Actor Salman Khan and Hair Loss

/by William Rassman, M.D./110 /

NOTE: I do not know who performed hair transplants on Salman Khan. I get many emails asking who did his surgery, and I have no idea. Sorry.

 

Dear doc,
Have you heard about Salman Khan, the most famous Indian actor? He is open about undergoing a hair transplant. Might help us if you have some information. Thank You.

ps: Thanks, you are doing a wonderful job which will earn you good Karma

I looked at his website and I did not see his present balding problem, so the hair transplant appears like a good one, at least from the pictures shown. I do not have any information on Mr. Khan, however.

Celebrities need image for much of the persona they create for their professional career. I have transplanted many of them in my Beverly Hills office so I am very familiar with the mind set and the importance of image on career. Some of the actors who were at the beginning of their career believe that the hair transplant was pivotal because of the confidence they got in themselves when they returned to their normal hairlines (at least their image of what they thought their normal should look like). It is difficult to be creative and free if you are bogged down with issues of self confidence and as looks are so important in the modeling, TV and movie business, I have found models and actors far more courageous and driven than the typical man who suffers from image in silence.

Making Grafts Finer for Eyebrow Transplantation

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

is it possible to transplant finer, smaller or thinner eyebrow hair follicles in areas surrounding or outside the edges of the thicker darker hairs of the eyebrow?

You can decrease the diameter of the hair follicle (make it finer) by damaging it in a controlled manner during the transplant procedure. This may reduce the survival of some of the hairs, but the procedure works well only in very experienced hands.

Hair Transplant in Young Adult

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

When I turned 18 I noticed that my hairline began to recede a bit and as the months went by my hair got thinner in the frontal area of my scalp & still getting worse. I tried Rogaine for a while but it irritated my scalp and caused flaking and I didn’t see any results, I was also on propecia for 2 ½ months then later stopped (kinda expensive). A month ago I saw an ad on tv about this product called scalpmed, (& it looked really convincing believe you me) they say its better than propecia & rogaine with no side effects. When I told my parents about it they were willing to support me but when we visited the website there was no return address, and I tried calling their customer care # and there was no answer. Now my mom gets the impression that it must be a scam or something. Basically I am just frustrated, but I would like to know the procedures taken in your hair transplants? is it safe for my age? How much will it cost? I hear its expensive. I just think transplant might be the only solution right now. Finally I hope I didn’t take up your time Dr and am looking forward to hearing from you.

When tackling male pattern balding, do not experiment and lose valuable time. Drugs like Propecia work best if early hair loss is treated, so time works against you and transplants in a person under the age of 24 (mostly) may be too soon to develop a good Master Plan for your eventual ending hair loss pattern. I generally discourage transplants in some men when I can not ascertain the final hair loss pattern. You need to have a diagnosis, so mapping out your hair for miniaturization is critically important to get a base line for the diagnosis and treatment. After 8 months of Propecia, you can get another assessment for miniaturization and see if you gained hair numbers and hair bulk.

If you are in California, come by for a consultation. Then we will put the entire power of what I know to work for you.

Temple Hair Transplant

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

Between the ages of 20-23 I went to an Norwood 2. Since the shedding of the hair at my temples, my hair has thickend elsewhere. Can a hair transplant be done just at the temples? Who could I contact for such a procedure?

What I am about to say relates to your age of 20-23. I would recommend first that you get your hair mapped out for miniaturization to determine the degree of the genetic hair loss that you have now and to get a good baseline for future reference. Then, based upon that examination (under the direction of a doctor), you may start on Propecia for your hair loss and take it for at least 8 months to 1 year and see if the temples return to the levels you want. Propecia may help regrow hair in the temple area. At the very least, it is worth an attempt. Beware of any person who would recommend surgery for you because he/she may not have your best interest in mind. I feel strongly that a trusting, supportive doctor-patient relationship is necessary in the hair restoration process. If you have any questions about the above information, I would be happy to answer them by email, telephone, or in person. If you live too far from California, I am more than happy to try to recommend a dermatologist in your area. I can be reached by phone at 800-NEW-HAIR.

