Toppik on 11 December 2014

It all started in 1990. I was twenty-one.

I had just broken up with my girlfriend. All of a sudden I started to lose a lot of hair. My pillow was covered in hair every morning when I woke up. The drain was clogged with hair when I got out of the shower, and every time I brushed my hair, I would have to brush the hair off the back of my shirt.

I made an appointment at a leading hair loss clinic immediately. I was told I had poor circulation of the scalp, embedded dandruff and oil blocking the follicles, which was causing my hair to fall out. They wanted to sign me up on a $1700 program that was guaranteed to stop the hair loss immediately.

As desperate as I was to do something quickly to stop my hair falling out, I wanted to get other opinions, so I told them I would think about it. They said, ‘What is there to think about? If you don’t do anything right now, all your hair will be gone in two years.’

It was a typical high pressure sales pitch, which put me off. I read the fine print on the guarantee and it was dependent on using the clinic’s own brand of products, which would make me a customer for life. I became suspicious so I contacted the Australian Consumers Association (Choice magazine). They sent me a story they had done on the hair loss industry entitled ‘The Bald Facts.’

It covered everything: cause and effect, cures and camouflages and, most importantly, what to do if you think you are losing your hair. The very first page told me that male pattern baldness is not caused by poor circulation of the scalp, embedded dandruff or oil blocking the follicles. It is a result of two factors: an inherited genetic predisposition combined with a certain level of male hormones.

Choice recommended seeing either a dermatologist or a trichologist (trichologists are not doctors, but they specialise in hair and scalp problems). I contacted the Australian branch of the International Association of Trichologists (IAT). They provided me with names and locations of its members, who are certified trichologists.

Seeing a Trichologist

I saw a leading trichologist, who told me what my options were (which weren’t many, back then). The only thing proven to work on male pattern baldness in clinical trials was minoxodil 2 per cent.

I got a prescription and applied minoxodil 2 per cent to my scalp twice a day. After six months it wasn’t working for me. My hair was still falling out, so I stopped using it.

I was devastated! There was nothing I could do to save my hair. I could only hope that the hair loss slowed down. I kept in touch with my trichologist every few months, seeing if anything new was on the market to help prevent male pattern baldness.

The hair loss did slow down, but five years later, in the middle of 1995, I was unable to style my hair the way I used to and get away with it. People began to notice my hair was thinning – some made comments, others made jokes.

Every time I looked in the mirror or saw myself in a photo, I got depressed. If someone made a comment or, worse, a joke, I was shattered for days.

Losing your hair affects different people in different ways. Some people say they couldn’t care less, while for others (including me), losing your hair can be devastating, especially when it happens at a young age. I felt it made me look older than I actually was. I felt less attractive to the opposite sex and I was less confident in social situations. I stopped doing a lot of things I enjoyed, so as to avoid the people who made comments and jokes. I avoided mirrors and wouldn’t let people take pictures of me.

It was beginning to affect me psychologically, so I started reading books on positive thinking, trying to convince myself it didn’t really matter. But deep down, it really did matter. I had to look at my options again. I couldn’t stop thinking about it. I wanted my life back!

My only options now were surgery or a hairpiece. I first looked into hair fusion, although I never seriously considered it as an option. This option is high maintenance and I am a low maintenance kind of guy. The fusion technique involves a hairpiece, or ‘unit,’ that is meant to be tailor-made to fit your hair and pattern of balding. Your own hair is pulled through the mesh base of the unit to hold it in place, along with clips or glue or double-sided tape. Because the unit is attached to your hair, it started to lift off as the hair grows and so needs to be re-fused every four to six weeks.

One subscriber to Choice discovered that ‘units’ have a limited lifetime. His only lasted nine months before the hair started falling out. In that time it had also changed colour, having been bleached or faded by the sun. Others complained the unit was very uncomfortable, did not look natural, and they always had to be on the lookout to protect it from sun and rain.

Considering the replacement cost, plus the cost every month for a ‘re-fusion’ and that the guarantee offered is dependent on using the clinic’s own brand on shampoos, reconditioners and revitalisers, hair fusion can be a very high maintenance and expensive option.

I also looked into wigs and hairpieces, the oldest method of disguising baldness. They are particularly good for people who have lost a lot of hair as a result of chemotherapy or an accident. For people with male pattern baldness, the only advantage a hairpiece has over fusions is that it can be taken off, making washing it and your own scalp easier.

