Health@Google Series: Hair Loss and Hair Restoration

>>
And happy to introduce Doctor Rassman as part of our Health at Google Speaker Series. Doctor
Rassman graduated from the Medical College of Virginia in 1966 where he received his
Doctor of Medicine. He completed a surgical internship at the University of Minnesota
and obtained a cardiovascular fellowship from--with Doctor Lily High. I think I said that right.
Doctor Rassman completed a residency in general surgery at the Cornell Medical Center and
Dartmouth Medical Center. In 1991, doctor Rassman founded The New Hair Institute and
quickly became a world leader in hair restoration surgery and in hair transplant technology.
This technology enables any trained surgeons to perform hair transplants with large numbers
of graphs in single surgeries. These high graph count--high graph counts were previously
thought possibly only with four to ten surgeries. His many innovations and techniques and equipment
have been presented at medical meetings around the world and published in industry newsletters
and procedures medical journals as he pioneered these advances. Doctor Rassman has presented
more than 19 scientific papers before national and international societies such as the International
Society of Hair Restoration Surgery and International Society for Hair and Scalp Surgery. And with
that I'll hand it to Doctor Rassman. >> RASSMAN: Thank you for those people in
this audience and of the people from outside of the campus. Want to ask questions at any
time, I'm always--I love to be interrupted. Anything is urgent. I tend to set the pace
so I will go toward there. For those of you who have seen something about my background
before I entered this field, I'd be happy to talk about dairy farming and milking cows,
if you like, biotechnology, windmills or any of the other things I've done if any of that
interests you. Meanwhile, of course, the focus today is of hair loss. Why do I have it? Of
course, that's the--that's one of the big questions and the most important question
is what can I do to keep it. And that is not an easy question to answer. Unfortunately,
we don't have the answer that's good, that's ideal which is a cure for balding.
[PAUSE] >> RASSMAN: I have with me four patients to--they
are very distinctly different and groups and I will introduce you to them as we get to
them in the presentation. So, why is hair important? It certainly reflects youthfulness
and heath and we do not want to appear unhealthy in the days of tuberculosis when that ravaged
the world. One of the first things that men would do is they would lose their hair and
so women who are seeking men for their lives would immediately eliminate balding men. And
so, the history of health and youthfulness and the ability to be around to father their
children, it was clearly an indicator, was the amount of hair they had on their head.
It's clearly an important issue for self-esteem. It's a big, dark secret for very many men
who are bothered by their hair loss. It's not a subject we talk about in public. I've
gone to--I've gone to many places to talk about hair loss and when I go to a gym where
there are lots of men and lots of women and I hold a conference there, no men show up
because they don't want to admit that they are vain in the slightest way. Yet I hold
these open houses in my office in which I have former patients come and we, we get very
big crowds there and I always look at it as like an Alcoholics Anonymous meeting that
if you're one of the people you don't mind joining others into the meeting but you just
don't want to be isolated as a separate person there. The hair has actual function. It protects
the head from sunburns and cancer and people who don't have any hair on their head will
be frequent for basal cell carcinomas and squamous cell carcinomas and the longer they
get exposure to the sun, the longer--the more surgeries they'll have on their head for skin
cancers. It is a radiator for the body's heat regulation. There's a story about when Napoleon
dated Russia and the winter came in and then devastated his army because they were poorly
equipped. The first men to die were the bald men because they lost their body heat and
they couldn't--they couldn't protect themselves from the cold. In the Africa plains, the hair
becomes a radiator. So the kinky hair we see with African-Americans is a radiator that
allows hair to--air to move through a sweaty scalp and cool the body. So it's a general
body regulator. And, of course, the industry is huge when we talk about haircut stylists,
a variety of hair products, wigs and advertising money. And let's take a look at hair. This
is your--almost your ideal hair presentation. And if we zoom in and take a look at the microscopic
somewhat micro-macroscopic view of the hair, what you will see is that the hair grows in
these little clumps and sometimes there are two hairs, sometimes they are single, sometimes
there are three hairs in the clump. And we call these clumps, if you will, follicular
units. It's the medical term industry standard medical term and you'll hear me refer to them
as that. So let's talk about the causes of hair loss. The most common causes of hair
loss is genetics. Of interest, about half of the male population have some degree of
balding and about half of the female population have some degree of balding. For the men,
it occurs mostly before the age of 45, many of them in their 20s. And the most severe
balding patterns are present in the very young men in their 20s. So the men who are going
to go very bald in their life will have it by the time they're 29, most of them. While
in females, the balding doesn't start showing up until they approach menopause. And when
they are hit by female balding, as I said 50% of the population are in that category,
they get generalized thinning. It's a diffuse process unlike the male which tends to have
a pattern balding. The female has a diffuse balding appearance. So there are lots of diseases
that also produce balding, the autoimmune diseases, variety of types of alopecia, thyroid
disease, there are mechanical problems, braiding, wigs. And I brought with me if you want to
hold in on my wig. I got this from a patient that I treated. He threw it out and he gave
it to me as a gift. And they are hard. They are very hard to attach. And this particular
wig has a--has a tape boarder, so you shave your head and then you take this on to the
head and this is a natural wig. So we call these things hair systems. The word wig is
fawned and disfavored by the users. The braiding issue is a really important issue, again,
against African-Americans. I would say way more than 50% of females who have pig tails
and twists and a lot of work on their hair when they're young will actually loose their
hair and develop traction alopecia. And the wigs are heavily used amongst African-American
women. And stress is a very important factor in hair loss. I remember a man coming to see
