October 12 2007, 3:32 pm PT | Posted in: Age + Density + Hair Transplantation
Last week, I met with two patients who came to me with thinning hair. One was 19 and the other was 22. The 19 year old had very early miniaturization, evident by the measurements that were taken of his scalp, and I built a Master Plan for him and advised him to go on Propecia. The 22 year old had clear thinning in the frontal 2 inches of his hairline with 40-50% miniaturization and a thin type hair shaft. The thin hair shaft made his miniaturization look worse than if his hair had been more coarse.
Both of these young men went to these doctors before they came to see me (and no, I won’t name names). In my opinion, both patients should not have hair transplants at this time; certainly the 19 year old is not a candidate at all and probably will not be for years, and the 22 year old may become a candidate if the Propecia does not stop or reverse his hair loss to meet his goals. However, the 22 year old might be able to avoid a hair transplant if the Propecia works well for him. The lack of ethics of the two doctors who viewed both men and gave them both recommendations of 3000 grafts each reflect the ’scum’ of the hair transplant industry. I know I’ve written on this topic a few times before, but it truly outrages me and demands this repetition. Performing surgery when it could be avoided with a simple daily medication shows that the doctors were chasing their patient’s pocketbooks, not pursuing their patients best interests. Fortunately, both patients liked my advice and will see me for a follow-up in a year or so. I am sure that they will get calls from these two doctors and/or their sales staffs and I strongly advised them to resist sales pressures to sell them what they do not need.
To make matters worse, in my normal examination I measured the hair density of the donor hair on these patients and found them both to be lower than average. That means that they might be limited as to what they can expect from a hair transplant when and if they balded. Both of the doctors that they met with just ran their hands over the patients’ scalp in the back of their heads and magically reported that they were unusually blessed with “lots of donor hair”. Neither of these doctors made a measurement of the donor density on either of these patients and as if by magic — *poof* — they had enough hair to meet the doctor’s income requirement. These scams are unfortunately common in this industry and I always warn patients that if the doctor does not precisely measure the donor density, they should run for the hills when told that their donor supply is good. Worst of all is the fact that if these men had undergone hair transplantation, their donor hair (which was limited in the first place) would be depleted, wasted, and worse yet, put in the wrong place. Over and over again I warn patients to do their diligence on the doctors they see and choose. This again, is a Buyer Beware market.
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Balding Forum




I am pretty sure I am the 22 year old that Dr. Rassman is talking about. He is 100% right. The other Doctor didn’t even give me the time of day that Dr. Rassman did. I was meeting with the sales guy first, who was showing me pictures of transplanted patients. The doctor then came in the room during my consultation for about a minute, ran his hands through my hair very quickly, mentioned that I was thinning in the front, and then ran his hands across the back of my scalp. He said I have a fairly “large” donor area and that since my balding was early, I was a very good candidate for about 3000 grafts. To make things worse, the sales guy then proceeded to say how I was so young, and how crappy my hair looks for such a young man (I’m actually 23), and that I need to get this as soon as possible. He made me feel really bad. And if that’s not enough, the sales guy said Propecia works only for the crown area, and that I was pretty much SOL. He still gave me a prescription though. But in my anger and disappointment at myself, I threw it away since it “wouldn’t work for my type of baldness”.
Dr. Rassman. Thank you for prescribing me the drug again. By the way, my diet is back to normal now, and my acne has subsided once again. I am starting on the drug tomorrow MORNING (since my testosterone levels will be higher).
Thanks again, and I will see you soon!
As a medical student I happened across a HT clinic near my school. I would like to say that I would highly recommend that anyone interested in treatment for their hairloss SKIP the promotional FREE CONSULTATION and have an honest talk directly with the licensed physician. The salesmen know nothing about the practice of medicine. Fortunately, I opted to skip the consultation and instead made an appt directly with the physician. I recommend everyone do this, because docs are governed by a code of ethics, whereas salesmen are out to make a buck.