Thank you for your question. You have submitted several photos and the narrative of your question,
you described having undergone approximately fifty five hundred grafts in September and
you are concerned because you feel like your scalp looks relatively bald and that you have
a deadline of February to look good for an event. So you want to get an idea of what
of whether or not you'll have adequate coverage.
Well I can certainly assist you with this question. a little bit about my background,
I'm a Board-certified cosmetic surgeon and have been practicing hair transplant surgery
for over twenty years in Manhattan and in long Island in addition I am also the founder
of Trichostem Hair Regeneration centers which is a non-surgical alternative to hair loss
using Extracellular Matrix and Platelet-rich plasma I'll discuss this in more detail later
on. In fact we have helped many people who have had hair transplants done elsewhere during
the early postoperative period.
So I give you some sense of what you can expect, so to begin with the number of grafts you
received was a relatively high number for any hair transplant surgery and I think you
are more than aware of that when people shop for hair transplant surgery very often they're
always looking for numbers of grafts, well unfortunately the hard limit is the actual
number of graft you can get out of the donor area.
In addition, it is also very important to understand that looking at your photos you
have very advanced hair loss which means the surface area that needs to be covered is very
large that means that you're taking, let's say for arguments sake that all fifty five
hundred grafts survived. Then you will still have the incredible lack of overall density
compared to when you had hair.
When we think of numbers, prior to hair loss is not unusual to say that you'll have approximately
a hundred thousand hairs in this area. Now when you first noticed hair loss you've already
lost half of your hair. Now of course, just looking at the density and the surface area
to give you an idea of what natural density is, it is not unusual to have people have
fifty to seventy five hairs per square centimeter naturally. In hair transplant surgery its
more common to put no more than twenty hairs per square centimeter, so of course there's
a lot of math here, but in the end it is likely you'll get coverage but you will not get that
type of coverage where it doesn't look like your hair is thin.
Nonetheless hair transplant can be very effective in making one looks like they're not as bald
as they were prior to surgery I think that's critically important for you to understand,
this is a discussion that I'm assuming you had prior to your surgery in order to get
proper informed consent. In our practice what we do for patients like yourself, who come
to us after they've had a transplant and also to understand a little bit about the phases
you're in. Just to get to that issue of why you look maybe like you have less hair than
you did initially, in hair transplant surgery there are two things that happen after the
surgery, immediately after the surgery things can look very good you have all these short
little hairs you feel them, it's feels great and you're optimistic.
But within a few months is not unusual for a good number of those grafts to go to what's
called shock loss, shock loss means that the hair is temporarily going to a telogen phase
they shed out, doesn't mean that the roots of the hair or the dermal papilla are gone
but just the top of the hair. In addition if there is existing hair, then there's collateral
shock loss which means existing hair that was there can shock out.
Now if you also had a lot of hair grafts it's also not unusual to have collateral loss that's
more long term because of the incidental trauma to the existing hairs it is something that
is always accepted in hair transplant basically because it is rationalized that if you are
going to loose, you better of losing a thinning hair that's gonna go away anyway and replace
it with a thicker hair from the permanent donor zone.
Now that being said the timeline is concerning because from September to February is about
five months and the length of time that we typically tell our patients after surgery
to expect they're most likely to have the full results is around a year and for people
who was slow growers who have more advanced hair loss it's not unusual to see somebody
look even better at eighteen months which means that your timeline is a little bit tight
and I'm not sure you going to be able to feel comfortable with your result by that point
but it doesn't mean that you're not going to see more growth as time goes on.
To go back to the comment about what we do for patients like yourself who come to us,
we developed a process called Hair Regeneration and Hair Regeneration is a non-surgical alternative
to hair transplant which works very effectively for both men and women with thinning hair
in fact when we looked at our data we actually saw that Hair Regeneration in terms of density
can actually yield the equivalent of two hair transplants in the right candidate.
Now, when it comes to someone who's had a hair transplant who was aware of the success
that we've had with what was initially the intention of this system was to improve our
hair transplant results which means to improve graft survival and to improve donor area healing.
Patients do come to have us treat them at a critical time usually within the first one
to three months and I prefer usually somewhere around the one to two months’ time where
we'll actually do this injection to help their grafts heal better to help their donor area
heal better and to help their thinning hair actually become thicker and we've had a lot
of success with that and this strategy of doing that is often the result of someone
like yourself who is nervous at this critical point where they don't look like they have
a lot of activity going on and then they learn about what we do and they come and we decide
whether or not it's appropriate for them.
So in your situation, I'm not necessarily saying you should pursue hair regeneration
but I'm saying that you may, you need to talk to your doctor about what to expect by February
because I would say conservatively you may get some growth but you're not going to get
the full growth of what you want and as far as the overall coverage, I think that its
import understand that hair transplant is still a compromise it's not an ideal solution
but when you're dealing with the limited donor area regardless of the method whether it's
a technique of FUT, FUE, Robotic technology whatever you want to call it, the limitation
is the donor area and it's clearly you got as much as what would be described often as
two transplants in one session so there's no question you and your doctor came to terms
with doing something that many would call as mega session.
So that being said I think your communication with your doctor is very important, you may
find the use of some topical fibers and other things that can be may be helpful for your
event.
But in the meantime once you learn more, you'll be able to strategize what you can do for
your February deadline. So I hope that was helpful I wish you the best of luck. And thank
you for your question.