me. He lost his four year-old child from acute leukemia. And in the six months that took
her to [INDISTINCT] appearance of the--of the disease until the child's death, he lost
all the hair on his head and he became an advanced hair loss pattern patient, all induced
by the stress of his child's illness. And, of course, then we have environmental factors
of the things that we eat, antidepressants, a whole variety of drugs, birth control pills
for women will frequently cause hair loss and particularly when they're genetically
inclined for--or vulnerable for that. And, of course, the vitamin deficiencies which
are not common in America are causes of hair loss. And there are a lot of people who are
selling vitamins to cure your hair loss problem. Unfortunately, it doesn't really work. So
let's take a look at a man who is going bald and this, when you get down to the microscopic
level and you look at it, you'll notice that the hair grows in--in little clumps as I--as
we saw when we saw the whole pattern from a--from above. And if you look over here,
you'll see a clamp on the far right of forehairs in a single clump follicular unit. And then
if we zoom in on another stage of balding. In this particular man, you'll notice that
the hair is thinner and more puny and this is what happens in the balding process that
becomes miniaturize, it looses its bulk. Its--the number count are still the same but the bulk
starts disappearing and then as it gets further down the course of the balding like on the
very front of that circle, all of a sudden you'll start seeing that the hair is just
starting to fall out and there's nothing left of the hair on the head. So what can we do
about hair loss? Well, if you've got a disease like thyroid disease, you treat it. If you're
anemic, you try to get to the root of the problem for the anemia. So, if you pick up
a deficiency, it's pretty easy to--to at least form it. Stop the hair loss. It may not return
the hair that you've lost. Then there is a material called concealers. And here is a
patient that has a concealer on his head. And a concealer is like--is like a powder
and here's a piece of paper and I'm going to put the concealer on this--a concealer
called Topic and you can imagine what happens. If you see this, I hope these shows up on
the camera. Okay. And that's the powder that sticks to the top of the head. You try to
get it in between the hair and this does a good job and it did a nice job on this man.
He--you have a see through back crown of the head and on the right you'll notice that you
can't see very much because the concealer reduces the contrast between the scalp color,
the hair color and it makes them almost the same and therefore, you can't distinguish
the balding. And this is very popular by the way. The companies that manufacture these
powders and sprays have businesses in the tens of millions of dollars a year. And a
lot of people are using them. The problems with them of course is that the powder falls
on your shirt, your blouse, and you have a problem on how to fix it there. And that's
one of the issues. Okay. Of course, I'm in the business of a hair transplant business
and that means that we move hair around the head, from one place to the other. And here's--here's
an extreme example of a man who has--who has the most extreme form of balding. This is
what they call class seven balding pattern. And if you look at the right side, you will
see the clumps and--of hair here have more hairs per clump, more follicular--follicles
in the follicular unit than we saw in the previous patient example. And these follicular
units--this man had one of the highest counts that I have ever made and as a result of that,
you can see he was all bald and I was able to put back a full head of hair on him in
a series of surgeries and he had a fantastic result. And this is highly unusual to have
this type of donor supply. The hair transplant business is a supply-demand issue. If you
have enough supply, you can meet the demand; if the demand is low. It's very, very unusual
for a man like the one in the picture here to have his demand met by the supplier of
his hair. And when you count the average male--Caucasian male, has about 100,000 hairs on his head.
This hair--this man had about 200,000 so we had a lot of excess hair that could be moved
around. Amongst the races, the hair densities vary. Amongst the Caucasians, there are 100,000
hairs on the head of a typical Caucasian in a--in a standard bell curve. If you're an
Asian, it--it brings a count down to about 80,000 hairs and if you're African, you get
down to about 60,000 to 65,000 hairs. So the amount of hairs on your head decrease and
it is somewhat rationally dependent. Okay. Now, since we pull out these follicular units
that I was talking about and we moved them to the top of the head. If you look over here,
this particular patient had, had two types of extractions. One was a strip where we actually
cut out a piece of scalp, sawed it together, as you can see we used trichophytic closure
and there's a little bit of a white scar, there's a bit of white scar but it's barely
is noticeable on this patient. He healed very well. In this particular type of closure,
surgical technique has minimized the scar. And then below it, we actually removed them
with a punch so there's about a 0.8 milliliter--millimeter or 0.9 millimeter punch, sharp circular punch
that gets cored--course out these follicular units and then you move them to the place
that's balding. In the old days, when hair transplants were first started up, the punches
were the size of the pencil and you could imagine if you took a pun--a pencil sized
punch and you put it in your bald head; you look like you are plugging. And of course
I gave hair transplant a pretty bad image for many decades actually, since it was conceived
in the--in the early--in the mid 1950s. [PAUSE]
>> RASSMAN: And here is a person that had--a young man that had 600 follicular units. These
multi hair units placed in his head--extraction from the back of his head, excuse me. And
we did not shave his head. We only shaved little strips and then on the right you can
see that the--the hair comes over it, so you really couldn't see it. So here are the strips
of the areas that we shaved. The hair follicles were removed from here and then placed in
the front of his head. So anybody has any questions about this or wants me to slow down
or something like that, please speak up. I'm just looking, scanning the audience on that
one. So what is it that we take out? Well we take out a follicular unit and this is
a follicular unit. On the right, over here, you will see what the actual follicular unit
looks like when it comes out of the head and this one has two--this one has actually two
follicles in it. One of the follicles is actually a baby follicle that's in the state of growth,
the other one is a mature hair follicle so this is what we call two hair follicular unit.
