Patient review from Italian Vacation (photo)

“As a professional consulting engineer, I have been trained over many years to appreciate the importance in the details. For example, when I decided to investigate hair transplant options for myself, I took my time; the overriding litmus test, was “A bad hair transplant result is far, far worse, than having no hair transplant at all, at any price”. That principal first led me to start at the very beginning… Who developed the first successful thousands at a time hair transplant procedure that was a completely successful result? Wikipedia will lead you directly to Dr Rassman. He was the original pioneer in this thousands at a time hair transplant procedure. I was hoping to find a doctor who had been trained by Dr Rassman; and to my surprise, I found Dr Rassman was still practicing! I immediately arranged to see him, for a procedure. He was hands on for the whole procedure, including his office staff professionally trained by him to totally exacting standards. Before this, my long term hair stylist for many years had cautioned me not to get the hair transplant; he had seen so many horrible results in the past. So it was with great surprise my hair stylist upon seeing me the first time after the procedure, couldn’t believe how natural my new hair line looked! That is the best feeling when I heard my hair stylist’s disbelief. Apparently, hair transplant results in North America are getting worse over these years, as more and more “Less than competent” doctors are doing unskilled procedures, only for the money. Do not allow yourself to become another billable bad example of what not to do. Thank you to Dr Rassman and your amazing staff.”

This type of comment made my day and warmed my heart. He had 2460 grafts.


2020-01-06 13:41:43Patient review from Italian Vacation (photo)

Could Propecia Be Used to Treat Cardiovascular Disease?

Doctor,

There is an established correlation between (early onset) androgenic alopecia and both cardiovascular disease and prostate cancer. Now interestingly, Propecia (more than likely) reduces the risk of prostate cancer. Since Propecia seems helpful against hair loss and against prostate cancer, could it also be helpful against the third correlate: cardiovascular disease?

At least some studies seem to consider DHT to be proatherogenic while others consider estradiol to be antiatherogenic (in men). Given the fact balding men carry an extra cardiovascular risk and prostate cancer risk, could finasteride not only reduce the risk of prostate cancer but work cardioprotective as well in this population? Unfortunately I did not find much empirical data (only one study – PMID: 12234510 – reporting a non-significant RR of 0.3). How plausible do you consider finasteride to be helpful in reducing the added CVD risk in balding (young) men?

A valid and interesting point. I honestly don’t know how plausible it is, but it is certainly a refreshing perspective from a sea of anti-Propecia campaigns and the paranoia of its side effects that I’ve been receiving via email lately.

Medications are not magic bullets. They have limitations and might not always work the way we think they should work, but there may be benefits as well as detriments (for those anti-Propecia fans) still undiscovered. After all, Propecia was an accidental discovery, but there is clearly a need to study the connection between heart disease on those men taking Propecia. Considering that many men on Propecia are young, the number of people needed for a valid study may be very high.


2009-12-22 09:54:09Could Propecia Be Used to Treat Cardiovascular Disease?

People Guessed I Was 20 Years Younger After I Had SMP Done

A 55 year old male patient had a complete Scalp MicroPigmentation of the scalp done. He has changed his hairstyle from long hair with a balding pattern to a shaved head.

He sent me this short email that I wanted to share:

About a week after my procedure, I was at a party where I met a number of guys that I didn’t know. Sometime later in the evening, the topic of conversation shifted to age, and we did the “guess my age” bit. Guesses of those who were in the 50 year old range were pegged between 45-60. When it came to me, they all guessed I was in my mid 30s! Totally made my day.

Awesome! I’m glad your day was made and I’m pleased that you’re enjoying your new look.

Could Transplanted Hair Fall Out? — Follow-Up

I was wondering if you could expand on your entry “Could Transplanted Hair Fall Out Months After a Successful Procedure?”

Does all of the transplanted hair fall out or just some of it? How long after the HT have you seen this occur? From what you’ve seen does it happen in younger or older patients? Most importantly can you re-transplant new grafts into the area? Would the same thing happen again or could there have been a mistake made during procedure?

