This tells me a few things:

1- His original juvenile hairline was located at the tip of the widow’s peak.

2- I can judge recession by looking at the shape, size, and location of the widow’s peak as well as when this man lifts his eyebrows high and shows the creases on the forehead.

His black hair makes everything stand out.  I showed this photo because I believe that he might have had a very early recession making the widow’s peak very prominent but this is a hard call.  I would look for miniaturization to make the diagnosis using a hand microscope.

 

Men with diffuse thinning from genetic balding can get great results at reversing miniaturization as shown in this man.

This man developed a full Class 7 pattern of hair loss before his only hair transplant of 3355 grafts.  Fortunately, he has blonde hair, which is ideal for his coverage.  We were able to get light coverage in the back of the head as well.

Dr. Shlain wrote a book called Time, Power and Money in which he gave a reasonable explanation for balding.  Back in the days when humans  were hunter/gatherers, the human population was made of communities of 200-300 people, of which maybe 20-30 were young men of hunting age.  Hunting parties would go out into the plains.  Within the group there was a few men that were bald and they were critical to be spotters whose heads would go above the bush to spot their pray. Animals had recognized that humans were problems and would run and scatter on seeing a human head pop up, but these bald guys were “not human” so they generally ignored this bald head.  It turns out that 7% of men are bald today.  In the hunting party, some men went left and some right. Those that through their spears with their left arm went left had to be left handed. It turns out that today 7% of men are left handed.  Also there was a problem with recognizing hiding tigers in the grasses and bush, so 7% of men were colorblind and could aid these hunting parties identify these tigers or other dangerous pray that were well camouflaged.  Now the last of the problems is that some men had to be left behind to watch after the women, who could be trusted?  It turned out that that job went to the 7% of gay men in the group.  These are generally good statistics today.

Balding has evolved since the day of the hunter/gatherer.  The balding genetics became complicated so that many types of balding developed, although the 7% rule for the Class 7 patient remains in today’s population. 

I anyone has another idea on the cause of male patterned balding, please send me suggestions to williamrassman33@gmail.com

Very nice early results which will only get better with time.

 If someone has a tight scalp, can they at least use the balloon expander to increase laxity to obtain a strip? Or if they are revising a big strip scar when the skin is tight, can they use the expander to excise the scar without leading to another big scar?

Tight scalps usually don’t cause scarring unless a surgeon closes it under tension; however, loose scalps have a paradoxical laxity that often produces more scars, possibly because there is more elastin in the collagen of the scalp skin. Expanders can be used for very wide scars that tend to get wider when they are excised, but that requires the judgment of a good, experienced surgeon.

If you pluck out hairs once, they will grow back, even those that are in the early growth of a hair transplant. If you pluck it out 20 times, likely it will not grow back. I don’t know how many times it takes to reach the threshold when it doesn’t come back. Doctors see patients with trichotillomania, in which some people pick out their hair. This is a real condition and sometimes ties to obsessive-compulsive disorders.