Hair Transplants in Women vs Men

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

I’m a 45 yr old woman who has been slowly losing my hair over the past 20 years. Currently, I have the typical female baldness (not completely bald, but lots of scalp showing through) just past the hairline. Blood tests revealed no thyroid issues, but I’m well on my way to menopause as far as hormone levels. I’m healthy as far as diet and exercise, have normal stressors in life, take no meds. There is no history of female baldness in the family, but my mother has always had thin, fine hair. I’m about ready to go the transplant route, but keep reading that it could be hormonal or vitamin based. My ob/gyn and dermatologist are both at a loss to explain it as other than bad luck. How do I know for sure if I’ve exhausted every avenue before resorting to transplants?

You must have the complete work-up of tests (see Female Hair Loss for info) and then get a good, caring, competent, and ethical doctor who understands when a transplant can help and what it will do for you. Setting realistic expectations is critical. Woman’s hair loss is very different than men’s hair loss with regard to the judgments and artistic distribution for transplantation. I use the metaphor that it is easier to make grass grow on an empty lot, than it is to make a green lawn even greener. Bald men scalps are like the ’empty lot’ , so any hair artfully placed and distributed is easily appreciated. Women are more like the green lawn and making it greener is difficult as expectations may not relate to the reality of what the transplant will bring. That is why a choice in the correct hair transplant surgeon is so critical. You must be confident that the surgeon is going to give you transplants because it will help you, not just to put money in his/her pocket. Like all industries, the axion: ‘Let the Buyer Beware’, prevails.

Major Hair Loss After 5th Hair Transplant

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

OK, I will start at the age of 18. I took accutane and started losing hair 6 months later. I was scared so I got a hairpiece. At 30 I was talked into a HT. I then recieved 5 more over 5 years but I do not see a large portion of what was transplanted. I had great results after the fourth surgery but it seems that I am at a great loss at the moment. I am 9 weeks into the last surgery and see a “lot” of hair loss. I mean worse than I ever was. I am on everything.. propecia, minox, avacor, nizoral. I spoke with my doc and he said wait, its just a shock. I have a full head of hair except for the first 1 1/2 inch frontal. I am thinking about going back into a hairpiece after $30,000 and lots of heartache but I cannot take this roller coaster anymore. I can’t sleep, work, or think. I’m 36 and feel lost on what to do….help

Going to a hair piece to deal with a temporary problem of shock hair loss may end up making it permanent. You may have made mistakes in the past, just do not make them now. Shock hair loss is very, very, very rare after the first procedure with a person on Propecia. The few times I have seen it, the process reversed at the time the new hair came in. I would expect you to be where you want at about 8 months.

Lichen Planopilaris and Hair Transplantation

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

I am a 55 1/2 yr old female. I have been diagnosed with “lichen planopilaris”. I am tired of scalp injection. My doctor said the next step is probably 3 hair transplant. There seems to be no information on this disease. Is there anything else that can be done? In addition, I am on a generic rogaine formula. April will make 1 yr. on this product.

Any advice? Also, I know the cost for a transplant vary with different results.

See DermatologyChannel.net for more information on this disease. The problem with transplantation is that if the disease is active and is autoimmune in etiology, then a hair transplant may be doomed from the start. Inactivity of Lichen Planopilaris in the autoimmune arena must be determined before starting the costly hair transplantation process. If you and your doctor believe that it is under control and inactive now or sometime in the future, a test hair transplant with a limited number of grafts (about 10) taken with an FUE approach will tell you if a larger hair transplant procedure will work. Either these grafts will fail to grow (indicating that the disease is still active from an autoimmune perspective) or they will grow (indicating that the disease has become inactive). It should take 5-8 months to determine success or failure of the transplant. For those people who have an autoimmune cause, reactivation of the process is always an added risk.

Woods Technique and FUE

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

Do you use the Woods style of hair transplant? Also are you in California?

Dr. Woods (in Australia) probably is doing something like what I published in 2002 and called Follicular Unit Extraction. He kept what he was doing very secret, whereas I always publish my advances as I prove and document them for the world to see. As such, Dr. Woods promoted what he was doing on the Internet and launched a marketing campaign to sell a technique that sounds just like what we developed in California and New York. But as Woods never told anyone what ‘magic’ formula he was using, I can not claim to be using his technique. The FUE technique was defined by me (see Follicular Unit Extraction: Minimally Invasive Surgery for Hair Transplantation). On my site, you can see what it is (see FOX Procedure Videos) and also the type of scarring that is produced (see FUE Photos). There is no secret with what we are doing and the world of competent and honorable doctors reference my publication as the inventive breakthrough in this field. Now, almost 4 years later, there are no other published articles on the FUE ‘technique’ that I have seen.

