Did Johnny Depp Have Hair Transplants?

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

Hi doc, I have a few questions.

  1. Do you think Johnny Depp has had hair transplants?
  2. I’ve been on propecia for 5 months now and so far the right portion of my hairline has actually filled in while the left has gotten worse. I’m 19 right now and I dont expect my right side to get as bad as the left side. Is it possible to get a hair transplant on just one side of my head? Would there be a particular reason why its like that?
  3. I’ve found this very interesting article on the aging process. (Hankooki.com) What would its implications have on the advancement in hair restoration?

Thanks.

Johnny Depp

  1. I am guessing that Johnny Depp did not have them either as I have no direct experience with him. I haven’t read anything where he has said he’s had hair transplants, so I couldn’t say. If he did and I did it, I would not be able to say that I did him because it would expose his confidential personal information.
  2. It is not uncommon to bald faster on one side than the other. The two sides will eventually even out. If Propecia worked on one side and not the other, then I suspect sooner or later the side it worked on will start to bald as well. Maintaining the Propecia may keep the imbalance present. I have transplanted one side in certain unusual cases. I judge each one on their own merits.
  3. I read with interest the article you referenced. I only know what I read. There are parts of our genetic material called telomeres which shorten as we age. This is an aging clock in our system and when the telomeres drop off to a certain level, cell death occurs. A great deal of research has been done to increase these telomeres so that our biological clock is extended. The science of anti-aging is developing rapidly, and hopefully we will live long enough to see the fruits of such developing science. Genetic hair loss may or may not be helped by this research. Your guess is as good as mine.
Tags: johnny depp, actor, hollywood, propecia, proscar, hair transplants, hairloss, hair loss, telomeres, aging, finasteride

I Want Hair Like Tom Hanks in the Da Vinci Code

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

Hello Dr. Rassman!

Thank you for answering my last two questions.
This is a quick one and I’m interested to see what pictures you post along with your answer.

If I get a hair transplant that resembles Tom Hanks in The Da Vinci Code (due to a below average donor density, for instance) could I potentially move my hair line to Tom Hanks in Big if and when hair multipication becomes possible?
More broadly, what is your advice for someone considering a less than juvenille hair line look?
If that is what someone desires can it be created in advance of total hair loss?

Tom HanksI have had many people pick out a celebrity and say that they want to look like this one or that one. Sometimes I make an effort to do just that if:

  1. The hair transplant option is part of a Master Plan that makes sense and looks appropriate.
  2. The patient understands the process.
  3. The goals are realistic with regard to hair supply and demand, and the characteristics of the hair itself.

The isolation of the frontal hairline in the treatment of the balding or thinning process may be appropriate in some people. There is a bonding between doctor and patient here that must be taken into account. If I met with you and bonded and believed that your goals were realistic, I am sure that we could develop a plan that makes sense to both of us. I have had patients get a mature hairline (playing conservative initially) and then move it down to their more youthful childhood hairline in another hair transplant procedure. I would rather do it that way then create a hairline that was too low which (because of its permanent nature) is there for life. If Tom Hanks wanted the hairline he had when he was young in the movie ‘Big’, he could get it moved down with little difficulty. For people who are not balding, I have replaced the youthful hairline to prevent the maturing hairline from appearing, but I have done this mostly for actors or male models whose career depends upon this youthful look.

Please just look at the NHI patient photo gallery and focus upon the variations of the hairlines. I could produce a Count Dracula type of hair line with a very wild widow’s peak, but I wouldn’t do that unless the Count himself asked for it.

Tags: hairloss, hair loss, hair transplant, tom hanks, davinci code, dracula, hairline

Touch-Up Hair Transplants?

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

Hi, Dr. Rasman I am a 22 year old Korean male that is confused whether I am suffering from a maturing hairline or male pattern baldness receding hairline. Everytime I take a shower and put my hands through my hair there is usually 2-5 strands of hair in my hands. This is especially the case towards the front of my hairline and occasionally the back. This depresses me a lot in the fact that I used to value my nice long soft hair as a teen and now feel unattractive that I can’t pull it off anymore. Many wouldn’t realize that I’m losing hair and just think I look older or have a big forehead. I was wondering if there is such thing as a touch up hair transplantation and if I could be a candidate. Although I know I shouldn’t let it bother me too much, it does do quite a damage to my self-esteem. Thank you and appreciate your help!

Can you email me pictures of your hairline and forehead with your eyebrows lifted high? Generally the youthful hairline touches the highest crease of the wrinkled brow. The mature hairline usually goes up by about 1/2 – 2/3rd of an inch in Caucasian males. Asians have slightly different maturing patterns, particularly with regard to the shape of the hairline, which is flat rather than receeded. You should be evaluated by an expert and as you are a Los Angeles resident, I welcome a visit to my office to help you with this problem. I will also map out your hair for miniaturization and see if any balding is evident today.

