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How Can I Expect a Natural Transplant Result when Donald Trump and Other Rich People Can’t?

Hi Dr.

I’ve been looking at your page for some time now and it is loaded with great information. I also consider myself to be fairly well educated regarding the various options available to balding men such as myself since I’ve spent years keeping up on these developments. I am 39 years old and my hairline began to recede when I was about 20. For the longest time, the rest of my hair was so thick that no one really noticed since I wore my hair long. Over the past few years, the top has thinned substantially and I no longer bother to try to style it. I just wear it very short. I’ve never wanted to be one of those guys who look like he’s trying to hide something. The problem is that I’m also not one of those guys who looks good bald. I wish I were, but I’m not. About 15 years ago I had consultations at two different hair replacement doctors and both, to their credit, told me I was not a candidate at that time and to come back in the future when my hair loss was more advanced. I’m sure that time is now. However, I’m not sure I want to commit to a transplant procedure. The biggest question I have is this. Is there really a chance for someone of moderate means such as myself to achieve a natural and attractive result from a hair transplant when people with unlimited resources like Donald Trump, David Lee Roth or the myriad other balding rich people can’t seem to do it? I would say that I’m probably somewhere around a 3 on the Norwood chart.

TrumpI laughed when I read your question; I’ve been wondering the same thing. A good hair transplant today is the norm, but in the days when Donald Trump did it (allegedly *cough, cough*), it was not a procedure that produced undetectable results. Mr. Trump, I believe, had scalp reductions (the bald spot was cut out) and hair transplants of the older vintage. The issue for people like him should be to repair the process, but he can not wipe the slate clean and go back in time prior to having the surgery. We wrote and published in peer-reviewed medical journals; most of the original articles were on the art of repair. I have no hesitation in discussing the repair process, but first, please read some of the articles we wrote on the subject:

For a person having his first hair transplant, you need to find a competent doctor (when you are ready) who is artistic and has a great reputation. I stress the importance of viewing patients (one-on-one) as a doctor who proudly shows off his/her results by giving you the opportunity to meet many of his/her patients. This will give you a very good idea of what you would look like after a hair transplant. I always say that what you see in the patients you meet will be a reflection of the surgical results you will get. Always ask for “before” pictures when you meet these patients yourself! Not to be alarmist, but I know of one immoral doctor who used a photo in a newspaper ad of a man with no balding to promote his practice — he was legally able to call this man a hair transplant patient because he had a few grafts placed behind his thick, normal hairline.

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What is the different between a Mature hairline and a receding hairline?

A Maturing hairline is a natural process and does not reflect any male pattern balding while a receding hairline reflects terminology of a presentation of genetic balding in men. The mature hairline is located in the midline, one finger breadth above the highest crease of the furrowed brow.


2021-03-11 06:52:30What is the different between a Mature hairline and a receding hairline?

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How common is body hair when using minoxidil?

My dermatologist said he “isn’t convinced” I’m balding (fingers crossed), sees no miniaturization and said if it is MPB it’s very early, but because I’m still shedding hair he’s told me to start using an ointment with minoxidil/finasteride and see how it goes.

One of the side effects of minoxidil is increased body hair and I’ve read stories of people getting huge amounts of (possible permanent?) back hair and so on which for me would be equally as bad as balding. How common is it? Should I just go back and ask for finasteride only?

It is common in women who use it. My best friend’s wife used it and shortly stopped taking it because it produced facial hair that she did not like. I can’t advise you on the finasteride as that is between you and your dermatologist

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What is This Balding Bump on My Head?

I am currently having a lump/hump(elevated)on my head it’s circle in shape and around that bump is a bald area but inside that circle shaped hump has hair. What should I do sir? Is this some kind of a disease? Should I do something or wait for it to go away. I had this for nearly a year now and I’m still 15 years old. This was small at first but then it became bigger. I fear this can do something bad to my health. Please reply. I really need help. I went to the doctor but the medicine and lotion i received isn’t working. I think she had a wrong diagnosis. 🙂

thanks!

I really couldn’t begin to guess at what the lump is without an examination. It could be a variety of things, but there’s nothing that stands out to me by your description. If you’re not satisfied with your doctor’s diagnosis you should get a 2nd opinion from another doctor. It never hurts to double check!


2010-06-22 08:18:08What is This Balding Bump on My Head?

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How Do I Know If I Have Telogen Effluvium?

I am a male in my early 20’s and I just came across your website. I have been on propecia for maybe 3 years and I have a feeling it is loosing it’s power. More so in the front of my scalp. What is another option? I received a book from a dermatologist and in it he lists some other medications. I don’t have the list handy but I would like to send you the list so you can let me know what you think.