And the anatomy, you can see is a bit complex. The hair actually grows some place over here,
right underneath the sebaceous gland is the growth center for the hair and the rest of
it comes from the bulb so the hair has got two different growth centers and when it re-grows,
it re-grows from contributions in both places; the general papilla and right below the sebaceous
gland. And here is a typical patient that we did. This man is fairly well known. I won't
tell you on what circles but he had a very dramatic change in his appearance and he loved
[INDISTINCT] work. And here is another man who was stunning, there wasn't much hair left
on his head and you' have seen the change that occurred in his hair transplant. And
this is Marque. I'm going to ask Marque and Fred to come up here. Marque, come on up over
here. And Fred you can join him because I have pictures of both of these men before
hand and I can have Mark, you can take the mic.
>> STRONG: Sure. >> RASSMAN: And I will keep this--one second.
Okay. And they can talk a little bit about their experience if that helps. Get you--get
you away from me. Go ahead Mark you can start. >> STRONG: Okay, well.
>> RASSMAN: Marque--Marque's a showman, I just want you to know that. And that's what
he does for a living so. >> I've been in rock and roll basically all
my life, toured all around the world during the 80s, developed a big hair--I was in a
big hair band. I toured with a lot of people that you probably were listening to when you
were ten years old and I was out there trekking it. And I'm still doing it. And about six
years ago--I--my son, we were swimming and I got out of the pool and he says, "Gee, dad
you're bald," and I go, "Really?" And I looked in the big Pike Glass window and I--"Oh my
god. I always combed it forward I didn't noticed." So I went out looking around like everybody
when they find something they really want change, they start actively searching the
web and everywhere else and you go and you get interviews and all this stuff. And I locked
out, as I was coming back from a gig and I heard about an open audition for extreme make
over, remember that show? The home make over salon. But it started out with making the
guy or the girl over the night and I said, "Well, I'm not ugly but I really love to have
my hair done" and I went and I was interviewed and I auditioned for it, and I got on the
show. I couldn't believe it. And the first thing I asked them, I said, "You can do anything
with this you want. Fine. I need hair." And they said, "Well, we'll think about it." And
they said sign this contract, that's about the size of the Webster dictionary and I said,
"Okay sure." So the rest of my life you could go on in YouTube or Google Me. It's Marque
Strong, M-A-R-Q-U-E, and you could find everything he did to me. This man changed my life. And
I've enjoyed it ever since. So the first time I went in I--it was four days before the airing--the
airing of the--revealed for the show. He did a 1,300 count re--transplant and they cut
my hair real short, they dyed it brown and put me on the show and you would never know
it. We can go into detail and he can... >> RASSMAN: That's because you combed your
hair forward and covered it up. >> STRONG: Not for the show. For the show,
they had it all real short and--a big family. >> RASSMAN: I look--I look at Marque like
Samson, you know, he lost his hair and he lost his strength.
>> STRONG: Yes. >> RASSMAN: Marque lost his talent when didn't
have his hair and now he feels more creative than ever since he got his hair back and there
really is a lot to it. A lot of patience that I've done; believed that I am the one who's
responsible for their careers because they didn't have the self-confidence necessary
to do what they wanted to do and that made it nicely in the world of acting or whatever.
>> STRONG: What the--he's obviously talking about his experience. So, go for it.
>> Sure. In my case, I had a general thinning and my hairline had gradually over the years
moved back to the point where I was a small forehead and the hairline was probably about
half way back on my head, three inches part of the back than where it currently is. I
was also thinning in the crown and in fact when I visited Dr. Rassman, when I--I actually
talked to him about transplanting in the crown and he advised against it at the time. He
said, "Now, look, you want to have unlimited amount of donor here. Let's save that for
the front and also let's get you on Propecia. Let's see--your crowns not too bad yet and
you might have a chance of getting some recovery." And I started Propecia right away and after
being on it for five months; I did get a good recovery on my crown. They--the hair hadn't
completely died. It was becoming miniaturized and thinner and kind of transparent. But that--after
being on the Propecia, it regained its health and thickened up and it got its color back
and so the--so I never did have to do anything in the crown. We did transplant the front.