At the age of 22, I would not rush to get a transplant. Touch up transplants are like being partly pregnant (metaphorically speaking) — it is not a good idea. Starting a hair transplant process at your age may ‘hook’ you too early and make little sense to reasonable Master Plan for your future hair loss.

Tags: hairloss, hair loss, asian, hair transplant, hairline

16 Year Old With Receding Temples Wants Dreadlocks

/by William Rassman, M.D./3 /,

Hello, I’m 16 years old and I’ve been planning on getting my hair put into dreadlocks. I noticed my hair line near the temples were receding quite a bit. If I were to get my hair put into them would there be any negative effects?

Also, I had a blood test taken, and my doctor thinks that my baldness is down to my high testosterone levels and not much can be done for me, I told him about my real concern and I was told to take another blood test however focusing on different things. Is there anything that can be done to help regrow or prevent the baldness? I have been tempted to try certain products however I remain skeptical, what can you sugest?

  1. Dreadlocks may put extra tension on your hair and may accelerate hair loss or produce traction alopecia (hair loss from pulling and tension is common with dreadlocks).
  2. At 16 years old, your testosterone level should naturally be high.
  3. There are hundreds, if not thousands, of hair growth products out there. I am also a skeptic like you and I generally tell my patients that it is a “buyer beware” market. If you are concerned, have a good doctor map your hair for miniaturization and determine if you have early genetic hair loss and see if the doctor can predict the pattern of hair loss. I generally can do this in a young man at about the age of 25. Just remember that at your age, you are NOT a good hair transplant candidate and need to get the proper evaluation
Tags: hairloss, hair loss, dreadlocks, teen

Scalp Mapping and Hair Miniaturization

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

Thank you for seeing me yestserday. You put my mind at great ease. As I reached you on this blog initially, please feel free to use my photographs to tell my story.

This is a 21 year old man who came to see me, because he felt that his hair was thinning in the forelock and his corners were rising. These pictures tell half of the story.

  1. The changes are consistent with the appearance of the male hairline.
  2. Mapping out the scalp shows no significant miniaturization present in any part of the scalp.

It is worthy to note the well illustrated picture of the left hairline where the fine hair (which is miniaturized as it is lost) is receding into a mature hairline. Behind this frontal immature hairline, is a mature hairline with no miniaturization. This clearly tells me that this young man is not balding at this time. As a 21 year old, the future is uncertain, so timing is everything. I always tell these young men to follow with me yearly, just to detect miniaturization at its first appearance and if the miniaturization appears, then with a drug like Propecia, the miniaturization may be arrested. The focus of a good Master Plan should be to keep the hairy person hairy, not transplant the balding one. Although this is not a profitable thing for me to do, it is what you would demand from a good doctor, doing what is in the best interest of his patient.

The good news is that he does not have to start Propecia at this time and may postpone it until miniaturization appears (if it ever does). Peace of mind is the reward for a good and proper examination (one way or the other).





Tags: hairline, miniaturization, propecia, hairloss, hair loss

Juvenile Hair Line

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

I am in the process of a losing my juvenile hairline. It is turning into the mature hairline. Does the hair that is receding to that of a mature hairline just fall out are does it have minuturization.

I am 26 years old and my straight across hair started changing to a mature hairline 2 years ago and have noticed minuturization for some time around the temple region,basically what i’m saying is this a normal event or the start of the balding process.I would be extremley grateful for your comments on the matter

As World War General Douglas MacArthur said in his retirement speech, “Old soldiers never die, they just fade away“. That is like hair and most people miniaturize some of the hair in conjunction with receding. The miniaturization process is an early indication of what the future holds, but there is no timeline on that prediction. We do not usually note miniaturization, because it sneaks up on us. Even your juvenile hairline will behave like the ‘old soldiers’ that General MacArthur talked about. The key for someone like you is to get the entire scalp mapped out to be sure that it stays in the juvenile hairline, otherwise drugs like Propecia may have great value in preserving the other hair you have before it sneaks up on you as well.

Tags: hair loss, hairloss, hairline, propecia

I Don’t Want a Mature Hairline!

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

Im 23, and know I have lost hair. My hair used to be really thick, and I have lost hair diffusely, at crown, and temples. 2 Derms I went to said it was simply a mature hairline. I dont want a mature hairline, I will not feel stupid being 30 with a teenage hairline. The derm said that I can try propecia if I want to. My mom and uncle have both mentioned my hair looks thinner. Im unsure what to do.

