Thank you for your question. You are asking how good are FUT results without taking Propecia
and you’ve asked a series of typical questions that people ask regarding hair transplant
surgery. You state that you are 31-years-old, you are a Norwood 6 which is fairly advanced
and you are asking about how many grafts you need for fullness. What would be the possible
necessities for a second transplant, would you keep losing hair afterwards and of course
would Toppik or hair fibers be problematic after surgery.
Well, I can certainly give you a lot of with this question as this is a typical question
we deal in our practice every day. I’m a Board-certified cosmetic surgeon and Fellowship-trained
oculofacial plastic and reconstructive surgeon practicing in Manhattan and Long Island for
over 20 years. I perform hair transplant surgery and I am also the founder of TrichoStem™
Hair Regeneration Centers. We developed in our practice a method of using an injection
to stop the progression of hair loss for both men and women with genetic pattern hair thinning
as well as reactivate hair and improve the appearance without surgery. So to begin with
your question about what would happen in terms of the progression of your hair loss, I think
it is self explanatory. You are 31 years old and you are already in Norwood 6, your hair
looks fairly thin and it is inevitable that you will continue to progress.
There is a general rule of thumb when we talk about hair loss incidents. Men in their 20’s,
20% are affected by hair loss, men in the 30’s, 30%. So when you think about your
relative minority in terms of your relative advanced level of hair loss, so you had an
early onset and relative rapid progression. When it comes to transplantation surgery,
when we perform surgery, we estimate numbers of grafts. But when it gets down to it, you
are limited by the actual available grafts in the donor area. Typically a younger man
with advanced hair loss tends to not have that strong of a donor area. And when I say
that, I mean the hair tends to be relatively thin, tends to have relatively low density
which means that when you think about the individual hair follicle or hair strand, if
it is thin, hair covers less scalp than a thick hair.
What I tell my patients before transplant that if we are going to do FUT or otherwise
known as a strip method, I’m going to take out the widest strip I can that can allow
for good closure and will give me as many hairs as I can possibly get for a transplant.
Why do I do that? Well because invariably people do need more than 1 transplant and
we don’t want to put stress on the closure of this scalp in the donor area and diminish
or compromise the variability of hairs that can be used in the future.
As far as the progression is concerned, I would say that before doing a transplant,
you want to do something to stop progression and this is where I can help you understand
what we do in our practice for people like yourself. The first thing I would recommend,
if you can’t take or won’t take finasteride and you are in good company. I would say the
vast majority of men who come into our practice and people come to us from all over the world
for Hair Regeneration treatment will not take finasteride or can’t take finasteride because
they took it and had side-effects. What I would say is Hair Regeneration would stop
the progression of your hair thinning, will reactivate hairs that are not growing which
is part of the characteristics of male pattern hair loss and as well as allow thinning hairs
to shed so that thicker hairs will grow in.
Stabilization is critical. Maximization of your existing hair or maximizing the quality,
the volume, the coverage of your existing hair is critical before considering transplantation.
Once that has been established, it is not unusual to then consider maybe doing another
injection. We often, in people who have advanced hair loss, will do a second injection around
15-18 months depending on how they look and we can then finally feel like we’ve used
every hair follicle we can to get the best result we can non-surgically and more importantly
to stop the progression. When we look at our results even with just thinning hair, we have
been able to get better coverage with a non-surgical treatment than we can than transplantation
particularly with men who have existing thinning hair. And why is that?
Well, one of the harsh realities of hair transplantation in someone who has existing hair is that there
is this collateral loss of existing hair because of the trauma of making sites. When people
say that I’m getting 1500 grafts, 2000 grafts, what are we saying? You are getting 1500,
2000 holes made in the scalp and what is the problem with that? Well, unfortunately existing
hair will be lost. A certain percentage of native hair gets lost with hair transplant.
Where is the exception? It is someone who has smooth bald skin. So what I’ve been
able to help people with is take their existing thinning hairs and making it thicker to the
point where they get better coverage. And with their existing hairs, they don’t have
to have surgical placement of hairs and they don’t have to lose existing hairs in compromise
for transplantation and it is something that is understated in hair transplant because
unfortunately, it is the reality and the limitation. Before we developed Hair Regeneration, we
accepted this as part of the reality and it always made sense even if you lost thinning
hair, it was going to go anyway. We are not going to replace it now with more thicker
and permanent hair. Now with Hair Regeneration, we have a different perspective.
So learn more about your options and learn about what your limitations are with hair
transplant. Think stabilization before you think transplantation. It is critically important
otherwise you find yourself a little bit older and you continue to lose hair and your grafted
hair will not look so good. We’ve seen many people like that and unfortunately their hair
went away too fast for their grafts to make enough impact for them to enjoy the benefit
of transplantation and it is the harsh reality of people who have thin hairs, early onset
and rapid progression. So make your decision from and informed state of knowledge before
you move forward with surgery.
So I hope that was helpful, I wish you the best of luck and thank you for your question!