Marco of San Francisco is a renowned professional hairstylist, who currently makes “hair-cutting house calls” by appointment only, and is the author of the book, It’ll Grow Back: How To Communicate With Your Hairstylist Before It’s Too Late. He graduated from Wilfred Academy Beauty School in 1965 and from Robert Fiance Advanced Hairstyling in 1966. He has worked on the East Coast and in Los Angeles, where he was associated with the Jon Peters and She and He salons. Marco’s clients have included business executives, Hollywood actors and actresses, and rock stars. He opened his own salon, The Galerie, in San Francisco in 1981. Marco’s style is to cut hair so that people look good, not so that haircuts look good.
Like many men, Marco began losing his hair. The thinning was hardly noticeable at first, but after several years went by his condition became increasingly difficult to hide, especially from himself. A few years after that Marco’s hair loss began to affect his self-image, and his business. Finally, in May 2000, Marco decided to do something about his own hair loss.
This is Marco’s story, told in his own words:
Finally Facing the Truth
It’s 3 a.m.
The TV had been turned off, the computer shut down, and even the crickets were quietly sleeping. In the cozy dark of the night, the children gently stirred in happy dreams, and the dog and cat snoozed side by side.
Gentle smiles graced every sleeping face in the world. Everyone, that is, except me.
From deep, deep down in the downstairs bathroom, a faint but ominous light hinted that all was not well behind the tightly locked door. A long, low muffled moan from within betrayed my deepest fears:
It wasn’t supposed to be like this. Here I was, a grown adult man staring in the mirror at three in the morning when I should have been sound asleep, resting calmly for my busy day to come. Up until now, I had actually managed to forget all about my problem—forget and go on just like nothing was wrong. That was until a few weeks ago, at the airport, picking up my five-year-old daughter from a visit to her grandparents. As I bent down to grab her pink suitcase off the crowded carousel I heard the fateful words that rang in my ears ever since:
“That’s my dad! The bald guy!”
The bald guy! The bald guy! My own daughter, for goodness sakes! Hadn’t I been a good father? Hadn’t I taken her to Disneyland this spring? What unspeakable deed had I done to deserve such demeaning abuse—in public? I would accept any lack of fatherly devotion as an explanation for my daughter’s totally inappropriate and disrespectful comment rather than—rather than the truth.
And then there was last week at that party…. Hey, I may have moved into the successful, married-with-child two-car family set, but I will always be hip. I was hip when I was fourteen playing the sexy, seductive lover in the high school production of “Bye Bye Birdie.” I was hip and young and single, living in the 70s. And I still know how to keep a party moving, serving exactly the right wine, telling the funniest jokes, just being me. But last week I could have exited a party by way of the balcony when I heard those words again. Two young women were having a conversation, and I distinctly overheard one remark: “But he is so cute for a balding guy!”
Please, not you too! What had I done to deserve such treatment? The bald guy! Was it a bad year for the merlot? Did I say something to offend you? It had to be some mistake!
You see: the bald guy was someone else. Someone who wore orange and turquoise plaid suits and had glasses as thick as crystal balls held up with masking tape.
Back in the downstairs bathroom, I begged; “Please, mirror, please,” as I angled my wife’s compact to get a clear view of the back of my head in the bathroom sink mirror, “say it ain’t so!”
But the wicked mirror only confirmed my worst fears—a shiny, expanding patch of flesh at the top of my head was devouring my remaining hair like an intergalactic blob of plasmic goo. It looked like I was wearing a skin-tight yarmulke made of orange Mylar. I, the legendary hair stylist, the renowned Marco of San Francisco who lived, breathed and ate hair, was indeed going bald! I, who had combed, cut, permed, tinted and styled world leaders and rock stars, was losing my greatest natural asset. And what was worse, the baldness pattern my head displayed was distorting my features in a very, very unflattering way.
It’s Your Head
Actually, some people can do “bald” quite well. Take, for example, the gentleman in the top hat, the astronaut with the shaved skull, or the artist with the beret and goatee. These men not only look OK without hair, they actually look their best in a bare head.
