Thank you for your question.
You state in your question which you submitted without a photo and any other details about
your history but you’re asking what’s the ideal time between two FUT transplants?
You state that you had a hair transplant about 8 months prior and your doctor said that you
have a loose scalp and that you could have another FUT transplant. And you want to know
what’s the ideal timeframe as well as what’s the optimal method.
Well, again, without any further details, I’m going to share with you a little bit
about the philosophy of hair transplant and what we’ve also done in our practice which
has been a significant benefit for those patients who have already had a hair transplant.
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’m also the founder of TrichoStem™ Hair Regeneration Centers,
a system I developed over the course of several years now going on over 7 which is a non-surgical
alternative to hair transplant but which has also been an option to help people who’ve
already had transplant using regenerative medicine technology which interestingly evolved
from us doing hair transplant.
So let’s understand a little bit about the basic rules that apply physiologically to
hair transplant surgery. To begin with, the indication for hair transplant is of course
the absence of hair in a given area where you want hair. So where do you get that hair?
You get it from the donor area. Now this donor area is limited to a narrow band behind the
scalp. And traditionally, FUT or strip surgery is optimal in terms of number or grafts yielded
as well as quality of grafts. And this is certainly easily debated now that FUE or follicular
unit extractions have become so popular. But in terms of the actual quality of hair and
the yield, you are really best served with FUT. Now of course, there are pros and cons
about that.
Now that being said, once the transplant is done, if you ask the patient or a physician
like myself what’s the best timespan between transplants, I would say as long as possible.
And why is that? Well, for the transplant surgeon, they may have a vision as to what
can provide you with optimal cosmetic result but at the same time, there’s a harsh reality
that you are literally tapping the area or the limited donor area and once you do a second
transplant, there’s going to be less and less transplantable hair. And essentially,
hair transplant is a race between your rate of hair loss and the ability of a hair transplant
to compensate for some of that loss. Essentially, you can never fill or restore the volume of
hair that is lost but you can try to create a certain perception such as developing a
frontal hairline to improve the density in the front to mid-scalp area.
Now what’s relevant is that in our practice, we have developed a treatment called Hair
Regeneration and this evolved from, again, 7 years earlier when we were doing hair transplants
in significant numbers and we wanted to maximize the yield of the transplants. We wanted the
grafts to heal better. We wanted the donor area to heal better. And what ultimately happened
is that we found thinning hairs became thicker. Over the course of several years, I developed
an algorithm and a system for people with both men and women with thinning hair. So
essentially, we’re not necessarily having to transplant hair for people who have hair.
Rather we’re able to reactivate hair that’s not growing, thicken existing thinning hair,
stop progression. And we are able to accomplish that without depending on other modalities
for about 5 years duration for the overwhelming majority of patients. There are always exceptions
but essentially, 99% of both men and women, we’ve been able to show this type of benefit.
Now what’s interesting is that many people have come to our practice for this treatment
from around the world for thinning hair, but in addition, we have patients come from around
the world who have had a transplant. And when they had the transplant done and they noticed
that they were losing hair, they are trying to look for an alternative to a second transplant
and that’s when they learn about Hair Regeneration and actually come in for that treatment because
it’s not like we’re saying never get another transplant. But if you can stretch out the
time as long as it’s possible physiologically, then you are not going to run out of hair
before you run out of transplantable grafts. The point is that for example, a person who,
let’s say, starts losing their hair in their 20s, we’ve had patients who had 4 or more
transplants by their mid to late 30s and because they’ve lost their native existing hair.
They ended up still looking like they didn’t have much hair. So that’s a frustrating
situation because they’ve lost their native hairs and the transplanted hairs could not
come close to providing the volume and density that they desire.
So from a surgical perspective, I can tell you that the time between the FUT transplants
usually, we’ll allow for a year for wound healing and remodeling and settling before
you would do another transplant but that’s more advantageous for the surgeon and you
for the healing process and graft yield. But if you’re thinking long-term, then you have
to also think what can you do for stabilization, what can you do to slow down progression?
And this is where Hair Regeneration has been a tremendous value to people who have had
hair transplant and want to minimize the number of transplants they go to because as I said,
the donor area is limited. Yes, people can get body hair transplantation and certainly
I have seen very good results with that. But I think that when it comes to the simplicity
of our procedure of getting injections to restore the hair growth as well as incidentally,
it also helps the quality of the hair transplants, the grafts themselves, then the injection
can be a very viable alternative to doing a second transplant. But certainly to answer
your question, I would generally tell my patients when we were doing a lot more transplants
that waiting for a year or so and beyond is advisable. And of course, I would also explain
to them that what we’re still trying to do is achieve a certain aesthetic result but
you may lose more hair and have limited amount of donor once a second transplant is done.
So in our current practice, basically the answer to your question would be, wait as
long as possible and learn about the regenerative technologies that can actually, such as Hair
Regeneration, that can help you avoid or prolong the time before another transplant. Like I
said, with our results of 5 years, that’s a significant amount of time when someone
has already lost enough hair that they need a transplant. At a certain point, the threshold
of hair coverage becomes so low that a little bit of loss results in a lot more scalp exposure.
So if you can save those hairs and thicken those hairs, I would argue that it exceeds
the results of not just one but two transplants.
So I hope that was helpful, I wish you the best of luck and thank you for your question.