I've had two surgeries; the first transplant, we did 2,800 graphs which really was a dramatic
improvement filling in the front. And then the second surgery which I did a few years
later, we hit the same area again with about half as many graphs, about 1,300 graphs the
second time just to thicken it up and get the density or the thickness in front to get
it a little bit more consistent with what I have in the back. I've been on Propecia
now for about five years. I've had no negative side effects from it, in fact, I've had a
positive side effect and that is also a medication that shrinks the prostate in men. At 50 years
old, it used to be that I was getting up in the middle of the night, use the bath room
once a night and after being on the Propecia for a number of months, it shrunk the prostate
down. I don't even have to get up in the middle of the night anymore. So that's been a nice
side effect. >> RASSMAN: It probably pays to mention something
about Propecia. It was on my agenda and I'm glad you talked about it. About 13 years ago--14
years ago, Merck released the drug Propecia which is finasteride--the drug finasteride.
It was used many years before that for the prostate as well and they did notice that
that it would stop hair loss and in young men, it might even reverse the hair loss particularly
in the back of the head, not much in the front. And that's a critical drug that I tried to
ask old men, not women, men only to go on the drug. There are teratogenic effects of
women. Teratogenecity means that there are side effects on babies that they produce if
they're pregnant and therefore they ask you to stay--limit, to stay away from the drug
particularly women in childbearing age. The other drug that's available is a drug called
minoxidil, Rogaine is the commercial version of--the brand name and that's not quite as
effective, it works okay. On women, maybe 15%, 20% of women will get a--get a benefit
from it and men about 10% to 15% will get a good result from it. It is an addicting
medication. If you get benefits, you'll--and you stop if you will lose it. If you stop
Propecia, you will lose your hair that you was--that was saved by Propecia. So for the
men, it becomes lifetime commitments for the Propecia in particular.
>> STRONG: I wanted to bring up one other thing that we talk about when we were having
your open house--open houses in your office which is really nice. He's one of the few
doctors that I've ever met that invites people in to meet previous patients and discuss things
informally and that's kind of like what we're doing here. So, any questions you have for
any of us or if you want to come up and pull and grab the hair, that's fine. It's our real
hair but here's the one thing that we talk about, when you take it from the donor area
which is you best hair and it's DHT, not pervious to DHT but DHT attacks a lot less and you
put it in the front of your head. Well, the number one thing that I've noticed is that
now you have the healthiest hair on your head right in the one spot on your head that is
the weakest, so all of the sudden now you got great hair in the front.
>> RASSMAN: The hair in the back on this particular man that I'm sowing you, it's a rim of hair
three inches high that runs above the ear around the side of the head--the back of the
head. And this hair is not--never bald in men for reasons that nobody really understands.
There are theories as to why that happen. But other than for the American-Indian that
all the other male populations on Earth have balding with the exclusion of the American-Indian
that came out of the Alaskan bridge. And there's some theories as to why that happened as well,
but this permanent rim on Victor here in the picture is the permanent rim that donates
the hair and that hair behaves like it did in its original site when you moved it.
>> STRONG: And it grows really fast. So you got to trim it all the time, even I trim my
hair. It doesn't look like it but I do. >> RASSMAN: There are no plugs anymore. Anybody
with modern technology, you really can't tell a hair transplant from a normal head of hair
and I would defy anybody in this audience to look at these two men. Well, myself whose
been transplanted, the whole back of my head has been transplanted and I would defy anybody
to show that they think it's artificial or it wasn't my own hair or God hadn't intended
to put it there in particular. Any questions for these two men before I bring the other
two guys up? Okay. >> Yes.
>> RASSMAN: Yes, go ahead. Was there a question here?
>> No, no. >> RASSMAN: Okay.
>> STRONG: No, you're good? There, I see. >> RASSMAN: Go ahead.
>> Sir, have you experienced hair loss since the transplant? I mean, does that happen?
>> RASSMAN: No, I have not experienced hair loss at all since the transplant. Generally
speaking, if you're over 40--35 years old, most of those people are stable and if you
take Propecia, it's almost certain to be stable. The big problem patients or the people in
their 20s--early 20s, mid 20s that have a lot of loss and who have very aggressive hair
loss patterns but you learn to create what I call a master plan. And the master plan
takes into account the worst case, the best case and the probable case. And if you can't
handle the worst case, you shouldn't do anything about it and just let nature take its course
but I think that the--that's an important question. Stability does occur as you get
older. It's unusual for a man to start losing hair at the age of 40--35, 40. It does happen
on a rare occasion, the famous actor, Don Ameche who started losing hair when he was
50, but that was an exception to the rule. Yes, Marque?
>> STRONG: I was going to say--again, my son says, "You shed all over the place, dad."
And I go, "Yes, I've always been that way." So a lot of people worry that there's a certain
amount of hair in my brush or whatever. Everybody does that but it's when you are shedding more
that you're growing then that's when you know you have the problem. All I could say is there
is that shock loss right after the surgery which we talk about in the office, which a
lot of people ask about. And there is a certain amount of that where you will lose from the
original area and then it'll grows back, that's why it's called a shock loss because it's...
>> RASSMAN: But this--but this condition can be prevented by just being on the drug finasteride,
Propecia. >> STRONG: Yes.
