Category: Uncategorized

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A Good Hair Transplant Made Great (with Photos)

Once you have a follicular unit transplant (FUT), if the procedure was done with care, there is no question that the results can’t be detected in any casual encounter, or even on close inspection in most circumstances. Yet with that said, there is still a difference between patient results that go beyond the characteristics of (1) hair shaft thickness, (2) hair character, and (3) hair color.

Let’s take a look at a patient who had two hair transplant procedures. The patient is Dr. Jon Perlman, the well-known Beverly Hills plastic surgeon that has been featured on ABC’s television show, Extreme Makeover. After his first session, he had good results that nicely framed his face when his hair was groomed. But on close examination, his hair was somewhat see-through. Dr. Perlman has very fine hair, so the bulk of each hair shaft was lower than average. By undergoing a second procedure, the bulk was doubled and the results shown in the pictures below say a great deal about the change he experienced. He was more-than-satisfied after the first procedure and thrilled after the second one. A good transplant became a great transplant.

Sometimes patients will tell me something like, “I don’t want it too thick and I am afraid if I put too much hair there, it will look unnaturally thick.” In all of the years of doing this surgery, I have never, ever had a patient who told me that I had made the hair too thick in a single session. We have seen many of our patients (initially satisfied, but wanting more hair) receive another transplant and become transformed back in time to their youthful look. By performing NHI’s pioneering dense packing procedure, we can increase the density of hair in a single procedure, often reducing the number of procedures needed to obtain results like the one shown here, but when the hair is super fine (like the example below) then two sessions may be needed. For many people, hair is like money — the more you have, the better it is.

Click the photos to enlarge.

Before and After 2 procedures (2890 grafts total):

 

For more photos, click “read more” —

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Before (left) and immediately after surgery (right):

 

After 1st procedure (1529 grafts):

 

After 2nd procedure (1361 grafts):

 


2011-02-03 13:24:30A Good Hair Transplant Made Great (with Photos)

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I’ve Had Sexual Side Effects Since Switching to Generic Finasteride 2 Years Ago

Hey Dr. Rassman,

Have been taking propecia for approximately 4 years and for the past two switched to finasteride due to it being cheaper. Have had fantastic results with my hair (have more hair now at 30 than I did at 24!)

However, I have slowly been developing sexual side effects over the past 2 years which has come to a breaking point recently. It is now difficult for me to get and maintain an erection and my semen is watery/decreased volume. I am currently taking 1.25 mg of fin a day. I am seeing a doctor today to get my hormone levels checked. I have two questions for you:

1. Do you think these side effects may go away if I lower my dosage to 0.5 mg/day and do you even think that is worth doing? I would love to keep my hair but I am worried I am poisoning my body.

2. If I want a hair transplant in the future, will me being off finasteride significantly limit my options?

Thanks

Lowering the dose of finasteride may lower the side effects, as I have seen this in my practice. Always discuss your medication changes with your prescribing doctor.

While it is advantageous to be on finasteride when considering a hair transplant surgery, it is not an absolute factor. Many patients undergo hair transplantation without taking finasteride.

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A Person with DUPA Should Never Have a Hair Transplant (Photo)

I wrote the original article on Diffuse Unpatterned Alopecia (DUPA) and yes, a hair transplant should never be done if you have this condition. However, too many young men assume that they have DUPA, and that is wrong. Get the diagnosis confirmed by an expert like me with microscopic examination of the donor area and a metric on the degree of miniaturization present in the donor area. The picture below cannot, without such a miniaturization analysis, arrive at a DUPA diagnosis.


2019-11-22 15:42:05A Person with DUPA Should Never Have a Hair Transplant (Photo)

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I’ve Been Using Rogaine and Got a Headache from It. Should I Stop Using It?

A headache could be a sign of reduced blood pressure from the Rogaine (minoxidil), so I recommend speaking with your doctor and to get your blood pressure checked out. Minoxidil was originally developed as a treatment for high blood pressure, so if you have normal blood pressure and the blood pressure becomes low while on the drug, then you can get headaches as the first symptom of the medication.


2018-10-25 07:39:27I’ve Been Using Rogaine and Got a Headache from It. Should I Stop Using It?

