Category: Uncategorized

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Corrective Hair Transplant Questions

dr.rassman, hello. as a former patient i cannot give you enough praise for the corrective work you did on my scalp. my reason for writing is to ask a couple of questions. first, can my old punch style grafts, be redistributed to create a softer look? secondly, can my donor area which is according to you less than a 2 be used to soften and thicken my hairline. i still wear a hair system behind my frontal hairline about 2 inches back. i am afraid of my donor area being bald yet i want a softer look in front to disguise my system. i would stop wearing a hair system but i now have a medium sized bald spot on top and i don’t see a way of covering it up with a very small amount of donor hair left. dr. can you help me? maybe i can fly in to california and have a procedure done to correct my first 2 questions.

People who have depleted donor areas are very difficult to treat. Yes, you can redistribute hair from the old plugs that you received years ago. What you must do is define your problems and your goals, then prioritize them, then visit me or some other competent doctor who can address your problems. Without seeing how you look today, I can not reassess your situation with the new tools and techniques that are now available.


2005-08-19 22:30:14Corrective Hair Transplant Questions

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Patches of Hair Loss from Medication?

I am 31 years old, and I have noticed patches of my hair have been falling out in certain areas. Friends have noticed as well, especially right at the front of my forehead. I have been on birth control for several years ortho novum 777, and recently changed to a new pill this month called (low estrogen), due to medicine I am taking for seizures(Topamax) What can I take to help this? I don’t want my hair falling out. Please help me

Some of the medications you are taking can cause hair loss, but patches of hair loss on one side of your head indicate either an infection problem (like ringworm) or a condition called alopecia areata. You need to see a specialist for this. It is not for me (over the internet) to diagnose your problem, but it does need a competent medical expert.


2006-09-14 09:11:51Patches of Hair Loss from Medication?

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Could FUE Make My Linear Non-Transplant Scar Worse?

I have a small, linear non-transplant scar above my ear. It has healed pretty well, and is looking more and more like normal skin each day. I’ve been thinking about transplanting hair into the scar by an east-coast doctor, about 100 grafts is my guess. If this were to be done with FUE, is there a huge risk that the scars produced from such a small FUE procedure will be worse than my linear scar? I want to be able to wear a buzz cut (somewhere around #2) as I believer my hair is thinning and short hair is a better look. Should I be very worried about moving just 100 grafts from the back of my head into this scar to minimize it?

Follicular unit extraction (FUE) is a good way to fill in a scar, but not all FUE is the same. Different doctors use different techniques and instruments. As long as the FUE instrument is less than 1mm (ideally 0.8 of 0.9mm diameter), you should be OK.

I am flattered you would ask me, but I would ask this question to your doctor since you need to trust the surgeon that will be performing the procedure on you!

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Patient Result — 1 Year After Rogaine Foam and 0.25mg Finasteride (with Photos)

This post comes from Dr. William Parsley in Louisville, KY:

Just saw this fellow (around 50 yrs old) today for follow up. I placed him on 1/4 tab of Propecia QD (0.25mg) along with Rogaine Foam BID a year ago. Attached are his results. Don’t know if he would have had a much better result with a higher dose. The appeal of a very low dose got him to give it a try, as he wasn’t excited about using it for worries about side effects. He had no side effects fortunately.

Click the photos below to enlarge:

After (1 year of 0.25mg finasteride and Rogaine Foam):

 

Before:

 

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Could My Scalp Reductions Be Preventing Transplanted Hair From Growing?

I’ve previously had scalp reductions and a flap hairline performed in the early 1990’s.

I recently in Feb 2010 had a 2000 hair (not graft) procedure performed by the same doctor who was responsible for the scalp reductions and flap hairline in the 90’s to address the lack of hair behind the flap which looked strange. It is now 12 months since the procedure and it appears only half of my hair in the triangular area behind the flap has grown, it is very patchy and is more scalp than hair. Could the fact that the previous scarring from the scalp reduction and flap hairline be causing this skin zone to not grow transplanted hair properly?

