Category: Uncategorized

Posted on

My Surgeon Talked Me Into Having More Hair Transplants That I Probably Didn’t Need

I’ve had a total of 5 transplants. Two in the front (700 grafts each) and one on the crown (1000 grafts). These three surgeries together produced a beautiful result. I should have stopped there but I was under the illusion that another transplant (1.5 years later) would give me even thicker hair. The Doctor that did the transplants is a pioneer and very well known and respected. I’m not going to mention his name because you would automatically know who he is.

Nine months after the fourth transplant (600 grafts in the front) I did not see any additional density. Three years later I went in for a consult about the front again and he told me that I did not need the fourth transplant but he would be able to do a small one (500 grafts) at that time so I had it done. Six months later I did notice a difference and was pleased with the end result.

It has been six years since and I still have all of my hair. My question to you is: Why would he do a transplant when I didn’t need it? I look back and feel that the grafts were wasted and I was taken advantage of. Like I stated earlier this individual is a pioneer and respected. He certainly did not need the money. Even the nurses joked with me saying that I had “a lot of beautiful hair” hinting that I didn’t need to have the last transplant. What is your opinion on this?

I speak of the importance of ethics at medical meetings. Some doctors push for surgery even if the patient does not need it. This is commonly seen in young men who are too early in the balding process where drugs like Propecia (finasteride) suffice for the sole treatment, and 80% of women with thinning who are not candidates for surgery, yet the doctor recommends surgery on many of them who feel that they must do something about their thinning. For them, the surgical option is an easy sell, even if there is no value for surgery.

My job as a hair transplant surgeon is to always be a patient advocate, pushing those who do not need surgery away from the FUE punch or the surgical knife. It is always good business when I can create a trusted following of patients who believe in my ethics, especially when I steer them away from a surgical decision in examples as those discussed above (majority of women, young men). Many times it is harder to talk patients away from wanting surgery than it is to recommend surgery for an actual candidate. By that, I mean I have to spend more time with each such patient educating them on the ‘whys’ of my decision process.

Posted on

Can I Stop Being Bald Like My Father?

I am 24 years old and now have advanced my balding to include the front and the crown. I don’t want to be bald like my dad who is probably has a Class 6 pattern of balding. He said he got most of it when by the time he was 35. What if I started taking Propecia when I was 18, would that have preserved my hair?

That is a great question. Most advanced balding pattern patients have their pattern established in their 20s. Despite that almost 20 years that Propecia has been on the market, we really do not know if the progression could have been stopped had you taken the drug when you were 18. There would have had to be controlled clinical trials where one group who had advanced balding in their families were put on Propecia and the other group not. In that situation, we would know the answer to your question, but no such study has ever been done.

I suspect, however, that had you taken the medication when you were 18, you would have slowed down the progression of the balding and most of such young men in the 18 year old bracket, would not develop their final balding pattern for many years. i doubt that the final pattern would have been thwarted, but for such men, delaying into their 30s could give them the benefits for possibly another decade of so. We will probably never really know the answer, but for many men who I placed on finasteride (Propecia) I have seen the process slow, stop or occasionally reverse. Better to do it than not to take the drug if you are one of these 18 year old men. At 24, it can’t hurt and probably will help.

Posted on

My Trichologist Told Me I Had Poor Blood Circulation and Oily Scalp That Can Be Fixed for $5000

Hi Doctor,
I just made a trip to a local trichologist (Svenson Hair). They did a scalp and minituarisation study for me. She commented that I have a few hairs growing from the same pore, as well as minituarisation at same parts. She also said I had dandruff that was not flaky, and a sensitive scalp (some slight redness).

So she said that I had these problems:

  1. Poor blood circulation (said my scalp was grey in some areas)
  2. Dandruff clinging to my pores (thus blocking the new hair from growing out. Said it was worse than flaky dandruff)
  3. Oily scalp

The treatment package was going to cost 5000 dollars, and she started to use the words VERY SEVERE as we got along, as she sensed my apprehension. However I’m not sure what she said was true. Can you help me verify the 3 points as above? Are they true??? I’m currently on Propecia.

Thank you very much. I hope no one gets pressured by such trichologists into a 5k package.

In my opinion, none of what your trichologist told you is true. We often grow multiple hair follicles (called follicular units) from one pore. If you have an oily scalp, you can treat it with shampoo formulated for oily hair/scalp, available at most drug stores or grocery stores. Grey scalp from poor circulation? Don’t waste your money! Now that I’ve saved you $5000, if that money is burning a hole in your pocket I suggest that you will get more satisfaction by donating some of it to charity.

Posted on

Can I Use Hypnosis to Regrow My Hair?

I was reading this site [Hair Loss and Hypnotherapy] and it got me wondering whether I could actually use hypnotherapy to regrow my hair lost from medication. I don’t have genetic loss, as my loss only began after I was on medication.

Sounds hokey, but I am impatient and willing to try anything. What do you think?

“Hokey” is not a poor description for this. The idea that you can will yourself to growing hair is pretty ridiculous, and if your hair loss was temporary it will regrow on its own anyway.

I guess anything is worth trying if you’re really adamant about it, but don’t set your expectations too high. While you’re visiting the hypnotherapist though, you can also see if hypnosis will change your eye color, which some people believe is also possible. As you might be able to tell, I am not among the believers.


2013-06-14 16:44:28Can I Use Hypnosis to Regrow My Hair?

Posted on

Can Miniaturization Be Reversed?