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Abnormal Cholesterol and Lipids in Men with Genetic Hair Loss

In a recent issue of the Hair Transplant Forum, Dr. Jeff Donovan reported a review of the literature which showed that “Levels of total cholesterol, triglycerides, LDL cholesterol, and HDL levels were compared between those with AGA (genetic hair loss) and controls. Results showed that total cholesterol, TG, and LDL levels were significantly higher in individuals with AGA and HDL levels were lower.”

We have known for some time that men with AGA seem to have more heart disease than other men without genetic hair loss. It was particularly notable with men who had crown balding had more heart disease than the comparable genetic balding peers. In April 2012, baldingblog reported that heart disease was 32% higher in men with genetic balding (https://baldingblog.com/2013/04/08/in-the-news-balding-men-32-more-likely-to-have-coronary-heart-disease/).

My advise to balding men, particularly for those reading this on baldingblog.com, is that for those of you over 40 years of age and every five years thereafter, you should get a coronary artery scan for calcium (it is a CAT scan) which picks up early coronary aging. For 70% of men, the first symptom of heart disease is death, so take this advice and put it into your overall preventive health picture as you will never know that you had heart disease when you drop dead. All of my friends and family over the age of 40 have had this test at my insistence, including myself. What I learned about myself, will save my life and hopefully allow me to match my grandfather’s age, when he died, at 102.

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I just had hairline lowering surgery. My hair is falling out, leaving bald patches and an exposed scar

Hair loss following a hairline lowering procedure, like any facial plastic surgery is a known risk. Many times, in men who get a hairline advancement surgery, it does not come back. If you lost hair at the advancement edge, the scar will have to be covered with a hair transplant. Usually women lose hair in the corners of their hairline and this is almost always permanent so a hair transplant will also address this as well. Hair loss elsewhere may reflect a dermatologic problem which should be diagnosed if you have one. The diseases such as FFA, LLP and other types of scarring alopecias need to be ruled out in the evaluation of your problem

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Accutane

I began to lose my hair in the frontal region of my head, shortly after beginning to take accutane. Is there any thing that will help?

Hair loss from Accutane is a known side effect. First you must weigh the options of stopping the Accutane. Your doctor should be able to help you make the right decision. The lost hair may return, so you need some time to observe what happens. If the hair does not come back within 8-12 months, then you might need a complete evaluation with a doctor like me, who specializes in hair loss.

I have previously discussed Accutane on my blog, which can be found below:

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Keeping the dying hair growing

Hello Doc, I’m 26 and taking minoxidil twice a day, finasteride, and doing microneedling twice a day. I take other medications as well. I will not quit medication because of the hair loss that I could get. Could you kindly tell from your point of view. What could be the reason of such an extremely fast diffuse thinning. I have developed a great deal of reversal from my Norwood Class 6 pattern of extreme thinning. Many of the hairs got thicker and new hairs grew out. Could the new regrowth cause the hair to thicken in next cycle? I know that is 6 months progress but maybe your experience give me more hope 🙂 Number of new hairs is quite big but they do not cover scalp completely. Is the diameter of each hair a key to success ? What can i expect ? Should I change finasteride to dutasteride or fin will be sufficient?

I saw your photos on a previous post on reddit and you indeed did partly reverse extensive thinning of the Norwood Class 6 pattern of balding showing before you started treating it. You asked a complex question. Hair growth (Anagen) seems to be induced by wound healing (microneedling) in early balding or thinning but without constant stimulus, I believe that these hairs are eventually doomed. I believe that ingrained in each hair is a biologic clock that dictates the number of hair cycles a hair has when exposed to DHT. This can be altered with drugs and certainly its environment (hormones). Estrogens, for example, when present in significant concentrations without large amounts of testosterone (most females), seem to dictate a different number of hair cycles (women don’t develop Male Patterned Balding). This is just one example. As many of the readers know, I am working with a major university on a solution that might maintain anagen (hair growth) keeping it in its normal cycle, and possibly re-induce the anagen cycle again to the same hair when it goes through telogen. In a male, a normal hair cycle might be 2 – 3 years, so it will take time for us to know. Until we try it in humans, I can’t comment further. We intend to use this discovery in a clinical trial sometime this year and from it, a new treatment for hair loss may arise.