How you wear your hair really does affect your features, both from the front (what you see in the mirror), and from the side and back (what everybody else sees). And, because your features are unique, it is important to wear your hair in a way that complements your features in a flattering way. That is why, while many cuts may seem attractive, they are actually not designed for every face. For example, misjudged bangs can turn a woman with a slightly angular head into a square-jawed quarterback for the Oakland Raiders.
Over years of styling hair, I developed quite a science for determining how hair affects various features. How, for example, the perception of the shape and size of your head is directly determined by hairstyle. You can buy the most expensive, trendy cut in town, but if it short-changes your natural curves and angles, you are likely to look awkward.
And just like a crew cut, a ponytail or sideburns, bald dramatically affects your features, for better or for worse. In my case, and that of many men, bald definitely affected us for the worse. Balding caused my oval face to elongate into an oblong head—the face I had counted on my entire life left and was replaced by this stranger sitting on my shoulders.
The image I have for myself is smart, sexy, confident and successful. In fact, the self-confidence I need to project is so great that it affects my audience—from an auditorium full of colleagues at a conference, to a one-on-one with a new client—so that they feel comfortable and secure with my abilities. As a hair stylist myself, I need to inspire my clients by showing them that I have the wherewithal to overcome hair loss and project a look that demonstrates that I really know my business.
Bald just did not fit my personality, period. It did not fit my body. It did not fit my career. So on many nights I found myself locked in the downstairs bathroom asking God, “Why me? Why did you give me this unwanted permanent haircut? I don’t remember asking you for a style suggestion.”
It didn’t fit, it had no mercy, and I didn’t want it.
You Don’t Have to Be Bald!
The answer was really terribly, terribly simple. There have been huge advances in hair loss treatment in recent years, and hair transplant surgery delivers the greatest promise of them all:
With hair transplant surgery you will be able to once again grow and maintain your own hair, growing out of your own head. Your hair loss will be a forgotten thing of the past.
Aaaah, it sounds like the promise that is too good to be true. But how does one find out for himself before committing to an expensive and life-altering treatment? Researching the hair-transplant field is a lot trickier than researching the new car market, and that’s exactly what I’ve been doing for the last five years. As a professional stylist and as a man suffering from hair loss, I’ve met with just about every hair-transplant specialist on the West Coast. I want to know how these doctors approach their clients, the surgical procedures and, most of all, the results.
Well the truth is that as a professional stylist I see hundreds of men and cut their hair. I’ve seen some really bad transplant jobs out there. Do you know what happens when you get the wrong job? It can look like trees are sprouting all over your head. In the past, some surgeons grafted those little follicles in ten or twelve at a time, the same way those hairs are grouped on the head of my daughter’s Barbie dolls. Instead of a nice wavy head of corn silk, you end up with dreadful little clumps bursting up in a crosshatched pattern all over your skull.
And even worse, in some cases those follicles can die after transplantation. If you thought anything could be worse than going bald, imagine your own head covered with little scars, looking like tracks. It looks like a truck ran over your poor, already-bald head.
With a shudder, I considered how intimate I would become with my mirror and our 3 a.m. talks, if there were no an alternative to the potential Frankenstein-effect of the hair-transplant.
But bad hair transplants are now pretty rare. I see a lot more excellent hair transplant jobs. Some transplants make guys look phenomenal! Not only is it impossible to detect the grafts, but the shape, the style, the thickness is just right for them, and blends perfectly into their natural hair and features. These guys have gotten back the original shape of their heads, and the full, natural, free feeling of their own hair.
What these guys have that I want is follicular unit micrografts. Follicular unit micrograft hair-transplantation is an art by which naturally-occurring clusters of hair follicles are carefully seeded into your scalp so that their thickness, direction and shape precisely mimics your own natural hair. I did my research, and I selected Dr. Peter Panagotacos to do my hair.
Dr. Panagotacos had performed tens of thousands of successful micrograft transplants, transforming men all over the world from that bald guy into that successful leader, artist, father, teacher, actor, sexy, happy, confident guy.
Within a couple of weeks, I could make an appointment, have the surgery, and walk into life with the confidence and stature of a man who has been given a new lease on life. No problem, right?
