Category: Uncategorized

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Moving All Donor Hair to the Top of the Scalp with FUE?

Dear Sir,

Could one perform a complete FUE of all the donor hair from the back of the head to the top, i.e. create the exact opposite of MPB look? I think it’s just a matter of this encoded aging pattern in peoples heads that makes them think one is older than in reality. Just moving the hair around would confuse people enough to like that as a nice hairstyle. It’s basically the same thing as shaving the head completely bald – no hair, no pattern, monkey-brain has no recognition of aging. Different pattern is also just a big unknown to our monkey brains, so people would just get confused and interested rather than think ohhh this one looks old. It’s that obvious idiotic pattern that makes men look old. Am I not correct?

Just some illustrations to my message.

Now, Without hair: here
What it would look if I were healthy (i.e. not balding): here
My idea of solution (complete FUE MPB pattern inversion): here

Sorry for the quality, I’m not familiar with graphics software, but the idea is there, right?

Please, take it into consideration, Doctor(s)!

Beauty is in the eye of the beholder. What you may perceive as a good look may be different for others. With respect to what you are suggesting, we do something similar for hair transplant surgery, just not to the extreme you’d like. We move the donor hair to create a non-balding look.

But follicular unit extraction (FUE) will still create small dot scars, and if you had all the money in the world and had every hair extracted from the donor area and placed into the top of your scalp, you’d still be left with thousands of these tiny dots all over the donor area.

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Born with Bald Spot and Everyone Would Laugh at Me

Hello everyone, I was born in 1982, and I have the same bald spot on the back right side of my head. Everyone in school would laugh and joke about it. When I was 15, they said is would become cancer and have to cut it out. The doctors also said that once I cut it out, it would leave a little scar. I agreed to do it and two weeks later the hair just fell out again, so here I am at 35 wearing the same ponytail I’ve been wearing all my life. Like many, I wish I knew how to fix the spot.

This can be easily fixed with either a limited hair transplant or scalp micropigmentation ( see here: https://scalpmicropigmentation.com/smp-for-women/)

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My 18 Year Old Daughter Is Losing Hair — What Should I Do For Her?

Could you please tell me what type of doctor you should take your 18 yro daughter to if they are experiencing considerable hairloss. Her hair is thinning all over her head, and especially on top in the front. Our general practitioner sent us to a derminatologist. We went to the dermatologist for around 6 months without any progress. He tried to tell us it was hereditary hairloss, yet no women in the family on either side has thin hair.

They finally ordered blood work that I got a copy of. They never even called us with the results. It showed her MPV was low, 6.4 fL and her Ferritin was only 12ng/ml. Not sure what MPV is, but I know ferritin is iron. I’m having her take a multivitamin in the morning and an iron supplement at night. I would like to get her into a good doctor who gives a darn and could help her out. She is very athletic and does a lot of working out and sports. Any reccomendations would be greatly appreciated.

Also, should I have her give Mens 5% Rogaine foam a try to see if we can accelerate the progress?

Ferritin of 12 is in the low side of the normal range. The best thing you can do is to see a good internist to treat iron deficiency if present and also to check for other medical conditions that can cause hair loss in women, including thyroid disorders, immune diseases, and PCOS. If there is a genetic component, then having her hair mapped out for miniaturization will show the classic signs of the genetic process in women.


2008-01-03 10:00:09My 18 Year Old Daughter Is Losing Hair — What Should I Do For Her?

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Brain fog on Finasteride

Do you lend any credence to the symptom of “brain fog” while on finasteride? I can’t find much documentation of it in the studies I’ve read.

Yes, I believe that I heard enough of these complaints on various forums to believe that it probably has credence. We do not know finasteride does have brain effects that have been documented.

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My College-Age Daughter Was Prescribed Finateride

Dr. Rassman, my daughter is presently attending college in Houston Texas and was just diagnosed with Androgenic Alopecia. Her dermatologist came to that conclusion after she did a biopsy. What concerns me is, she prescribed a treatment of Minoxidil and 0.5 mg of Propecia daily. I understand the Minoxidil but I thought Propecia was for men only?

She did inform her of the pregnancy risks associated with taking the drug but it has me concerned and I asked her not to take it until I get more info. I’m not questioning this doctor’s diagnosis of the problem, just her remedy. Would you think an appointment with a proven hair loss professional would render any alternative advice? It seems this sort of hair loss in women is difficult to treat but I would think there are options available other than Propecia. Do you have any colleagues in the Houston area you might recommend? We may just wait a couple weeks and make an appointment at your office when she comes out for the summer. I appreciate your time.

Androgenic alopecia is not diagnosed with a scalp biopsy! More importantly Propecia (finasteride) is not to be taken by young women! It may cause birth defects if they get pregnant. There are a minority of women past their childbearing years who do take finasteride for very specific reasons, but even those women have equivocal results. Unfortunately, minoxidil is the only FDA approved hair loss treatment for women.

