History: This 50 year old male had the jarring experience of looking in the mirror and seeing his Dad staring back at him. He was otherwise healthy and had enjoyed a lifetime of thick hair over the rest of his head, so he always thought he would be able to avoid hair loss. Additionally, he was comfortable with the fact that a normal mature male hairline has some temple recession, so the slow thinning that had been slowly progressive had not bothered him – up to this point. He had not ever tried any therapies for maintaining his hair. He hoped to simply fill in the corners and reframe his face with hair surgery.
Physical Exam: This patient’s hair was a medium brown throughout and showed significant hair thinning at the fronto-temporal corners and in the vertex (crown) areas. The hairs were “miniaturized” on microscopic exam, except in the safe “donor” area at the back of his scalp, where the density was well above average. The rest of his physical exam was unremarkable. He kept his hair a medium length and anticipated that he would never choose to wear his hair short.