Dear Doctor,
If you have miniaturization developed in the past 6 months at a rapid pace is it possible to fully reverse it or maybe most part of it ? I Got onto propecia last month once my derm confirmed I have MPB. I am thinking of adding Minoxidil too to the regimen the logic being since the miniaturization/ slight halr loss too has been in the past 6 months Minox might help steer those hair follicles slipping away into complete dormancy. Is my thinking right ? or will propecia and something like a 2% nizoral shampoo be enough to do the job/revive thoseminiaturized follicles ?. My miniaturization is mostly on the top and my hairline is intact. My hairloss history is about 7 months. I am late 20s. Also What is the ideal times a week you should wash hair for a male who has a desk job from 9-5 and works out 4 days a week. ?
I will appreciate your feedback.

In my opinion, I would hold off on the minoxidil and stick to the Propecia for the first 8 months. If the hair loss is as you have defined, then there is a high possibility that it will reverse because it seems to work best for short term genetic hair loss. If you take other drugs like minoxidil and make too many changes at once, then you will never know which one worked best and you’ll be ‘hooked’ on both of them for years. Play your bet out and try the 8 months of Propecia first.

As for washing your hair, I’ll just quote what I said in an earlier blog entry: “Frequent shampooing does not hurt, but aggressive massaging during shampooing and rough brushing will cause fragile hair to break easily.”

To conclude, yes miniaturization can be reversed. The more advanced the balding you have and the longer time you have had it, the less likely will be reversal of the balding process. But the resuls with Propecia (in particular) have at times been very powerful and I have seen a few men who I would have never guessed would reverse, reverse it nevertheless.

Posted on

What You Need to Know About Forehead Reduction and Hairline Lowering Surgeries

There are two types of procedures for lowering a hairline. One is a surgical excision of the upper forehead, followed by the downward advancement of the hairline up to an inch from where it was prior to the surgery. To accomplish this, the entire scalp from the frontal hairline to the very back of the crown is lifted up and pulled forward. When this is done by an experienced surgeon, the hairline can often be advanced about 2/3rds – 1 inch, if there is enough looseness when this lifting process is done. This procedure is often completed in one surgical session; however, it may not address receded corners of the hairline if the corner recession is significant. A great advantage of this surgical approach is the immediate impact of the procedure on hairline location, with healing usually complete in a week or so. Sometimes, this procedure produces a scar in front of the hairline, and if this is the case, a hair transplant in front of the hairline can address the scar. If there is corner hair loss, or if you are a male, a hair transplant lowering surgery is better, because the risk of recession in men with genetic balding is very high. A recession will always reveal the scar from a hairline advancement surgery. The only disadvantage to the transplant is that it takes 6-8 months to fully grow out. For men, a hair transplant is a better procedure because the risk of hair loss is high, and hairline recession will show the scar from a hairline advancement surgery.

The second type of hairline lowering procedure is done through hair transplantation. The number of sessions varies by the thickness of the hair. For women with other than fine hair, they might do this in a single session. With fine hair, it often takes two sessions. The time to see the impact of a hairline lowering hair transplant procedure is 5-7 months after the surgery date, and if a second session is required, it will take another 5-7 month wait for full growth. See web references below for photos of this process on women we treated. When done properly, a transition zone is created that makes the frontal leading edge of the hairline soft – what I call a no-hairline hairline. See here: https://newhair.com/female-hairline-lowering/


2018-05-22 10:05:17What You Need to Know About Forehead Reduction and Hairline Lowering Surgeries

Posted on

Can a Person Run out of Hair for Hair Transplants?

I don’t get it!!! Doesn’t every strand of hair for men have a genetic life cycle that eventually runs out in some areas?? (Hairline, crown). How can a male have unlimited replenishment of hair?

Good question. In every one of us who is balding, the pattern of balding we inherit determines the extent of the permanent hair on the side and back of the head. Because we can’t predict the pattern we inherited with absolute certainty, I assume that only the fringe area in a Class 7 patient is the permanent area. This area has a finite amount of hair (about 20% of the total birth hair population on the scalp). You can have this 20% area (called the donor area) harvested over and over again until the area has lost 50-70% of its hair density. Then, the donor area is depleted and no more hair can be harvested without producing balding in this area around the back and side of your head. Each hair has both a hair cycle (Anagen and Telogen) and a limited number of hair cycles that it can have in your lifetime. For the balding Class 7 patterned patient (with only 20% of his hair remaining in a rim around the back and sides of the head), the hair that was lost underwent apoptosis (an effective cell death). These men often have fewer than 10 hair cycles (as few as 6-7) of their anagen/telogen cycle. We know that these hairs, which are absolutely gone to the naked eye, are actually in some stem cells located where each hair used to be. One day, some doctor/researcher will find the switch to turn on these hair stem cells to create new hair. I believe we may actually see this breakthrough in the next few years.


2018-08-15 09:33:32Can a Person Run out of Hair for Hair Transplants?

Posted on

Can Propecia Stunt Growth?

Can Propecia taken by mid-teen guys stunt height growth?

There are some teenagers who take Propecia (finasteride) under the care of their doctors, but it is generally not prescribed to teenagers. The effects of finasteride on developing teens is not clear and should probably not be used in those who are still in growth mode (usually under 17-18 years old). It is theoretically possible that it may stunt growth during the puberty years, as it interferes with testosterone conversion into dihydrotestosterone (DHT). DHT is one of the many hormones that is involved with secondary sex characteristics such as beard, chest, and pubic hair.


2008-09-24 08:45:29Can Propecia Stunt Growth?