The funny thing is that several of the hairs transplanted into the actual scars have grown quite well and show thick well developed hair shafts. But as mentioned before the triangular shape of bald scalp behind the flap is completely surrounded (an island of forelock scalp) by scarring from the old surgery. Could this zone be of limited blood supply due to these scars or does the scalp still get enough blood supply anyway? Also could 12 months be too soon for me? The island of scalp behind the flap hairline has sensation although somewhat reduced sensation but the skin goes white than straight back to pink when pressed. I have compared my post op photos with my current photos and it appears that only half of the hair has grown. I can email a couple of photos if you wish, I have not been back to the doctor since my 1 week post op check up (for personal reasons). it was about 1000 grafts I think. I will get back to him when I feel ok about it, thanks

Prior scalp reductions are not a reason why a hair transplant surgery would not work. Many patients that had scalp reductions in the 1980s and early 90s followed them up with hair transplantation with relative success (growth was fine, but they were the pluggy look from back then).

I think the best thing for you is to follow up with your doctor when you are ready. Maybe you took pre-operative photos, but your doctor should have one (or more) as well and it may be useful to compare what you have now and what you had then. There are many factors that can be the cause of a hair transplant failure and that is why you need to see your doctor for a better understanding.


2011-03-15 13:35:59Could My Scalp Reductions Be Preventing Transplanted Hair From Growing?

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Penis Dysfunction- What To Do?

Thank You doctor for the advice on Propecia. I have started taking it now and within days my hair has improved. Yes, i do get proper erections but when i think of my penis….i dont…so i guess psychology is playing a part in not getting erection.

Anyways, can you please suggest some tests which i need to keep doing to check if my testeterone levels are normal (what i mean to say is tests which can check if my sexual organs are normal).

Thank You

There are doctors that specialize in sexual problems in men. If you are penis-focused, you may be causing your own sexual dysfunction, that is why a doctor who specializes in sexual problems may be a good starting point. They will be able to help differentiate between physical and emotional causes. You can have your doctor measure your testosterone levels to see if they are normal.

I am glad to hear that Propecia is helping, but I would expect that the benefits of it will take months, rather than days.

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Could the Topical Steroids Prescribed for My Foot Fungus Impact My Scalp Hair?

I have a small fungus on my foot. Mr dr. gave me clotrimazole/ bethameth. could it impact mpb?

I do not think a medication for your foot or a fungus can impact the hair on your scalp. Topical steroid on your foot should not affect male pattern hair loss. If there is long term / high dose skin applications with significant steroid absorption into your body, there might be a connection. Be sure to ask your doctor this question.


2012-09-18 10:58:29Could the Topical Steroids Prescribed for My Foot Fungus Impact My Scalp Hair?

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Is permanent Erectile Dysfunction (ED) going to happen to me?

I have been on for almost a year and i noticed recently in the past few months that my erections have gotten weaker. is this going to be permanent? I have stopped taking fin and i’m hoping for the best for my sexual health and my hair

We just polled a group of experts who have written at least 10,000 prescriptions of finasteride to find out what the incidence in the hands of good doctors who have good communication with their patients. I believe I am one of them. Everyone of them has never seen a permanent case or ED. I will comment; however, that in this group of doctors, most commented that they recommended that patients with ED that don’t respond to a decreased dose, were recommended to go off the drug. Maybe that is why the incidence is so low in this group of doctors, but we really don’t know for sure.

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Crash diet, lost hair (photo)

No real history of MPB in family other than normal hair loss after ~50 years old. I am 23 and was fat all of my childhood. I lost about 70-80 lbs in under a year and a half about 2-3 years ago. I basically lost it in the worst way possible… starving, keto, etc. Barely functioned during that time. Since then my hair seemed noticeably thinner on the entire hairline and crown a bit. However, it seemed to get bad and then stay the same since then. Hasn’t really gotten worse. I read that weight loss can trigger MPB somehow. Does this mean I’m basically starting now what I would start at 45/50 years old? Does it necessarily mean it’s going to keep getting worse? Or is there a chance it’ll take some time? I’d really rather get a hair transplant than take drugs daily.

Significant weight loss causes hair loss. 30 pounds in a month is very extreme. A safe number is 1 pound/week and should reflect a new lifestyle of eating, not crash dieting. Even though your family history doesn’t show balding, you have developed a Norwood Class 3 Vertex pattern of balding which was mot likely accelerated by your crash diet.

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Photo of young man showing 1 month change on finasteride but not real (from Reddit)

The hair is longer so the impact I believe we are seeing is due to longer hair. Hair grows about 1/2 inch per month so if the December photos has a 1/2 inch of length and the January photos (30 days later) and 1 inch of length, the hair mass will have doubled.


2019-02-01 15:31:01Photo of young man showing 1 month change on finasteride but not real (from Reddit)