Balding Blog

Dear Dr Rassman,
I’ve got to a point now where i need to address my Hair loss!! I started losing my hair in my early 20’s but it was never that noticeable -this was probably due to the fact that it was a gradual thing and that my hair was densly thick! I’m now 29 and my hair seems to be falling out rapidly and it’s becoming harder and harder to cover it up. I’ve started using Propecia with the hope that it will stop the Hair loss. I’m an actor and am worried that my eventual lack of hair will effect my work! Any advice?
Yours Faithfully

I understand the need to maintain your appearance as an actor. Some character actors can establish a balding persona, so you can accept a balding fate and still make it in the movies or theater. As actors reflect the male population, half of all men will be balding by the time they are 45 years old.

Now that does not mean that I am advocating balding. If your desire is to maintain your hairy appearance and Propecia does not hold it, then hair transplantation is a reasonable option that can produce wonderful, normal, and undetectable results. First, get your hair loss pattern established with a map of your miniaturization. Then, work out your supply versus demand possibilities for hair over time based upon the mapping I just outlined. With that in hand, you can establish a Master Plan, from which you can then make plans. Hair restoration surgery does not mean that you must go bald to get hair back. It means that you plan out everything that is happening to you, short and long term, with the best tools and doctors available today. We are there, just look for us.

Are any of the topical ointments being sold on TV effective? I have heard (in Jacksonville, FL) of a new transplanting system without surgery – any such thing??

Effective? That depends on what you want them to do. I’m not even sure what hair regrowth products are being marketed on TV these days.

There is nothing new on the face of this earth that can give you a hair transplant without surgery. Someone is dishonest or plainly a crook. Maybe you misunderstood, so giving the benefit of the doubt, please send me a phone number, website, or at least the name of this procedure the next time you hear about it, and I will check it out for you.

What exactly is the “lateral slit method”? Do you use it? How does it improve results?

The lateral slit method for placing grafts in a hair transplant recipient area constitutes the use of slits which are oriented from ear to ear, rather than slits that are oriented front to back. Proper slit making is best done with very small slits, measuring between 0.8-1.1 mm in length. Clearly for people with coarse hair the wider hair shaft may require the longer slits, while those people with fine hair will require smaller slits.

The skills in placing lateral slits is different than the more conventional slits oriented front to back. It is slightly more difficult for those not accustomed to the technical issues involved in the process. The claimed advantage of lateral slits are many, including:

1. As the grafts heal, there is a fence like orientation of the hairs within the grafts which may increase a sense of fullness from a frontal view.
2. There is a possibility that the hairs may angle forward from the point where they exit the skin. This may accentuate the layering effect from the transplant and some people believe that this will create more fullness.

The problem with these ideas is that there is no proof. But despite the absence of proof, I perform lateral slits in almost all of our transplants because there is no down side to doing it this way. I wrote about the lateral slit method earlier this month: Lateral Slits and Transplanted Hair Direction.