>> RASSMAN: So for most of--let's say 90% of even young men who are on the drug before
they have hair transplant, they can hold their hair pretty well and they won't develop shock
loss. Just to--he just pointed out an important issue is that hair goes through cycles. You
don't grow a hair and then it stays there for the rest of your life. You grow a hair
two to three years, at a rate of about a half an inch a month. And then it falls out and
gets replaced by another one. And this cycling from growth to resting phase occurs over an
average of three years, two years in men, three years in women. The story of the Brother
Grimm, Brothers Grimm who wrote the story about Rapunzel, talked about the princess
up in the tower, let down your golden hair so the prince can climb up and rescue her.
Well the hair never gets that long. The most the hair can grow is probably about five and
half, six feet and then it'll fall out and grow another hair. The good news is it occurs
at about a 100 hairs a day on a Caucasian and it grows another rate of 100 hairs a day
so that there's a big wash between what you lose and what you gain. What you see in the
drain, the hairs that you see on the drain, is really the 100 hairs a day that you're
going to lose if you get an acceleration of that that maybe balding. Yes.
>> You're talking a little about the recovery period that [INDISTINCT] pain experienced,
how long is [INDISTINCT]. >> RASSMAN: Fred?
>> FRED: Sure. >> RASSMAN: The question was how much pain
is experienced, what's the recovery like. >> FRED: Yes. In the strip method [INDISTINCT]
if it's in the back of the head where they actually extract the section of skin and then
enclose it with the sutures. And the surgery itself is not at all painful because they
numb you up, you know, there--it's--you might have little bit of trouble sleeping the first
night but they give you some medication to help with that. But by the day after the surgery,
I was completely off the pain medication. I never felt anything up in front where the
hair was transplanted, only in the area where we extracted the skin strip and enclosed with
sutures. Had staples for about two weeks to keep the suture closed and then had those
out. Just a little bit of numbness in the back where the strip was taken and that eventually
goes away after several months. There's a redness initially up on top where the new
hairs are transplanted. That redness generally goes away in seven to ten days.
>> MARQUE: I personally found that I had a little bit of swelling around the forehead
and just cold compresses. They always plead with you to come in the next day to have them
shampoo your hair and show you how to take care of it properly for the first week. I
always equate it to like planting tulip bulbs in the ground. You can't just hose it down
with high pressure hose and expect the bulbs to stay underground. Everything has to have
a nurturing point and then it--it's so negligible. I mean he just gave me a couple of Xanax and
I'm sitting there listening to him and he went through the whole procedure and I was
fine with it. And I've had three procedures and every one of them has been exactly the
same. And the recovery period is according to your skin color, your hair type, and how
easily you bruise, that kind of thing. But, for most of us that healed fairly easily,
the recovery period is very, very quick. The body comes back really quick. And then you
will notice hair growth within three to six months.
>> FRED: If I noticed [INDISTINCT] immediately. >> RASSMAN: What was that Fred?
>> FRED: For me it was about--there was about a four month adornment period where nothing
was happening for the first four months but then it started coming in and then it really
came in quickly between month four and month eight. But for even a year, a year and a half
out, I mean, it was still some stranglers kind of coming in and also even the hair that
had come in early was thickening up over time and getting more healthy.
>> MARQUE: And I color my hair. And I've known Fred the whole time he's been going. And his
hair, if you get really close to it, it looks like a 20 year old hair and he is amazing.
There's a couple of other guys, Moses and a couple of others.
>> RASSMAN: Okay, there's another question. >> [INDISTINCT]
>> RASSMAN: Well it's a good idea to catch it early because then you can stop it with
the drug and then you could put it back and hopefully that'll take care of it. So that's
the best of both worlds. Yes, another question? >> Can you talk about the reports of [INDISTINCT]
sexual side effects of Propecia? >> RASSMAN: I have just told a number of doctors,
that accounts for about 10,000 patients over 20 years, and the numbers of cases that were
reported of irreversible sexual side effects, meaning loss of libido, erectile dysfunction
was about four. So, use those as statistics. It does happen. We didn't recognize it before.
The drug company has not been forthright at coming toward with that as a side effect probably
because it didn't fall within the statistical range that they have required reporting. But
it's still rare. And most of the time, if you develop sexual side effects, you work
with a good doctor and you can deal with those sexual side effects pretty well. Yes?
>> Just make sure you repeat the question. >> RASSMAN: Oh I'm sorry that was on sexual
side effects and how often do you get irreversible side effects. Sexual side effects itself is
about 1%, 1% to 2% reported by the drug company Merck. In my--in my experience it maybe a
little higher, maybe 3% or 4% but the irreversible, I've done thousands of men, put them on that
medicine. I've never seen it for those people that have stopped it. And that was true amongst
the six or eight doctors I polled. If you go on baldingblog.com and just look up sexual
side effects, you'll see the statistics that were done by the doctors that I polled, specifically
to answer a question like that from the audience. Yes?
>> And with the Propecia, how long before you see the effects of the drug and, and later
on? Now, for our second question with you guys. Do you cut your hair really short and
find that it--and find that it just grows back or is it something where once you--now
that you got them then you kind of... >> RASSMAN: Let me--let me answer the first.
