Category: Uncategorized

The photo below shows a man with an advanced balding pattern (Norwood Class 7 pattern). This is the pattern that is a risk for every man having a hair transplant. Everyone runs this risk. They could lose all of their hair except for this 2½ inch rim of hair around the back and sides of the head. The white line shows where the neck hair begins and the arrow is 2½ inches long. The neck hair below the white line is not permanent hair. So if your surgeon takes hair above this rim area (where it is bald) or below the white line (neck hair) in any FUE surgery, you run the risk of eventually showing scars all over your head where the hair used to be before the balding happened. Not good!

This is why strip surgery is a better surgery for people with advanced balding patterns. If the density of this rim hair is good, then the area immediately above the white line can be harvested over and over again, decreasing the density of this rim with each successive harvest. I have harvested as many as 10,000 grafts from this rim in Class 7 patients and still left enough hair to keep the rim area covered when the density was very good. I have also been able to harvest routinely 6000-7000 grafts in people with average donor hair densities. If this area is harvested with FUE, the surgeon must stay away from the upper border or the FUE scars would show as balding progressed (https://newhair.com/donor-area/). The depletion of the donor area with FUE is not uniform so the number of grafts taken from this area is more limited than with the strip which is always harvested and re-harvested just above the white line if the surgeon does it correctly. The density of the residual hair after a strip surgery is always uniform. Of course, the scarring risk from repeated strip surgeries is real, but because there is always hair above the scar and Scalp Micropigmentation can address the scar so this is a manageable problem if it should happen (https://scalpmicropigmentation.com/scar-covering/).

The other important issue is the size of the bald area, which in this man is 80% of the original hairy scalp. So, this rim must supply hair to cover the entire bald area. The math is a real challenge and that is why your surgeon must be both an artist and a mathematician. Your surgeon must calculate what you need now and what you might need later as your balding progresses. This donor area is limited to about 50% of the original donor density. EVERY balding man will develop more hair loss over time, so a great surgeon understands this and should always be able to give you a status report of your reserves for future hair loss. Maybe you will not progress to a Class 7 pattern but rather a Class 6 pattern as only 7% of the population ever progresses to a Class 7 balding pattern. Poor planning by the doctor or patients who are in a rush to satisfy their immediate goals (particularly when they are early in the hair loss process) at the expense of your future needs, is not good. You and your surgeon must always develop a Master Plan for your future hair loss. Always think long term so that your decisions will be calculated to address the problem you have now and the problem that you will almost certainly have in the future.

Assuming that you don’t have an infection because your doctor cleared this diagnosis, then your hair and skin color often produces sensitive skin. To find out if this is the cause, you can scratch your forehead with your fingernail by pressing it into your forehead and moving it about 2 inches. IF the scratch area stays red for more than a few minutes, you have Histamine positive response and may be able to treat your red recipient area with topical steroids. ?

A recent study shows conclusively that there is no association between male breast cancer and those people taking finasteride (Propecia).

http://cebp.aacrjournals.org/content/early/2019/04/19/1055-9965.EPI-18-0904

Does finasteride make your penis smaller by reducing blood flow to it? Have there been any studies on that?

I know that many men have complained of this, but you must recognize that a man’s penis size changes throughout the day. It is often larger at night, and smaller during the day when not in use. I don’t have any evidence one way or the other on any connection between penis size and finasteride, but if your sexuality is impacted by this drug, I would think that it would be smaller from less use.

Although there is few questions i have that cannot be answered somewere on this site i seem to have one in which i cannot find an answer. It is stated that the hair loss gene comes from your mothers genes(hence if your mothers father is bald you will be bald.)If this is fact i have a question with a certain situation. If my father started balding early(about the age of 23-24) But my mothers father started around the age of 55-60, what is in store for me? My hairline is as my mother’s father’s was but it is not the same as my fathers, also my hair color and texture is like my mothers fathers. What is your opinion?

Hair loss is genetic, but it does not follow a specific predictable genetic pattern. It has been observed that the hair loss gene seems to favor the mother’s side (about 52%), but this is not always the case. While scientists can say hair loss is genetic, they still have not found the specific gene for hair loss because it probably reflects a series of genes. In addition, carrying the gene does not mean that the gene will be expressed and you need to express the gene to be balding. So when we get smart enough to learn how to control the ‘expression of the gene’ then the solution to hair loss may be at hand.

There is an old joke known in this industry — A bald father with a heavily balding son complains to his wife, “Look what you and your family gave him” (pointing to the son’s hair loss). In our male dominated society, we tend to blame women for every conceivable problem with the children, because we know that as men, we are just perfect.

I hope the sarcasm comes through to the casual reader.