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I overplucked, then had to have them tattooed because they wouldn’t grow back. With the tattoing, of course, they didn’t regrow either. It’s been years and I would like a natural looking eyebrow, one that doesn’t fade and frames my face. What would you recommend?

Hair transplants into the eyebrows is the answer and it works wonderfully. Here’s an example of a female patient that had eyebrow restoration — Patient BG. For more info about eyebrow transplants, here’s an article from a few months back that I was quoted in — Women who pluck too much turn to eyebrow transplants.

I have FUT surgery scheduled in late late July. I started taking propecia early July..so would have started about 3 weeks before surgery. Is this long enough before to help reduce chances of shock loss?

The longer the better, but 3-4 weeks should cover you. Stay on the medications until all of the results are achieved and then consider staying on the drug for life. Talk with your doctor about this.

Snippet from the article:

Sclerotherapy has seen a 226.3% increase in males over the past five years. A drastic comparison to the 3.5% increase in females since 2002.

On the opposite end, males have strayed away from hair transplants. Cost is likely to be a cause of this decline. Over five years, the price of hair transplants increased by $1,296, while sclerotherapy decreased by $103.

Read the full article at ScienceDaily

I realize this article is a few months old, but somehow I missed it. It is, however, still interesting and worth posting about. My commentary on the article is that it is probable that the increased cost reflects the higher number of grafts being performed by today’s modern hair transplant surgeon. From what I hear amongst the transplant community, the doctors have been following the “more grafts is better” trend and is more profitable as well. More grafts means more hair in less surgeries, which drives the fees up. A fuller head of transplanted hair may not be better for the hair transplant surgeon’s wallet though, as the higher fees may drive patients away.

Dr. Rassman

If you were to judge from your own picture (the one shown on the website), would you say you have genetic hairloss? If so, to what degree?

I had a bald crown measuring about 3 inches round. This is classified as a pure vertex balding pattern. I originally made a mistake and had scalp reductions in the early 90s, which left me scarred. Since that time, I have had hair transplants and the scars and balding spot is largely gone. My hairline is natural.

Hello Doctor

When transplanting hair between previously transplanted hair (for thickening), is there any danger for the previously transplanted hair? I am not referring to shock loss but to permanent and irreversible damage.

Thank you

In the past, I have tried to kill hair transplants that are too pluggy. No matter what I do, I can not kill them unless I focus on electrolysis, FUE, punch excision, or lasers that kill hair. So the answer to your question is that this hair is permanent and quite resistant to damage, even from another transplant tool.

Hello Dr,

First of all,,,a Fantastic/helpful blog. I am 50 years old. I visited 10 different hair transplant surgeons and decided to go with a doctor in Northern California. I think you hit the nail on the head, when you say ‘you have to feel RIGHT about the surgeon’. I did an FUT for 3000 grafts about 1 month ago, and everything has gone great. We just have to wait and see now as to what will be the outcome.

I wanted to contribute ’something’ to your blog,,,so I decided to send photos of my scar before and after application of a masking black lotion (COUVRE). It takes 1-2 minute, it will not come off with water and it is practically invisible from about 12″ away. The photos were taken by my wife. I keep my hair at 1/4″ length (I know I can go to #2 clippers and still mask it good). I send these photos for folks whom are worried about having the surgery and wanting to keep their hair short.

Now to my questions. I am on Propecia (4 months now) and Rogaine. I also have the laser comb, but I am hesitant to use it, fearing it might damage the ‘babe grafts’. What do you recommend to your patients regarding this scenario. I truly believe the comb works, not as much as the hype, but it DOES work (for me anyway). The question is, can it hurt the newly transplanted/asleep grafts

My second question is related to a comment my surgeon made prior to surgery. I asked, what percentage of the grafts are normally expected to survive. The reply was 113-120%!!!! It was explained by my surgeon that they do not believe in ‘dense packing’ of grafts in a CM2 and by inserting no more than 40 grafts (or was it 40 hairs?!), it insures the growth of all grafts + some regeneration of already dormant follicles!!! I found that pretty interesting, what is your opinion on this?!

