Thank you for your question!
You submitted a single photo of the top of your head and you are stating in your question
that you’ve been rapidly losing hair for the past 3-4 years and you are asking how
many grafts you will need and you don’t know exactly how much hair you will lose.
So certainly you are looking for guidance based on your idea of maybe improving your
appearance with transplant. Well, I can certainly give you my perspective based on how I treat
people like yourself in my practice.
A little bit of background, I’m a board certified cosmetic surgeon and fellowship
trained oculofacial plastic and reconstructive surgeon. I have been performing hair transplant
for over 20 years and I’m also the founder of TrichoStem™ Hair Regeneration Centers
where we’ve developed a method for non-surgical treatment for men and women with thinning
hair and pattern genetic hair loss. so I think that you can certainly get an informed opinion
from what we do if someone like yourself comes to our practice.
First of all, I think that one of the things that you have to understand when you ask a
question of how many grafts you will need is first how are you going to stop the progression
of your hair loss. For men, really the only drug that is currently of any significant
value to slow down the progression is a drug called finasteride or tradename Propecia.
Now this drug works by blocking an enzyme called 5-alpha reductase that stops the conversion
of testosterone or dihydrotestosterone or DHT. The challenge here is that only 60% of
men will actually respond to the finasteride in terms of slowing down their hair loss but
at the same time, at the level that you’re at, certainly, if you don’t slow it down
then you will find yourself in a difficult situation when it comes to getting transplant.
In our practice, for someone like yourself, one of the first things we would recommend
is an injection treatment that we’ve developed called Hair Regeneration. What we have done
is figure out a method of using platelet-rich plasma and a material called extracellular
matrix to stop the progression of hair loss to reactivate hair that is not growing and
to help thinning hairs become thicker. Now what I didn’t mention was that people are,
since finasteride is a drug that is only indicated for male pattern hair loss, unfortunately,
there have been some reports and concerns about long term sexual side-effects which
means that a lot of men are not taking finasteride and this may be a concern for you once you
do your research and learn about this as an option.
With this single treatment and some cases, two injections done separated by a year and
eighteen months apart, we have been able to sustain improvement for our patients with
99% success for both men and women in the course of over 5 years. So we treat everybody
as individuals and we treat patients from all over the world and we do these injections
every day.
For someone like yourself, that would be my first which is to try to help you stop the
progression and try to strengthen whatever hairs are salvageable. One thing that we have
definitely learned over the many years of doing this treatment is that the earlier we
catch somebody, the more hairs we have to work with, the better it is. Once a hair is
gone and then it’s too late to help that area of skin because there’s no hair follicle
that salvageable.
Now when it comes to this topic of hair transplant, with someone with advanced hair loss as yours,
you have to make a compromise. You’re not going to get coverage and density on the full
scalp. For most men, when we talk about transplant, we talk about placing most of the grafts towards
the front to develop a frontal hairline. Secondarily, you also have to understand that to achieve
optimal density, you are going to need more than just one transplant. It is very common
for people to expect that they are going to get what they want with one and although you
will get improvement, from my experience, most people want a natural looking density.
And in order to achieve that, although it can be achievable in certain areas in the
scalp, you would probably want a second transplant.
Now, what is the limitation? The limitation is the number of hairs in your donor area.
So again, for us in our practice where we were doing several transplants a week, we
are doing so many more injection treatments to help people stop and reverse to their maximum
potential with Hair Regeneration injection.
So at this point, I think it’s a good idea for you to learn more about stabilization
to prevent progression. Losing so much hair in 3-4 years, the trend appears to be that
you will lose a lot more in the next 1-2. So if you can stop that progression before
you a transplant or at least slow it down, it might be combination. Maybe you’ll take
finasteride and do a treatment like what I discussed with Hair Regeneration but at least
you will have more hair coverage and you will depend less on transplantation to try to maintain
a desirable look.
So I hope that was helpful, I wish you the best of luck and thank you for your question!