This patient with frontal balding (Class 3A pattern) had surgery 4 days ago. He has black hair and white skin, making the grafts very obvious, but as I always tell my patients, keep their hair long so that they could get good camouflage for the grafts, and so that is what these photos of a fresh hair transplant show. The hair already gut pushed out a bit so it looked like the hairs were growing. Note, at 4 days, there are no scabs present and this is typical of our patients because of our special focus on keeping the blood from building up during the surgery and after the surgery in the post operative special washing instructions are followed carefully by each of our patients.

On NPR duing my morning drive this morning, a somewhat interesting study of work habits was discussed. Hedge funds are those funds which manage wealth for the very rich. It seems that for those funds which have a single manager (common), if the manager is either getting divorced or getting married, the performance of the hedge funds falls to the point where they lose money as compared with those hedge funds where the manager has either a stable marriage or is not married. That tells us that we bring our personal lives to work and our personal lives impact the work we do. One might extend that concept to every working man, doctors, dentists, accountants, contractors, carpenters, plumbers, etc… should we find out more about those people we need to do business with before committing money or our health to someone who may produce unpredictable performance?

FYI: Drs. Pak, Kim, Fargo and I are all committed to a monogamous relationship where we find great joy and are very happy, so we can safely take care of you, our patients.

This week I met a 22 year old balding young man names Alex. His father and mother joined him and were very supportive. He is well on the way to a Class 7 pattern (just a rim of hair around the back and sides of his head). The remaining hair on his head looked like a more advanced balding pattern than Prince William has now but the entire frontal area has not a singe hair on it. His hair supply was slightly under average for a Caucasian and his hair was fine and dark brown. His father told me that this is exactly where his hair loss pattern was when he was 22 years old. It was clear that Alex would develop his father’s hair loss pattern. I measured his hair density which was lower than average. He could never have had a full head of hair with a hair transplant contrary to other doctor consultation he had before he visited me. The previous doctor told me that hair transplants were a reasonable option and he could transplant his entire head.

Fine hair is not the best hair for hair transplants on a very bald man if the goals are to get a full ‘appearing’ head of hair. Frontal hair coverage with a bald crown is a reasonable option, but Alex did not like that look because at 22, nothing but a full head of hair was an option. He also did not like the idea of going on the drug Propecia. Doctor who promise or even suggest that a full appearing head of hair is a possibility are not honest doctors and young men like Alex could become victims of such physician behavior. Alex was smart to bring his parents with him, something he didn’t do with his previous physician consultation. Alex and his parents listened carefully to what I had to say, and we quickly ruled out hair transplantation. He did, however, quickly embrace the scalp micropigmentation option which would give him a quick, far less expensive alternative that would give him a youthful look, just like his age would requires. I told him not to rush in this important decision. I suggested that he come to one of our Open House events where he could meet others who had scalp micropigmentation. At 22 years old, he must recognize that this is a decision for the rest of his life and a good decision today, is a good decision tomorrow. He liked that approach.

More and more men are taking supplemental testosterone to increase their feeling of youth and augment their sex drive. The concern for some time has been concerns about safety asking questions related to the risks of increased stroke or heart attacks in those men taking supplemental testosterone. For men who have a low serum testosterone, the indications are clearly present but, but for men who have not tested their serum testosterone and just want to take the drug (this is common), now there is new data from “two studies — one observational, the other a meta-analysis —just presented at the American College of Cardiology (ACC) 2015 Scientific Sessions that also showed no increased cardiovascular risk (heart attacks) among testosterone users”. For those men reading this, it may allay fears if this is a consideration, but still each man considering this should clear taking this hormone with his doctor.

A recent paper published in “Perspectives on Psychological Science” indicates that people who spend less time alone and are less socially isolated might live longer and this has been found to hold in all ages of people. The study was done at Brigham Young University analyzing 3 million participants from a variety of health groups. The metrics included socioeconomic status, age, gender, and pre-existing health conditions and the study suggests that a lack of social connections presents an added risk. People with relationships had showed greater health.

Specifically, “the mortality risk is increased by 29 per cent for socially isolated individuals and by 26 per cent for lonely people. Individuals living alone have a 32 per cent higher risk of dying prematurely.” When one adds excessive drinking and smoking to the mix, the numbers may be worse. “In essence, the study is saying the more positive psychology we have in our world, the better we’re able to function not just emotionally but physically,” said Tim Smith, co-author of the study.

