Thank you for your question.
You submitted some photos, and you're asking about how many grafts you need to fill in
the temple area.
You stated in your question that you know you'll lose more hair, but you just want to
know how many grafts you need to fill in the temple area.
Well I can certainly help you with this.
I’m a Board-certified cosmetic surgeon.
I've been practicing hair transplant for over 20 years, and I'm also the founder of Trichostem
Hair Regeneration centers, which is a non-surgical solution for hair loss, which I will discuss
in the context of your question.
Now, it's very good that you at least realize that your hair loss will continue, and when
you start asking the questions about the numbers of graphs, you really go down the vortex.
There are some physiological realities that you have to understand before you move forward
with any type of surgical hair transplantation.
Let's begin with coverage.
When you think about numbers and grafts, you have to understand that the donor area, the
area where the hair is harvested from, is not bottomless.
And so, when people shop hair transplants, and hair transplants become such a commoditized
field, where doctors are offering sales on X dollars per graft and patients are being
misled into believing that it's all the same, and there’s an incentive to close the deal
and just get the patient on the table.
But what is not clearly communicated consistently, is that this area, at the back of the scalp,
the area with the band of hair in the baldest man you've ever seen, is the limit of where
you can get the hair.
So, in addition, when you think of graphs, you also have to think of coverage.
Hair has caliper—it has a certain diameter and thickness.
The darker and thicker covers more scalp than finer and lighter.
When we do hair transplantation, you can't really put more than 20 grafts in a square
centimeter.
So when we do hair transplants, we actually draw the squares on the scalp to show how
much area we’re going to fill, and on the donor area we draw out how much we can potentially
harvest.
But very important to understand is that, the coverage will probably require, to look
natural, more than one transplant.
A lot of doctors may claim they can put 50 or 100 hairs in a square centimeter, which
technically may be possible, but from our experience, the diameter or the circumference,
I should say, of skin that you need for a graph to survive still limits how many hairs
you can put in a square centimeter.
Now for a natural density, you need 40-50 hairs per square centimeter, and that's why
a lot of people are afraid of hair transplants because people look "pluggy".
So even if people look good after a transplant, the hairs are never as close together as they
are by nature.
This, of course, has been a frustration for a long time, now we add to that that you will
continue to lose hair and you'll understand that the number of grafts and number of sessions
and the longevity of the procedure are all open questions.
In our practice, what we perform is something called Hair Regeneration.
We have been doing hair transplants for many years and a few years ago, we started developing
a non-surgical solution for thinning hair.
For areas that are smooth and haven't had any hair for more than 3 to 5 years, hair
transplant is still necessary to put hair in those areas.
But majority of patients who came to see us we're actually men who had active thinning.
With Hair Regeneration, we do an injection that results in a reversal of the hair thinning.
Any hair that’s thinner appears to grow back thicker and this is using a wound-healing
technology called extracellular matrix.
We have had such good results with this that we've essentially significantly decreased
the amount of hair transplants we do and we're now creating centers where people can have
this treatment as an alternative to transplant.
We've actually have gone so far as to say that, in the right candidate, the yield and
coverage of Hair Regeneration will exceed two hair transplant procedures.
So I think that one of the things that you should pursue first is stabilization, whether
its using finasteride or whether it is a technology like ours—Hair Regeneration.
You want to maintain stability before you move forward with transplantation and think
about the future.
When you've been doing this for 20 years, you see how challenging it can be when someone's
hair continues to thin and you run out of hair to transplant.
Even with the best technical execution, and with the use of wound-healing materials like
Acell and extracellular matrix, it's still a limited procedure.
So learn more about stabilizing before you pursue filling in the temples, because you
may be unhappy with the receding temple but you'll be much more unhappy with a artificial-looking
or operated on temple.
A lot of our patients, who has been able to treat on the temples, actually get back a
decent amount of hair and are able to fill in pretty nicely without a surgical procedure.
So I hope that was helpful and I wish you the best of luck thank you for your question.