I decided that hair pieces and hair fusion were not an option. I spoke to my trichologist and saw a hair transplant doctor he recommended. At the time, scalp reductions, flaps and plugs were the most common forms of hair transplantation. Mini grafts and micro grafts were just starting to be introduced as the latest technology in hair transplantation.

I saw guys who’d had scalp reductions, flaps and plugs, and was not impressed. Scalp reductions create a scar that sits in the middle of an area of the scalp, which is often still seen. Also, the direction of the hair growth is altered, which results in an unnatural appearance. Flaps leave scars both above and below the flap. They also result in a hairline that grows backwards at an angle of 45 degrees to the scalp, which results in an unnatural appearance. A plug contained 15 or 16 hairs, which meant the new hair looked a bit like rows of corn and not very natural at all. These methods were not an option as far as I was concerned.

Mini grafts and micro grafts were the most natural-looking option at the time, but were only being done in small numbers, which meant several sessions were required to cover a large area of baldness. Due to the size and spacing required, you would have a ‘tufty’ or ‘pluggy’ appearance after the first couple of sessions that could only be filled in with multiple sessions in the gaps between grafts. This could represent a period of two to three years to achieve the final result, with the potential for some embarrassing moments during that time.

I wasn’t prepared to have several operations and look like a freak for two or three years. Again my hopes were shattered. Here I was, twenty-six years old, going bald, and there was nothing acceptable I could do about it. All I could do was try to accept it. I went out and bought a hair clipper and put a number one through what was left of my hair.

Waiting for a Breakthrough

In 1996 a breakthrough came. It was discovered that the drug finasteride, which was being used for treating people with enlarged prostate glands, had a fascinating side-effect: some patients’ hair started growing back.

generic finasteride tablets

This led to the discovery that male pattern baldness is caused when the male hormone testosterone is converted to a derivative, dihydrotestosterone (DHT). High levels of DHT cause hair follicles to age prematurely and shrivel.

Finasteride works by blocking an enzyme, 5 alpha reductase, which converts testosterone to DHT. The drug can cause DHT levels to drop by up to 70 per cent in eight hours. When DHT levels are low, follicles can strengthen and produce hair for longer. The only downfall is a possible loss of libido and difficulty in achieving an erection in less than 1 per cent of patients.

It was simple: reduce DHT, reduce hair loss, and maybe grow some hair back. Now I had some hope. The only problem was the drug had to be tested in clinical trials before it could be sold to prevent male pattern baldness in Australia.

My trichologist said it would be at least a year before finasteride was released in Australia. He also told me about an herb, saw palmetto, that could do the same thing (and cause similar side effects). I immediately went to a health food shop and purchased some saw palmetto (Proseren) capsules. I took two a day at a cost of $20 a month and took my chances. I had no side effects, but no noticeable improvement in hair growth either. It did, however, slow down the hair loss. I saw less on my pillow in the morning.

saw palmetto hair loss capsules

I did this for about a year until finasteride, marketed as Propecia, was available in Australia. I decided to change to Propecia, since it had been tested and proven to work on male pattern baldness, where saw palmetto had not.

I have taken Propecia ever since, with similar results to saw palmetto, at a cost of about $70 a month (my health fund allows me to claim $500 a year of the total cost). Propecia is definitely helping to keep the hair I have left. I know this because the rate of fallout is virtually nil. It took a while before this happened.

I decided to stay on Propecia for at least 12 to 18 months before I could confidently say whether it was working or not. By mid-1999, I still had not had any regrowth, but I was holding what I had left. So I started looking into hair transplants again. I found they had improved dramatically over the previous four years. Follicular units had been discovered. It had been found that the hair at the back of the scalp does not grow individually, but in naturally occurring groups of one to four hairs. The discovery of the follicular unit had allowed doctors to mimic nature by transplanting hairs in the same way nature grows them.

It sounded good. The doctor would remove a strip of scalp 1cm wide and up to 20cm long from the back and side of the head. The donor site would be closed with stitches, staples or sutures until the wound healed. The strip of scalp would be divided up and given to several technicians. Using microscopes to see these follicular units, the technicians would dissect them precisely and then replant them densely into the bald scalp in large numbers. This procedure is often referred to as a mega-session.

For the first time in a while, I was excited.