With that said, Woods did publish one article that shed no new light on the great ‘secret’ of his technique. The article contains a case study and there is no scientific methodology defined, nor anything that meets generally accepted standards for publishing, so I was very surprised that this reputable journal took an article of this type without a good clinical scientific base. The article appears to be another type of marketing promotion. According to Woods’ site, TheWoodsTechnique.com, his technique was “Published in the British Journal of Plastic Surgery December 2004” and “First in the world to develop and perfect single follicular unit extraction (since 1989)”. There is no reference to my published article on it a few years earlier and his claim that he perfected it in 1989 is completely unsubstantiated. It is interesting to note the gap of 16 years from the date of the unsubstantiated discovery to the date of his first publication. Woods, in my opinion, approached this process like P.T. Barnum (best known as the 19th century American Huckster). My work in the development of FUE was started in the mid-1990s and I was unwilling to publish it for grandstanding purposes (this is not a sour grapes issue), because I would not publish something for the purpose of just getting the word out to create a reputation. I know that I am very critical of Woods, but that is because all I have ever seen, even in a lecture series that he set up, was a hyped up marketing presentation with statements made that neither his commercial video nor the photos from his web-site can realistically support. The most blatant example of this is his statement about no scars, yet I have video from his office in my possession that shows more scars then I got from the technique I published and with the smaller instruments I use today, our scars are even smaller than what I have published. If you are believer in everything you read, should I have mentioned that I am the inventor of today’s modern computer chip (I don’t believe anyone would really believe me on this last unsubstantiated statement).

To answer your last question — yes, I have offices in Southern and Northern California and would love to see you. I hope that this entry on FUE entertained you. I did try to spice it up a bit.

Weak Results 6 Months After Transplant

/by William Rassman, M.D./1 /

Hello. i’m 23 and had a 2000 graft procedure in new york on july 1st 2005. its been about 6 months and some weeks and i havent seen the dramatic results i thought i was suppose to see. I asked the doctor and he says its early and everyone is different, just wait and be patient. What do you think? I “feel” some hairs growing in different spots but not everywhere, and i have some slight cobblestoning, does that go away?
Thanks so much

I always tell my patients to wait a full 8 months before judging what the results look like. At 8 months, 80-90% of the transplants should have grown and much of them at styling length of 2 inches or so.

Be patient and wait it out. Significant changes will probably be evident in the next few months.

Graft Placement, FUE, and Body Hair Transplants

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


first:
i need your opinion concerning the placement technique of DHI Greece group.

Second:
i had a transplant with famous doctor in Australia, he is very good in FUE (body & head) but the placement is not good & transplant hair nature is changed. i think his way with washing hair not before one week of tranplantation is not good for hair, i need your opinion for that.

finally:
i think you are the best doctor in this field but i have 2 problems to proceed with you:
1- getting the VISA, my application was introduced from 18 months & there is no answer. i know this is not your fault, but this is the situation
2- i am Norwood 5 to 6, i prefer to use BODY HAIR & untill now you do not proceed with this option

finally thank you for this valuable website, i know everydetails of hair transplatation & made me have standard for quality procedure

Thank you for the faith that you expressed in my skills. To answer the first part of your email about DHI, please take a look at FUE / FIT — Minimally Invasive Hair Transplants.

It sounds like although you did your research, the “Buyer Beware” axiom still failed even after considerable research. If you are a Class 6 pattern balding patient,l the best and probably only real good source of donor hair is from the back and sides of your head and you need to exploit this first before you consider body hair transplants (most people never need them). You have clearly recognized that the art of placement is critical to the final result, which is something that many people do not differentiate from medical clinic to medical clinic. As the inventor of the Follicular Unit Extraction (FUE) technique, I know that it is not always the best procedure for those who are extensively bald. I personally think that you must focus upon the quality of the transplanted hair, and body hair does not have that same quality or quantity as head and scalp hair. Performing body hair transplants will produce a poor quality hair transplant (when compared to a good transplant with scalp hair), which may be what you are observing and blaming on your shampoo and washing technique.

