My Eyebrows Have Gotten Thinner Since I Was a Child

/by William Rassman, M.D./0 /

I am a male, only 18 years old and starting back in elementary school my eyebrows have gotten less and less hair. Now its evolved to on both eyebrows only half being thick. It looks like half eyebrows, goes from normal looking to just bald. Is there anything i can do? It can be very embarrassing. I am not plucking or pulling my hair. They just keep getting thinner.

The most common cause of loss of eyebrow hair is plucking of the hair. I realize you said that you aren’t pulling or plucking, but many people who do pull out their hair (including eyebrows) deny that they do it. This is an obsessive compulsive disorder called trichotillomania. If the loss of eyebrows are not connected to plucking or pulling them, I wonder if you have any other hair loss or if it is limited to just your eyebrows.

Eyebrow transplants are an excellent solution for thin eyebrows. I have seen loss as your describe in the outer half of the eyebrow and have replaced the hair with scalp hair, which is very effective. Scalp hair in the eyebrows must be trimmed about twice a week to keep them short and they need to be cut on a slight angle to create a point to their ends.

Tags: eyebrows, hairloss, hair loss, eyebrow transplant

My Dad Lost Hair at 16 and Now So Am I — My Doctor Said I’m Too Young for Propecia

/by William Rassman, M.D./0 /,

Hello,
I am 16 years old and I started to lose hair a year ago. I know its quite unusual to lose hair so young, but my father also started to lose at this age, so I know it is genetic (lucky me). I went to a dermatologist and he gave me a shampoo, a couple of vitamins and minoxidil. And I have been using it since then, but the hairs keeps falling and I have lost a lot since then. I have asked him for propecia, but he says I am too young for it.

I dont know what to do. Is there any other alternative for me? And also what would be the so severe problems that I would have if I took Propecia?

Thank you

Assuming that you are fully grown, the drug Propecia can be used and I would prescribe it; however, there is more here that I would want to know —

  1. How bald did your father get by 20, 25, and 30 years old?
  2. How bald is he now?
  3. How do your parents feel about your desire to go on Propecia?

You may wish to get a second opinion. If you are still undergoing puberty, Propecia is not advisable.

Tags: propecia, finasteride, hairloss, hair loss, teenager

Propecia vs Grapefruit Cologne

/by William Rassman, M.D./0 /

Hello,

I am aware that grapefruit and finasteride (and other medications) may not mix well together (hence me not eating or drinking any since I started). I just bought some eau de toilette, and noticed that one of the “notes” is grapefruit. I know in my brain that, even if the scent used real grapefruit as an ingredient, the amount used would be extremely small, but am I crazy to worry if it will affect my propecia intake? I know wearing it is not the same as drinking it…

Many thanks.

For those that aren’t aware, grapefruit can impact many prescription medications, including Propecia. I don’t think you have anything to worry about as long as you’re wearing the cologne and not consuming it.

Tags: grapefruit, cologne, hairloss, hair loss, propecia, finasteride

Why Do Technicians Do the Graft Placing in a Hair Transplant?

/by William Rassman, M.D./0 /

I see in many hair transplant surgery photos that technicians place the grafts on the scalp. Since the placing is so crucial (angle, position, etc) how do surgeons leave this to technicians? Also, the survival of the extracted hair follicles is also a crucial matter, how safe is to leave the follicles’ processing to technicians?

is there a center where technicians intervene minimally and where skilled surgeons take charge in most of the procedure? in other kinds of surgeries I have watched, technicians and nurses are just there to pass the instruments to the surgeon, hold them, and generally do not interfere with the main procedure, so I really need to know a HT center mostly crewed by surgeons and not a big name surgeon that leaves the procedure to technicians

The total man-hours to do a surgery of 2500 grafts may be 30-40 hours. No doctor can do it all and I would not want them to try to do it all, because by the time the doctor finished, the grafts would be dead. This is a team surgery and graft survival is a complex process that requires many skilled people to do the job.

My technicians are highly skilled, working 8 hours/day doing either cutting the grafts or placing the grafts. When I used to do much of this work, I worked along side of the technicians and set the standards for training, and the skills needed for cutting and placing. Today, I still work along side of the technicians, though I work more in a supervisory role.

If you employed 4 surgeons in addition to myself, the costs would be out of sight for most of our patients and the quality would not be as good as the surgeons will most likely not have the manual skills that the technicians have. The secrets to success in getting the results that the patients want and need is that such a team approach needs (1) skills, (2) speed, (3) good and tight quality control systems, (4) good organization.