There are men that do not ‘grow up’ from a hair line perspective, so you can get reconstructive hair transplant surgery to bring back that old child-like hairline. While it is respectable that you do not want a mature hair line, it is something most hair transplant doctors do not treat, but something that I would be willing to do in a 30 year old who met certain criteria. The criteria would be:

  1. that the predictable hair loss pattern will not be advanced
  2. that your supply of donor hair will be enough to meet your needs on a worst case scenario
  3. that the various elements of your hair characteristics meet my criteria
  4. that you understand what is the worst case scenario for progressive hair loss and have a plan worked out with me to deal with it
  5. that you are mature and of sound mind and body
  6. that you have the finances to follow a worst case scenario through if it happened
  7. that you can tolerate and are willing to take Propecia for the rest of your life

Currently there is no data that shows finasteride (Propecia) will stop the progression to a mature hair line. Propecia can only be prescribed by a medical doctor and it is important to establish a correct diagnosis before you start any medication.

Tags: hair loss, hairloss, hairline, hair transplant, propecia, finasteride

I Want Even More Hair (with Photos)

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

I have wonderful results from the transplants you have given me, but now I want more hair in the crown. Can I do it one more time?

This is not an uncommon question. I have shown his before and after pictures here, with permission. He has received 3,218 grafts in three procedures. The first procedure was a limited FUE surgery placed into the corners with 484 grafts. This gave him a nice result, but he wanted more fullness so another procedure was performed in the front to finish out the hairline reconstruction. Had he elected to allow me to dense pack the frontal hairline and use a more traditional approach (strip harvesting), I would have done the entire procedure in the front (1391 grafts) in a single procedure, but the FUE limited the harvesting in the early days (2001) when this was considered a large FUE procedure for me. He elected to come back a third time now to address the top and back of his head. His third procedure had 1,827 grafts and it achieved wonderful, natural results. Now he wants a tighter swirl in the crown and a second procedure into the crown (a 4th procedure overall) will finish the job.

A good Master Plan might have reduced his entire process to two procedures (front and back), but sometimes it takes a slower approach to make the patient feel comfortable with the process. He now has 3,218 grafts total and will receive another 1000 in the crown in the very near future.

Before (click photos to enlarge):


After:


From Bowling Ball to Gorilla (with Photos)

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

Patient ZU is in his mid 60’s and he is what we call a Class 7 Norwood scale balding person (click name to see his before picture). He came to an open house last week and he has now filled out nicely. He told every person at the open house that he looked like a ‘bowling ball’ before his hair restoration, smiling as he made that reference. I talked about him before on this site (and posted some photos), but when last I spoke of this patient, I had said I’d post updated photos of results from his last procedure when I got the pictures. Well, now I have them. He had a total of 8,300 grafts. Would you believe that he still wants more hair? The crown area needs more fill and his comb-back styling is now working well for him, but he believes that with more hair it will work better. I guess when you have been deprived of hair for 40 years, you may over-react. Patients continuously tell me that when it come to hair, like money, more is better.




Wide Temples and Balding

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

Hello Dr. Rassman,

I have always had a big forehead and relatively wide temples. I am 29 and my head looks kind of like the second stage of hair loss diagram. I think my hair may be a bit thinner than say 5 years ago, but not too sure.

My question is, do men with wide temples always end up balding? or is it possible that some men just have a large forhead and big temples without ever balding…

Size and shape of the head are not indicative of future hair loss, as there is no relationship between the two. Some men do have large foreheads or an abnormal shape of the head accentuating the detectability of receding hairlines. Some of those men more sensitive to the impact of hair loss on their ‘look’.

Asymmetrical Hairline

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

Dear Doc, is it normal to develope a very asymmetric hairline at the age of 18-19 ?
I have the right part of my hairline very regular, but the left side is extremely high… it seems that I losed hair only on the lef temple region. In the other areas of my head I have a full density of hair. Is it a normal thing? Could my stress have caused this recession, or was this something impossibile to avoid anyway?
Thanks for your help Sir

Hair loss from genetic causes, can start on one side and then eventually the other side will catch up. Get a diagnosis by mapping out your scalp for miniaturization to determine if you have genetic hair loss. Then tackle it with a good doctor and the appropriate medications that work really well in young men.

I Don’t Like Having a Mature Hairline

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

I am 23 and notice I have a mature hairline. its a 2 on the scale. I dont like my hairline though and would like to get the hair around my temples back. Is there any procedure that can fix this? If so please tell me

I have transplanted the juvenile hairline back in some men, but I do so only under certain conditions:

  1. There is no evidence of advanced balding either on examination or in the family line.
  2. I want to get to know the patient and he must be mature and able to understand the ‘worst case’ scenario that could happen (in your age the worst case thing is advanced balding).
  3. I look at the value of the various elements of hair quality, skin color, hair density, and overall donor supply characteristics and connect it with potential demand considerations.

