Dr. Rassman,

What is your opinion on using products such as Toppik to enhance a hair transplant on a Norwood 6 or 7 patient who cannot achieve full coverage? Obviously the need to use a product like Toppik long-term may not be ideal, but for a man whose hair loss is too extensive to achieve full coverage from donor hair, a keratin hair-binding product combined with a hair transplant may be the most effective and natural looking solution for a lot of men with extensive balding.

A bald Norwood class 6 or 7 patient does not do well with a concealer like Toppik, which works better with some hair. Many men who use this product without hair in the bald area will actually show the Toppik itself, which is often irregular in the way it is put down. If used to enhance a hair transplant that is not thick enough, it might work if it can be applied so that the Toppik can not be detected. The keratin hair granular product has significant disadvantages, as it can come off on your clothes, your sheets and pillows, and when someone runs their fingers through your hair.

There is another treatment which is a permanent concealer that can thicken up a hair transplant look — Scalp MicroPigmentation (SMP). If you look at the SMP site, you will see examples of this type of concealer and most of these patients (who have hair that is just not thick enough) can avoid another hair transplant with the SMP alone. We have successfully used this SMP technique to address individuals whose balding patterns are too large and the transplants too few to get the coverage they want.

As everyone is different, I would suggest that you request a virtual consultation with me and send photographs in good lighting so that I can understand your problem as you see it. Also, please include a phone number.

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