I Had a Hair Transplant, But I Want the Corners Lower Than “Normal”

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

Hello, I had 1200 grafts last year, and they have done well, but the hairline is too far back in the corners. It is probably just fine for most men, but I wanted a more rounded hairline. I think that I got the male “template.” I have a widows peak, it does not, nor the area of about 1 inch to either side, need to be lowered, just the area in the corners. I have heard of hair line advancement, could this help? Most literature says that all men should look the same, as it comes to hairlines, its just not what I want. I travel to Sacramento and San Jose frequently. Hope to hear from you.

Picking a hairline is a negotiation between you and your surgeon. I have restored the original hairline in men and if this is part of your Master Plan, then it can be done. Be sure to get a great doctor, because these rounded corners can be a difficult part of the art of hair restoration.

Here’s Patient NU, whom I have featured on this site previously. The corners of his hairline were lowered dramatically and the patient wanted his central frontal hairline to look like actor Andy Garcia. Each of us has a different look and different taste, thank God. If we did not, then the world would be farily dull. The patient shown below had let his hair grow out to shoulder length for a number of years, and then recently cut it to crew cut length. He clearly enjoys the freedom of having his hair just the way he wants. Also, it is worth noting that he had temple transplants many years ago, and his results are available here and here.




Other examples include patients EO, KB, and IU.

Transplanted Hairline at 3 Months (with Photos)

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

I am concerned about transplants in the front of my existing hairline. Will they be noticable if I lower my hairline 2/3rds of an inch?

Here are some 3 month follow-up photos of a patient with dark hair. He had received about 700 grafts in front of an existing hairline. Since it is only a few months after the transplant, only some of the hair is growing and I expect much more to grow out in the subsequent months.

What is important to note is that the patient styles his hair forward so there is no way to tell that these little hairs are growing. Even if he did not do that, it was not clearly evident that these transplants are even there. The point is, it is easy to ‘hide’ transplants even in the front of the existing hairline, because these hairs grow from nothing (bald forehead) to something (fine hairs) very slowly. Most men are very sensitive to having their hair transplants seen by anyone, so I thought that these pictures would show a ‘worst case’ where the hair is growing directly from the forehead (its future home).




Please click the photos to enlarge.

Propecia for Hairline

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

Hello again doc, I’ve taken your advice on taking procepia instead of saw palmeeto pills. I still have a patchy thinning hairline that’s type I on the right side and type II on the left side. My question is, how long will it take until my hairline thickens and returns to type I on both sides? My dermatologist prescribed Proscar for a period of one year.

And one more question, my mom is in her late 40’s and has been thinning and receding around the front as well, though her’s is more apparant. Is there anything you can recommend for her? Thanks.

These drugs will probably not reverse the frontal hair loss. It will be more preventive for future hair loss if the cause is genetic. If you are talking about Norwood Class 1 to a Norwood Class 2, then this could be just a maturing hairline and I do not frankly know if Propecia /Proscar will stop the hairline from evolving naturally. My question for you is: How do you know that you have genetic hair loss? You need to have your hair mapped out for miniaturization to determine if you have hair loss.

Wiht regard to your mother, female hair loss has been extensively covered in previous blog entries and I refer these to you and to her.

Very Bald Patient Megasession Results (with Photos)

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

Norwood Class 6Here’s a before and after picture set that I wanted to show. Though you can’t see it in the photos because I can’t show his face, the smile he showed me really says something about the value of one session of 3539 grafts just one year earlier. The patient’s crown still needs more coverage and he is expecting to do one more session in the upcoming month. Very bald people take a large number of grafts and this man will require between 6000-7000 grafts total, which should complete the entire restoration process. It is important to take note of the high number of grafts required to fill in a Class 6/7 balding pattern patient. Some doctors say it can be done with 500-2000 grafts, but that type of lowballing is not the reality, as shown here. This man has a very fine, gray, slightly wavy hair. His wife says that she has a new man at home, and she shares his smile, as well as the credit for supporting him the way she did.