I learnt that the mega-session consists of 1500-3500 follicular unit grafts placed in one sitting. Each of these grafts contains from one to four hairs. One follicular unit mega-session equals three to five sessions using the commonly performed conventional methods with mini and micro grafts. The small follicular units can be placed much closer together than traditional mini and micro grafts, effectively negating the ‘tufty’ appearance.

Since there are fewer sessions, there’s less time off work, less discomfort and less anxiety regarding the procedure. There is not much difference in the price (since fewer sessions are required) and the end result is much more natural.

It all sounded good, but I wasn’t getting my hopes up. After what I had seen before I was sceptical, so I decided to look further into follicular unit hair transplants.

My Research

The internet is an excellent source of information. This is where my search started. I spent most of my time on the non-commercial sites to find out the positive and negative aspects of follicular unit hair transplantation, as the commercial sites focus only on the positive aspects. I also wanted to talk to as many people as I could who’d had follicular unit hair transplants and ask them about their experience and results.

Finding a Doctor

After studying the websites and speaking to people who had had a follicular unit transplant, I was convinced this was the breakthrough I had been waiting for. I now had to find a doctor in Australia who was using the same procedures and getting the same results.

I spoke to my doctor and others registered with the IAT to get an independent view on the hair transplant surgeons in this country. I had consultations with four of the doctors they recommended, all of whom were members of the Australian Society of Hair Transplant Surgery. Most of them gave me phone numbers and names of former patients. After meeting some of these former patients, I found they were all getting excellent results.

I have listed my reasons for choosing Dr Barry White at the end of this story.

Before My Procedure

I booked the operation and requested two weeks’ annual leave. This would allow me time to completely recover from the operation. I didn’t tell anyone at work I was having a hair transplant, as I wanted to go back to work unnoticed.

After I booked the operation I felt relieved. I had finally done something about my hair loss, which had been bothering me for a long time. I also felt very nervous. Even though it is minor surgery, it is still an operation and I was worried about complications. Hair restoration procedures differ from general surgery, however, in that they involve only the outer layers of the body. In Dr White’s experience, post-operative complications have been infrequent and never serious, the most common being minor swelling and occasional bruising around the forehead and eyelids on the third day. This may last for up to a week. I was told that part of my scalp might remain numb for some time due to temporary interference with the nerves in that area.

I was also worried about how I would look after the operation. Some people look better than others after a hair transplant due to certain factors. After having many consultations and doing so much research, I knew the following factors about my own hair and skin:

  • My hair is straight and dark brown in colour on fair to olive skin
  • My hair texture is medium and I have good donor density and scalp flexibility

Dr White described various aspects of restoring my hair and how these factors would contribute to the outcome of my transplant.

My Expectations

Hair transplantation does not create new hair. It simply relocates it from your donor area (the sides and back of your head) to your area of male pattern baldness. Transplanted hair may look wonderful and full, but it will never be as thick as it once was. Some people are satisfied with just re-establishing a thinning look in an area where they were once bald, while others are not satisfied until they’ve achieved a look of having a full head of hair.

I was prepared for a natural, thinning look, but hoping for a look of a full head of hair. I believe it is better to look thin than to look bald. My expectations:

  • I wanted a natural look, with an even coverage of medium density
  • I wanted it to blend in with my existing hair and not be detectable

I went over these expectations several times with Dr White. Although it was impossible to predict what the final outcome would be, he guaranteed I would look better after the procedure.

Twelve Months Later – Final Result

I went to a club recently and had to produce ID. The bouncer looked at me, then looked at the picture on my licence, three times before he let me through. It is unbelievable how different hair can make you look. I still haven’t decided what hairstyle suits me best, but to be honest I like keeping it short and brushed down because it is the least maintenance and I don’t have to worry about the wind messing it up.

I am still getting comments from people I don’t see regularly. They all tell me I look different, and I do. Because the process is so gradual, people don’t notice. It’s not like getting a rug and in one day going from bald to having a full head of hair.

I was telling a friend it’s been 12 months since I had the transplant and he gave me the ultimate compliment. He said, ‘You know what, I had forgotten you had it done.’

Conclusion: Am I Happy?

Yes, definitely. It’s not the hair I had when I was 18, and I knew not to expect that, but it has exceeded my expectations. I guess the hardest thing was waiting to know what the final outcome would be. But it was worth the wait.