But Did You Consider
How long has it been since you’ve had a full head of hair? For me it’s been about ten solid years since I gave in to the fact that my hair loss was inevitable—but a good fifteen or twenty years if you count the denial associated with gradual thinning. As a stylist I know that for most men undergoing a hair transplant, it’s been as many as twenty years since you’ve given up on the mousse, donated the bristle-brush to the dog, and taken to washing your remaining fuzz with Soft-soap, hot water or toothpaste. The last real haircut you bothered to get was for a Grateful Dead concert, and even then you spent most of the show envying the hair on some of those aging musicians.
Your life, your career and your schedule are probably fundamentally different than they were twenty years ago. First, you are going to have to consider how to take care of your new hair. Remember that aisle at the supermarket with shampoo and brushes and all kinds of gels and mousse? Well, you’re not only going to have to purchase the appropriate products for your hair, but you’re also going to have to relearn how to use them.
“Easy,” you say? Well, just consider how much time you took in your twenties to blow-dry and style your hair every day. An hour? And that little comb sticking out of your back pocket that came out every time a girl walked by, or every time you passed a mirror? Where did you get all that time? How will you fit your hair care into your Palm Pilot?
And you are going to have to decide what your new head of hair is going to look like. What was that style you wore to the Grateful Dead or to the disco? Would it be appropriate for the boardroom? Client meetings? Presentations? Do you simply want to display your ability to outwit Mother Nature, or do you have an inner cool—a personal confidence—you want to awaken and leverage with your new hair? For the past fifteen years or so, the wicked fates have controlled your look, but now you can be back in the driver’s seat. Which features are you going to accentuate? Which ones will you soften? What is the combination that spells success for your personal vision?
Once again, a professional hair stylist is going to be a key player in your life. And to help you move forward and express a look that enhances your vision, it is crucial to create your new style from a set of criteria that includes your daily schedule, career and goals, as well as the physical construction of your face. As a professional hair stylist I firmly believe that your hair care professional should be your partner in creating the look that’s right for you. However, since not all stylists take that approach, you are going to need a set of communication tools to ensure that you get your message across and end up getting the most from your new hair.
As I looked in the mirror, I was convinced that the new me would be sexy rather than conservative, carry the attitude of a seasoned professional, and give me the confidence to perform better. My face will not be framed by baldness, or by the carefree hair of a twenty-year-old, but by the mature, commanding head of hair I was meant to have at this point in my life. Look out life! Marco of San Francisco shall reign again!
Going from Bald to Bold
I heaved a sigh of relief. The quest was at its end. Or so I thought. A successful transplant process is really much, much more than just checking in and out of a doctor’s office for surgery, and then driving off in your convertible. Undergoing the consultations, surgery, and waking up to the possibilities of a new head of hair is a complex conversation you need to have with yourself, your hair-transplant doctor, and your stylist. Using myself as a guinea pig, I am going to give you a first-hand account in the following pages of just what to expect, what to watch out for and plan for as you go from bald to bold.
First there is the interview. How are you going to communicate your vision to the doctor? This isn’t a haircut where you can afford to take a chance, and then re-do it three months later if it didn’t work out. And how comfortable would the doctor make me? What could I do to prepare? Certainly not belting back a stiff drink. That one-hour interview would really affect how I looked for the rest of my life.
Then there is the operation itself. I’ve heard it’s not all that bad, but I just don’t like hospitals or doctor’s offices, or the idea of wearing a surgical mask on the top of my head. What would I do to keep the anticipation from dominating the rest of my life?
And as the new hair grows in, would it be like spring flowers, where every day there is a bit more difference, more growth? Would I find myself staring at my new hair for hours in the bathroom mirror at 3:00 a.m., but unwilling to let anyone else see? They say that after a week you can’t even tell the difference any more, but when would I be satisfied?
And what about “The Big Day?” How would my family react? My colleagues? Would I blush when I went in to work, would people know? Would curious children want to run their fingers through it in fascination? How about sexy women? How about my wife?
The road ahead is long, and it’s very important that I make the right decisions at each step of the way, but now I have a vision. A vision of my personal successes, of my daughter being proud of her good-looking dad, of no more 3:00 a.m. talks with the mirror, and of a confident, sexy, younger looking me.
The Results are In!