Perhaps your daughter should get a second opinion by another doctor. I don’t have any personal recommendations in your area, but you can check for physicians using the doctor search at ISHRS.org… or of course, contact our office for an appointment here in Los Angeles.


2011-05-07 06:46:41My College-Age Daughter Was Prescribed Finateride

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Bruce Willis Will Kick Your Ass

Apparently, this is pretty old, but I don’t think I saw it before so it’s new to me and worth sharing. Actor Bruce Willis was quoted earlier this year as saying…

“I’m a man and I will kick anybody’s ass who tries to tell me that I’m not one because my hair’s thinning.”

Strong words. There’s not much more to the article, but here’s the link for those interested:


2006-10-10 09:01:09Bruce Willis Will Kick Your Ass

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My dermatologist says combining finasteride and minoxidil doesn’t improve results

I just got my first box of finasteride 1 mg today. I wanted to get minoxidil 5% as well, but I need a prescription for that where I live. However, my dermatologist said the action of finasteride and minoxidil isn’t synergic, and that I won’t get better results by adding topical minoxidil to oral finasteride. That’s the opposite of everything I’ve heard so far. Men do combine oral finasteride and topical minoxidil 5% exactly to get better results, don’t they?

I don’t agree with your dermatologist. These two medications have different modes of action so taking them in combination, especially for the crown, is more effective.


2019-03-27 09:42:12My dermatologist says combining finasteride and minoxidil doesn’t improve results

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Calculating Lifetime donor supply

My question is, how many grafts can the average Caucasian person get from their donor via FUE? I don’t mean in one session; I mean in total over their lifetime. I saw different answers in different blog posts, some said at the very least 6,000, others said about 7,000, and yet others said that most people would become depleted after 5,000.
Depletion is a matter of residual hair bulk. Hair density and thickness make up hair bulk, so the coarser-haired people can afford to have more grafts removed from the donor area. For coarse-haired Caucasians with a typical Caucasian density of 2.2 hairs.FU, 6000-7000 grafts are an easy lifetime hair target in such an individual, while on the other extreme of fine hair and low density, 1000-1500 grafts might be the lifetime donor supply. Higher original density changes the equation in favor of more graft potential regarding lifetime hair. Not so simple, and that is why you need an experienced surgeon to do this for you.
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My Doctor Said Finasteride Is Given to Transgender People

Time to say good bye to propecia …

after 3 years on propecia, all this venture end with a gynecomastia surgery ! According to my surgeon the breast gland size was like a lemon…

He also said to me that finasteride drug is also gives to men who want to be a female (transgender…). according to the drug compagny, gynecomastia is a rare side effect… Now i think it is more a common side effect but impossible to really know at least at the beginning of taking this drug… like me….

Anyway this is my own story, i simply want to warning those guys that might thinking of taking this drug…PLEASE READ TWICE THE SIDE EFFECT SECTION, ESPECIALLY THE “RARE SIDE EFFECT SECTION” BEFORE ENROLL TO PROPECIA.

TootsieWhile I’m not entirely familiar with medications transgender patients might take, consider this — most male to female transgender patients do not want male pattern baldness, so finasteride is a good choice to prevent that. Propecia is not a medication to make you transgendered. In other words, transgender people do not take Propecia to make them “more” transgendered.

One of the potential side effects of Propecia is gynecomastia. This side effect is rare (my recollection is 1 in 300 or 500). Most of the time it is reversible, at least in my 14 years of experience… and most men will complain of breast enlargement when it is early, way before their breast turns to the size of a lemon.

In general, for older men (not taking Propecia) the prevalence of gynecomastia is 24-65% (source: eMedicine). But statistics aside, if it happens to YOU it is 100%, right?

Drugs other than Propecia that can cause gynecomastia are:

  • Cimetidine (Tagamet), ranitidine (Zantac), to treat heartburn
  • Nifedipine (Adalat, Nifedical, Procardia), to treat high blood pressure
  • Spironolactone (Aldactone), to treat high blood pressure and heart failure
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Can a Younger Patient Have SMP First, Then Have a Hair Transplant Years Later If Hair Loss Progresses?

Hey Doc,

Regarding the order of SMP and a HT (either FUE or Strip) – is an order of procedures preferred or needed? Specifically, if a younger candidate with the beginnings of thinning hair wanted to get SMP first to “fill in” some thin spots while anticipating the need of a HT procedure down the road, would the ink from the SMP hurt the recipient area? Thanks so much!

There is no real anatomical risk to the Scalp MicroPigmentation (SMP); however, there is something that we call the Master Plan that you need to discuss with your doctor, which includes planning for SMP and hair transplants.

If you want us to be your doctor, please contact my office at 800-NEW-HAIR and send me some good photos. I will be happy to offer you a free consultation and keep your photos confidential.