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    Bald for many years, can microneedling grow it back?

    Nov 30, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    Does it? How does collagen help a hair cell which is dead in regrowing hair? I think it is the stemcell transfer that happens during the microneedling that help dormant cells to actually regrow back. Any thoughts?

    Probably not if the area has really been bald for many many years. If it has been just a couple of years, some of the stem cells might be stimulated with microneedling plus minoxidil.

    Does hair transplant cause permanent numbness?

    Nov 30, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    I red some people saying after hair transplant their scalp never felt the same again, like there is always some kind of weird feeling sort of numbness, is this a common thing? It’s said that since there is thousands of scars, it leaves small nerve damage

    Some people get temporary numbness from the small nerve endings that goes away in a month or two at most; however, there are major nerves that the surgeon should stay away from which can give numbness to major parts of the head that can last years.

    finasteride before 20 years old

    Nov 30, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    Those who have started taking finasteride before age 20, what have been your results?

    The younger you are, the more likely you will see results. What we have seen is that when the hair loss is recent, finasteride is often more effective.

    I had a hair transplant at 23

    Nov 27, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    I have been struggling with hairloss since i was 21. When i turned 23, it was really bad. My temples were gone and it was very hard to hide it.

    So i went to a private clinic in the Netherlands and they told me a 1500 FUE transplant would be good. But first i had to take finasteride. I was scared of finasteride, but i decided to take it. I’m taking it everyday since april 2019. And i had made an appointement for the transplant on 6 september 2019.

    It has been almost 6 months since the transplant (5,5 months). It has been 10 months since i started taking finasteride. I actually started using dualgen 15 plus (topical minoxidil and topical finasteride) 2 months after taking oral finasteride. So i would say it has been 8 months since a started using this.

    Overall i’m happy with the results. I think i’m maintaining my hair. There are periods where i lose a lot of hairs and there are periods where i lose a little.

    Regarding the transplant, i wish my temples were denser. I know i’m still on month 6, but i don’t really see it getting better.

    At 23, chasing hair transplants sets you up for a lifetime of doing it. Wait until you get more balding before you do another hair transplant. As a general rule I don’t do hair transplants on 23 year old men because the balding patterns are usually not evident and too much of the donor supply gets used up without a good Personalized Master Plan to be able to address your future needs.

    Does the crown grow slower than the front

    Nov 26, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    I searched the sub but did not find an answer, sorry if it has already been asked.

    I’m on the big 4 since the end of November. I know it’s too early to draw any conclusions but I already had very good results on top and front, managing to fill an area on the right temple that has been bald for 15 years!

    However hair on the crown is still rather thin, as if it’s lagging behind. Does it take longer to regrow according to your experience?

    My routine:

    1. Finasteride 1 mg / day

    2. Minoxidil 5% foam twice a day

    3. Dermarolling 0.25 / 0.50 mm 3 times a week before applying Minox

    4. DS Laboratories Revita shampoo 3-4 times a week (it contains ketoconazole, biotin, caffeine, etc.)

    5. Biotin 5000 mcg / day

    6. Vitamin D 5000 UI / day

    The crown hair usually regrows faster than frontal hair with drugs like finasteride and/or minoxidil. I am not sure how the microneedling changes that. After a hair transplant, I believe that they grow at about the same rate.

    finasteride, minoxidil and microneedling 3 months (photo)

    Nov 26, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    Here is a nice early effect by combining dermarolling, finasteride and minoxidil for a 3 months period of time.

    Combover can be seen by everyone but the balding man (photo)

    Nov 26, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    Although this view is from the back of his head, someone who loves him should tell him to cut it all off.  Having it is worse than the alternative. I personally would rather be bald then be ridiculed by others who see what I could not see

    Wound from Turkey patient

    Nov 25, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    This patient went to Turkey for FUE and now has the huge wound on his head. All of the skin from the area fell off and now the wound probably needs to be skin grafted once the infection is resolved.  This resulted from loss of blood supply to this area.  This is another example of FUE work performed by someone who didn’t know what they were doing.

    Thinking Of Traveling Abroad For A Transplant

    Nov 25, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    It has come down to this, there is no doubt that I will lose all my hair, so I either get a transplant or go bald. The thing is that I live in Sweden and it’s kinda pricey here. I know “You get what you pay for” but I kinda want to look in at the opportunity of getting one in another country. I talked with a doctor that had gotten one, but he couldn’t say where he had gotten his. So just wanted to ask if anyone got any information that could help about where to get one maybe?

    There are many good doctors in South America, Mexico and Europe (including easter Europe) where prices are less than the US so if you are going to consider traveling to save money, find some of these excellent doctors. In Turkey, there are also some excellent doctors but they are not the cheap ones so you will pay Eastern European prices for them but you can get good quality. The amount of money they charge tells you if they have delegated the surgery to non-physicians so that they can offer if for ridiculously low prices.

    Hair character of hair transplant

    Nov 25, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    My front, top and crown have changed character as I am progressing with my balding and losing some of the hair. With the transplanted hair look like the hair that is now in the back or will it take on the character of the hair that is falling out?

    Most of the transplanted hair carries the character from its source which is the back and side of the head.  Hair that is falling out and/or miniaturizing hair in the front, top or crown area often show a different hair characteristic from what was there before the balding process started.

    I have high testosterone levels

    Nov 25, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    What does that tell you about my response to finasteride?

    I don’t remember seeing anything written (published) that relate testosterone blood levels to finasteride effectiveness. There is some logic that suggests that high natural testosterone men might be less responsive to finasteride but I could not find that published. We do know, however, that higher testosterone levels might lead to earlier initiation of the balding genetics.

    Over-harvested donor area from FUE

    Nov 24, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    This man either had (1) too many grafts taken from his donor area, (2) a lower than normal donor density unable support the FUE he received,  (3) very fine hair that could not over his donor area after his FUE was Done of (4) the surgeon used a large punch. Patients believe that FUE is a scar-less surgery but this shows that under certain condition as defined above, this is not the case.

    Turkey Technician performed surgery

    Nov 24, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    When doing a hair transplant, you must understand more than the technical issues of putting grafts into holes on the head.  The person doing this obviously didn’t understand this. It was done by a clinic in Turkey that had no surgeon, no artistry and no knowledge of what makes a good hair transplant. This picket fence can be seen coming from the post operative photo on the left

     

    5 months on finasteride (photo)

    Nov 24, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    This young man had a very good response to regrowing his hair on just 5 months of finasteride.  I suspect he will still have more benefits over the next year.

    Recycling transplanted hair

    Nov 24, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6026438/

    Although Recycling transplanted hair is a reasonable technology, the need for this obscures the fact that to move it means that it may have been done wrong in the first place.  Doing it right is better than doing it wrong and then having to move the hair as this article shows.

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