I Am Male, But I Have Female Patterned Loss

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

Hello! What is the best treatment for female pattern hair loss? I am a 28 year old male, however my hair is thinnest 1/3 inch behind the hairline as described in female pattern loss. I visited a Dr. about five years ago when this began although he he claimed I have MPB. Confused and hopping to find a treatment asap as thinning is spreading. Thank you!

What it seems like you are actually saying is that your juvenile hair line is persistent and that you are losing hair behind it. This juvenile area (located in the first 2/3rds inch above the frontal muscle crease which you can see when you wrinkle the forehead) has a different genetic makeup than the hair behind it. This is common to many women who have patterned hair loss. I have seen men develop patterned hair loss where they go almost completely bald, but their juvenile hairline remains. Sometimes the same is seen in a persistent forelock, which can have a different genetic makeup as well. The use of the words female pattern hair loss is a poor choice of words. What you have is a frontal hairline that is very strong and may never go away in your lifetime. Count your lucky stars. If you elect to have a hair transplant, this persistent line will keep your costs down and give you an outstanding frontal presentation. To more accurately diagnose your hair loss, get your hair mapped out for miniaturization for a complete diagnosis. You need to be sure that the rest of your scalp is normal and develop a Master Plan to be sure that you are properly dealing with the short and long term decisions that are now before you.

Matthew McConaughey’s Hair

/by William Rassman, M.D./2 /

I read somewhere that the actor Matthew McConaughey restored his hairline with “regenix”. What is that? His hair looks great and a lot fuller than a few years ago. I also read that you did a hair transplant for him. I know you can’t tell, but if you did, congratulations on an excellent job.

Matthew McConaugheyFunny you asked about Matthew McConaughey. I saw his new movie this weekend, Failure to Launch.

I must thank you for the compliment, but I cannot take the credit for his hairline. I do not personally know Mr. McConaughey, nor do I know if he had a hair transplant, and nor do I know if he uses “Regenix” (though I did see him mention it on the Letterman show). That being said, even if I did work on him, I could never divulge such confidential information. I did, however, pay particular attention to his hairline (which seemed very natural) in the movie, while my girlfriend was probably paying attention to his body. Your guess is as good as mine with respect to a hair transplant. A good hair transplant should not be detectable. I could have made that hairline, but alas, no I did not. You might ask: could this be a good hair system, a mesh or some wig attachment? The answer is absolutely a yes to that question as well, although you did not ask it.

I am well aware Mr. McConaughey has been a popular topic in such hair forums, hair related websites, and even this blog. If he is reading this and if his hairline is just a great hair piece, I would like to meet him (professionally of course), as would my girlfriend and my entire office staff who are fans (non-professionally I am sure)!

The questions never seem to end when it concerns hair and the famous men in our society. Many of our readers may be jealous and the high interest reflects the many questions that we keep getting. I’ve previously posted about Matthew McConaughey here and here.

High Forehead in Teenager

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

Hey,
I’m 15 years old and my forehead is huge, my hair is about 1-1.5 inchs further back then it should be. I have long hair to cover it,but I hate having it, I would prefer having short hair. Is there anything I can do? Is this permanent?

I’m not certain if you are male or female, so I am assuming your are male. If I am incorrect, please send me another email and reference this response.

There are a series of reasons that can produce a high hairline:

  1. if this is new for you and is an evolving process then it could be a maturing hairline
  2. you could have a genetic high hairline, something that is not uncommon
  3. you may be experiencing hair loss

Youthful or female hairlines: Wrinkle your brow while you look into the mirror. The highest wrinkle reflects the top of the frontalis muscle and both youthful and female hairlines start at this level in all children (male or female). If your hairline is touching this line, then you may have a genetically high hairline.

