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To determine if you are a good candidate for hair restoration, you need to know the following and put it all together (1) donor density, (2) degree of balding (you are advanced), (3) the thickness of your hair shafts (fine, medium or coarse, (4) the color of your hair compared to your skin (you have a high contrast between your brown hair and light skin which is not great) and (5) the degree of waviness of your hair (the more wavy, the better.  If your donor density is low, the you might not have enough hair to cover the entire balding area and if you should continue to bald further, you may run out of donor hair before finishing. All of the hair in the center of your head is probably miniaturized and will sooner or later fall out. At 35, your hair loss should be slower. With all of this put together, your doctor can build a Master Plan for your hair restoration to account for not only the central hair that will almost certainly be lost, but the sides which may work their way down further than they are now.

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I had a question regarding hair loss. In a perfect world, if hair loss did not exist,  would males just have just a mature hair line which doesn’t indicate hair loss?

Yes, but 95% of Caucasian men develop a mature hairline, less among among Asians, Indians and Africans as each ethnic group may or may not develop a mature hairline. For those that do not, then they maintain their juvenile hairline like Bill Clinton did. He has had some erosion of his hairline but the line I drew is where his hairline was before he had his heart attack.

bill clinton


I had a hair transplant three weeks ago and these pimples bother me a great deal and they look horrible as well. What should I do?

This could be mild folliculitis. Go back to your doctor.  He will probably want to lance one of these pimples and see if any pus comes out. In any event, a culture of the lanced pimple may yield a positive finding and if it does, then an appropriate antibiotic will be used to treat it.


These pimples could be mild folliculitis.


You get screwed! This is why you do your research and you don’t go to the first local search on Google for a hair transplant… I dealt with a shady practice. A hair/wig stylist who ran the company based in CT, he basically had a cosmetic surgeon that they used the name of and to sign off on the surgery but not do any of the work. The nurses and the stylist did all of the incisions and the transplants. The guy who ran the company was a real sales man and I was naive at the time, made it seem like i didn’t need any drug and that the surgery would reset the clock 5 years and not need to be reassessed for at least another 5-10 more years.

The surgery itself… wasn’t great, wasn’t disfiguring though (as I learned later I got lucky) but long term there was no plan so i will be seeing another HT surgeon within the next few years if i have enough money saved up.

As Dr. Rassman said, the key is to develop a master plan and any good hair loss approach should start with stopping the hair loss and then addressing the transplant.

Right on.  Well Said! The problem is far worse than you know.  Doctors who know nothing about hair transplants, hire salesmen who sell the surgery and then they bring in teams of technicians who perform the surgery and even give the anesthetic.  This is, of course, illegal but the prosecutors in each State don’t want to address this illegality because they say that they don’t have the budget. When some poor victim dies, then the prosecutors will go after the person who did it with Manslaughter charges if it is a non-doctor. If the surgery was done by an ignorant doctor who did not understand what he was doing, a death would just mean possibly loss of license (worst case) when it should be Manslaughter or murder. Our International Society for Hair Restoration Surgeons are very proactive, but the different governmental bodies just don’t seem interested. I for one, will volunteer my services as an expert witness in any prosecution in such circumstances as I have done before. Use this old axiom: LET THE BUYER BEWARE.


When I try to cut my hair in the back short, I see ‘holes’ from the FUE I had done a year ago.

There is a trade off between FUE and strip surgery. The large FUE sessions deplete the donor area and give you a see through look like what you have here while a strip procedure does not do this, but may give your a fine line scar on the back of the head. In either event, hair length may be important to cover the thinning of the back and side of your head, or if this is a problem, you can have Scalp Micropigmentation to make the back and sides of your head normal.

donor site depletion2



Shock loss is an acceleration of hair loss after the stress of a hair transplant. It is more common in younger men in their 20 and less common in men as they get older, like their 40s and 50s. The best prevention of it is the drug finasteride which seems to protect the patient against shock loss.


This is a diagnosis called Triangular Alopecia and it is inherited.  The area can easily be treated with a hair transplant and achieve great results.

triangular alopecia2

Triangular Alopecia is genetically inherited.


He could not make our new office opening even though he was invited so he wrote: “I’d be as bald as Mr. Clean had it not been for both of you guys…thanks again!


I am 40 years-old and I have a high hairline with slight receded corners. Is it advisable to have a hair transplant to fix this? Are there any risks?

At 40 with only recession in the frontal hairline, you are a good candidate for a hair transplant that will move the hairline down. The greatest risk is acceleration of your hair loss. It is unusual to have significant hair loss if you only have recession at your age.  To answer your second question, this risk is low.

receded hairline.

Corner receding on a hairline.


I‘m about to do one at the age of 25. However since I’m not an extreme case (a slower hair loss) I’m scared that my hair behind the new implanted hair will fall out. How often does this happen? Will this happen if I don’t use finasteride?

The key to doing a hair transplant is to develop a Master Plan with your doctor. Balding develops patterns that are inherited from your family.  Depending upon the pattern you inherited, the balding will progress sooner or later to your inherited pattern and if you start having a hair transplant now, you will have to accept that you will follow the hair loss until your hair loss pattern is reached by having more hair transplants.  Of course, the reason for a Master Plan is to know where your hair loss is going and if you have enough donor hair to follow that pattern.  You never want to look ‘half done’ which would happen if you did not plan properly. After a hair transplant in someone of your age, shock loss may develop which is common in men in their 20s (an acceleration of the hair loss process) so  to avoid this, the drug finasteride is the ONLY drug that can stop shock loss in its tracks.


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