Consultation Questions for Sept 12

[htownballa]

Hey guys,

 

I have scheduled an appointment with Dr. Rassman in LA this coming Tuesday, September 12. My goal is basically to understand my hairloss situation better and get it "mapped for miniturization". If you dont know what that is he explains what he does in www.baldingblog.com. Anyways, the following is a list of questions I will ask him during my consult. Let me know if there is anything I should add or edit. You guys are a big support.

 

1. Get my hair mapped for miniturization (so I know exactly how much hair is thinned and can quantify my progress with Propecia)

 

2. Is thinning on sides indicator of DUPA? (the hair above and around my ears seems to be thinning...if i have diffuse alopecia I am screwed in terms of a transplant, as I have no stable donor hair)

 

3. Hair characteristics- thickness, waviness, donor density? approx how many grafts would you estimate I have for surgical use?

 

4. Estimated future pattern of baldness (based on mapping and family history)

 

5. Formulate a master plan (what he will suggest I do and when he thinks surgery would be appropriate in terms of potential risks)

 

6. Is my hairline considered mature right now or receded? IF I got surgery would it be wise to lower it? (not sure what NW I am)

 

7. Significant risk of shockloss for me? What can I do to reduce it?

 

8. Do you use custom-cut blades, according to my FU size?

 

9. What density do you think I need for a non-see thru front

 

10. If I go strip route, is it better to do larger or smaller session in terms of results and shock loss?

 

11. What do you think of this plan: pack it dense in front with sparse crown if it does eventuall go? would this look foolish in the future?

 

12. Lastly, based on his experience, how effective does he think fin will be in keeping my hair? (this is just so maybe he will give me some piece of mind)

[htownballa]

Hey guys,

 

I have scheduled an appointment with Dr. Rassman in LA this coming Tuesday, September 12. My goal is basically to understand my hairloss situation better and get it "mapped for miniturization". If you dont know what that is he explains what he does in www.baldingblog.com. Anyways, the following is a list of questions I will ask him during my consult. Let me know if there is anything I should add or edit. You guys are a big support.

 

1. Get my hair mapped for miniturization (so I know exactly how much hair is thinned and can quantify my progress with Propecia)

 

2. Is thinning on sides indicator of DUPA? (the hair above and around my ears seems to be thinning...if i have diffuse alopecia I am screwed in terms of a transplant, as I have no stable donor hair)

 

3. Hair characteristics- thickness, waviness, donor density? approx how many grafts would you estimate I have for surgical use?

 

4. Estimated future pattern of baldness (based on mapping and family history)

 

5. Formulate a master plan (what he will suggest I do and when he thinks surgery would be appropriate in terms of potential risks)

 

6. Is my hairline considered mature right now or receded? IF I got surgery would it be wise to lower it? (not sure what NW I am)

 

7. Significant risk of shockloss for me? What can I do to reduce it?

 

8. Do you use custom-cut blades, according to my FU size?

 

9. What density do you think I need for a non-see thru front

 

10. If I go strip route, is it better to do larger or smaller session in terms of results and shock loss?

 

11. What do you think of this plan: pack it dense in front with sparse crown if it does eventuall go? would this look foolish in the future?

 

12. Lastly, based on his experience, how effective does he think fin will be in keeping my hair? (this is just so maybe he will give me some piece of mind)

[Guest]

htownballa, don't forget to pick up a copy of his book, The Patient's Guide to Hair Restoration, while you're there. It's a bit old being from 2001, but very good resourse. I picked one up free from Dr. Bernstein's office. At least I hope it was supposed to be free

[Pat - Community Publisher]

htownballa,

 

You have obviously done your home work. I think all your questions are valid. I'd also like to know if Dr. Rassman still charges $10 per graft if he performs the surgery.

 

All the best, Pat

[htownballa]

I just got back from my consult with Dr. Rassman and I must say I am disappointed. I was hoping to build a master plan with him if my hairloss progressed, but he seemed content to not have one and just see what Propecia does. The following are the answers to my questions

 

1) Hair Mapping: He basically stated that my hair has over 50% miniturization in the frontal zone, with extensive thinning (greater than 50% miniturization) the frontal corners especially. He stated that Propecia would probably maintain hair in the region but not regrow any. He also told me Rogaine would be useless here.