I lay in bed and drowsily smiled. The world blurred in and out of existence as the effects of Dr. Panagotacos’ three-pill ‘cocktail’ gradually began to recede. Not six hours ago I had been on the operating table with Dr. Panagotacos and three more-than-capable nurses having the back of my head cut and all the hairs therein—3,800 of them—transplanted on the top of my head. Wow, I’d finally done it, after all these years of telling myself I could. “You see, God,” I thought, “I always knew there would be a way. And now, I have just one thing to ask. And that is—Did I have won-ton today?”
Just how strong was that so-called “cocktail”? Where was the merciless scalp pain I had received so many warnings about? Shouldn’t I be running back and forth to the bathroom to count each individual new hair, charting its hour-to-hour growth progress?
Truth be known, long after that little cocktail had worn off, my memory of the day long surgery revolved around the question of whether or not I had hallucinated eating a really yummy bowl of Chinese soup with Dr. Panagotacos—smack dab in the middle of my hair transplant surgery.
Not that hair transplant surgery is quite as easy as eating a bowl of soup. For example, the night before my operation, I had a lot more than the next day’s lunch on my mind.
The butterflies started in my stomach the night before. We’ve all had butterflies before a trip to the doctor, and some of us before a trip to the barber, but the night-before-the-hair-transplant butterflies are unique. They are every kind of butterfly you’ve ever had combined. Not only would my outward appearance be irreversibly altered; not only was the transplant the culmination of years of research and personal visioning: but some people I had been talking to had suggested that a hair transplant might involve PAIN.
About friends who want to tell you all kinds of stories about transplants and pain—don’t listen to ‘em. I sure wish I hadn’t. There are lots of folks out there who will tell you all kinds of crazy things about post-transplant pain—everything from itchiness to blood squirting out of the tops of their heads. If you try hard enough, you’ll find someone with just the right horror story to send you into nightmares for weeks before your transplant. I don’t know if these so-called friends are some new breed of super-wimps or if they just drum up these tales to watch you squirm, but take it from me—you don’t need the advice. You’re going to be just fine.
The actual process of having a transplant is one of the most relaxed, worry-free, painless stages of life’s hair experience. It’s done on-site in a doctor’s office and usually takes about six to eight hours—you come in at 8:00 a.m., and by 4:00 p.m. you’re on your way home. It’s like going to work, but instead of sitting at an ergonomically unsound desk worrying about next quarter’s figures, you spend the day on a special surgical chair, stoned out of your mind, surrounded by great-looking nurses.
“Good morning, Marco,” the nurses said, when I walked into Dr. Panagotacos’ office on that Monday morning in May. I thought they were going to ask me whether I’d prefer merlot or Chablis. By the time Dr. Panagotacos sat down with me, I was starting to feel pretty comfortable. They asked me some standard questions, showed me some pictures, made a few jokes and then the process got under way. First, they gave me a three-pill “cocktail.” Now I’m not saying what’s in that cocktail, nor am I even sure I fully know myself, but when that kicked in, every bit of remaining fear vanished. They could have cut my foot off and I wouldn’t care.
“Ahoy there, Doctor!” I thundered, “I reckon I’ll swim over to that table about now!”
“So you’re ready to begin the hair transplant, Marco?” the nearest nurse inquired.
“Nurse,” I said, “I’m going scuba diving, and I wonder if you’d come with me to my kingdom under the sea?”
At this point I’d like to note that while the operation itself is completely painless, men may experience considerable pain if their wives ever hear what they said while under the influence of “the cocktail.” In my own defense, I didn’t even recognize the nurse I had propositioned the next time I walked into the office.
The nurse then proceeded to completely numb the back of my scalp with the same kind of injections a dentist uses. Under the influence of “the cocktail” all I felt was the lightest pressure—maybe as if I had on a hat that was one size too tight.
The next part of the operation requires the removal of the donor hairs, which is an inch wide strip of scalp. The doctor removes the strip from the hair-rich region on the back of your head where you’ll never miss it. It’s from that strip of scalp that the hairs are extracted for transplanting into your cap. The skin is quickly stitched back together while the nurses begin working vigorously under the microscopes to remove individual follicular units for transplant.
When people talk about “pain,” the donor area is usually the part of the procedure they are referring to. In my case, and in most cases, there will be a slight feeling of tightness or maybe an itching feeling for about a week where the skin is stitched back together. This very superficial discomfort entirely disappeared the second the nurses took the stitches out a week after the surgery. The scar, if noticeable at all, is and unobtrusive fine line, and completely hidden by your natural hair.
