After reading your articles and Q&A, I decided that before doing anything I should check with some dermatologist. I search for doctors for hair disorder in my area through The American Academy of Dermatology website. I am just curious about how to check if the doctor is expert in this field? or is it safe to assume that the doctors suggested on the www.aad.org are expert in this area? I am just being cautious because once I went to a dermatologist and he just gave a glance to my hair and prescribed me propecia, and that was like one minute consultation. So I just want to make sure that I dont end up doing the same. Thanks for your time.

There are many steps in the process of selecting a good hair doctor. You have done one. The ISHRS site has doctors who participate in the international hair society. These doctors do more hair work than most, but then again, that does not guarantee the best doctor. If it is a hair transplant you are looking for, go visit and interview the doctor and ask to see his/her patients. What you see is a good indication of what you are going to get.

In your situation, where the doctor didn’t provide you with a full consultation, that generally says to me that the doctor you got may not be a real expert, and although he may have done the right thing by prescribing Propecia, you still need to go through a better examination to be sure of the diagnosis. Typically, you should have a microscopic examination of your hair before the Propecia is started.

I am preparing to have another session in September for added density. The only discomfort that I had in my previous surgery was that the scar(strip harvest method) in the donor area. Is there any way to stretch that area before surgery other than massaging that area? ie an implant device to stretch the skin?

Some people have tighter scalps than other people. Also, as some people get transplanted, the tightness of the scalp may get tighter, although this is not the routine case. There are tools that expand the scalp ahead of time. These tools were invented for scalp reductions, a procedure that has fallen on hard time (for the right reasons). Many of these devices (expanders and balloons) are painful and should be preserved for those with indications for their use (burn scars, large scars from accidents and the like). Your question is difficult for me because there is an implication that either you want more donor scalp removed than is safe, or that you had unusual pain associated with your donor wound closure. It would help me to understand your question better by further clarification, call me at 1-800-NEW-HAIR so that I can grasp the direction you want me to take.

I am 32 years old and started balding about 3 years ago. My wife told me that I have about 60% hair loss located in the vertex of my head. The size is about 3″ wide and 2 1/2″ high. Here is my question: Do I need to wait until I lose more hair or all my hair in order to qualify for the transplant or can I start the transplant and make it a smooth transition so that no one will even notice a change?

Another question: Is hair plugs still used in hair transplants? or is this an old procedure? I do not like the look of hair plugs and it is obvious when someone has them.

Thanks.

You should be evaluated first to see if you are a potential candidate for hair transplantation. You should also consider the use of medications that will slow or stop the hair loss, possibly even return some of the lost hair.

The hair transplant methods have advanced light years since ‘plugs’ were the norm. Although there may be physicians who still use the ‘plugs’ you are talking about, they would be practicing outside the standard of care and as such, it could be considered malpractice.

I am 20 years old and very nervous about losing my hair. Since about my senior year in highschool ive seen the front of my hair line recide. This is a very stressfull and private thing for me so I only talk to my family members about it. When I ask if it looks like im going bald the answer is always no. But my hair line from my senior pictures to now has deffinately changed. Its seems to be going back on the sides, right above the eyebrow.(im sure you know what im talking about. So I do have a couple of questions.

1. Am I to young to get a hair transplant?
2. How much hair do I have to lose to actually be able to get one. Im always reading different sites and all kids my ages ask almost hte same questions but everyone always says wait till you go more bald… Well I dont want to wait, I want to prevent it before it starts. I dont want any sign of thining hair or a reciding hairline. Its like my petpeve.
3. Do hair transplants look like real hair, or can you tell the difference? Ive seen about 2 people in person that got them done..and one person It was pathetic he had like 3 strands of hair growing out of one section. Then about a 1/4 inch space and then more hair. If I get a transplant I want it to look so real that even I cant tell it was doen.

Also I was reading a question that someone posted on your site. And I read an answer by some John Doe. He said that there were scars from his transplant. This is the first time that ive ever heard anyhting about scars. Can you tell me more about that?

