafts in Frontal Area

Dear Dr Rassman,
I am a 24 yo male who has experienced hair loss in the frontal region and am told that i am a Norwood type 4. I went to see a surgeon/dr in Australia. He told me that the best treatment was to have one large megasession and that he would use 2500 grafts on the frontal region. I am curious as to know whether this is an extreme amount in that region and your feelings on megasessions. I was also wondering that given my age how many sessions in my lifetime will i need and how frequently do people my age have to have more done. If i had a megasession would there be enough hair in my donor area if i did suffer more hair loss. Is there any way of doing a procedure, where you have existing hair, to transplant it to that area to prevent it if it was to fall out. Does one procedure in people’s liftime exist if they stay on propecia (which I am on, and doesn’t seem to be working that well).

Sorry for so many questions Dr Rassman. Thank you very much for your time.

For a Norwood 4A balding pattern, 2500 grafts in a single session sounds like a reasonable number that might meet all of your needs, depending how large the area is. Most people have about 6,000-8,000 grafts available in their donor area, but the actual number may vary. That is why we measure everyone’s density to determine a Master Plan for the worse case scenario of hair loss. Your age is a bit young, but if the pattern of loss is relatively complete and did not reverse after taking Propecia on a trial basis for 8 months, then a transplant could be reasonably done. Hopefully with Propecia that is consistently taken, the hair loss will at least slow or stop, stalling any need for further transplants for some time. Provided that you keep the work done to the frontal area, there is little worry about running out of donor hair for most people. I would discourage work in the crown at your age.

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Massive shed after switching Finasteride to another source.

Shedding after switching Finasteride supply source may reflect a counterfeit drug or a faulty production lot. Check the source and go back to where you originally got it from. I have seen this even in good stores when they purchase off-brands of genetic finasteride. Hair loss from Finasteride withdrawal may become permanent so act quickly and get back to a source you can depend upon.

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Are juvenile hairline loss triggered by DHT?

I know what’s the difference between two cases? DHT miniaturised and non-DHT miniaturesed? What else causes miniaturisation except DHT?

If the miniaturization is DHT dependent, then it occurs in the hairs of the scalp that are susceptible to DHT from genetic causes (i.e. Norwood Class 7 pattern patients). I have believed that the juvenile hairline in most Caucasian men have hairs that have a limited life (i.e. develop apoptosis when the clock reaches its genetic finality which may vary in men between ages 17-29). I have met some men with a Norwood Class 7 pattern who had a persistent juvenile hairline that stayed strong into their 60s. That is why I don’t believe the juvenile hairline is not sensitive to DHT and its loss is apoptosis tied to some biological clock.
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Maturing Hairline at 18 Years Old

Hey doc, I’m 18 years old and I have long wavy hair. I’ve noticed that my hairline is receding in the front…more so on the right side and a few small bald circular spots in the front. My dad is in late 50’s and he has a head full of thick hair while my mom is in her 40’s and is showing signs of baldness. However, she is constantly stressed out about various issues so I’m not too sure if its heridetary. My grand-dad passed away in his 50’s and he was balding. I tried shaving my head before and i look absolutely horrible! Is there anything I can do to promote the regrowth of my hairline? I am not exactly the Brad Pitt look-alike and my hair was the only thing I had! Are there any new treatments under development and on the market that can do something about this dire issue? Thanks for your help.

What you are reporting is the maturation of your hair line, which occurs between the ages of 17-29 in most caucasian men. The corners rise about 1 to 1 1/2 inches and the center rises about 1/2 inch to 3/4 inch. To see if this rise is normal, look into the mirror and lift your eyebrows up. There is a high crease, which reflects the top of the Frontalis Muscle, the place that hairline transition zone usually starts in boys and most women. As caucasian men go through an aging process (I like the term maturing process) where the hairline rises as discussed above, but for many non-caucasian men, the hairline is flatter and does not rise as far in the corners or not at all. If you have sisters, have them lift their eyebrows and look at that crease and you will see hair just touching that crease. This is a normal male process and nothing to be concerned about, provided that it does not rise higher than the measurements I just referenced. If it does, or if a doctor examines you and determines that you have miniaturization (too many fine hairs behind the mature, adult hairline location), then you may have early male patternedgenetic balding and the best drug to slow or prevent hair loss is Propecia. I have seen many wonderful, miraculous results from this drug in young men. Propecia has been on the market for about 7 years and it is safe. My son, many members of my family, and I take this drug and none of us has defined any negative side effect, sexual or otherwise.

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Are These Side Effects from Propecia or Stress?

Dr. Rassman,
I am 23, and have had diffuse thinning for the past three years. I am currently taking propecia and minox and have been for 15 months. During that period, I have not noticed any significant regrowth, but the appearence of my hair has seemed to maintain to some degree. I am also a law student and in December I had my first set of finals. During that time, I can honestly say that I was more stressed then I have ever been in my life. Since december, I have noticed that my hair has appeared to thin significantly.It used to be thin only in the back, now I can see a thinning pattern in the front. Additionally, in the month since finals ended my libido and sex drive have significantly increased. I do not know whether that increase is due to my lack of stress, however I am speculating that the propecia has stopped working for me. I was wonding if these are typical effects if it does stop working; i.e increased thinning and greater sex drive or perhaps I can attribute both the my level of stress and current lack there of. Any help would be greatly appreciated. If propecia has stopped working for me, then I really don’t know what else I could do

Stress impacts everything in our lives. Your hair loss and thinning is certainly (assuming you have genetic hair loss) being made worse by stress. Propecia sounds like it has slowed or stopped the present hair loss, but as male genetic hair loss is a progressive process, it is only a matter of time until you notice more thinning/recession. The sex drive issue relates to many things. Men can find sex to be a good outlet for frustration and hiding from problems. Propecia can initially cause an increased sex drive due to the increase in testosterone levels, but the sex drive of a man your age should already be high, so perhaps your body is just learning to deal with the stress better. Could it be that your normal sex drive is what you are now experiencing?

With regard to your thinning and possible genetic hair loss, you should get your hair mapped out for miniaturization to determine if the hair loss is genetic and to what degree it is progressing. You need a Master Plan for your future hair loss. As you are in Los Angeles, I would be pleased to see you myself at no charge in my LA office. If you are interested, please call my office at 800-NEW-HAIR to set up a free consultation with me.


2006-01-30 10:36:12Are These Side Effects from Propecia or Stress?