As the nurses removed the 3,800 or so hairs from the extracted skin and turn them into little follicular unit grafts, Dr. Panagotacos expertly placed them up on my top. The mark of an expert is in the subtle attention to detail, and Dr. Panagotacos definitely lived up to my expectations. First, those grafts were individually placed, avoiding the “hair-forest effect”.
Second, they were placed in a shape that was carefully created to mimic a natural hairline for a man my age, rather than the hairline of a teenager (although I admit I’d still like to see what I’d look like with the hairline of my early twenties).
Third, and in my opinion the most impressive, the individual grafts were placed at angles to mimic natural cowlicks, waves and parts. That means that instead of 3,800 hairs growing pell-mell out the top of my head like a punk rock zombie, my hair will have shape and character, just like the natural hair we are born with.
Although I’m sure I had an incredible won-ton meal somewhere during that procedure, the next thing I remembered was that beautiful and tolerant nurse gently shaking me awake. I guess I dozed off during surgery. Without moving, I opened my left eye and carefully looked about for any lingering pain that might have been waiting at the threshold of consciousness, but none was there. So I opened both eyes and put my feet on the ground. To my relief, I felt no pain. Nothing but the receding silliness of the remaining pills.
“Dangkoo, Dott-or,” I attempted groggily. “Dat wuzzent too bad.”
“Thank YOU, Marco,” the staff proudly trilled. “You make sure and get some rest…”
“Wazabbout da won-ton?” I asked, flashing on a memory of the delicious mystery meal.
“Oh—so long to you, too!”
And then, in the passenger seat of my friend’s BMW, I was headed home in rush hour traffic, to begin a new life. I chuckled when, in the rear-view mirror, I caught a glimpse of the peach fuzz growing out of the top of my head in a style that was pleasantly similar to the buzz cuts that Tony the Barber used to give me in New Jersey when I was eight or nine.
When you get home from your transplant, make sure you come home to exactly the environment in which you need to recover. For me that meant sending my daughter over to her friend’s for the night, and stocking the refrigerator with pasta, chicken soup and a variety of foods I’d prepared in advance. I rented twenty-four hours worth of the latest releases at the local video store, and bought two gallons of coffee ice cream with walnuts. Dr. Panagotacos had given me another “pill cocktail” to get me through the night, along with about eight pain pills to subdue any residual discomfort. My wife Janet had to work late, so the house was completely empty, leaving me nothing to do but take another “pill cocktail” and sleep it off.
That bed felt like the mist of heaven as I smiled myself into a deep, healing sleep.
Later on, when Janet did come in I was barely able to move my eyelids.
“Oh Marco,” she breathed softly, “You’ve done it! You’ve finally realized your dream and conquered your hair loss. You must feel wonderful!” “Wuzzza wuzza won-ton?” I mumbled.
Over the next few weeks I made some of the most profound discoveries about the hair growth process of my entire career as a stylist. Life returned more or less to normal over the next few days. My daughter came home, I returned the videos, got tired of pizza for every meal, and resumed everyday life. Two days after the procedure I returned to light duty as a stylist, performing cuts. Although I had eight pain pills in the medicine cabinet I never felt the need to take any of them (although every single client to whom I mentioned the pills made a ploy, an offer, or a plea for even one of the happy capsules). For me the pain had been greatly overestimated, and in hindsight seemed almost like a trivial worry.
The most important thing to remember during that first week is to keep using the antibiotic ointment they give you. There are no reasons for taking any chances with that new crop of hair of yours, so grease yourself up like a championship engine and you’ll be all right.
Dr. Panagotacos believes in providing those new little hairs with plenty of fertilizer. Fertilizer for your head is called Rogaine. Right after those stitches come out, you start spraying it on. Rogaine is credited with growing hair on totally barren heads, so imagine what it can do for those 3,800 or so new seedlings. Another supplement Dr. Panagotacos recommends is Propecia. Propecia is a drug that prevents hair loss, and after the stitches are out, one tablet a day helps you keep the hair you have.