Tags: hair transplant, surgery, technician, hair loss, hairloss

Transgender Teen Wants a Hair Transplant at 18 Years Old

/by William Rassman, M.D./0 /

So, at 17 years old, I’m in between a Norwood 2 and 3 hairline and was aiming to get a transplant. I understand that this is very young, but I’m transgendered and the hairloss has stopped with the use of hormone replacement therapy so I was curious as to if I’d be at least able book a surgery date when I’m 17, to have the surgery when I’m 18. I’d have parental consent too if that’s important.

Yes, you can do it if you find a surgeon willing to take you on. You run risk for balding based upon any testosterone production, but if you have your testicles removed, that would mitigate that risk. I am not an expert on the effectiveness of the drugs you are presently using without orchiectomy. I would let your doctors tell you those answers.

Tags: hair transplant, transgender, hairloss, hair loss

Not Hair Loss News – Man Has Replacement Nose Growing On His Forehead

/by William Rassman, M.D./0 /

Snippet from the article:

A new nose has been grown by surgeons on a patient’s forehead, so it can be transplanted to replace his original one.

Xiaolian, 22, didn’t look after his badly damaged nose following a traffic accident in August 2012. The infection corroded the cartilage of his nose, making it impossible for surgeons to fix it. They then decided to grow him a new one at a hospital in Fuzhou in Fujian province, China.

It was grown by placing a skin tissue expander onto Xiaolian’s forehead, cutting it into the shape of a nose and planting cartilage taken from his ribs.

Read the rest — New nose grown by surgeons to replace original one

The article notes that the “forehead skin can be moved to the nose and keep its blood supply“. Check out the photo at the link above.

Tags: nose, surgery, facial restoration, forehead

I Got 2500 More Grafts Transplanted Than You Recommended

/by William Rassman, M.D./0 /

A few years back I went to you for a consult where you recommended 1,500 grafts to fill in my front hair line, but I went with another doctor that gave me 4000 grafts at a lower cost per graft. The total surgery price was more but what is bad about putting in 2,500 more grafts than you recommended? I have coarse, dark hair and wanted dense packing.

Individuals with a coarser hair do not need as many grafts as a person with a finer hair, so dense packing may not have been necessary.

If we would have put only 1500 grafts into that area and the other doctor got 4000 grafts, that indicates to me that the surgeon must have transplanted into the normal non-balding area (possibly just to make a few dollars extra). Some doctors may claim that preventative hair transplantation into the fringe behind the balding area is an acceptable practice, but with good drug therapy (finasteride) the progression of balding is often less of a problem. I find that for those doctors that say the normal fringe area is going to eventually bald anyway, that excuse is a self-serving financial decision by the doctor which only feeds his pocket.

Still worse, as the average person only has about 7000 grafts to utilize in his lifetime, depletion of the donor supply will absolutely leave many people worse off if the balding become progressive and moves into a more advanced balding pattern, like a Norwood class 6 or 7. Maybe the crown will start balding when the frontal area is stabilized on finasteride, so by putting these extra hairs into the frontal area, the surgeon only deprives the patient of hair for a balding crown if it should develop.

Tags: hair transplant, dense packing, hairloss, hair loss

Any Patients Take Propecia and Still Have Shock Loss?

/by William Rassman, M.D./0 /,

Just wondering as you have said a few times that being on propecia will decrease your chance shock loss after a hair transplant if you are under 30.

Have you had any patients under 30 who have had shock loss after being on propecia for a considerable period of time? And if so to what extent was the loss? Thanks

When I saw the great majority of shock loss cases, it was before the availability of Propecia (early 90s). Since that time, most of my patients take Propecia to protect themselves from shock loss, and there was far less of the fall out after the surgery… but it did still occur for some.

I don’t have statistics on the extent of loss or precise age, though.

Tags: propecia, finasteride, shockloss, shock loss, hairloss, hair loss

Not Hair Loss News – European Men Are 11 cm Taller in the Last Century

/by William Rassman, M.D./0 /

Snippet from the article:

The average height of European males increased by an unprecedented 11 cm between the mid-nineteenth century and 1980, according to a new paper published online today in the journal Oxford Economic Papers. Contrary to expectations, the study also reveals that average height actually accelerated in the period spanning the two World Wars and the Great Depression.

Timothy J. Hatton, Professor of Economics at the University of Essex and the Research School of Economics at Australian National University in Canberra, examined and analysed a new dataset for the average height (at the age of around 21) of adult male birth cohorts, from the 1870s to 1980, in fifteen European countries. The data were drawn from a variety of sources. For the most recent decades the data were mainly taken from height-by-age in cross sectional surveys. Meanwhile, observations for the earlier years were based on data for the heights of military conscripts and recruits. The data is for men only as the historical evidence for women’s heights is severely limited.

Read the rest — Average Height of European Males Has Grown by 11 Centimeters in Just Over a Century

Researches theorize it could be due to better living conditions, better nutrition education, and better health systems, along with a decline in infant mortality rates.

Tags: average height, research