The Propecia effect. Remember it might work within the first week or two and it probably
does. But it takes time for the hair to grow out and it takes a bit of exposure to Propecia
to see it. So we tell about--most people I started on it that don't intend on doing on
any surgery to basically wait a year, eight month to a year to see what the effects are.
They are very subtle on the front of the head and they may work in the crown and you'll
know whether you respond in usually in 8 to 12 months.
>> FRED: I will tell you that for me, it was four months on Propecia before I saw noticeable
results. Both in terms of recovery and the crown getting thicker, healthier hair and
also about the same for the shrinking of my prostate which I talked about.
>> MARQUE: There is a friend of mine that I send over and he's going to have the hair
transplants done now. And he actually met with Doctor Rassman 15 years ago and got on
the Propecia. And he's had hardly any hair loss, he said to me, before I ever send him
back to Doctor Rassman in the last 15 years, strictly because he stayed on the Propecia.
He's had hair loss but it was all there 15 years ago and it has not progressed. And he
said I'm finally ready, I've got the cash, I'm ready to go in, so.
>> RASSMAN: Yeah. The--to answer your other question, if you shave your head it'll grow
out at about half an inch a month. Okay, so. >> FRED: Yes, yes, it acts just like every
other hair on your head and there's no difference at all.
>> MARQUE: We talked quite often and there used to be a gentleman that would come into
the office. And he had long hair like I did and he was an extreme sports guy and he had
a lot of balding all the way back. Well he had Doctor Rassman bring his whole--the--where
his hairline was down even further that it was originally. And then he joined the Navy
Seals and now he shaves his head. So, it still grows out just fine but he keeps it really,
really [INDISTINCT]. >> RASSMAN: But you--but you need, not everybody
will get the same result and that's why you need a good doctor to work out what is the
plan, what are the expectations, and to set realistic expectations always, that's important.
Because what's good for one person may not be good for another one, like anything in
medicine, that's the standard. Any other questions? I'd like to call up the other two guys. Yes?
Is there a question at the back? Oh, okay. All right. If you guys will step back, we'll
have everybody open to this in a few minutes. This is Jeremy coming first and Tony behind
him and they've had an unusually different type of a procedure that has just been introduced
by our company. And this is--we call it scalp micro-pigmentation. It's a fancy name for
a tattoo and it's--to try to make it look like it was there forever and it's like a
stifling effect on the head to reflect every hair follicle that was there. And both of
these men were class seven patients. So, here's Tony before hand and this is Jeremy. And Jeremy
and Tony both had class seven patterns and if you remember what I told you earlier about
a class seven pattern. This is a class seven pattern. So, they were almost to the class
seven patterns but much younger and if they waited it out they would look like this man
I don't mean to scare you, okay. I don't know why I told you that.
>> TONY: Pretty much already he was. >> RASSMAN: Anyway, Tony you're the first
one on the picture so why don't you go and tell how the hell--pardon me. How did you
make this decision to go do this? >> TONY: Well, hair loss is a very sensitive
subject for most men and anyone in general. And I started when I was quite young and I
didn't want to accept it so, for the first couple of years, you--as more of a denial
phase. And then there's reality that sets in and you just haven't--none--don't have
a choice, you're going to be bald the rest of your life, basically. And so, I started--I
just said, "Screw them." Started shaving my head pretty young and I didn't have a problem
with it. Went through college and stuff, shaving my head and just looked it like that that's
how it was going to be the rest of my life. And then I started thinking one day, "What
if there was someway to give it at the illusion that I have a full of a hair but it was shaved
because I shave it anyway, what's the difference, I can't look any worst than I already do,
you know." So, I just kind of went down that path and did some research and I came across
micro-pigmentation. Now, the thing is, what I did is to change the focal point of my face
and it's more of a personal thing. Honestly, there shouldn't be anything wrong with going
bald. It's more like a personal thing. Society might look down upon it but as a personal
thing, it's like a breast augmentation and, you know, if you want it done or not, if you
want to feel better about yourself, is it going to make you a better person in general,
people might look at you different or something like that so, it as a personal thing. And
it has changed my life greatly in different aspects and stuff; I can't say that I didn't.
I wasn't unhappy with how I looked at all, I really wasn't. My wife love me the same
with or without. And it was just something I chose to do and it--it's made a good impact
in my life and I'm pretty sat--I'm very satisfied actually with how things are going. The hairline
as you see I was--I've had it done quite a while ago, if I was to redo it, I might do
my hairline a little different or something because what white guy with a fuller of hair
beaks their head, right? Oh well, it's more of a choice thing. Got most guys that shave
their head, don't do it by choice because they're losing their hair and they don't want
to look like a, you know, the round thing going around the sides and what not. Anyway,
that's kind of my story why I went with it. Doctor Rassman is the--by far the best in
the business if you're looking to get a hair transplant or this micro-pigmentation. If
you have, there's guys that do wear the hair pieces they--as Doctor Rassman brought up,
they weave--I'm only nudge this because I research it. They let the hair on the sides
grow out and then they weave it in. So, every month you're going in and they get these things
tight down. Well, there's a lot of guys that do that and they can get those taken of and
then he can do micro-pigmentation and you're going to work a week later and it looks like
you just shaved your head. And honestly, I just saw one of my best friends; I haven't
seen him like eight years, two days ago and he doesn't have a clue. I see my friends I
might not see for certain amount of time, they literally don't even notice. It's not
like it's a drastic change to them at all, they don't even realize it. And it's so--what's
the word I'm looking for--honestly, people just think you just shaved your head. I got
questions at work, "Oh, you've decided to let your hair grow out." Or I've even had
the question, "Did you get a hair transplant or how did you do that?" Just curiosity things.