Thanks again for all your great help on the blog, keep up the great work

Masking/concealing agents like Couvre can work “miracles”, as your photos demonstrate. There are two surgical solutions that also work well:

1. Follicular unit extraction (FUE) into the wound will put hair into the scar, or
2. A trichophytic closure could wipe out much of the wound if the laxity is good enough

The telogen count is about 10% of hairs, but as these telogen hairs grow back, others fall out so I would not expect more than 100%. I have read such studies and they are clearly flawed in their methodology. You can’t believe everything you hear or read. Nonetheless, thank you for contributing your photos and allowing me to publish them! The results after the Couvre look great. The photos are below; click to enlarge.

I am 36yrs old and am considering getting a HT. I need a little in the front and some on top. What are the risks of shock loss in males over 30? I would also like to know why some men receive less grafts and their hair look fuller than some who receive more.

Risks of shock loss following hair transplantation occurs in young men, but Propecia/finasteride usually prevents it.

The value of a hair is not equal amongst all hairs. A fine hair may have 1/4 of the bulk of a coarse hair, so a transplant in a coarse haired person will be fuller (hair for hair) than on a fine haired person. A good character wavy hair will cover better than a straight hair. A kinky hair will have even better coverage. Also, the difference between the color of the hair and the scalp (contrast) has a lot do to with the result of a transplant. Add to that, the artistic skill of the surgeon and the distribution of the transplanted grafts and one patient can have a very different result, all things being equal, from one surgeon to another.

I have just had a hair transplant on Tuesday 1st July, so only 2 days ago. I am itching where my grafts are placed and i know it takes about 7 days before i can touch them incase they come out. it is driving me mad, with this itching, is there anything i can put on or you can recommend please. Thanks

While I am flattered you’d turn to me for advice, I am also shocked how there seems to be no relationship between a patient (you) and his doctor. This is a perfect question for the doctor that performed your surgery!

In general, you can touch your head or lightly tap on it to alleviate the itching. Please follow up with your doctor. There may be other issues (aside from general itching) that may be causing your problem. I really don’t know, as I was not your surgeon.

Hi i started balding when i was about 19 and now i am 23. I have had 3 transplants within that time period and have got some coverage on the front of my scalp, but it still is thin and it makes my forehead look big. My problem now is the crown is balding and i don’t think i am going to have enough donor hair for the crown. Is there something else i can do or what do you think my best option is because it still is thin in the front but is getting alot worse on the crown. Thank you

You may be in big trouble. I would want to know things like:

1. What was your Master Plan for hair loss?
2. Did your doctor tell you about the possibility of running out of your donor hair?
3. Were you led to believe that you could get all of your hair back with good coverage?

Regular readers of this site may notice that I’ve written time and time again about the problem with transplanting younger men with early hair loss — and it is for precisely this reason. I am concerned about a 23 year old (who is probably still balding) asking me a question like you did. If you ran out of donor hair (or are about to), then you need to sit down with a really good doctor (hopefully you have one) and get some basic answers to questions about your future. An in-person exam with an expert is key for you right now. You should be worried.

Dr. Rassman,

I had a question regarding traction alopecia. I’ve always had a widows peak/high forehead. For years I had really long hair. Yet, I never knew the affect of tightly tied back hair would result in hair loss. I recently worked a job for a year where I would tie it back quite tight. Everyday it seemed I was breaking hair and after a few months I started to notice my front corners looking thinner and broken. I saw a dermatologist a few months ago. He gave a quick glance and asked about my family history. I do infact have some family members who have baldness and others who don’t on both sides. I was instantly given the MPB diagnosis. I was prescribed to Propecia on the spot and basically told good luck and that I should look into hair transplants. As I’ve been reading more about shock loss in young men. And as I’m 21 years old. I’m curious to know if I should begin looking into it, or wait and hope the propecia can help what’s been thinned. I’ve read that you’ve seen some patients reverse frontal loss with propecia.

Is it likely to help a hairline that’s intact but thin?

Thanks for your time and most importantly for having this blog. It’s a place that gives many hope.

Do not rush to transplant your frontal hairline. You can just say no!

Stop pulling on the hair and get a caring doctor who is not so much interested in your wallet and get one that is more in your welfare. Get a proper examination. If you are just having a loss of the mature hairline accelerated by the traction, then there is nothing to treat. If you do indeed have MPB, you should take Propecia for a year or so before you even consider a transplant. Then again, at 21 years old and with early hair loss, most respectable surgeons wouldn’t transplant you anyway (you may continue to bald and you don’t want to use up your valuable donor hair just yet).