I had a question regarding hair loss. In a perfect world, if hair loss did not exist,  would males just have just a mature hair line which doesn’t indicate hair loss?

Yes, but 95% of Caucasian men develop a mature hairline, less among among Asians, Indians and Africans as each ethnic group may or may not develop a mature hairline. For those that do not, then they maintain their juvenile hairline like Bill Clinton did. He has had some erosion of his hairline but the line I drew is where his hairline was before he had his heart attack.

You get screwed! This is why you do your research and you don’t go to the first local search on Google for a hair transplant… I dealt with a shady practice. A hair/wig stylist who ran the company based in CT, he basically had a cosmetic surgeon that they used the name of and to sign off on the surgery but not do any of the work. The nurses and the stylist did all of the incisions and the transplants. The guy who ran the company was a real sales man and I was naive at the time, made it seem like i didn’t need any drug and that the surgery would reset the clock 5 years and not need to be reassessed for at least another 5-10 more years.

The surgery itself… wasn’t great, wasn’t disfiguring though (as I learned later I got lucky) but long term there was no plan so i will be seeing another HT surgeon within the next few years if i have enough money saved up.

As Dr. Rassman said, the key is to develop a master plan and any good hair loss approach should start with stopping the hair loss and then addressing the transplant.

Right on.  Well Said! The problem is far worse than you know.  Doctors who know nothing about hair transplants, hire salesmen who sell the surgery and then they bring in teams of technicians who perform the surgery and even give the anesthetic.  This is, of course, illegal but the prosecutors in each State don’t want to address this illegality because they say that they don’t have the budget. When some poor victim dies, then the prosecutors will go after the person who did it with Manslaughter charges if it is a non-doctor. If the surgery was done by an ignorant doctor who did not understand what he was doing, a death would just mean possibly loss of license (worst case) when it should be Manslaughter or murder. Our International Society for Hair Restoration Surgeons are very proactive, but the different governmental bodies just don’t seem interested. I for one, will volunteer my services as an expert witness in any prosecution in such circumstances as I have done before. Use this old axiom: LET THE BUYER BEWARE.

Shock loss is an acceleration of hair loss after the stress of a hair transplant. It is more common in younger men in their 20 and less common in men as they get older, like their 40s and 50s. The best prevention of it is the drug finasteride which seems to protect the patient against shock loss.

I‘m about to do one at the age of 25. However since I’m not an extreme case (a slower hair loss) I’m scared that my hair behind the new implanted hair will fall out. How often does this happen? Will this happen if I don’t use finasteride?

The key to doing a hair transplant is to develop a Master Plan with your doctor. Balding develops patterns that are inherited from your family.  Depending upon the pattern you inherited, the balding will progress sooner or later to your inherited pattern and if you start having a hair transplant now, you will have to accept that you will follow the hair loss until your hair loss pattern is reached by having more hair transplants.  Of course, the reason for a Master Plan is to know where your hair loss is going and if you have enough donor hair to follow that pattern.  You never want to look ‘half done’ which would happen if you did not plan properly. After a hair transplant in someone of your age, shock loss may develop which is common in men in their 20s (an acceleration of the hair loss process) so  to avoid this, the drug finasteride is the ONLY drug that can stop shock loss in its tracks.

I am 24 years old and have had 600 FUE done a year ago. I also use minoxidil which seemed to help. I’m wondering if it’s possible to maintain this hair with FUE and FUT alone? Money isn’t an issue and I’m wondering if it’d be possible to get 5000-7000 grafts done from my head and another 10-15 thousand from my neck and body? Thanks so much for your help!

It is best to develop a proper master plan which will (1) determine what your present hair loss pattern is with an instrument called HAIRCHECK that will measure the hair bulk throughout your head, (2) get a good family history so that we can determine what is your worse case, (3) measure your donor density to see just what you have available for transplantation in a worst case scenario.  This requires an excellent doctor who cares about you and only focuses on your needs, not the money he/she will make.  I firmly believe that a Master Plan will address the other questions you have. The scalp with FUE might produce 5000 grafts safely and adding FUT it might go up to >8000 (depending upon your donor density), the beard could add another 3000 and the body, I believe, is a poor course for hair for many reasons. I do work on patients from all over the world, so contact me and send me some good pictures of yourself in your worst light with your eyebrows lifted high so I can determine where your hairline belongs.

I tell all of my patients to be patient and wait out the growth for a full 8 months when they can expect to see 80% of the growth to styling length. From what I see, there is early growth present so be patient and wait it out until it fills in more