Most of it, it's from other guys losing their hair because I knew I was losing my hair prior.
This was at work, a lot of guys and they're like, "What did you do and stuff?" And it's
kind of tough to explain. It's quite a story obviously but, yes, I highly recommend it.
If you're thinning on top, you can get the hair transplant, of course, but it will also
thicken up everything on top and give you more a thick view.
>> RASSMAN: If one of the--if Tony for example, wanted to do a hair transplant, but if he
have a density like an Asian or an African density and he didn't have a lot of donor
hair with a class seven pattern, you'd never get enough hair to transplant his head.
>> TONY: Yes, my hair is really thin as it was anyway. So, even if I wanted a donor,
it's pretty much no way that I could even do it. I mean, maybe in the future when they
have an unlimited amount of hair because they can clone it or something, maybe go down that
road. >> RASSMAN: And I will--and I will address
that at the very end so let's--okay and... >> TONY: Anyway, go ahead Jeremy.
>> RASSMAN: Go ahead Jeremy. >> JEREMY: Hi. My name is Jeremy.
>> RASSMAN: Jeremy talk a bit--a little bit about what happen when you went to work as
you recently did it and you can... >> JEREMY: Yes.
>> RASSMAN: ...talk about your experience. >> JEREMY: Unlike Tony, Tony's had it done
almost a year ago now. I had mine done about a month ago. I had it done on a--I had it
done on a Thursday and I took off Friday and Monday. So, I had a four day weekend to recover
from everything. And when I say recover, we're not talking anything like a hair transplant,
it's really--I was sitting in a chair, I watched movie on my phone and it took about two and
a half hours and it--it's like somebody giving you a tattoo on top of your hair, a little
tiny dots all over at the top of your head. That--like Tony said, like Doctor Rassman
said it replicates the look of actual hair follicles. I went back to work, I've been
working at the same job for 12 years so, these are the people who see me everyday, day in
and day out. I went back to work, a couple of people said--just like Tony said, "Hey,
are you shaving your head like with the razor now?" And I said, "Yes, that's what I'm doing."
And couple of people say, "You're growing your hair out?" And I said, "Yes, that's what
I'm doing." Whatever you say, I'm going to agree to it and it was really a seamless transition
and again, speaking as somebody who's also class seven, if you guys would have seen me
a month and a week ago, I had a full clear line through my head. If I were to have turned
around, you could have seen the cul-de-sac and everything even though if I kept it really,
really short, that's what was there. And, you know what, like Tony said, it's not--it's
not something you should be embarrassed about necessarily but a lot of guys don't like it
and I was one of those guys. I felt uncomfortable about it. I realized I was going bald I think
five years ago. I was in a cold dressing room trying on a pair of slacks and came out and
there was mirrors all over the place and I saw the back of my head and I thought, "Oh
my gosh, like what's happening here?" From that point on, immediately, self-confidence
shutdown and I'm just, you know, didn't feel good about myself and so, I've been looking
into a couple of things. I--I'm not trying to do a hair transplant. I kept my hair short
anyway so, I was thinking, you know, of something else. And I didn't know of anything else until
I ran into Doctor Rassman and he said, "You know what, you would be perfect for this scalp
micro-pigmentation thing coming out." I looked into it, saw some things on the internet,
looked to be too good to be true like a lot of things in the internet, right? My dad always
taught me, "Something is too good to be true usually is." I insisted on meeting somebody
who had it done. Doctor Rassman brought Tony in. I met this guy; I'm looking at his head.
I'm like, "Hey, I had no idea that that's not real hair." You know, if you let that
grow, this guy's going to have the thickest head of hair ever. But he won't.
>> RASSMAN: And that's not something--and that's not something you want to do. By the
way, you don't want either of these men to let their real hair grow because then they
would have a runway in the middle of their head and that looked shaved and then they'd
have bushy hair around the side and the back of their head with long hair and that's not
what we think is a normal look. >> TONY: Yes. And you don't have to beak it.
We just beak our heads with the razor, it's less noticeable I guess. You can honestly
deal with a low razor setting and it can just look like a trim look. He's a zero--or I used
to use a zero actually but it started beaking and I just like it much better. This is all
real. All around the sides, only the top appears--only the top appears, I don't know if you could
see it with the lightings stuff but... >> RASSMAN: And we can end--at the end of
this, we can have you look at all of these four gentlemen when we move into the informal
place. Are there any questions here from the audience about this? Okay, this is very new
and we just started to build the patient numbers here and it's been nice and satisfying.
