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Should I do SMP or a hair transplant?

First you must ask yourself if it is hair that you want. If the answer is yes, then you must get an objective assessment with good numbers on (1) your donor density and (2) your hair mass index. These two factors will determine if you have enough hair to cover your entire head. Keeping in mind that if it is remotely reasonable, then you might be able to combine Scalp Micropigmentation (SMP) with a hair transplant to get a full head of real hair (see here: https://newhair.com/wp-content/uploads/2018/11/Combining_Follicular_Unit_Extraction_and_Scalp.98621.pdf ). But if you decide to have SMP, you could do it first ( https://scalpmicropigmentation.com/), see how you like it. If that turns out that you rather have a hair transplant and if the analysis of your donor area points to a good possibility of having a hair transplant as I discussed above, you can then go the transplanted route. Having SMP does not preclude a hair transplant.


2020-04-19 08:57:14Should I do SMP or a hair transplant?

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Should I do FUE or FUT, I am confused?

Been to two different consultations now and want to decide between FUT and FUE. Both surgeons I spoke to didnt have a big preference between the two, which I was surprised by. They mentioned that with a skilled surgeon FUT scar shouldn’t be visible, as long as you care for it properly.

The cost difference is significant. For reference I have a really good donor area, NW4. If I have a thin scar in back i really don’t care, as long as it’s not huge.

Second question is that I dont want to take fin. I already have mild ED issues so I don’t want to risk it, neither does my soon to be fiance. Has anyone had success with HT and just minoxidil?

I have written extensively on my website about the differences between FUE and the strip surgery: https://newhair.com/. As the person who pioneered FUE, I am an authority on it. FUE is a great surgery if (1) you have a great surgeon doing it, (2) the surgeon who does it has good judgements on placing the distribution of the FUE excisions so that they are not clumped together and they don’t cause necrosis of the donor area and (3) they know how to handle the grafts to keep them viable for removal and until they are placed back in the head. Add to that, patient selection is critical as people with very fine hair and/or low density often make poor candidates for FUE. I believe that if you are going to develop a very advanced balding pattern, then the strip surgery is better because FUE causes donor site depletion when too many FUE grafts are removed from the donor area as shown here: https://baldingblog.com/collection-victim-photos-internet-harvested-depleted-donor-areas/

I have had 3 strip surgeries and I don’t have a scar that anyone can see. This man had about 4 strip surgeries and a few FUE surgeries and look at his donor area: https://baldingblog.com/norwood-class-7-pattern-patient-received-11000-grafts-plus-smp/. His scars were not very prominent but he had Scalp Micropigmentation just to be sure that nobody would be able to see them as the photos show.

Finasteride will prevent shock loss which is common in young men under 30.


2020-04-19 10:36:52Should I do FUE or FUT, I am confused?

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Should I Cut My Hair Shorter to Reduce the Weight?

(female)
I am 53 years old and wear my hair in natural locks. I have thinning hair in the crown an front hair line due to medication. Also the new growth is much softer than my natural texture. I understand that the hair should begin to regrow when treatment ends in a few months. Should I cut my locks shorter (currently shoulder length) to reduce the weight or cut them off and start over after treatment?

The weight of your hair shouldn’t have anything to do with its growth or loss, though if you cut your hair shorter you do reduce the risk of damage to weaker hairs you might have. If you would like to cut your hair to match a certain style or achieve a better look then by all means…

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Should I Be Proactive?

Dr. Rassman,
I have been figting the good fight (against Hair Loss) for years. I first noticed thinning temples, and a “thin-spot” on the front middle section of my head, around the age of 19. I saw this as a warning sign(since my father is very bald)and began using propecia when I turned 20. I know that this led to a thickening of the ‘thin-spot” and a slow down of thinning. I managed to maintain my hair between a norwood II and III throughout my twenties. After many years of peace I am noticing a renewal of the “thin-spot” and new thinning in scattered areas like the temples and sides of my head. Some of these areas were not a an issue before. I find myself stressed out by styling and seeking new hair products. I worry that I could quickly become a Norwood III – IV if I don’t take action as I did when I turned 20. I would like to explore all options and I am very interested in Dutasteride. I like having hair… although I don’t look like I did when I was twenty anymore, I would like to keep/possibly thicken what I still have. Should I visit you at NHI? I would rather visit proactively than for a transplant later.