I am not sure about your question. The newly transplanted hair usually falls out in a month or so after the surgery and it comes back 2-5 months after in waves of hair growth. Once you’re past the 7th month, everything should be stable and your transplanted hair should be there for the rest of your life. If transplanted hair falls out, it may reflect hair that was not taken from the permanent zone and in that case it may reflect an error from the surgeon.

Persistent frontal hairline

I have published on the genetics of the persistent frontal hairline. This man could bald and yet keep his frontal hairline. For a hair transplant surgeon, that means that he will not have to get the leading edge of his hair transplant, saving the patient money and donor grafts. For him, it means that he will retain a frame to his face with a good comb-back of his hair for styling purposes.

Photos sent by 23 y/o man of his donor area

I wrote: You can pick up a hand microscope from Amazon (https://www.amazon.com/SKYBASIC-Microscope-Magnification-Compatible-Smartphone/dp/B082SVF8SB/ref=sr_1_10?dchild=1&keywords=hand+microscope&qid=1586193649&sr=8-10) and send me photos (see attached: trichoscope view of hair) like those below with your hair cut in the field of view. Once I see that, I can tell you your birth hair count and your donor supply for your lifetime if you should elect to get a hair transplant at some point when you are older.

In this particular young man, he had a Class 5 pattern of balding heading to a Class 6 from what I could see in his photos. The metrics obtained from these simple pictures, tell me that he will have enough hair to handle any balding pattern he develops. Those of you reading this should consider a phone consultation with me and also sending me these photos so I can give you an analysis as I did for this young man. This is a critical part of a Personalized Master Plan for lifetime hair loss.


2020-04-19 09:25:53Photos sent by 23 y/o man of his donor area

Curis and Hair Loss

How long will you think CURIS take to be produced commercially? Also, does it have capability to grow hair on already balded areas?

This is a most interesting and exciting technology in its early stages. A great deal of work will be required to take this from the animal study into the human realm and it may not transport easily. What this does show is the many faces of the regrowth phenomenon in hair regeneration. Generally this process, under FDA regulation, will take years. To answer your question, I really do not know exactly how the medication works, but as I find out more, I will let the blog readers know. Thanks for pointing this out to me.

For those interested in learning more, please see Curis Presents Study Showing Stimulation of Hair Growth by Small Molecule Hedgehog Pathway Agonist.

Pimples in the Donor Area 7 Weeks Post-Op

I will ask the question again. I am a NW3. I had a hair transplant of 3650 grafts, about 8500 hairs into an area about 50cm2 in the frontal area. This was a FUE procedure. I am having small bumps, nodules, pimples? in the DONOR, NOT recipient area. I am exactly 7 weeks post op. What are these bumps and what caused them? thanks

When FUE transection occurs, remnants of hair are left in the donor scalp and they become a foreign body causing pimples and abscesses. You should see the doctor who did this and get his expertise in treating it. If you do not get the infections under control, they may just get worse and worse.

Daily hair loss in shower and elsewhere

I’ve heard it’s normal to lose over 100 hairs throughout the day, but every time I wash my hair and towel dry it’s seems I’m losing a ton of hair. I’ll shampoo and each time I run my hands through my soapy hair and look at them there’ll be close to or over 10 hairs and appears like it adds up to almost 100. No matter how many times I run my hands through my hair I’ll see a bunch of hairs. Then, if I towel dry with a white towel I’ll see even more hairs. Is it normal to lose this much hair just in the shower? I shower every day but wash my hair every two to three days.

The average hair loss per day for an average Caucasian male is 100,000 hairs, but I doubt that you would lose them all in the shower unless you are losing more than 100 hairs per day which would occur in a hair loss situation. When you rub hair that is miniaturizing, these hair easily come out with your fingers, your towel and almost anything you do to rough up your hair.


2019-03-26 18:23:11Daily hair loss in shower and elsewhere