How has it changed my life? I am now a lot more outgoing. Before, I used to avoid social outings with friends. Cameras and mirrors don’t bother me anymore, either. I no longer spend hours on the internet looking at hair loss websites.

One of the best things – no more bald jokes. I remember being best man at a wedding and getting up to make a speech. Someone yelled out ‘Baldy!’ and everyone laughed. I had never been so humiliated in all my life.

Would I do it again? Actually, I am going back to have another procedure. Dr White told me before the first operation that at my stage of baldness, if I really wanted to look good, I would need at least 5,000 grafts. I have already had 2,811 in the front. The next procedure will add a few more in the front and put the rest in the areas we couldn’t cover last time. I think I look great now but, being the perfectionist that I am, I want to look as good as possible. I will be continuing this story, so stay tuned.

What do other people think about it? Friends and family say it looks great. I went to a couple of Dr White’s open house seminars so other people could see my results up close and to get an independent view from people who don’t know me and would be totally honest. The bottom line: a lot of the guys I met there were impressed enough to have subsequently done it on themselves.

I have written this in the hope that the people who read it don’t fall into the trap I almost did, and to let you know there is now something you can do about hair loss that is successful. People losing their hair – especially in the early stages – are desperate, and will do just about anything to try to stop their hair falling out. Some hair loss clinics take advantage of this, and the only reason a lot of them are still in business today is because after their customers get ripped off they are too embarrassed to do anything about it.

Making the correct decision about treating your hair loss can make the difference between happiness and hell. Some people will agonise over their hair loss their whole lives and never do anything about it. Others have tried and failed, been ripped off or, even worse, been scarred and disfigured in the process. I consider myself to be one of the lucky ones. I found an excellent trichologist who referred me to a person I consider to be the best hair transplant surgeon in the country.

Hair transplants, in the right hands, really work. Before you do anything, please read everything you can get your hands on, talk to as many people as you can, and make a wise choice.

Good luck!

Reasons Why I Chose Dr White

  1. Dr White has been through this procedure himself. He had the confidence to have it done on himself. He knows what losing your hair is like and I found him to be a genuine and caring person.
  2. Dr White specialises in follicular unit hair transplants. He doesn’t do any other type of cosmetic surgery.
  3. Dr White uses the latest state-of-the-art techniques. He has received intensive training overseas and has brought technicians over from the United States to assist him and his staff with the latest methods, and has been applying them for the last five years with excellent results.
  4. Dr White was the first doctor mentioned by my trichologist and others registered with the International Association of Trichologists.
  5. I met with several of Dr White’s former patients, and even spoke to a patient while he was having the procedure.
  6. I met Dr White three times (twice on a Saturday, so I didn’t have to take any time off work) and was not charged for any consultation. I called him several times to ask questions. I was always put through to him and not a consultant. He always confidently answered my questions and when he wasn’t available he always called back the same day.
  7. Dr White holds open house seminars where you can meet and ask questions of former patients.
  8. Dr White’s was the only hair loss clinic where I felt comfortable. The staff at the National Hair Institute were all very friendly and extremely professional. The day after I made an appointment, I had a video delivered to my door. It introduced Dr White and explained why hair loss occurs and what can be done about it. It also contained a detailed explanation of what follicular unit hair transplantation is, what the procedure is like and, most importantly, some pictures of former patients, before and after the procedure.
  9. Dr White would perform the most grafts in one session (up to 3,500). Most other doctors wanted to do between 800 and 2,000 grafts in one session. I wanted to achieve the best possible results in the least possible time, with the least number of operations.
  10. There were never any phone calls, letters or high pressure sales pitches from Dr White or anyone else asking me if I had decided to go ahead with the procedure. I first saw him in November 1999 and made my decision in May 2000.
  11. Dr David Seager taught the techniques currently in use at the National Hair Institute to Dr White. I regard Dr Seager as the best hair transplant surgeon in the world, because other hair transplant surgeons from Canada, Brazil, Mexico, the United States, Europe and Australia (including Dr White) have chosen Dr Seager to perform the surgery on them.
  12. You have to consider the technicians the doctor uses. I felt Dr White’s technicians were the most experienced and intensively trained in the country. They are also a very tight-knit group, who socialise and even go on holidays together.
  13. With Dr White there would be fewer sessions, which meant less time off work, less discomfort and less anxiety regarding the procedure. I didn’t want to wait two to three years to achieve the final result.