Mature male hairline: Repeat the above procedure, and if the center of your hairline is about 1/2 to 3/4 inch above that top wrinkle, then the hairline is a normal mature male hairline. For you, at 15, that would be unusual as this hairline usually starts to appear between the ages of 18-29 in most men.

Genetic hair loss: This would be higher than any of the two above hairlines, certainly higher than 3/4 inch above the highest wrinkle. One way to rule out hair loss is by mapping out your head using densitometer or a magnifying video-camera. A good doctor should be able to tell you this.

Going Bald, But Retaining the Widow’s Peak

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

Hello I am only 24 years old and am losing my hair from the front to the back. My doctor said there isnt anything I can do. Is that true? I have a widows peak and I dont think that is even going to last that long.

If you are a male with genetic male patterned hair loss, Propecia may slow or stop hair loss. The widow’s peak usually follows the forelock loss and when the hair loss occurs in the forelock, it rarely reverses (just like the frontal hairline).

Hairline Too Low — Can It Be Raised?

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

My girlfriend has the opposite problem as your patients seem to have. She has a low hairline which crouds her forhead and seems th throw the whole proportions of her face off. What can be done to create a more natural and astheticly pleasing hairline for her?

Yes, hairlines can be raised. Brow lifts do just that, but candidacy for this type of procedure in the young patient will be very restricted. In the older women (above 40 or possibly even above 50), a brow lift may have value.

Losing Hair in the Middle of My Hairline

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

Hi Doc,
I have noticed that i have started receding slightly on the sides of my head. Could be as you say just a muturing hairline, but recently I have noticed a little divit in the very middle of my hairline right between the eyes. I have always had it a little bit..bit it has recently gotten worse. Is this male pattern balding?

Without pictures it is difficult to make a diagnosis. These divots in the hairline that you are referring to may be the early part of hair loss in a forelock. Some genetic patterns have weak forelocks. I need to know your age, see pictures and get a family history from you. When this happens in the forelock, you often can see the same pattern in the family. If you are above 30 years old, these changes reflect a less aggressive ‘progressive’ hair loss that may be controlled by Propecia. If you are under 25, then this could be a reflection of a more aggressive pattern of hair loss and as you record the degree of miniaturization that is present around it, a good doctor can predict what may actually happen to you and estimate the time-frame it may occur. If you send me good photos, they will be kept private (a medical record requires privacy by law) and then we can arrange a time when we can speak and I will personally give you a private consultation. Without seeing you in person, such a consultation may or may not fully address the diagnosis, but it is a starting point.

Minoxidil, Propecia and Frontal Hair Loss

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

Dear Dr. Rassman,
I am male, from Nebraska US. I’m suffering hair loss for about 4 years, as far I can see I think I lost hair on every region of my head… but basically I can see baldness on the front the most. I didn’t consult a dermatologist yet because I’ve been told that there is not alot that I can do to get my hair back. My questions are: Do you think is worth it to go to a dermatologist (I have a dandruff case also)? Since I have frontal hair loss, will a minoxidil treatment work for me?

Thank you

It is worthwhile to visit a dermatologist for your hair loss. He/she can decide which type of hair loss you have and possibly the cause for it. There are many reasons for hair loss besides just male pattern baldness. Minoxidil and Propecia will mostly likely help slow down your loss, if not stop it completely and in men, Propecia for stopping hair loss in the frontal areas is more effective than minoxidil.

What is Considered the Hairline?

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

So propecia helps the hair on top and vertex of your head but most of the time not the hairline. My question is how do you determine where the hairline ends and the top begins? Is there a certain measurement that is considered the hairline? Thank for your time Dr. I have asked alot of questions and everyone has been answered. I appreciate it very much! I’ll be in to your office sometime after I manage to get my butt out of Iraq.

I would say the frontal area is roughly the first 3 inches above the highest crease in the wrinkled brow. The hairline should start about 1/2 inch from this crease. Propecia may slow hair loss down everywhere, but the drug is less effective in reversing it in the frontal area. There are exceptions to this rule: see Propecia Patient Results (with Photos).

