Hi Dr. Rassman,
I’m wondering if you could tell us a little about what you’ve personally gone through? I’ve managed to gather, based on reading about half of all your entries (i’m aiming to get through all of them!) that you’ve had a full transplant and that you’re currently on Propecia, but I was wondering if you could elaborte.
In the early 1990s I had three scalp reductions for balding in my crown. I realized after the third (about 8 months had passed) that I was worse off after the three surgeries than before I had them done. Worse off because:
- my bald spot returned larger than before I started the first procedure
- the skin was fragile, bleeding easily
- the scar looked like a Mercedes emblem on my head
I was not angry with my doctor because he had done what others were doing, practicing a standard of medical care that was sub-standard. What angered me was a phone call I had made. I called the authority on this surgery, explained what happened to me and found out that it was a common outcome for many patients. I remember clearly that when I asked him one simple question: What was this outcome not published? His answer was: It would be bad for business. I was sickened. I had personally performed 8 of these surgeries myself, one of them on my first cousin. He was the only one who had the complications of scars and the emblem on his head. We joke about it today and he never loses the opportunity to be dramatic about the impact of the scar I gave him. I transplanted his crown three times to try to make amends, and although he now has great results, he still teases me over his suffering.
Like him, I had hair transplants performed into the scar in the back of my head. I no longer belong to Mercedes and am a free man with a good head of hair. My crown (1600 grafts later, see below) is still slightly thin, but few people notice it unless I call their attention to it. I use a comb-back and the hair in front of the thinning hair covers the bald spot reasonably well.
Click the photo to enlarge.
Because of the scalp reductions I had, it was not reasonable to replace the swirl in my crown so I accepted a change in hair positioning for each of the grafts to enhance the comb-back styling that I had gotten used to. I often do this in people who have a supply/demand mismatch, where the supply is short and demand is high. On some patients where there is no demand mismatch (like with Patient CL and Patient OR), we can replace the swirl.