Thank you for your question.
You submitted your question with a single photo of the top of your head and you’re
asking a very common question. How many grafts do you need for your first transplant? Well,
I can certainly share with you a perspective that I think you may not always get from people
who are only looking at this from a purely surgical transplant perspective.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island
for over 20 years. I am also the founder of TrichoStem™ Hair Regeneration Centers. This
is a system that we developed which ultimately has defined a new category of hair loss treatment
with regenerative medicine technology and we treat patients from around the world, men
and women with a genetic pattern hair loss. And certainly, we’ve treated a lot of patients
who have a similar appearance as yourself.
So it is certainly a natural question to ask how many grafts do you need. Well, it’s
also important to understand the other factors that impact the success of your potential
surgery. So when we evaluate a patient who comes in for hair loss management, as I mentioned,
we developed this Hair Regeneration system that was used at the time when we were doing
a lot of hair transplants. When you do a lot of hair transplants, you learn very quickly
that there are many challenges in getting a successful outcome.
Patients always want much more hair than is practically often the case to be able to actually
deliver. Why is that? Well, when you look at the top of your scalp, you fairly have
an advanced degree of hair loss. Now, when you look at the donor area, you have to look
at how much hair there is that can potentially be transplanted. Now the quality of coverage
is dependent on the density of your donor area which means if you have higher density,
you have more hair than you can transplant. And if you have thicker hair, thicker hair
covers scalp better than thinner hair. Generally speaking, that is really something than can
only be determined during the time of consultation. And when you look at the absolute amount of
scalp that needs coverage, you cannot get enough grafts even if you do multiple transplants
to get a 100% coverage comparable to before you started losing hair.
Now generally speaking, it’s the desire for every patient to have as much as possible
but I would say most people are realistic about the kind of outcomes they are willing
to accept. Basically as explained often in consultation is that hair frames the face.
So you want to at least have some type of defined frontal hairline which you also don't
want to look pluggy so you need hair grafts behind.
Now with Hair Regeneration, we learned a lot about the process of helping people during
transplant but when we saw that not only did the hair grafts heal better and the donor
area healed better and that the thinning hair became thicker, I basically asked a different
question. I asked what can I do for patients who are experiencing hair thinning who are
willing to have hair transplant. What if we did the injection alone? Well, the results
actually changed the way I practiced, the way I manage patients with hair loss.
Now when someone is ready for transplantation, it’s very important that someone like yourself
also think how can you slow down the progression of your hair loss and get maximum coverage.
Transplant is not a cure for hair loss. And progression can leave a lot of people who
had transplants looking not as good as they want. So whether it’s using a drug like
finasteride to help slow down the progression as well as the technology that we developed
called Hair Regeneration, when we meet someone like yourself, we developed a classification
system that is a way to help patients understand how much improvement that they can potentially
get and how to strategize the coverage that they are able to achieve with any future transplantation.
We look at your current age, we look at the age that you started losing hair, the degree
of your progression, the rate of your progression, previous medical intervention and how successful
they were as well as other medical variables.
That being said, you have to understand also the long view. So for a younger person considering
transplant, the perspective and planning is going to be very different than a middle-aged
person considering transplant. And in situations like yours, I have often been quite impressed
by the effectiveness of non-surgical treatment. So using something like Hair Regeneration,
I have drawn the conclusion that a lot of times, the results that we’ve gotten even
with people with advanced hair loss like yours, we’ve gotten results that exceed not just
one but two hair transplants.
Now when it comes to hair, very often people are very ambitious about how much hair they
want to have on their scalp. And the ambition is often a challenge by the limitations whether
it’s transplantation in terms of the donor area or the limitations of Hair Regeneration
with actual salvageable hairs. I always explain to our patients that hair loss is progressive
and there is no cure but there is management and management is a function of a relative
density and thickness of hairs and the longevity of the hair growth cycle that can be achieved
within the genetic permissibility. And further, being proactive is so much more effective
than being reactive.
So I think that you can certainly get some consultations and you’re going to get a
wide range of ambitious, speaking of ambitious, ideas about how many hairs can be placed and
how much of result you can get in terms of number of grafts. But remember, it’s not
just the number of grafts but how well they survived. But I would assert that in a strategic
way, maximizing coverage non-surgically is strategically valuable in being able to plan
out a better hair transplant because every hair that is reactivated, grown and provides
coverage is an area of scalp that doesn't need a graft and therefore, you can optimize
the strategy of using transplant. So a lot of our patients come to us like you having
advanced hair loss and then once we’ve maximized their coverage, they then move forward with
the transplant and it works in synergy.
So learn more about medical and this regenerative medicine technology and of course learn more
about hair transplantation and see what are the realistic potential outcomes that you
can achieve.
So I hope that was helpful, I wish you the best of luck and thank you for your question.