>> JEREMY: If I could go--if I could jump back in, I think--the thing about the scalp
micro-pigmentation is that it doesn't have to be somebody who's, "Hey, look at my head,
I'm going bald so, I'm going to do this." I think if I would have known about this prior,
if I was a guy who was loosing my hair but I still had, you know, some hair on top and
it was kind of going away, you could literally take a day off have this done, go back to
work three days later and now you're the guy who shaves his head and appears to have a
thick full head of hair and nobody knows. And that's really what it comes down because
I think--I didn't want anybody to know that I had something done. That's the most--that's
probably the most uncomfortable thing because you don't want people to know that you've
got a hair transplant necessarily. You don't want people to know that you're uncomfortable
about this part of your body. But again, I think this could go kind of across the board.
Anybody who's looking to have something done, if you decide, "You know what, I'm going to
start shaving my head from this point forward keeping it short." Get something like this
done and it's just again, seamless transition. People don't know what's there and now you're
the guy with short hair. >> RASSMAN: And it works wonders for people
who have scars on the back of the head or any place on the head that could make the
scar go away. And we do it in conjunction with hair transplants when people get enough
hair and then they just fill it in will these pigmentation. So, it's a very interesting
blend when you work the hair transplant with the pigmentation. Okay. [INDISTINCT]. Okay.
I have--yes. No more questions. Okay, yes. Go ahead.
>> So for women who are [INDISTINCT] and they can't take [INDISTINCT]?
>> RASSMAN: For women, Minoxidil works. Not great but it does work a little bit. The--you--for
women, you want to get--make sure that you've had a full medical work up that you're not
walking around with hormone deficiencies or a variety of diseases like thyroid disease
or anemia. And--so the first thing we do is go through a thorough or recommend that the
patient has a complete thorough medical work up and laboratory work up. But by and large,
there isn't very much we can do. We do transplants on women. About half the women that we do
are women that have had face lifts and cosmetic surgery. It worked great for that. And the
other half are women that have more pattern balding like a male, which is about less than
20% of the women that have balding. And sometimes I can--I can actually transplant a woman if
we work out a style that they want to fix on their head. I can put hair on that area
like parting the hair in the middle. I can, you know, cover an area of maybe two inches
by four inches and put hair there and that works for women. The big problem with women
is that the hair in the donor area, those fringe area that I've showed you on the man
before, is usually not healthy so it might have miniaturization to 40 or 50 or 60% of
its original population. And that's moving bad hair to bad hair so you have to be highly
selective. I don't think I would say only about 20 to 30% of women have that without
even having a surgical procedure like a hair transplant. We have been doing a few women
with scalp pigmentation in between the hair and that's work very nicely on selected women
to thicken it up so it doesn't look as thin. And I'm, I think that'll have a nice bright
future in our practice. Yes. >> Any validity to biotin? [INDISTINCT] validity?
>> RASSMAN: Is there any validity to biotin? No, there is no validity to that helping.
Well, most of the claims on variety of vitamins and medicines just are just not true. And
unfortunately, there's a lot of people got played on by a lot of not good marketing material
and scams all over the internet and, of course, everybody buys--a lot of people buy into these
scams unfortunately. So if you see a good doctor, they'll tell you that's not good stuff.
Don't waste your money. And if you read my Balding Blog, I have that all over there.
People will ask questions constantly; will this work? Will biotin work? You can go on
Balding Blog and ask about the question about biotin. I've answered it already before for
the people. Yes. >> What about cloning for women?
>> RASSMAN: Okay, let's talk about cloning. We just started a study in our office. We
just got an IRB, an Institutional Review Boards ability to do human experimentation. And that
is a--with hair multiplication. We've selected the population that we want to do it on. They
have to have a big bald area. And what we do is we pluck hair out of the back and the
side of the head pluck. And the hair that you pluck out will re-grow and then you put
it into the front or the back or the bald area that you're targeting. We've been doing
100 hairs per area and sometimes two or three hundred air, two or three hundred hairs are
placed at maybe two or three area. And we have just started this about three to four
months ago to getting all the patients to come in. Now, I have not seen any growth yet.
I wouldn't expect it if I saw that hair transplant either at this stage, but maybe in three months
I'll have answers on that as to whether hair multiplication works. There is some evidence
by one doctor in North Carolina that in the case that he's had success with it. And I
know what he did and we're just doing the same thing to validate the study like any
good science. He wants the study to be replicable in more than one institution in the hands
of more than one doctor. And that will put credibility to it if it works. If we get a
failure of this, all the patients who've volunteered for this have agreed to realize that one is
a completely experimental procedure. I don't charge them for it and it's free basically
to do it. So we're just doing this to learn. The people just lined up as soon as I've announced
that I would be doing this on experimental basis. We were swamped with people wanting
to be experimental subjects. And, of course, most people had too much hair for that. I
want absolutely bald areas. Thank you for the question.
>> [INDISTINCT]. >> RASSMAN: Yes. We haven't done any experimenting
on women yet, but there should be no reason why a woman wouldn't respond the same as a
man here. Okay? I would invite those people in here to come down and meet these gentlemen.
And I will--you may test to see whether you could tell they're transplanted. If you want
to run your fingers through my hair, you're welcome to do that, too. Thank you very much--very
much for inviting me here.