Please send photographs to the address on the Contact page as a starting point of a dialogue.

Appropriate Amount of Grafts in Frontal Area

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

Dear Dr Rassman,
I am a 24 yo male who has experienced hair loss in the frontal region and am told that i am a Norwood type 4. I went to see a surgeon/dr in Australia. He told me that the best treatment was to have one large megasession and that he would use 2500 grafts on the frontal region. I am curious as to know whether this is an extreme amount in that region and your feelings on megasessions. I was also wondering that given my age how many sessions in my lifetime will i need and how frequently do people my age have to have more done. If i had a megasession would there be enough hair in my donor area if i did suffer more hair loss. Is there any way of doing a procedure, where you have existing hair, to transplant it to that area to prevent it if it was to fall out. Does one procedure in people’s liftime exist if they stay on propecia (which I am on, and doesn’t seem to be working that well).

Sorry for so many questions Dr Rassman. Thank you very much for your time.

For a Norwood 4A balding pattern, 2500 grafts in a single session sounds like a reasonable number that might meet all of your needs, depending how large the area is. Most people have about 6,000-8,000 grafts available in their donor area, but the actual number may vary. That is why we measure everyone’s density to determine a Master Plan for the worse case scenario of hair loss. Your age is a bit young, but if the pattern of loss is relatively complete and did not reverse after taking Propecia on a trial basis for 8 months, then a transplant could be reasonably done. Hopefully with Propecia that is consistently taken, the hair loss will at least slow or stop, stalling any need for further transplants for some time. Provided that you keep the work done to the frontal area, there is little worry about running out of donor hair for most people. I would discourage work in the crown at your age.

Continued Balding After Hair Transplant

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

I have read a lot about mega sessions and micrografts, etc, and don’t doubt that they can produce satisfactory results if done properly. My question is: what happens as time goes on and balding continues in the untreated areas? I assume a patient would have to keep coming back every so many years to fill in the newly balding areas. How many times can someone go “back to the well” as it were. I am 43 years now, and have a receding hairline (especially at the temples). My concern is that when I am 60 or 70, I will look ridiculous with a perfect hairline but balding at the crown.
Thanks

This is a good quesiton which I have answered in many ways before. Generally the hair loss for most people tends to plateau after the age of 35, and by the time someone reaches your age, the final pattern can be estimated by mapping out the scalp and hair for miniaturization so that you do not play ‘blind man’s bluff’ with your hair. If you will advance to a very balding pattern, then some of the hair in that pattern will be miniaturizing now, so it will be easy to see under high powered imaging.

If you take drugs like Propecia, it has several advantages, including reduction of the progressive nature of the hair loss, and probably preventing prostate cancer. Both are desirable side effects of the drug.

In most men of your age, chasing the hair loss is unusual. It is usually more of a problem with men in their 20s who get a transplant, are destined to become very bald, and who do not take Propecia. With a good Master Plan, you should never look ridiculous at any age after having a transplant, providing that you have the conversation with your surgeon and he/she is honest about his/her answers and not a salesman going for the cash that is your bank account and wanting it to be in his instead.

Hair Transplant for Patient with Oily Scalp

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

Is a patient with an oily scalp a good candidate for a hair transplant? My scalp is very oily. I want to enchance my hair density by doing hair transplant. However, I am worry about the oil excreted from the scalp will affect the newly transplanted hair grafts.

An oily scalp will not effect a hair transplant, as transplanted hairs grow in either a dry or an oily scalp.

Transplanting with Limited Donor Area

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

I have had several transplants over the last 20 years. My donor area is generally depleted and cannot support any large procedures. I have 1-2 very small (quarter size) areas that if some additional transplants were done only in these strategic areas my hair would appear much fuller. Considering the small amount of donor plugs needed could these be provided by smaller more random/scattered donor sites as opposed to the larger harvesting rows that are more concentrated in one area. Thereby minimizing the thinning effect we see in a typical donor area.

There is an art to making less hair look like more hair. I have many patients like you who have paid the price of the old antiquated procedures of the 1970s and 1980s. I have already written articles on the subject, but what I do for each patient is a one on one determination that takes the years of experience I have spent to develop the Master Plan for such person. Simply put, a good doctor, upon examination, should be able to determine the answer to your question.