I am nearly 30 and have been wondering about getting a hair transplant for some time.
What's your advice?
I have attached pictures.
My hairline seems to have a convex shape and pretty bizarre.
My uncle on my mom’s side is thinning.
He's 60 but apart from that my family has good hair.
It really has started to bother me (I know this may sound vain).
I am not looking to have a perfectly straight hairline - just a hairline that looks decent
when held up etc.
I would appreciate your comments on what you think I should do or not do ! P.s this is
my hair wet and stretched back.
Thanks you so much, Denis.
Thank you for your question!
You’re nearly 30 years old and you submitted photos where you expressed a desire that you
want to have straight hairline and that you feel that you current hairline look bizarre.
You also shared with us the family history where an uncle is approaching 60 and is beginning
to thin.
Otherwise, you have a family where hair loss is not significant.
So that’s great.
Now the question we have to answer is of course is, how motivated are you to have this hairline?
Unfortunately, the perception of hair transplantation through very aggressive advertising appears
to create this perception of an easy procedure but I want to share with you a little about
how we make these decisions in our practice when someone like you comes and says “I
want a lower hairline.”
First of all, I appreciate that you submitted photos with your hair wet.
Very often, someone with very good thick individual hairs that are caliber and are very thick,
when the hair is wet, you see a lot more scalp.
When your hair is wet, you look like you still have a great amount of volume.
So, you have to ask yourself about how a motivated you are to have this frontal hairline.
You see, when you think about hair transplant, you have to think about the area that needs
the transplant and the amount of hair available to transplant.
Of course since you didn’t have a transplant before, we would evaluate the donor area and
determine the density of hair and how much hair would be available to transplant.
Then we discuss the options in terms of the type of transplant.
There’s follicular unit extraction, there’s follicular unit transplants also known as
the strip method.
But more importantly, it’s very important to understand that there’s no such thing
as a scarless hair transplant.
A lot of people are making claims using FUEs where they’re making little punches to remove
individual hair clusters and then stating that there are no scars or scarless.
That’s not true.
There’s actually in geometric terms and absolute numbers more scars with FUEs than
there is in a strip method.
And if you are to go and get a second FUE, you’ll definitely have a lot more scars.
So whether you are using a robot or a new device or just doing it manually, hair transplant
means scars in the back of the head.
When we do an examination, we discuss do you go into water a lot?
Is your hair wet a lot?
We’re looking for places where the scars would be obvious and could draw attention
and can be a source of potential embarrassment.
That being said, let’s say that’s not an issue for you, your hair is not wet a lot
and you’re fine with whatever scars you have, then we have to think about how many
transplant session do you need to achieve your goal.
You see, one of the biggest challenges of transplant surgery is achieving density.
And the level of density you have is very difficult to achieve with a single transplant
surgery.
Lots of doctors make all kinds of claims about the number of grafts per square centime but
although technically a skilled surgeon or technician can place these hairs very close
together, every hair needs a circle of skin or tissue which means there’s an absolute
limitation.
And a lot of times, depending on the transplant factors in terms of the method, the survivability
of the grafts, things we can control, things we can’t control, the yield of the transplant
can be not the same with the number of grafts placed.
I’ve had patients who come who have lost over 90% of grafts when their transplant was
done elsewhere.
Now those are exceptions.
One patient in particular comes to mind, his blood pressure was not very well controlled
and I think this transplant facility did the transplant in spite of the blood pressure
and of course, it led to more bleeding which led to the grafts not taking.
So when you are in that transition period, then that appearance may be undesirable for
you because that is something that is very hard to camouflage.
When we try to do a hair line lowering procedure, we try to be conservative and try to feather
the transplant so that it starts in the edge of the existing hair and goes downward as
opposed to drawing a line lower down and try to fill that space with grafts.
For us, that’s not the way we like to work.
So, it’s sometimes nice to want something like this where your hairline is lower but
I think that most people would disagree that your hairline look bizarre.
I suspect that this is most likely a familial trait and it’s not a really as bizarre as
you may feel at this time in your life.
You can be sure coming from me that a lot of people would envy the amount of hair that
you do have.
So I think you need with experienced hair transplant surgeons and get some opinions,
get some understanding of the realistic expectations.
Think of what you are willing to put up with and in our practice, we try to maximize our
grafts survival using a material called extracellular matrix.
It helps with the wound healing in the donor area.
It helps with the survivability and healing process of the grafts.
And those people who are actively thinning, having thinning hair, it actually reverses
the thinning process and makes those hairs thicker and we call that Hair Regeneration.
In your situation, if we were going to do a microscopic evaluation, there’s a good
chance that we won’t find a miniaturization so what you’re looking for is a specific
type of result which is certainly fine as long as you understand the process and the
steps of involved.
So I hope that was helpful, I wish you the best of luck and thank you for your question!