Why Don’t Other Doctors Create Very Low Hairlines?

Dr. Rassman, I have followed your great blog for a while now and I know that you have been in the business for a number of years. I’ve recently discovered the work of Dr. [name removed] and noticed that one of his specialties is the lowering of the hairline beautifully. His work interests me as I have quite the receding in the temples and would love to establish a lower hairline. My donor area is great with extremely thick hair (thanks mom). My question to you is how come other Doctors do not try to establish themselves (via website, testimonials, great hairline photos) more like Dr. [name removed]? Would you be comfortable taking on the same tasks that he does in procedures?

I am asking because I want to know if his hands are truly as gifted as his prices are steep.

What makes you think doctors do not lower hairlines? Doctors generally recommend a neutral hairline appropriate for one’s age. It generally should be in the mature hairline position. Often, younger men will request a hairline that may be too low or lower than what is considered “normal” and certainly more like their 12 year old hairline rather than a mature hairline. There is nothing wrong with this request as long as there is communication between the doctor and the patient and the long term plan takes into account what the worst balding could be… and that the hairline will be appropriate for life! Yes, for life! This is a lifetime decision and as hair transplants are irreversible, if it is transplanted too low, you are up the creek without a paddle.

Keep in mind if the hairline is too low it can never be raised, but if the patient still wants a lower hairline (even an abnormally low one) the doctor and patient need to come to a mutual agreement with respect to the patient’s wishes and with the patient’s understanding that their request comes with consequences. There are a few doctors (like the one you referenced) that like to create abnormally low hairlines, as they appeal to the younger patient who never accepts the understanding that their hair loss will continue to move backwards (it is a progressive process). Any good doctor can create any hairline he wishes and if it is too low, well, trouble will sooner or later follow. So while some doctors may publicize lower hairlines with many examples on their website, I have also seen many of those patients who regret the decision to recreate a low hairline and have come to see me to ask me to move it back. You don’t see those on the websites. Aside from placing it too low, these hairlines may deplete the donor supply more rapidly, so as the hair loss moves back in many balding men and they need more hair to follow the loss, they may find that the hair supply has been used up and that there is not enough hair to follow the hair loss back to what I call ‘a reasonable stopping point’. I tell everyone that the good news and the bad news about hair transplants is that it is irreversible. Unfortunately, I am not able to raise hairlines with any ease and I can not create enough donor hair if the patient has used up his supply, so again, there are consequences.