On a side note, you have my support for what you are doing in Iraq. As you may know, I was in Vietnam and saw the dark side of war and the good side when I helped the people I treated in hospitals. In many ways Iraq and Vietnam were driven by similar ideals. Good luck.

Will Propecia Thicken the Hairline?

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

I’m 25 years of age with miniaturization all around the hairline (about 2-3 cm deep) especially in the area above the temples. I would estimate in this area I’ve lost about 50 – 60% of density in the last 3 years. I also have some vertex thinning but it’s in an early stage so it isn’t obvious but it is definitely thinner. I’ve been on propecia for 7 months now. My question is if propecia is effective for me is it likely that the already thinned area in the front will continue to thin while the areas behind remain strong as they haven’t yet been impacted my MPB? Is there a possibility I could have a solid, healthy hairline just receded more after the thin areas are gone? Or do you think my hairline will continue to be thinner the mid scalp?

Please send photos so I can see you; make sure the photos show with your eyebrows lifted high as you frown. Get good frontal and side pictures and send them to the address on the Contact page.

Propecia can slow hair loss, but usually will not reverse frontal hairline loss. It probably will fill in the crown, but by now you should have seen a gain as you have been on the drug for 7 months. What I am particularly concerned about is the difference between a mature male hairline and balding, so the photos will help me make that distinction. This is critical, because you do not want to undo a mature male hairline with hair transplants if that is all that is happening in the front.

High Hairline in 22 Year Old Man

/by William Rassman, M.D./2 /,

Dear Doctor Rassman,
I am a healthy 22 year old man. I was born with a naturally receding hairline. It has been with me since I was a kid. I am experiencing no hair loss and I use Revivogen to shampoo. My receding hairline has always bothered me since I can remember and I wanted to know of some remedies to get rid of this hairline that is natural to me. I have been recommended a hair transplant and would like some recomendations from a professional such as yourself.

At only age 22, you can not be sure if the hair loss may come on in the future. By age 30, you can tell by mapping out the hair for miniaturization. For this reason, we generally do not treat high hairlines, but that is a generality and is something that should be worked out with your doctor. I have transplanted the frontal hairlines in actors and male models your age, and would only do so after I had made a diagnosis and developed a Master Plan with them for a worst case scenario. I would consider this non-therapeutic and might consider doing it.

Female Hairline Restoration After Brow Lift (with Photos)

/by William Rassman, M.D./8 /, ,

I have had a higher hairline since I was a teenager. I always hated it. When I had a face and brow lift at the age of 49, the high hairline became even higher. Is there a simple way of lowering it? Is transplanting the only solution?

The photos below are of a 45 year old woman who, like you, had a high hairline compounded by a brow lift as well.

These first 3 photos are surgical pictures because they show what was missing, the deformities that were there and the problem that was tackled before (the middle and right photos were from immediately after surgery):




This next set of photos were taken after this lady’s 2nd procedure had grown in. The black hair and light skin are the most challenging contrast for hair transplant surgeons, explaining why it took two procedures to get the results you see here. She had a total of 3,508 grafts (in two procedures). Note that the side hair and temples were brought forward. In normal female hairlines the temple prominences often extend closer to the eyes than in men, narrowing the amount of forehead shown. Women’s hairlines, because they are rounded, not recessed, and the temples are important for accentuating femininity, make the work more difficult from an artistic vantage point.




The high hairline bothered her greatly after the brow lift and became unacceptable. The brow lift produced a wide scar behind the hairline (compounding the problem). In this situation, a hair transplant is the correct decision because lowering the hairline and filling in the scar behind the hairline can be accomplished with a single procedure in a person with blonde or white hair, and two procedures with someone with dark hair and light skin. The hairline was lowered by 3/4 inch and filling in the brow lift scar was also accomplished in the same procedure. A brow lift usually takes away the possibility of a hairline lowering procedure.