Thanks

I have an office in San Jose (where noted as your location) and would be happy to map your scalp for miniaturization and make a diagnosis. I would not rush off to non-approved drugs for genetic hair loss if that is what you have. Let’s get a diagnosis first and go from there. Proactive is good. If you would like to setup an appointment, you can call 800-NEW-HAIR or visit my Request Info page.


2006-05-24 08:52:54Should I Be Proactive?

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Should I Be Applying Rogaine with a Rubber Glove?

Dear Doctor:

Two questions about Rogaine application:

  1. In addition to taking 1.mg finasteride daily, I’ve been applying Rogaine foam for a few months now, mainly the frontal third of the head. That area alone takes more than the recommended half a capful. Although it is the frontal third that is my main concern right now, I’m somewhat miniaturized pretty much on the N5 area, albeit, to the naked eye, I have a pretty good head of hear at the moment (I’m 29). I just don’t see how it is possible to treat the entire area with less than three times the recommended dosage (which makes the treatment prohibitively expensive and fraught with side effects).Is there any residual benefit to the vertex area through general scalp circulation at all, if the application is on the front third?
  2. Since Rogaine absorbs into fingers rapidly, does it make sense to apply it with a medical rubber glove, to ensure that more goes into the scalp, not hands? For some reason this issue hasn’t been addressed by Rogaine users.
  1. Overdosing Rogaine for the entire scalp application is a real concern, but the best I can offer is to just watch out for side effects. Any Rogaine you use will be absorbed into the body before it works its way around the scalp where it is not applied, so if you use it on the crown, do not expect benefits in the front of your scalp or visa versa.
  2. The photo below (click to enlarge) shows the result of Rogaine Foam (minoxidil) on the hand that applies the medication to the scalp when compared to the other hand. Although this patient’s hands are quite hairy to begin with, clearly, the right hand has more hair than the left. This patient has been using the Foam for 3 months. It is up to you whether you want to use a glove when applying it.

 

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Should a Norwood Class 3 Person Consider Himself Lucky?

You may have touched upon this question before but I was looking for clarification. In an early post (I’m talking a few months ago) you mentioned how a norwood class 3 would rarely, if ever, progress to a norwood 6/7. By this, can a norwood 3 consider himself quite lucky in the sense that he’s probably not going to experience crown loss? What exactly did you mean by this?

Norwood 3Everybody is different. If you have stabilized your hair loss pattern at a Norwood class 3, then you will probably not progress to further balding.

You are born with certain traits ranging from eye color, skin color, dimples, to hair loss patterns. I would not say having one trait is better or luckier than the other. I believe about 8% of men are born with a Norwood 6/7 trait. Does that mean those men are unlucky? For example, Michael Jordan is likely a Norwood 6. Would you consider him unlucky?

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Shortness of breath on Rogaine

I’ve tried rogaine in the past and it surprisingly worked really well. I stopped due to having shortness of breath. I was able to take in air but it felt like a low amount would go in from what I would breathe in if that makes sense. I never had shortness of breath associated with chest pains or anything like that, which is described by others. It just seemed that everything would be fine until a month of use. Then I would experience the shortness of breath. For example, if I was walking the shortness of breath would start to kick in.

I was wondering if you know anything I can do or take to offset this from happening? I tried every other day and even 2%. But eventually, after about a month I would experience the same issue. Thank you for your time.

Rogaine (minoxidil) when absorbed by the body is both a hypotensive agent and is a known medication to cause heart damage. Sounds like you shouldn’t use it. Check with your doctor


2019-05-01 08:16:36Shortness of breath on Rogaine

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Short Tapered Hairs Falling Out, Is This A Sign Of Balding?

I’ve noticed recently in the shower that short hairs are falling out that are tapered at the end of my hair, not the root. I’ve noticed more of these recently. Some are thinner and some are thick. All my uncles are balding on my mothers side. Are these hairs a sign of future balding? Thanks.

Hair loss in men occurs in a pattern and that is why it is called “Male Pattern Balding”. How a hair looks don’t really mean much unless you are looking at miniaturized hairs will look thinner for people who are balding. We all can lose up to 100 hairs a day normally and if you do the math, 100 hairs per day is 36,500 hairs per year and as the average Caucasian male has 100,000 hairs on his head, that means that his hair cycle is 3 years as he replaces all of the hair on his head every three years.