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I am 29 years-old and would like to bring my corner hairline down. How many grafts will it take?

The number of grafts used in a hair transplant is dependent on the characteristic of the hair (fine, medium or coarse). Fine hair need more grafts and coarser hair need less grafts. So I might quote you a range between 1200-1500 grafts but that would depend upon the final design of the hairline that we determine together. What I am seeing is a faint outline of small remaining hairs that is marking the hairline position. I am using this as my guide for my recommendation.

 

Dear Doc,
I have been experiencing hairloss for the past 8 months. I still have a good amount of hair it’s just become alot thinner. My problem is that on my right side about 4cm above my ear I have a patch that has gone extremely thin. It’s not bald but it looks as if someone has got a pair of clippers and shaved a chunk of my hair hair off – it looks rather odd. The other side is fine. Why do think this has happened? Thanks.

Some people have a different genetic trait in the area above the ears. It is usually on both sides and frequently present for a long time. There are a variety of hair conditions that can cause patchy hair loss or thinning. You need to see a good dermatologist for an examination and an opinion. You should also get your hair mapped out for miniaturization to see if this is happening in other parts of your scalp.

I’ve been on finasteride for half a year and I’ve just started topical minoxidil (regaine) about a week ago, I’ve been applying it on my temples because that’s where my hair is thinning and receding, I don’t have any hair loss on other parts of my head. I found that using a few drops on each side already covers the whole balding areas and using any more makes it wet and drip down my forehead, so is it fine to just use enough to cover those areas even if it’s less than 1mL? Thanks

You don’t have to flood your scalp. Using the liquid, put if on the scalp in small drops and rub it in. Do it best after a hot shower before you go to bed

These are elevated grafts (photo on the left). The surgeon that put them in used a Choi or Lyon Implanter and left the upper part of the graft sticking out. This is not the way I do it for many reasons including:

1- You have to wear a hat for weeks after the surgery and can’t be normal

2- It may leave cobblestonning of the skin as the skin from the grafts lived and may remain elevated

3- It is not undetectable short or long term. Look at my patient to the right of your picture which is one day after the hair transplant. No cobbled grafts seen.

For the bald man that wants hair cover, he should let the side hair grow long enough to be able to sweep the hair from one side to the other. Once that is done, the center part of the long hair is pulled forward to the eyebrows. The final product is the last picture, a damn good covered hairline very common in many men who slowly bald over time. The problems occur when the bald area becomes too large and the amount of hair that is grown from the sides is both too low on the fringe area and too short, and you get the failed comb-over shown in the last picture. Note that the comb-over just doesn’t last as you can see in the gray hair suggesting that this man let his comb-over go on too long. The last set of photos I found on Google images which shows how creative some people can be to get their hair covering their bald area. This photos is not as outlandish as it may appear as this is called a Bouffant and is not infrequently built from scalp hair. In my 29 years of practice, I have seen such Bouffants on a number of men. I remember one man who got up at 2:30 am every morning to build the Bouffant hair by hair (a three hour process). His Bouffant looked good enough to fool me when we first met, but when I unwound his hair, he was fairly bald. He had two hair transplants and told me that these transplants changed his life. He now slept to as long at 7:00 am without worrying about his hair and was able to engage in activities with his children, including swimming and vacations in places that he never thought he would travel to.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The HAIRCHECK instrument measures hair bulk. Follicles that stop growing do not add to the hair bulk on your head. Everyone with genetic balding will show patterns of reduced hair bulk when this is measured. I answered this in past tense. If you are asking me about the future, I don’t have any way to predict it. If you have genetic balding, then it is almost a guarantee that you will see more and more of it as you get older. see photos here on use of HAIRCHECK instrument: https://baldingblog.com/2017/01/10/value-haircheck-bulk-measurements-two-patients-seen-today/

It’s expensive when compared to the oral pills. Dutasteride is not FDA cleared for hair loss so doctors don’t write the Rx for it very often. Topical finasteride in the liposomal form costs around $70/month. The finasteride pill from Costco costs about $27/year. Big difference

If I say on the minoxidil, will my body hair keep growing longer, like 10 cm? That is scary…

Body hair rarely grows that long because it undergoes telogen at about 6-8 months and falls out, only to regrow after. Telogen is the sleep phase and in all hair follicles go through it. These body hairs may stay in the sleep phase for up to 6 months before a new hair appears crating a new beginning of its new anagen hair cycling.