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When you buy a cheap airline ticket and you are flying American Airlines, neither the airline nor the seat is shoddy. But when you buy a cheap hair transplant, you may not be getting a ‘legacy carrier’ doctor. Cheap hair transplants means that it is highly possible that you will get the pluggy doll’s hair look, inexperienced surgeons, poorly trained teams of people working on you, and an absence of quality control. I know of one of my former technicians who did a hair transplant on a friend on his dining room table. The procedure was done outside the United States and his friend would have bled to death had he not gone to a hospital to stop the bleeding. On a more local level, I have seen many patients over the years who were enticed by a new doctor who wanted to build his experience by offering discount prices. Sadly, they now needed an experienced and ethical doctor to undo the damage. Fundamentally, I can recommend if you are committed to going to the cheapest place for a hair transplant, that you do your homework. Make sure that you extensively research their medical licenses, how they were trained in hair restoration, how long they been performing hair transplants, what techniques do they use, their board certifications and in what field, are they active members of recognized hair medical societies (like ISHRS), and what do their results look like – because you will usually get what you pay for.

I’ve touched on this before in a previous blog entry, Bargain Hair Transplantation.


Can doctors legally give someone a prescription for proscar when they just need propecia?

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Yes, doctors can prescribe whatever is in the best interest of their patients. With regard to Proscar versus Propecia, they are both exactly the same medication, but Proscar is a 5mg dose of finasteride while Propecia is a 1mg dose. The two are exactly equivalent if you can cut the Proscar 5 mg pill into fifths. That is a problem for some patients, because the cutting process is not easy.


I am a 57 year old male. Recently I have been under a lot of stress. Have been taking a topical testosterone ointment off and on, HGH injected of and on. Have noticed a great increase in hair loss lately. Have been taking Saw Palmetto as a DHT Blocker. Would I benefit from beginnning Propecia or am I too old to benefit from it. I am going to get a Hair transplant with NHI in the future but now just want to stop the hair loss. Thank you.

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It appears that you have many reasons for hair loss (stress, testosterone, HGH injections). Clearly a good DHT blocker like Propecia will be far more valuable than Saw Palmetto which is very weak, if effective at all. Still, the combination of contributing factors may not be enough to stop the hair loss. Visit me and let’s talk.


Is it not possible to transplant hair from other body parts to the head. I do realize the texture etc is different, but it might be usefull as filler to make the transplant of people with finer hair like myself have a fuller look. I have had 2 procedures with you with over 3000 grafts but i still really am not 100% happy with the density. And i do not think i have enough hair in my donor area to do another procedure. So i thought it would be great if other hair could be used in order to give my already transplanted area a fuller look. What do you think?

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Body hair is being transplanted by a few doctors, but there has not been any real follow-up on the results. The few that I have seen did not meet my standards on density or quality so I have not jumped on board to do body hair transplants. FUE is possible from your remaining donor area, however I would need to assess your supply to judge what kind of density and coverage you could expect. Generally most people have well over 3000 grafts in the donor area, so I would suggest that you make a re-check appointment at my office. While I do keep an open mind on new and creative solutions, I would need to be convinced that body hair transplants will give good results before recommending them over standard solutions.


Do women really care if a man is bald?

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According to a survey that appears in the July/August issue of Cargo on newsstands June 14, “almost half of U.S. women do not mind if a man is losing his hair, but 99 percent are against comb-overs.”

Forty-eight percent of the women in the online poll for Cargo magazine say men shouldn’t even worry about hair loss, while 32 percent recommend going with the flow and cutting all hair off. Only 1 percent suggest hiding a balding head under a cap or a comb-over.


In your opinion is there ever any reason to up the dosage of propecia? Do you know of any side effects from doing this? If you were to raise up your dosage would a smaller dosage then become ineffectual as your body gets used to the larger amount?

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The dose of Propecia has been tested from as high as 20mgs to as low as .25mg. The researchers did a good job testing the value of higher doses. They determined that higher doses were no more effective than the recommended 1mg dose, much to their surprise. If you were to take a higher dose, you might start to see sexual side effects which start to show up as the dose increases.


I am 30 and I have had a good results from Propecia on my crown, but not good enough. Can I have my crown transplanted? What will the results be like?