We see in our hair restoration practice, men who lose their mates. Many feel lost and some seek hair transplants to get their hair back with an anticipation of dating again, We see this with great frequency as men want to look more desirable, and appear certainly younger. Adding hair to a balding head, makes this happen. I distinctly remember three patients; one a 68 years old, who sat with his dying wife for 4 years as she eventually succumbed to breast cancer. He rarely socialized while she was dying. When she died he visited me and told me how difficult life was during those 4 years, but he loved her a great deal and appreciated her though the end. He was missing the hair in the front of his head and got, in just one session, terrific glistening silver hair. Once the hair grew out, he went on a cruise by himself and met a beautiful 29 year old Japanese woman and by the end of the cruise they decided to marry. He came to visit me two years later to introduce her to me. His smile was radiant. He told me that being alone, just was not for him. The second man was 86, and he lost his wife and thought he looked too old, so he got a hair transplant with great results in just one session. It did not take him long to find a new wife. At 86, there were more single, available women than men by a long shot so the hunt did not take long. I think that the women hunted him out. The third patient was 55, his wife left him and he refused to date until he got a hair transplant. After just one session, he came back and told me that dating was great. He met many women on the internet and loved the attention he was getting, but he did not marry again, at least not in the first year that his hair grew out. Maybe he could not find ‘Miss Right’.

In conclusion: Hair makes a man feel more confident, younger and more able to tackle the world of ‘available women’. It also has a major impact on careers. Many Hollywood celebrities that I worked on before they became famous, developed the confidence in themselves that boosted their careers. They often felt my contribution to their ‘look’ was one of the main reasons they made it professionally. From the article referenced above, it appears that maybe hair transplanted patients will live longer, who knows. Life’s value, a man’s confidence and maybe life’s length are related.

I am concerned about shock loss from having a hair transplant. A few years ago, I had taken Propecia for my hair loss and got Erectile Dysfunction when I as 35 years old, so I stopped taking it. I stayed on the drug less than a month and could not tolerate it. My hair loss continued as my doctor told me it would. I am now 48 years old. I want to have a hair transplant so what do you recommend that I do?

My answer is always to think worst case. Not everyone that has a hair transplant gets shock hair loss, but the risks are there and the drug finasteride (Propecia) is a great drug that usually prevents this complication. These are my general rules that I tell patients, but reading this list is not a substitute for checking with your doctor first:

1- For those under 30, I recommend it 100% of the time
2- For those between 30-35, I generally strongly recommend it.
3- For those between 35-40, I recommend it most of the time if this is their first hair transplant procedure
4- For those between 40-50, I do not insist on if if they had no previous procedure but generally recommend that they take if for up to a year
5- For those over 50, I tell them about it, but do not feel strongly about if it they are concerned about using the drug

If the patient has had a previous hair transplant in the past 5 years, I do not feel strongly that it is important to be on the medication if the patient does has hesitation on taking the drug. Usually the greatest risk of shock loss occurs after the first hair transplant as it creates shock to the hair and it is common in men under the age of 30 who are not on the drug finasteride.

Artificial Heart: The SynCardia artificial heart has already been used in 1250 patients awaiting a heart transplant. The FDA just gave SynCardia the green light to study whether the device could be a permanent solution in people for whom transplant isn’t an option. This is a very interesting breakthrough as I patented a type of artificial heart in 1967 and worked in the heart field for a number of years developing about 11 devices, one of which made it into commercial use ‘The Intra-aortic balloon Pump’ which is now in every coronary care unit in the world. Now a similar device which is implanted into patients “Left ventricular assist devices (LVADs) are becoming an increasingly viable alternative therapy for heart failure, either as a bridge to heart transplantation (BTT) or destination therapy (DT). The LAVD has become increasingly popular in recent years, in the face of a donor organ shortage and a rise in elderly patients ineligible for heart transplants. For these patients in particular, device durability is a key contributor to survival, morbidity, and quality of life”.

3-D Printing: of a heart is on the horizon, possibly in 5-10 years. A skeleton of collegian is laid down and then fat cells containing stem cells creates myocardial cells which fit into the shape of the skeleton created by the 3-D printing system. This was shown on CNN’s this past Sunday morning. Imagine, getting a new heart when the old one just wears out.

3-D Printing: of cartilage that can be used to replace the meniscus of the knee. This is one of the most common injuries occurring from sports, running, skiing and almost any injury of a knee joint. Now, these meniscus are removed and in almost all situations, these injuries lead to degenerative joint disease and crippling arthritis in many people.

Artificial limbs: are starting to work directly from the brain with thought propulsion activating the limb for walking or hand movements. This will be miraculous for Vets who have lost limbs or for those who have become paralyzed from almost any cause. Christopher Reeves would be smiling at these advances.

A Hand That Can Feel: a European Union effort to develop advanced prosthetic hands, has created one of the world’s most advanced artificial hands—one that can feel objects. When recipients grasp an object, hand sensors that are linked with nerves in the upper arm allow them to tell what it is. It will still take a few years to make it to market.

Retinal Implants: “About 100 people worldwide have now received the Argus® II retinal prosthesis system. This “bionic eye” uses a tiny camera mounted on a pair of glasses that sends images to a retinal implant via a small conductor. The device does not restore sight completely, but it does allow patients who have lost their vision to make out shapes and distinguish between light and dark areas”.