Men with diffuse thinning from genetic balding can get great results at reversing miniaturization as shown in this man.
This result was obtained in a single surgical procedure of 3300 grafts. There was not enough hair to cover the bald spot in the back of his head, but he didn’t care about that as he was 6 feet tall. His hair is black and has a medium thickness to it. Because of the color contrast between hair and skin color, my focus on his surgery was the front and top of his head, to put enough hair there so that it would produce good coverage. We achieved this goal.
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.
So you essentially drew long hair on your head with tattoo ink? Did I get it right?
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
It is unusual for a 44-year-old male to reverse all of the frontal hair loss as this man did. I don’t have a history of him but possibly the thinning that he showed in the before picture was more recent, making it more susceptible to the drugs he took. Well, he worked it out. I am certain that the microneedling helped a great deal. Congrats, this is a great recovery and hair loss reversal.
Very nice early results which will only get better with time.
Is age related thinning genetic or just natural part of getting older? Do you lose any hair shafts on the scalp or the existing ones just thin and is this separate from Dupa?
Age-related thinning is not a localized genetic issue like genetic balding; it is not a target’s diminution of hairs within a follicular unit found across all follicular units in a pattern like male patterned balding. It is a uniform change in the thickness of all terminal hairs on the scalp. It may be caused by hormonal or other genetic causes, yet unknown. It is most often found in men and women past 50, but I have seen it in 20 and 30-year-old men and women.
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.
It is interesting to see such a quick result in the crown (not uncommon); however, I do not see that your frontal corners responded. If that bothers you, you can add microneedling to the frontal corners and maybe bring that back. Am I correct that the frontal corners are receding?
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.
The number of grafts depends upon the thickness of your hair in the donor area. For simplification, lets assume that fine hair is 30 microns thick, medium weight hair is 50 microns thick and coarse hair in 70 microns thick. If you have one of these thicknesses, then this is what it might take in grafts:
- Fine Weight hair: 3000 grafts
- Medium Weight hair: 2500 grafts
- Coarse Weight Hair: 2000 grafts
Of course, these numbers might go up or down slightly based upon my examination of you, your lifetime donor supply and my assessment of the likelihood of more future balding and to what degree your badling may take. I must be careful of leaving ou with enough hair to completely address future balding.
It does appear that your forelock has slightly thickened; however, you might consider a more aggressive approach by adding microneedling and oral minoxidil. The microneedling might stimulate the stem cells in the corners which have not responded to finasteride. 7 months are on the right on the two photos.
You are shedding while on finasteride (in your case, 3 years) indicates to me that you have entered into a new phase of balding. Most men forget that balding is progressive and not all balding can be prevented with finasteride alone.
Amazing results from these two drugs in just a little over one year. This only happens to men in their early 20s.
