I’ve had surgery 14 times on my hair (5 scalp reductions and 9 hair transplant procedures) since I started the process 20 years ago at the age of 19. I don’t look normal and that is hard to say, even in an email. I went to a number of doctors over the past 20 years and each one told me confidently that they could make me normal. I want to believe that I can be made normal, but I am not sure if I can trust anymore. Do you have any advice for me?

This is a question that I could write a book to adequately address. It involves many things including (1) ethics and earlier surgical solutions that were sub-standard solutions for hair loss, (2) what was/is informed consent for the surgical process of hair loss, (3) After 14 surgeries, what can he expect from the more modern procedures available today, if anything, (4) how does anyone get faith back, when they have experienced hopelessness, etc..

1. Ethics and the Earlier Solutions for Hair Loss: There was a time when surgeons and patients alike were naive and thought that they solved the hair loss problem with creative surgical solutions. Patients want to believe that doctor could produce miracles, and doctors want to view themselves as miracle workers. No field was more fertile that the balding young man who desperately felt that solving his hair loss was more important than almost anything ‘on his plate’. Unfortunately, desperation mixed with over exuberant doctors (some of whom had the ethics of a viper) was drawn together with an inferior surgical procedure that was (unfortunately) the only procedures available at that time. As more and more men came in ‘hordes’ to the doctors doing the surgery, doctors convinced themselves that what they were doing must be the right thing, for why would the patients come in droves if they were not pleased. For the pluggy or deformed patients that were produced, denial was a quality that played tricks on the mind, like the Emperor’s New Clothes, everyone saw what they wanted to see rather than what was there, or did they?

   In the 70s and 80s, many celebrities were drawn into the stampede. When Frank Sinatra had hair transplants, everyone found out about it. Even the doctor who did it promoted the Sinatra name as if it was an endorsement for either his services or the procedures themselves. A patient of mine and friend of Sinatra (1993) told me how angry Sinatra was when he discussed his hair transplant experience. The rumors of despair and depression that followed Elton John’s transplant experience are legendary and echo the questions posed by this 39 year old’s questions to me. If the rich and famous were sucked into a substandard standard, how could the ordinary working class man avoid the trap? The answers here are many. There were ethical doctors around in the 1970s, 80s and 90s, so the axiom buyer beware still prevailed then as the ultimate fail-safe control for our welfare in our capitalistic society. Even today, finding an ethical doctor is as important as finding a competent one, for the vipers are still out there and buyer beware paradigm is still an important guide in selecting a doctor. Unfortunately, in the 1970s and 80s, the procedures that were available were still (in my opinion) substandard which is the dilemma that our questioner implied from his early experience and it unfortunately still goes without an adequate answer.

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