You have many questions, all good ones, but not easy to answer without writing a book. I actually wrote a book, The Patient’s Guide to Hair Restoration, which you can get by clicking here. The entire book is available in PDF format, but you can also order a complimentary print copy complete with photos at the Request Additional Info page. Many of these questions will be answered by the book or even in the previous blog questions from other young men about your age. No matter what I tell you, you must have a visit with a competent, caring doctor. Although I have performed hair transplants on patients as young as 18 years old, it is not my usual case, but before I would do this, I would want to know what is happening to you. Make an appointment with a good doctor who specializes in hair loss treatments. Dr. Robert Bernstein in New York is such a doctor, if you can handle the 5 hour drive to visit him. He is at (201) 585-1115.

I am 45 years old and I came to your office 1 year and one month ago. I have a bald spot about the size of a silver dollar in the middle of the back of my head (I believe you call this the crown) which did not go away when I used the drug Propecia for the past year. When we met last month, you suggested that I get the dollar size area transplanted with 700 grafts. I am a careful buyer, so I went to [Note: Doctor’s name removed – let’s call him Dr. X] office for a second opinion. Dr. X told me that I needed between 2500 and 3000 grafts, 1500 in the back of my head and the rest in the front. I was shocked by the difference between the two opinions. Is it possible that you missed any hair loss I had in the front? Even though I did not see any problem in the front, I have been looking at my hair a lot lately, and I am now starting to think that maybe I have hair loss there too. If you are right, then where is Dr. X going to put 3000 grafts? If he is right, will you be chasing my hair loss every few months? Who do I trust? Should I keep getting more opinions?

First, you should see me again and let me review your examination. Although I would be surprised if I missed frontal hair loss, there is no great mystique to the diagnosis of genetic patterned loss. We can mutually review this on the video densitometer which will absolutely show the existence of any hair loss one way or the other. I just met with another man who had a similar story to yours. He had frontal loss and no loss anywhere else, but when he got another opinion, he was told to transplant his entire head. Integrity and medical ethics should prevent doctors from transplanting men who do not need it. The buyer must always beware and is ultimately responsible for such decisions.

With regard to your comments about thinking that you may be losing your hair after staring at it day after day, just make sure you are not talking yourself into something that is not there. You have the power to control what is about to happen to you, use that power wisely and do not get sold on something that you do not need.

Hello Doctor. Recently I had a hair transplant in NJ with a very respectable Dr., someone you have worked with, lets leave it at that. I was scheduled to have 1500 grafts, but after taking the string, the doctor came back in and said I have to cut another piece because we could not get 1500, so in total at the end of the operation I recieve 1800. I was alittle upset, because I had no choice of paying the additional 300, they gave me 100 free grafts for free, so I only paid for 200. Not only did this happend, but my original scar probably grew by another 2 to 3 inches. But anyway. It has only been 2 1/2 months and to be honest, I have less hair than I originally did. My original hair was evenly spaced, now, after the surgery it looks like I hae patches of hair. It looks so weird. To be honest, I have not seen such great results, I know that 2 1/2 months is nothing but so far I am displeased with the results. My question is, when you have results such as mine, and if you are displeased, should I contact the doctor, and if I should, why should I explain that I am not pleased with the results so far?

Sometimes an initial estimate of a patient’s density is quite different from what is actually obtained during the hair transplant procedure and this affects the amount of hair that is harvested. When this happens, the surgeon may take more tissue to obtain additional grafts to more closely achieve the patient’s desired results. Additional grafts can be obtained by going back over the same area or extending the initial incision to one side. The surgeon makes that judgment based on factors noted during the surgery, such as scalp laxity.

Hair doesn’t generally begin to grow after a hair transplant for two to three months and when growth starts it is characteristically uneven. Although it is way too early post-op to have a sense of what the transplant will look like, it is still best to contact the doctor that performed the surgery with any questions you may have, as he would best be able to answer these questions and explain the reasons why specific things were done. I would encourage you to do this.