Thank you for your question. You’ve submitted several photos and you state in your question
that you have hair loss based on the combination of traction alopecia and hair relaxers and
damage related and you are asking about hair transplant and expectations for coverage.
Well, I can certainly give you some perspective. Of course this is in the absence of physical
examination. A little bit of background, I’m a board certified cosmetic surgeon and fellowship
trained oculofacial plastic and reconstructive surgeon practicing in Manhattan and Long Island
for over 20 years. I’ve been performing hair transplant surgery for this time as well
and I am the founder of TrichoStem™ Hair Regeneration Centers which is a non-surgical
alternative to hair transplantation. And this technology that we offer for people who had
genetic pattern loss such as male and female pattern loss was actually derived from experience
for hair transplant. So, I’ll speak to you a little about the assessment process and
what are specific issues that are applicable to people with African descent.
So first of all, in terms of coverage, you want to measure out essentially prior to proposed
procedure, what I do is I measure the square centimeters that we would try to fill. Now
you have a large area that needs help. The area at the temples as well as the frontal
hairline which means that now you have to determine how much you can fill based on how
much hair is available in your donor area. One of the challenges with hair donor area
of people with African descent is density. Although, we often feel by perception the
people with African descent have a lot of hair the problem is that the density of hair
is not as high as people who are Caucasian or Asian. The basis is probably because the
hairs individually are very curly which means the hairs can’t be that close together in
nature. But on the flipside of that, you get the benefit is you get the good amount of
coverage because of the curliness of the hair.
Also from the technical side of transplantation, there is a challenge of placing the hairs
so that they don’t become ingrown as well as they grow in a good direction. So I think
that in evaluation is critical for you to determine how much is realistically possible
with one transplant. I would propose that you would need at a minimum 2 transplants
and you’ll need to make decisions in terms of the priority of where you want to see proportionally
more hair relatively speaking because unfortunately, as I said earlier, the donor area is the limiting
factor. Several years ago, one of the biggest challenges is that we are dealing with and
that it is always a challenge with hair transplant is not just getting enough grafts but also
getting grafts to survive. And the reason is when you think about it is making lots
of little openings and you need those hair grafts, once they are placed, to take to heal
which makes it a challenge when you are dealing with skin that has been damaged from hair
relaxers. Hair relaxers are essentially something in the sodium hydroxide or potassium hydroxide
family. Chemicals comparable that is what’s used in drain cleaner. And unfortunately,
this can cause burning of the skin and thinning of the skin. So we use a material called extracellular
matrix. Extracellular matrix is derived from pig bladder which is used for wound healing
and it help us improve the healing of the hair grafts as a serendipitous discovery,
we also learn that there is actually the thinning hairs became thicker. Now this is probably
not the situation for you so in terms of what we are doing for pattern loss, we call it
Hair Regeneration where w actually inject platelet-rich plasma (PRP) and extracellular
matrix to help men and women with hair loss. I think in your situation, if for patients
like yourself in our practice, we would use variations of this treatment for maximum viability.
It is remarkable how resilient hair can be. I’ve actually implanted hair in circular
scar which was damaged from chemical or hair relaxer and the hair was able to grow nicely.
And the reason I am mentioning is this scar was very thin. You can go right through it
but thanks to technology and method and technique. So you have to meet with hair transplant specialist.
You have to learn what your realistic opportunity is and make sure you are comfortable. Unfortunately
hair transplant field is full of people either who don’t have a lot of experience and think
that things will work out and based on robotic or new technologies to harvest grafts or people
who are unfortunately just to get more procedures done but not thinking of the patients long
term. So you want to meet with a surgeon who is going to meet for you throughout the procedure
and beyond the procedure and get some opinions that are realistic. I doubt you’ll have
enough of donor area to be able to get the full coverage you want and you may want to
think about other options such as micropigmentation and other things to help you improve your
overall appearance.
So I hope that was helpful, I wish you the best of luck and thank you for your question!