Activity after FUE

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

I have a hair transplant programmed in 2 months. My doctor told me to avoid all kind of exercise for 2 weeks prior and 4 weeks post-transplant. I will ask him for more details about it, I mean, can’t I do a few sets of really low weights just to maintain the muscle? or is it absolutely nothing at all? Also, I find it strange that he didn’t tell me anything about having sex, it is a super high-intensity exercise…

If you are going to have FUE, then exercise up to the day of the surgery and then you should be able to start up again 5 days later. I don’t know where your doctor got his information from. Full activities include sex, possibly as early as 3 days after FUE. sweating doesn’t harm the grafts or cause infections that I know of.

Finasteride 0.25mgs/day?

/by William Rassman, M.D./0 /
Statistically, based upon the original Marck studies, 0.25 mgs daily was 50% effective. Every other day will reduce its effectiveness even further. It will have some value, but certainly not like 1mg/day. If this is a way to slowly increase the dosage every few weeks until you get to a real solid dose of at least 0.5mgs daily which is 83% as effective as the 1mg dose, then your plan makes sense to me.

Napoleon, Impact of balding on his troops in 1812

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

During Napoleon’s retreat from Russia after the defeat of 1812, more than 4500 of the original force of 500,000 men died for all causes, battle wounds, heat, starvation, and especially the cold.  Many of them went to sleep and froze to death. Daron Larrey, the army’s Chisleetef Surgeon, noticed that bald men died of the cold before those with hair. 

Do hair transplants last more than 10 years

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

I have been doing hair transplants for 32 years.   Some of my patients from 25-30 years ago, call me from time to time and tell me that their hair transplants have held up very well.  One who recently spoke to me 22 years out, send photos and it seemed that his transplants thinned.  This happens to a minority of hair transplant patients

Taping dosage of fiansteride

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

I plan on switching to dutasteride. Do I need to taper the finasteride, and if so for how long?

If you switch to dutasteride, you do not have to tape off of the finasteride.  Remember, the half life of dutasteride is 6 weeks so if you get any side effects, it will take you a good half year to rid yourself of them

Norwood Class 1

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

Recently I’ve decided to start care about my look and hair overall. My hairline is a nw1/1,5 and i have a full head of hair. I want to start dermarolling for now, just to keep this hair as long as i can. If i will notice hairloss i will add minoxidil to my regimen. Is it a good idea to start microneedling a non balding head, or it will cause damage? Also what dermaroller did you recommend? 1mm or just go for the 1,5?

If you really have a Norwood 1 or 1.5, then you don’t have hair loss and are not balding. It would be bad for you to commit a lifetime of medications and treatments for no balding.  Maybe you will not develop balding. I would be happy to look at you and give you my opinion if you wish. Write to me at williamrassman33@gmail.com and send some good photos and your phone number and I will call you. No charge for my opinion.

Inherited bald spot

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

I was born in the US in 1974 and have had a dime sized bald spot (white in color) at the crown of my head my entire life. Oddly enough, my daughter, born in 2000 has an identical bald spot in the same exact spot. She is due to give birth to my first granddaughter in 2 weeks and we are both curious to see if she has one as well. No clue why either of us have them.

Based on this history, I suspect it is an unusual inherited bald spot.

2 months finasteride and minoxidil

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

One question, how long can I expect finasteride and minox to keep my hair around. Since I’m pretty early on in life, I’m worried they’ll grow less effective the more I take them. But, I just don’t know how it works. Is me responding well a good indication they may last longer? I’m hoping to keep my hair for as long as possible, none of this “I’m aiming for 40”, I’m aiming for until I’m on my deathbed and the doctors forget to administer it.

Some small amount of fill of the forelock with some extension into the lateral hairline is what I see.  Two months is way too short a time to make a judgment; however, assuming that you keep getting more filling in the forelock and the full hairline, your lifetime should be a good expectation or hope.  The forelocks are interesting because they are tougher than the rest of the hairline, so it may work in your favor.

FUT stretches the scalp

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

It just made me realize something though, will stretching the scalp with FUE greatly decrease hair density? Even with a larger FUT session, since there’s stretching involved, does that decrease hair density? If so then what is the difference in a decrease in density due to either FUE or FUT since in either one, the size of the scalp does not change and you would be taking whatever hair is available and redistributing it over the same surface area.

It is true that FUE will stretch the entire scalp (very modestly), mostly on the back and sides, but elsewhere.  The difference between FUE and FUT is that FUE is a patchy decrease in density confined to only the donor area (3 inches high around the back and sides of the head) while FUE stretches uniformly all around the head but mostly in the back.  FUT also reduces scalp redundancy, which FUE does not