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You have had an excellent result from Propecia. The readers of this should first put themselves into your place and ask themselves if they would be satisfied with this result. If not, yes you can have transplants, but transplanting the crown without knowing what will happen to the front has risks. You need to know what is your worst case balding scenario. Whatever grafts you use in the crown now, will not be available for the front later if you start frontal balding. However, if your donor supply is very high, or if you don’t have a family history of extensive balding, or if you have no significant amount of miniaturization in the donor area, then saving grafts for future balding may not be a concern.

You and your doctor must lay out the long term goals and the plan that you will follow. Only you will be in a position to make the final decision.

The photo on the left was taken about 18 months ago (before taking Propecia) and is scanned from a Polariod, so please excuse the quality. The photo on the right was taken this month and shows the results of this patient’s crown after taking Propecia.


I am 43 years of age and have been classified as Norwood 4. I started slowly losing hair in my mid thirties or so. Both my grandparents had a full head of hair, but my uncles on my Mothers side are Norwood 6’s. So, is it a high probability that I will progess to class 5 or 6 + in my later years?

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Norwood Class 4

Norwood Class 6

With treatment using the drug Propecia, I suspect that you can arrest your hair loss so that you do not become the Class 6 pattern of your mother’s side. If that is all you want, then no transplants are needed. If you want to reverse the hair loss, then hair transplants are the only real option.


I am 33 years old African American and am very concerned about my hairloss. I am probably between a Type 3 Vertex and Type 4 hair loss pattern. My crown is very thin and my hairline is getting thinner by the day. I tried Propecia for 10 months and did not see any substantial differences. I stopped using Propecia because of the uncertanity of future complications.

My hair on the sides and back are very strong, but I am concerned about how a transplant would look. I have seen some guys that have that pluggy look, which looks bad. Can you give me some advise on what the best step would be.

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A man of your age who is still at a Class 3 Vertex or Class 4 pattern, is usually not going to get very bald. In the African American, this is more typically the case, but it would be best to get a complete history of your family to be sure that your ancestors did not have advanced cases of hair loss. My concern would be that Class 4 patterns sometimes do lead to Class 5 or even to a Class 6 pattern. That is why I like trying to prevent progressive hair loss with a DHT blocker like Propecia which will probably stop or slow the progression. Stopping the progression is as important as fixing your problem correctly.

African Americans’ are the best candidates for transplant. The characteristics of very curly hair make the frontal work look awesome and the hair just covers better. It is always a pleasure to show off the results. Here are some examples from our website,


I am a 47 year old female, who has had thick, coarse hair all of my life. Last year, I had a few hot flashes, my gyn gave me some estradiol to take……..I felt better, discontinued it. *this was in April…I took it for a few months. I had a surgery in August…general anesthestic. In December my friend mentioned my hair looked thin. I got some Rogaine…..used for one month until my hair was falling out by the tons and I had noticable thinning in my temples/hairline. Hair looked much, much worse. Stopped using it Jan 21. Gyn gave me estradiol Feb 21st.,,after I saw him complaining of hair loss….he said I was periomenapausal. My hair shed slowed until two weeks ago and is now shedding again. I still have very thin hair in the bang area/temples….you can see my scalp in the sun or bright light. Blood work showed normal levels in all tests. I do have lots of new hair that can be seen over the back of my head…but I don’t see anything in my bang area. I am suffering anxiety and worrying constantly…which I know doesn’t help. How long does it take for hair to get back to normal if it is going to? Am I expecting results too soon? Have you ever heard of Rogaine making the problem worse and does it make it permanently worse?
I would like to consider a hair transplant if it can give me some density back. I am taking vitamins/EFA supplements….don’t smoke, ….also interestingly my once coarse hair is now soft/finer feeling which seems wierd.
thanks for any insight, help.

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Your email sounds desperate and you need to be sure that there is no underlying medical condition causing your problem. Assuming that you fully check out (see female hair loss Q&A), then it sounds like much of your process is reversing. The reversal time should be less than a year. You should be evaluated by a doctor like me, who can determine your base line today, the full extent of your miniaturization and then follow your progress. A transplant can solve the ‘bang’ problem, but first let’s clear you of a medical problem.


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