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Very impressive results. It also might be the finasteride causing most of the benefit. But it is anyone’s guess.

Always tough to do. But Day 1, Month 3, and Month 6 updates. 1mg fin and dermarolling. Look at those baby hairs! from tressless


Hi there, my question is as above. I have been lurking/debating a transplant for a few years now. I am getting back into researching who is out there now as this year I have more of the means to acquire one. In your opinion who would be among the best for FUE in North America currently? I remember Rahal for example being a big name a few years ago but unsure now. Thanks!

 Today, many doctors have learned to do FUE very well. The key to finding a good doctor is to find a doctor who cares about you, is willing to show you patients of his or hers and allow you to meet them so you can see, first hand, what the quality that he or she is so proud of and really looks like. I have monthly open house events where former patients come in to meet with new people who have never seen a hair transplant patient and have an opportunity to speak one-on-one with a former patient. We also allow prospects to come into the operating room (with mask on) to observe a surgery. I wrote the first article ever on FUE and started the FUE movement; however, despite these credentials, I tell my patients to judge the doctor not only on their technical ability, but how they treat you and their former patients.


Many times the transplant does not provide enough hair to cover an extensive balding pattern because the donor supply density is too low for the high demand of the balding pattern. When that happens, the surgeon who is skillful with both hair transplants and SMP will know how to use the transplants to form a good foundation so that the SMP will make the hair look much fuller.

Here is an example: The picture on the right has the exact same amount of hair as the picture on the left except that SMP was added to fill in the thinning hair.

Screen Shot 2018-08-22 at 8.51.14 AM


I have had Chemotherapy and lost my hair. It has been a full year and still only some of the hair has not returned.

If the hair has not returned, then a reasonable alternative is Scalp Micropigmentation (see: We have treated hundreds of women this way with great results from the women.



I quit finasteride 2 weeks ago because I noticed less libido. I’m in desperate need for reassurance that I could still get it back and that it didn’t do permanent damage. Any reply is appreciated especially from those who had similar experience.

 If you have been on finasteride for a long time (more than 6 months) and developed any benefit from it, when you stop it, you will get “catch up hair loss” which means that the hair that you retained or gained will be lost and any hair that you would have lost will be lost as well, all in the next 3 months. I have seen men on finasteride for decades, stop it, and lose a lot of hair because their hair was dependent upon it.


4,500 FUE grafts is a high number of FUE grafts for anyone with a lower than average donor density.

If you are from India or South Asia, your donor density will not support that number of grafts and thus you have a depleted donor area.

Scalp Micropigmentation is the only solution to this problem (see:

Screen Shot 2018-08-22 at 7.47.15 AM



The reason a man under 25 should not have a hair transplant is because the hair loss patterns just starts appearing by the age of 25-26. So, for example, if you recede 1/2 inch of your frontal hairline at 20, got it transplanted, then by 21 you lost another 1/2 inch behind the transplant and then had to get it transplanted again, and then by 22, you lost another 1/2 of the hair behind the two transplants plus loss in your crown, then you would want to transplant in the frontal hairline and possibly the crown again and so on. By 25, your crown balding may have expanded and if you don’t transplant it, you will have hair in the center of the crown with a bald area surrounding it.  Sooner or later, you would run out of money if you were not rich or run out of donor hair (even if you were rich) and be stuck half transplanted with no recourse and nothing to do. If your doctor is sloppy, he would deplete all of your donor hair.  I have, in my 27 year career in doing hair transplants, many men caught in this trap, because the doctors make the money (often a lot of money) as they deplete the victim’s donor supply with repeated surgeries on the promise that this next surgery will be their last.

I am certain, that at 22, if your hairline is actively receding, that your future hair loss can’t yet be predicted. That is why I like to develop a Master Plan with my patients so that I can keep them with hair on their head as they continue to bald without depleting their donor supply or promising the impossible. If you were my son, I would not do it any differently. I would do a HAIRCHECK test, treat your balding with the non-surgical options, and then when you got to be 25, discuss a plan with you and what we can do together to keep you hairy and feeling better about yourself.

FUT Questions from tressless



Finnish researchers conducted a study involving women’s hair loss to determine if a high-glycemic diet and carbohydrates contribute to their balding. In the study, women who were more insulin resistant and ate more carbs had a higher risk of developing androgenic alopecia (AGA) hair lossAug 10, 2017. 

We also know that men with insulin resistance have more cardiac disease and many with such diseases seem to have more hair loss as well, male or female. 


For example, I have noticed, that sometimes when I lose a hair, it is thinner than other hairs that fallout, yet it is still as long as the thick hair. I understand that a normal hair loves and grows for 2-7 years. So would a hair that has begun to shrink have a similar life expectancy? If I am diffuse thinning, and some of my scalp hairs are beginning to lose caliber, would it be appropriate logic to think that some these hairs (although smaller) will last at least 2 more years? The reason I ask is I believe myself to have good density, and I do not notice an abnormal amount of hair fall out. But the hairs I do shed look thin.

  1. Does miniaturization decrease the size of the hair by half every cycle? Or gradually?
  2. Will the thinner but still not quite miniaturized yet hairs I have be around for a while?
There are many degrees of hair miniaturization and the life of these hairs depends upon the degree of miniaturization. When it progresses to a thread thinness, then it is near the end of its life and often is not growing at all, just hanging in. Hairs that lost 50% of the bulk, for example, will vary in the time it takes to get to a thread-like state because the disappearance of the hair depends upon the aggressiveness of the balding process. So, it is impossible to really answer your questions as the answer relates to the aggressiveness of your balding and what you are doing about it. People on finasteride, for example, can hold on to 50% miniaturized hairs for years.


You might have to wait out a full hair cycle before seeing improvement. Hair cycles in women run between 2-5 years. The older you are, the shorter the cycle. You are in between the cycles of an older and younger woman.


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