In addition to the antibiotic ointment, the Rogaine, and the Propecia, I also bought a beret in case the new hair grew in funny. But it didn’t grow in funny at all. What a hair transplant does that isn’t so funny, is that it all falls out after the first few weeks. It takes four to six months for the transplanted hair follicles to begin to grow new hairs on a permanent basis.
A week after I had the transplant, friends doubted whether I had undergone the procedure at all. I couldn’t blame them either—all the grafts had healed so well, and the scar at the back of my neck had fused so quickly that there was no physical evidence that I had ever been to Dr. Panagotacos and had a transplant.
Well, anything worthwhile is worth waiting for, and at that point I’d been bald or balding for almost two decades so a few more months seemed reasonable, considering the payoff at the end. I donated the beret to my daughter—she, in turn, placed the thing on her pet stuffed elephant.
What To Expect
Four to six months of just being me. Just being plain old Marco Schatzman with a shiny flesh-colored yarmulke on top of my head. No immediate gratification, no super powers.
Which brings me to the most important point of this chapter. A hair transplant is a cosmetic change, and the appearance of new growth on your head is not automatically going to make you a better person or solve any other problems.
As I began the long four to six month wait for the new hair to emerge, I became more and more certain that while a new “look” was developing beneath my scalp, what I did with that hair was going to be entirely up to me. Nothing is more critical to a successful hair transplant than the patient being very clear on his vision of personal success, and how hair will help him achieve that.
In my line of business, first impressions are very important, and I did not like presenting myself to the world as a bald person. When I would meet a new client or associate, I always had the feeling that I would have communicated better, had more confidence, and been less distracted, if it weren’t for the lingering feeling that I did not look the best I possibly could.
What could 3,800 hairs do that I couldn’t do on my own? When you are feeling good—when you know you’ve got nothing to worry about—people around you can’t help but be affected by your positive attitude. When I’m with someone, whether a client or a friend, I want to be one hundred percent there. With the bald spot, I’d find myself getting distracted thinking that I wasn’t looking my best. But now without those worries, I am going to radiate the kind of confidence that will have everyone in the room feeling upbeat. People might never know what changed about Marco (although I’d find no discomfort telling them all about my transplants), but they definitely were going to be totally jazzed about me. They were going to be turned on to me because I was turned on to me. Although I hate to say it, what with my work, my daughter’s various lessons, and my wife’s kind of nutty schedule, I’d all but forgotten about my transplant over the summer. Two months after the procedure, the first little sprouts started peeking out from my scalp. Every day I felt growth on the top of my head—rapid growth. It was like one of those movies where they speed up time and you get to watch a flower grow and bloom in a matter of minutes. I kept putting my hand up to my head to see what had landed there. The final results will be in by November when I will be celebrating my fifty-second birthday—the first hairy birthday in almost fifteen years of tucking, folding and compensating to cover that bald spot.
A good surgeon knows you can add hair to a bald area with transplants, but it’s difficult to remove it later without visible scars. For that reason, it’s best not to get hair transplanted unnaturally low on your forehead (like you had it as a teenager). Remember, your new hair will have to work for you in the boardroom, at presentations, as well as in social settings.
Dr. Panagotacos gave me the hairline of a forty to fifty-year-old man, off the forehead and with a slight peak at the center. I think that’s a pretty good look for a CEO, but I decided I’m going to have him lower my hairline to the thirty-five-year-old mark next time I go in. In any case, I was glad to have the option to go further, guided by the expert opinion of Dr. Panagotacos regarding the hairline that would be appropriate for me.
In the meantime, thoughts about my hair turned to how I would style it, how my face would look as a soft, pleasing oval, and how happy I would be to shave off the compensating beard that had adorned my face ever since I had admitted defeat many years ago.
I picked up the phone and called Dr. Panagotacos to discuss the next chapter of my hair growth.
He asked if there was any pain? “No,” I replied.
I told him they all fell out a few weeks after the procedure. “Right on time!” he chuckled.
And then I asked him the question that had really been on my mind. “Dr. Panagotacos,” I started, “I have this, uh, memory, and I’m not sure if it was real or a hallucination. But I have the strangest feeling that, well, in the middle of the surgery you and I were having won-ton soup.”
Apparently we were. “I always order lunch for my patients,” Dr. Panagotacos replied. “Nourishment is very important during a transplant.”