Thank you for
your question.
You submitted your question without a photo and you’re asking which type of hair transplant
technique is preferable in case you’re unhappy with the outcome and you decide to shave your
head.
Well, I can certainly help you understand the philosophy that guides me in counseling
patients with hair loss before we take that step of moving forward with a hair transplant
and this would probably be beneficial to you depending on the degree of your hair loss.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon. I’m also the founder of TrichoStem™ Hair Regeneration
Centers, a system we developed which evolved from hair transplant surgery which is a non-surgical
solution for men and women with thinning hair. And we treat patients from around the world
with this method. I have been in practice in Manhattan and Long Island for over 20 years
and I have a lot of experience with hair transplant surgery.
So again, to begin with, let’s start, before we move forward with these transplant procedures,
I try to help my patients understand the very critical limitations of transplant surgery
regardless of technique and the importance of doing things to maintain and stabilize
as much as possible or slow down the progression of your current hair loss. You see, depending
on the age of onset and the relative rate of progression, you are, with any transplant
strategy, you are racing with time. And hair transplant is using a limited area of your
scalp which is the permanent zone of hair and essentially, it is the area that never
goes away. Essentially, the bar of hair that you see on a man who has very advanced hair
loss, that is your true permanent hair. When you take that hair and move it to the areas
which are typically where it’s needed which is basically the front part of the scalp,
you are dealing with a limited resource. So essentially, there is a limitation right there.
No matter how many times you go to that area, you are going to hit a wall. Now there are
advances now with body hair transplantation for those who are willing to do that. So it
does mean that you do have additional options but it’s a very small percentage of patients
who actually go for that.
So when we were doing hair transplant surgery a lot and we wanted to maximize the outcome,
I mean, that’s a very key issue. You’ve already stated that you are prepared in case
you are unhappy. Well, reality is that more than 65% of patients after hair transplant
surgery, based on the International Society or Hair Restoration Surgery survey of its
members, are not fully satisfied with the density after a transplant. And it’s not
for lack of quality of work. It’s really the challenge of achieving natural looking
volume and density to create a satisfactory result.
So when we were doing this, we were trying to help maximize the yield of grafts and we
were using platelet-rich plasma and Acellular matrix which is a wound healing material.
And a serendipitous result occurred which was thinning hair actually became thicker.
And so what we developed over several years was a treatment called Hair Regeneration.
Now the reason why I’m putting this in the context of your question is that what I figured
out is that most of our patients who are coming for hair transplant consultations were losing
hair. And when we figured out that we can actually help reactivate hair that isn’t
currently growing, prolong the growth cycle of hair that’s present as well as thicken
thinning hair. Well then, we were able to actually exceed one, if not two transplants,
with the understanding that it’s only people who still have hair. If your scalp is smooth
bald, that’s not going to happen.
Now, that being understood, we’d also and still suggest to our patients, male, to consider
taking a drug like finasteride to help reduce the DHT levels. And essentially, I developed
over many years of managing people with hair loss a certain awareness of how DHT sensitive
a lot of people are. Basically, my thinking is that when younger people have relatively
rapid progression, they don’t have the luxury of time compared to a middle-aged person who
has slow progression. So very often, we’ll actually recommend a DHT blocker as well as
Hair Regeneration. So understanding that stabilization and maximizing whatever hair you currently
have with this type of treatment is an option as long as you have hair.
Now when it comes to this question about scarring, if you’re going to shave your head, more
than likely, in term of scarring, then probably an FUE versus an FUT or the strip method is
likely to be more acceptable but technically speaking an FUE creates a lot more scar tissue.
And although the intention of FUE is to avoid the strip scar or the linear scar that people
have objected to, essentially if you shave your head, you may still see a lot of the
dots from the FUE surgery. So there is no perfect solution there and you really have
to make sure that you’re comfortable with dealing with the realistic issues of the limitations
of transplant before you move forward.
Right now, it’s always been, essentially, a race between doctors by promoting different
technologies and claims of being better at XYZ transplant but the limitations are still
there. And invariably, a person who gets one transplant is highly likely to need a second
transplant only a few years later. It’s pretty much the trend because people seek
attention for hair loss when they’ve already lost more than 50% of their hair. And they’re
basically going downhill and losing a lot of hair proportionally that needs more coverage
once you’ve committed to hair transplantation.
So I think the take home message is get a realistic assessment of where you are in terms
of your hair loss. Learn about drugs like finasteride to slow down your progression
as well as technologies like we’ve developed called Hair Regeneration to help maximize
the coverage of your hair and you might be able to delay needing a transplant. The Hair
Regeneration as a final note, we’ve been able to establish longevity of 5 years with
our treatment. Of course, there are going to be some exceptions but essentially, our
treatment system where we follow our patients for 5 years has worked out very favorably.
And when it comes to hair loss, 5 years is a big deal.
So again, consider all this, learn more and then start having consultations with doctors
to become comfortable with your decision before you get to the point where you regret doing
it and have to shave your head.
So I hope that was helpful, I wish you the best of luck and thank you for your question.