Story of Jake Gerkalm. Written by Omar F. Najjarine. Note: This article contains images of a surgical procedure being performed.
I was always told I had masculine features. Not to sound vain, but I was always proud of my fit and rugged look. I loved my jawline, nose, eyebrows and the general symmetry of my face. All of this began to change, however, when I began to notice hairline recession at 25. At first I thought I was having a bad week or a bad month caused by poor sleeping habits and unhealthy eating choices. I also had heard that temporary hair loss can be caused from stress. But as the months went by and the hairs around my widows peak began to shrink and fall out in ever growing numbers, I knew further hair loss was inevitable.
My new receding hairline began to really take shape at around the age of 27 and I was devastated. I could no longer hide the fact with comb overs and styling tricks. After my morning showers, I’d catch myself staring at the profile in the mirror with uncomfortable consternation. Whenever I’d meet someone new, I’d fidget sideways or tilt my head upwards so they couldn’t glimpse the full extent of my hair loss. On my 29th birthday, after two years of living like a shell of my old self, I began researching hair transplantation.
I had recently moved to Southern California for work and began to look up hair transplant clinics in the area. I met with Amir Yazdan, a well-known hair transplant surgeon in Orange County, and immediately felt listed-to and understood. I respected his delicate, conservative approach and appreciated how he spent real time listening to my story and making sure I felt comfortable and properly educated. As Amir explained the basics of the procedure, we began to discuss personal goals and reasonable expectations. He was extremely honest and transparent about what could and could not be done, and what could be done was aesthetically transformative and most importantly, permanent.
Once I firmly made the decision to move ahead with the hair transplant surgery, I told my family. When I told my father the news, he revealed for the first time that he also experienced crippling confidence issues in his late 20s when he began to experience hair loss. He admired my determination and willingness to go through with the procedure and I thanked him for sharing his piece of emotional history with me.
The Consultation
My consultation with Dr. Yazdan set me at ease. We started out talking casually about my hairline – what I liked and disliked about it, any relevant medical concerns, and other usual questions. Then he did an evaluation to see if I’d be a good candidate for a hair transplantation. He conducted clinical tests and analyses to see if I suffered from pattern baldness. He examined the quantity and condition of my donor hair, to see if my healthy hair follicles could be successfully transplanted – they were as strong as they could be.
Then he took a bunch of pictures from different angles and stepped out to review them. A few minutes later, we sat down in his office to go over the images. He showed me three distinct perspectives: front, profile, and from behind. With each photo, he presented a revised image of what my hairline could look like after the procedure – and, wow, what a rush of happiness! It was honestly everything I was hoping for: fuller, wider and thicker.
Dr. Yazdan then laid out his surgical plan for me: He’d perform a follicular unit extraction, or FUE, removing hair follicles one-by-one from the back of my head (called the donor site), as these were the strongest and most DHT-resistant strands, before transplanting each hair into the thinning areas of my scalp. The other surgical option is called follicular unit transplantation (FUT) or the strip method. With the FUT procedure a thin strip of scalp is removed from the back of the head containing those earlier mentioned DHT-resistant follicles. These follicles are then transplanted hair-by-hair into the balding area. This method leaves a very fine linear scar at the back of the head which may be rendered non-visible once the hair grows back.
Dr. Yazdan told me he often prefers the FUE method over the FUT or strip method because the former leaves no visible scar and can result in a finer and more natural-looking hairline.
I began to get excited and wrongly assumed that he could recreate the hairline I had when I was 18 or 22. If it was only a matter of picking hairs from the non-balding parts of my head – for which there was plenty – and placing them into the balding areas, I believed a complete density restoration was possible. Dr. Yazdan corrected my error by informing me that quantity and donor strength is only a part of the solution – I needed to consider future thinning and a conservative, mature-looking hairline. A hairline ‘stuffed’ with news hairs with no regard for angle growth, design and future thinning will look catastrophic.
Before I left his office, Dr. Yazdan took me through some before-and-after shots of some of his hair transplant patients. Many of them had hairlines similar to mine, and their “after” pictures were much like the ones Dr. Yazdan had generated for me. He told me that of all the hair transplants he’d done in his career, not once did he have to return to a patient for a second procedure due to flawed execution or poor design. That clinched it for me: I knew I was in good hands and that my hairline would look sharp and handsome, but not ‘overdone’.
