As Seen on


Scars like this are usually the result of an overly aggressive surgeon who removed a strip too wide, and the tension may have been too high when he closed the wound. Alternatively, a very elastic collagen is present in some people which can produce stretching of the wound. In this case, the wound reflects your genetic make-up with regard to the way you heal. The best treatment for this is Scalp Micropigmentation (see here: Sometimes, with scalp exercises, you can loosen up the scalp enough to try to get the scar removed. During that time, the surgeon would perform a trichophytic closure which will help obtain a better scar. If your scalp is not loose enough, a surgery will not work.

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I had a young man do this for more than a year. He still lost his hair. The problem with hair loss in young men is that it is genetic and not blood flow related. The reduction of blood supply occurs because the volume of hair gets reduced, and this requires less blood flow.


You are a good candidate for a hair transplant. The crown component is narrow, which is good when it is presented that way. It requires less grafts, but there is a good possibility that it will get wider in time.

Be aware that if you choose the FUE route, there is a limit on how many FUE grafts you can have in your lifetime, and that depends upon your donor density. The average Caucasian, with 100,000 hairs on their head, have an FUE limit of about 3,600 FUE grafts. Anything more, then the donor area will look bald.

When you meet with your doctors, ask them to measure your donor density and have them build a Master Plan with you to account for future hair loss. Future hair loss will almost certainly occur because the hair in the middle of your head will eventually fall out and the crown component may widen and go lower.

Read this as well:

FUE or FUT? Photos inside and would like additional advice! from tressless


before SMPafter SMP

The patient above had both strip and FUE surgery. He had scars from both procedures. We performed Scalp Micropigmentation in the morning, and this is what he looked like just 6 hours later. The pinkness in the repair will resolve within a day.



I know honest doctors who use PRP (Platelet Rich Plasma injections). Many of these doctors are unimpressed, so they may be doing it because patients want it. There is considerable hype on the internet that this procedure does wonder for hair loss. We’ve heard “universally good results” and “very effective in my hands” comments from doctors doing PRP. However, PRP has no standardization, and it has been around for more than 25 years without any absolute proof such as a clinically valid ‘Double-Blind Study’ with objective measurements of the results. What we hear among many of the doctors offering it are glowing comments, and some even say “I’ve seen a tiny handful of impressive visual results,” but is this really true? Most good results occur when PRP is used in combination with Finasteride, Minoxidil, etc., which is an important variable, scientifically, and something to keep in mind if you are considering PRP.

PRP is a very profitable business for the doctors who offer and perform it. How popular would it be for doctors pushing it if it were not so profitable? Would they believe in it as much as they do now?  When a person spends a few thousand dollars getting PRP treatments, they often rationalize that they are better. After all, it cost a great deal. However, it would be better to be able to tell a patient, who had PRP that their hair bulk was checked with the HAIRCHECK instrument, “You Mrs. Jones, had a 30% increase in your hair bulk since you started your PRP treatment.” Yet, the HAIRCHECK test doesn’t seem to be offered to these patients. I ask, why not?
You can tell from this post that I am not a fan of doing certain procedures that I don’t believe, nor something that I can not see or objective measure. So, I don’t offer PRP to my patients.


Donor area depletion occurs when more than 50% of the donor area hair is removed, especially if the hair is fine. Medium weight hair is better for slightly more harvesting with FUE, while coarse hair is certainly better because more than 50% of the donor supply grafts can be harvested. This is a number calculation that can be made prior to your surgery. See here:


Most of my patients actually enjoy the surgical experience. We use drugs to bring the patient into a light sleep and then perform the local anesthesia, so they don’t feel it. I always tell the patient to think about taking a trip to Hawaii. Last week, a patient told me he preferred Cancun, and when I was doing the surgery he was moving like he was dancing. It made the surgery a bit more difficult, but at the end of the surgery, I asked about his trip to Cancun and if remembered dancing at the beach. He said he somehow went to Hawaii but did remember that he was dancing with beautiful women at the beach in Hawaii. We all laughed. Don’t worry, the surgery will be a great experience.



I was prescribed 0.25mg oral minoxidil for hair loss. I stopped taking Finasteride and topical Minoxidil. I lost much of the benefits I had, including my gains from my previous treatments such as my frontal hair, my temples, and the hair in the crown, which had regrown with the topical Minoxidil. I regret ever switching the original treatment approach.


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Yes. If this is a change, then it is possible that you have developed early gynecomastia of the right breast. If there are no lumps (painful or otherwise), then you should see your doctor for advice on what to do.


A haircheck test should be done to:

  • confirm that you are balding
  • to document the actual degree of balding

When and if you take Finasteride, you can measure the benefits or the lack of the benefits of it every year.

What tests should I do before taking fin ? from tressless


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