I want to know about telogen effluvium. How do you know if you have it or if you are going bald? I read on the net that for telogen effluvium there is an overall thinning of the scalp but not baldness and that the hair comes back. But how long before the hair comes back? I am guessing if the hair doesn’t come back within a year then you are going bald I guess.

congrats on the site once again. Really helpfull.

It would be hard to judge about the efficacy of Propecia. You don’t know how you would look if you were not taking it. It is true that some patients experience better results than others, but your hair loss may get even worse if you stop taking it now (by catching up to the point of loss you would have experienced if you’d never taken it at all).

As discussed here before, the effect of Propecia on the frontal area is not completely studied. Current studies on Propecia indicate good result on crown and back of scalp. Other options are minoxidil and hair transplantation. Propecia and minoxidil are the only FDA approved medications that should be used for treatment of hair loss.

Human hair is in growth or anagen phase most of the time (between 3-6 years), and following that enters to a resting or telogen phase (about 3-6 months). The hair loss that we experience on a daily basis is due to shedding of hairs that are going into telogen phase (10% of our hair population at any one time). Telogen effluvium is triggered when a physiologic stress or hormonal changes cause a large number of hairs to enter to telogen phase at one time. Telogen effluvium is characterized by diffuse hair shedding. It is usually caused by a metabolic or hormonal imbalance or medications. Typically, recovery occurs within 6 months without any treatment. If your hair didn’t come back after 6 months, you should see a dermatologist for further evaluation and to rule out the other causes of hair loss.

At your age, with frontal balding, I would expect that you have genetic hair loss. The diagnosis is made by mapping out your scalp hair for miniaturization. This will show regional miniaturization weighted to the frontal area as you are describing. If the diagnosis is telogen effluvium, it will not show that pattern and it will be more generalized beyond the frontal area into the permanent zone.


2006-11-27 14:54:19How Do I Know If I Have Telogen Effluvium?

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What Product Can I Use to Make My Thinning Hair Look More Full?

So my hair is thinning in the front and I would love to find a product that I can use everyday for styling that makes it look good?
Right now I use dry shampoo and I style that way but it’s drying out my hair… I wouldn’t use gel or hairspray because it makes my hair look oily which makes me look even more bald. I would love a product that keeps hair in a style but also looking dry so it looks more full.
Thank you so much in advance.


Many men and women use Toppik, Dermmatch, or similar concealing products to thinning hair. Scalp MicroPigmentation is a permanent concealer. Some of these women had Scalp MicroPigmentation as well as hair transplant surgery.

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How do you make the diagnosis of DUPA (Diffuse Unpatterned Alopecia)?

The only way to determine DUPA is with a video microscope showing the details of the donor area. I always insist that the area I look at is cut short (a couple of mm long) so that I can count the miniaturized hairs. A count in excess of 20% of miniaturized hairs reflects DUPA as I defined it in my published article. Yes, finasteride sometimes works to reverse it (less that 50% of the time).


2019-11-08 08:34:07How do you make the diagnosis of DUPA (Diffuse Unpatterned Alopecia)?

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What’s New In Transplants?

If you ever heard someone tell you to “get your head together’ I don’t think that they were tell you to get a new head as these researchers did here:

This is a technical challenge for the surgeons doing these head transplant, but it is a real ethical issue for me as we know monkeys are thinking, feeling beings.

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How Effective Is Minoxidil at Restoring Hairline Recession Caught Early?

I’m sitting at about a Norwood 1.25 or so right now, and was wondering if I could restore it to at least a 1 reliably with only min since I caught it early. I’m also horrified of the dreaded shed making it appear worse, will this be lessened since I caught it early?

The younger you are, the better the chance that finasteride might work on the hairline. This does not mean restoring the juvenile hairline and reversing the mature hairline, but I am referring to real hairline recession in men under 22 years old. Although, I have seen this happen in older men under 30 less frequently.


2020-06-04 18:34:57How Effective Is Minoxidil at Restoring Hairline Recession Caught Early?

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When Does Stress Become a Factor in Hair Loss?

i am a 23 year old woman, who has always had VERY thick curly hair. I have noticed that my hair is much thinner and requires many more wraps of the hair tie to put it up in a pony tail. I am very upset and wondered if you had any clue what is going on. I do not have a receeding hair line or anything. how stressed out does a person have to be inorder to affect their hair? thanks

The internet is no place to get a good examination of your head, scalp, and hair. A good dermatologist should be a starting point. Some people get hair changes with age that is not necessarily diseased hair, and others get hair thinning and loss from medical problems (see Female Hair Loss on this site to see other posts that reference the many medical conditions that can cause hair loss). You need a good doctor to make an assessment of you and your problem. If you have genetic female hair loss, then hair loss can be a problem anytime you experience stress.


2008-08-14 14:38:32When Does Stress Become a Factor in Hair Loss?