I’m going to is talking about using a robot to harvest grafts I’m just wondering if I can trust it I’m worried about losing my donor area. The surgeon said it’s better but I would rather have a surgeon do it themselves. Do you have experience with this?

Focus on the quality and experience of the surgeon and his/her team. I am the inventor of the hair transplant robot (https://patents.google.com/patent/US20080033455A1/en?q=(Hair+Transplant+Harvesting+Device+Rassman)&oq=Hair+Transplant+Harvesting+Device+Rassman), so I can tell you that the skill is not in the robot but in the surgeon’s hands, artistic skills (so he knows where to place the grafts, create a hairline, and direct the hairs that are placed), and knowledge of the field. Check to meet some of his patients to be sure you have the right place.

[If you have any questions, you can reach me at williamrassman33@gmail.com]

So I’m 34 and had a fue hair transplant 7 years ago (1000 grafts ) it was probably to young for me to do.. but you live and learn. I know I’ll eventually have to get another transplant & I’m tempted to soon .. but I’m trying to hold off getting another one soon as I know the donor area has around 6000 grafts to be used over your lifetime ,with medication I’ve only stuck to natural remedies(should of jumped on fin/min earlier.. ) but here we are . I know I need to make a decision, what are your experiences with topical solutions ? 

Try three things: 1) finasteride, 2) oral minoxidil, and 3) microneedling. If within 8 months you don’t get results from this combination of things, then a hair transplant by a good, competent doctor is the next thing to do. If you can’t tolerate oral finasteride, then topical liposomal finasteride is an excellent option as it mostly stays in the scalp. After having had one hair transplant and being 34 years old, I doubt the medications will regrow your hair. If you don’t want medications, then you can go for another hair transplant, and considering this would be your second, I suspect it will work well. Depending upon your donor hair thickness, a good hair transplant surgeon can determine how many grafts you need and predict your probable outcome. I do this, and I have been doing it for 33 years, all with follicular unit grafts before anyone was on to it.

[If you have any questions, you can reach me at williamrassman33@gmail.com]

When i pinch that area and just slightly pull hairs just fall out? Mpb on my moms side don’t even lose their temple peaks this bad, they stop around a NW5-6 with Their peaks intact, they were never perfectly squared off anyways but why is this area so thin? I’m about a NW2.5 in the hairline with thick hair other than that & this area. it’s on both sides of my head. anything i can do to fix it or?

The temple peaks have considerable variation in thickness. Comparison photos from your younger days might help determine whether this is a variation or something else. I have done extensive writing on this and found that the temple peaks are independent of the general balding process, carrying their genetic code. Time will tell you where you are going; that is why earlier photos of you for comparison will tell you a great deal. You might consider being examined by an expert like me. If the pull test is positive, I would be more alarmed than just observing what you show. I have performed hair transplants on many men who were Class 7 pattern balding, and as you know, that is really advanced balding; however, in these men, they retain a normal temple peak despite the loss of all of the hair in the front, top, and crown of their head. 

[If you have any questions, you can reach me at williamrassman33@gmail.com]

Started with oral finasteride and switched to topical after years of use once low libido and ED side effects started. Topical had been working well for a few years, but now once again suffering from low libido and ED. I understand Duasteride is stronger, but does anyone know or have anecdotal experience with switching medications and not having the same adverse side effects? Is there a chance Duasteride won’t cause the same issues or am I just going to have to give up on my battle with hair loss?

If finasteride causes low libido, the dutasteride will also do the same however, the dutasteride, with its long half-life of 4-6 weeks, will take many months to get out of your system, unlike finasteride, which has a half-life of 4-6 hours.

[If you have any questions, you can reach me at williamrassman33@gmail.com]

Most of the follicular units placed in the recipient side shed between 2-5 weeks after the surgery, and then sometime 2-4 months later, the new hair grows somewhat magically.

[If you have any questions, you can reach me at williamrassman33@gmail.com]

I messed up and scratched while sleeping on my second night after the surgery. I’ve had a real problem with this, and this time I paid the price and lost a hair in my hairline. It seems to only be one graft, luckily. I’m actually going to stay awake for the rest of the night and find a way to strap my arms to my sides tomorrow. 

Get a pair of mittens and put them on at night. That is what I have advised others like you who can’t stop scratching. Some men continue to scratch their recipient sites after days or weeks. Scratching will cause folliculitis and the result is in the loss of the transplants if not treated.

[If you have any questions, you can reach me at williamrassman33@gmail.com]

This man has a heavy distribution of hair on his body. Fortunately, he has no balding at this time.  Can this man use all of this hair for hair transplants? 

The hair thickness of body hair is about 20-25 microns, while the hair of the scalp ranges from fine (25-45 microns), medium 45-60 (microns), and Coarse (greater than 60 microns), so the value of each hair transplanted (usually a single hair in each graft) is generally poor from a coverage point of view.  Worse yet, these body hairs have a long telogen cycle and a relatively short anagen cycle.  Let’s assume that the anagen and telogen cycles are equal (reasonable), meaning that 50% of the time, the hairs will have fallen out and not reappear until the anagen cycle kicks in for the duration of the hair cycle. The entire body hair cycle ranges from approximately 6-10 months. So if a surgeon were to transplant 1000 of these very thin 25-micron hairs, then only 500 would appear at any time.  Most surgeons charge by the grafts, and as most of these would be single hair grafts, the value of each graft based on the number of grafts growing would be reduced by 50% (based upon the hair cycle) and further reduced when compared to the scalp donor hair because that average # of hairs in the scalp average 2+ hairs each.  That would further reduce the value per dollar spent.  In addition, the body hair thickness is so ‘fine’ (25 microns) that it would take a lot of these body hairs to significantly impact a hair transplant recipient area. I am NOT a big fan of body hair as a donor source for a hair transplant for the above reasons. 

Comparing scalp and body hair’s value to what you see after transplant grows	Average Caucasian	Man in photo below
Hairs per graft	1	2+
Hair thickness	25 microns	25-90 microns
Avaibility of hair to show(cycle)	50% of the time	95%+
Quality of hair	Looks like body hair	Looks like scalp hair
Value compared to Scalp Hair	Ranges downward from 25% and less	100%

[If you have any questions, you can reach me at williamrassman33@gmail.com]