 

2) Diffuse Alopecia? He told me that the thinning around my ears was probably genetic and not an indicator of DUPA

 

3) Hair characteristics: Ok this is where I was really disappointed. He said my hair has a slight wave, with medium thickness. He said I had decent contrast with medium brown skin and black hair. However, he said my donor denisty was only 1.5 units/mm squared while the average caucasian was 2.0 units/mm squared. This translated into roughly 4-6000 grafts for surgical use. Bummer!

 

4)Estimated future pattern of baldness? He would not care to make a guess

 

5) Master plan? This is where I wanted more input from him...he told me to stick to the propecia and wait a while, but if I wanted to, I could have an 800 graft transplant to the front...this really confuses me because I can't imagine much cosmetic benefit from 800 grafts on an early NW3...He also added that anyone who gives me an estimate of more grafts is probably ripping me off

 

6) What is my NW? NW2.75

 

7) Risk of shockloss? He basically told me that if I came back to him in a couple of years while still taking Propecia I would not have a high risk of shockloss after a transplant

 

8 ) What density would I need for a non-see thru front? He said I would not need a very high density due to my color contrast, but I am skeptical about this... His definition of see-thru is probably different than mine

 

9) Session size with strip? Did not ask him this

 

10) Should I pack in dense up in the front while having a sparse crown? He told me since I only had 4-6000 grafts I would need to put ALL my grafts in the front leaving the crown bare. DAMN!

 

Ok guys, these are the results of my Q and A session with Dr. Rassman. I will try and get a second opinion soon from the other top docs and see what they tell me. Only problem is that I am in Texas and I dont know any other good docs besides the Limmers. I might just settle for an email from H&W and Armani, as I'm not sure if I should travel just for an opinion. Please give me your thoughts and opinions on my situation. Thanks

[Guest]

He does seem a little vague on your questions. Try sending you pics to some docs, and you should get a write up of your consult in a week or two. This can actually be pretty informative. htownballa, how old are you now?

[nikkop23]

He doesn't sound vague, really, it's just that he told you things that you didn't want to hear. Obviously, your hair characteristics are not great, and your donor density is very low, which means 6000 grafts would be pushing it as an outside limit. I'm also guessing that you're probably 25 or so, 30 tops, which means he's being conservative and doesn't want to see you rushing into surgery. As far as a Master Plan, if 800 grafts is all you could take now, it doesn't sound like your loss is that extensive. Nevertheless, that amount could make a cosmetic difference, but it's hard to tell without seeing any pics of your situation. Can you post some?

[htownballa]

Thanks for the replies. Yes, it was not what I wanted to hear. I was hoping I would have a greater donor density, he said my donor density was the average for my race as I am Indian.

 

I am also 24 years old. I am definitely not planning on rushing into surgery, but I was hoping that the combination of Propecia and transplants could stave off me ever having to go bald in my early years.

 

I will try to post some pictures for you guys to judge

[slick old]

I don't think you're in that bad of shape. I had my ht right before turning 25 and was looking much thinner than you are. I think if you stick with the propecia you could probably hold off on surgery for a few years at least. Have any loudmouth friends commented on your hairloss?

[wesley949]

I would follow what he said to do. Get on propecia and see what happens. Your hair looks good. There is no rush for a HT and the technology will get better. He was truthful. He could have done a "1000" grafts and taken your money and you may have had a lot of shock loss.

[htownballa]

Thx for the replies...

 

 

Want to bump for any more opinions...

[John_in_NC]

Personally, I see nothing wrong with your hair as it is, unless you're in your in your early 20's and are freaking out. In that case, you need to be even more careful with the donor since you might go totally bald in 10 years.

 

If you have the money, an FUE doc can probably get another 1500-2K grafts from your donor to sparsely fill the crown. Thanks to the scar you will not be able to buzz the back hair too short anyway, so it's easier for the FUE doc to go a bit more aggresive.

 

I am sure you will find a doc to do the HT on you--Armani will even pack them all in the first inch of the hairline if you want--but is the best for you? If I were you, and wanted to have the HT, I'd visit a few more clincs and see what they say. Maybe you can get better laxity and get more donor. Hasson and Wong seem to get more but soem of the scars are longer...a tradeoff.