I have clearly done this more than once, but in my present memory the only ones I have done under 25 years old were professional actors, television soap opera sexy men, or models whose livelihood depends upon that ‘youthful’ look.

Hairline Regrew with Meds

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

I’m a 27 year old with recession to a NW2 pattern, but thinning over a NW5 area. I’ve been using Propecia, Minoxidil and Spiro for roughly 1 year, and I’m noticing pigmented hair starting to sprout around my original NW1 hairline. However, the density on the top of my head appears to have gotten slightly worse. Maybe it’s a shed, I don’t know.

With success continuing on the hairline regrowth standpoint, do you think the thinning on top is just taking longer to grow in — or could it be possible I’ll end up with a NW1 hairline, but with a thin NW5 pattern? I understand that hairlines usually come back in (if at all) AFTER the crown and vertex have filled in…? It just seems odd to me to be having regrowth success in the one area people have a lot of trouble with, but be lagging behind in the areas that are meant to respond best to treatments.

My father has a NW4 recession/NW6 thinning pattern at 55, and my hair loss seems to be following the same pace and pattern as his did at my age. In the scenario that I don’t achieve desirable density on treatments in the next 12 months, is FUE an option to fill in the density of the thinning pattern? On that same note, if I were to have FUE done in the next 1-2 years, would it still be possible to pursuse Hair Multiplication when it became available? I can’t remember where I read it, but someone mentioned that previous HT patients would not be suitable candidates for HM for some reason. Or maybe I misunderstood/misread…?

Call it vanity or risk, but I’d rather have decent hair in my 20s and 30s, and the confidence that goes with it, and worry about my 40s onward if/when I get to them. What can I do NOW to achieve my goals, even if they’re temporary fixes until the next great drugs/procedures come along?

Thanks

Norwood Class 2

Norwood Class 1

I am very impressed with your questions, particularly the way you distinguish the difference between the way to classify recession and thinning patterns of hair loss. You are correct to assume that the impact of medication is different between the front and the top/back of your head. I do not understand why the treatments you are having are impacting the juvenile hairline (Norwood Class 2 pattern moving to a Norwood Class 1 pattern).

With regard to filling in a thinning pattern — that would depend upon many things. There are many doctors who would gladly sell you hair to fill in a thinning pattern, but there is always the really important question to ask: Will the gain off-set any loss from the transplant? Many unscrupulous doctors would like to tell you that this is preventive hair transplantation to stop the balding. When I hear that statemen (preventive hair transplants) I know that the doctor has ethical problems and $$$ are getting in the way of his/her judgment for good patient care. To get a proper answer to that question, you MUST find an ethical doctor who will answer it from your perspective. Judging that you are focusing upon a Norwood Class 1 pattern, I might think that you are overly worried. If you choose to have an FUE or a conventional strip procedure, that is an independent decision to having a transplant in the first place.

Any transplant you *or any person having them) might have will not interfere with the advances in hair cloning or hair multiplication that may come up in the future. You are worried about what you will look like in 13 years, but I would ask you to have you scalp mapped for miniaturization and if you really are thinning in the patterns you discussed above, then the drug of choice is Propecia/finasteride and that could do more to fix the thinning problem than any hair transplant you can do.

Unnatural Looking Balding Pattern (with Photos)

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

This appears like a hair transplant that did not grow, but it is actually a natural balding pattern in a 50 year old man with frontal balding. So why does it look so unnatural? The reason is that the hairs that remain are all healthy hairs, and the surrounding healthy hairs have disappeared (died). Most people develop miniaturized hairs, which is when the hair shafts become finer (front to back), and they just get thinner and thinner in appearance. That is what normally happens in most men. Sometimes, men have mosaic type genetic balding patterns, where some hair in the front remains for the lifetime and looks healthy (hair by hair), but the overall appearance on this type of balding pattern is particularly ‘shaggy’ and has a less-than-healthy look.




Propecia and Body Hair (with Photos of Hair Transplant)

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

This patient had a very nice result from one hair transplant procedure. An interesting item to me was that he reported that when he started to take Propecia, the hair from his chest and back (which was very heavy) returned to his barely hairy 18 year old body’s hairless appearance. In addition, he also reported a reduction of nose and ear hair. So this patient shows not only the benefits of a good hair transplant, but also a rare but good side effect of Propecia (I have rarely seen been made aware of this loss of body hair). I only have photos of his head, as I didn’t think people needed to see photos of the inside of his nose or ears (and so I didn’t take any).

The first set shows his before photos. Click the images to enlarge.




And this set shows his results after one hair transplant procedure of 2,073 grafts.