Once we set a date for surgery, Dr. Yazdan advised me to stop any blood thinners and cease all alcohol consumption. There would be very minimal swelling and bruising, he said, and most patients resume normal activity in a day or two. After three months, I’d begin to see my new hair, but the majority of my new hairline wouldn’t be in full bloom until month eight or nine.
The Surgery
The morning of surgery, I was definitely feeling nervous, as the anticipation and buildup of the prior weeks had gotten me pretty anxious. I was mostly nervous about getting everything together and making sure I was as prepared as possible for the recovery and the acceptance of my new self. My biggest worry was not being able to go back. Am I rejecting the real me by going through with a new hairline? How would I look and feel? How would others react to seeing me? Do I really need this? Is this actually going to make me happier and more self-confident?
I took a few deep breaths and remembered everything – all of the anguish and self-loathing at my loss of confidence, my draining masculinity, all of it. I knew if I decided, last minute, to pull the plug on the operation, I’d regret it, because I’d still be unhappy with my hairline – and that realization outweighed all of my fears.
I was on my way to the doctor’s office. After a few final checks, Dr. Yazdan took some more pictures, marked my head with light indicators and told me to lay down in the chair as the procedure was about to commence.
He began applying the anesthesia and in a few minutes the procedure was underway. I felt Dr. Yazdan extracting the follicles from my donor zone, one at a time, in a highly meticulous and systematic fashion. The longer the extracted grafts remain outside the scalp, the greater likelihood of its being damaged or ruined, so quick processing time is essential. To ensure 100% graft survival rate, Dr. Yazdan had a dedicated team of 3-5 assistants to quickly process every extracted graft. Within two hours the extraction was complete, and it was on to the next phase. Dr. Yazdan began preparing apertures for the extracted grafts to be implanted into the recipient zone. Like clockwork, the same meticulous process occurred during graft implantation. I was amazed at how little bleeding occurred during all of this.
The Recovery
When I got home that afternoon, I felt completely fine physically and mentally. With a fully wrapped and bandaged head I needed to exert very little energy and generally take it easy. I talked with my brothers for a bit and watched some TV, then I took a short nap. The procedure had taken a total of six hours and I needed to recharge my batteries after such an intense day. Post-op recovery instructions were plain and simple according to Dr. Yazdan. Do not scratch or pick at your scalp and wait a full 48 hours before showering. The same instructions given to me pre-op applied post-op with regard to alcohol and blood-thinners – stay away from them.
With each passing day, I felt more and more excited. My surgery was on a Monday, and by Wednesday afternoon I was back to work interacting with coworkers and writing emails. On Friday night, I went to see a movie, and it felt so exciting to be out with my transformed look. Even though no new hair was growing, the comfort of knowing that it was there was indescribable joy.
Three Months Post-Procedure
I see my new hairline growing in, if ever so slightly, and I’m so grateful and happy. I think about the days when one glance in the mirror would turn into an entire internal monologue berating the passage of time and the follicular genes I was so ashamed of. The days when I would simply try to survive a night out without dates or friends who would stare at my patchy and balding hairline.
This experience has been life-changing. My new hairline is absolute perfection, and I haven’t experienced a tinge of regret. I’ve felt so completely taken care of by Dr. Yazdan and his team, and have received so much support from my friends and family. My father and brother continue to ask for before and after pictures, as they can’t believe the transformation I’ve underwent.
When you’re in the thick of waiting for your new hair to come in, it seems like you’re going to look and feel that way forever. But honestly, I moved through it so quickly. Each day that went by, I looked considerably different from the day before, which is strange – you really can’t get too attached to any one image in the mirror because you know it’s still evolving.
Before surgery, friends and family would say they didn’t see anything wrong with my hairline, but to have something that’s so personal and integral to you feel so wrong, it’s exhausting and disheartening. Today I not only feel more confident and handsome, but also much more comfortable in my own skin, and that is truly priceless.
Dr. Amir Yazdan, MD, is an internationally renowned hair transplant surgeon, expert guest on Dr. Phil and The Doctors, creator of the GroMD hair restoration product line, ISHRS member, accredited member of the IAHRS and a visceral advocate for patient care. Learn more about Dr. Yazdan or read rave reviews from his patients.
A question that comes up often is whether or not hair color plays a role in things like density, thickness, and eventually, hair loss.
Many men who experience hair loss experience it in the form of a receding hair line. A receding hair line is when the front hair line loses hair over time causing the hair line to appear as if it’s being pushed back. This also gives the appearance of a larger forehead.
