Hair has receded and caused me to be unhappy with my appearance: What am I to expect with
hair transplants?
The masculine appearance caused by the hairline has caused me to become very unhappy with
myself and I'm looking to recreate the lower feminine hairline.
The 'estimate' hairline I drew in is approximately 42cm squared, or 36cm squared if you don't
count the widows peak and slight temple bits.
What am I to expect in regards to transplant density and graft numbers to repair my hairline?
Thank you.
Thank you for your question!
You've submitted some photos and some very nicely done squares to measure the square
centimeters that would be necessary to fill-out the areas to lower the hairline to a more
female type of hairline.
And so, you described in your question that your hairline has been receding and you want
an estimate to the number of hairs per square centimeter and the predictive aspects to a
transplant.
Before discussing that, I think it's very important that you first understand the cause
of your hairline receding.
When you think about hair loss, we always think about male pattern hair loss.
It is very common, it is very socially understood, accepted and people don't think about it beyond
a certain age.
But we don't always talk about female pattern hair loss very much.
It is my opinion since there is no block buster drug for female pattern hair loss like there
is finasteride for male pattern hair loss .That awareness for female pattern hair loss
has been less than for male.
Statistically, it is estimated that 30% of women under the age of 50 and 50% of women
over the age of 50 have hair loss.
When a woman comes to our practice with hair loss, we don't look at it during the surgery
to create their desired look first, we first look at the cause.
It is very important to understand the cause.
If it is genetics, that's one type of situation.
If you are pulling your hair back and the temples are receding, then you might be developing
something called traction alopecia and this is seen in a lot of women wearing tight pony
tails or who pull their hair very tightly or do these little braids and things like
that.
In addition, we have to look systemically.
We have to look at hormonal and nutritional factors.
Prior to a transplant, a proper work-up to establish the medical basis of a hair loss
is important.
You see, when you take these drawings of those squares and you place them the way you did,
certainly any experienced hair transplant surgeon can give you an estimate as to how
many hairs it will take to fill that area.
But that is a slice of time and you have to think about your future and where your hair
may be progressing.
This is commonly seen in men when you into a restaurant and you see a man with "bad hair
plugs" you wonder why he has such hair plugs.
Why doesn't he just accept their hair loss and be bald.
It's because most likely he had hair in that area when you see the plugs but the hair eventually
thinned out and disappeared leaving this pluggy appearance.
Another factor to understand, moving forward with what to anticipate with the transplant,
if you want the density or the coverage, doesn't just think about the numbers of hairs.
Think also about the diameter or caliper of the hair.
When you look at people with thicker hair, well, it is because the hair caliper or the
diameter of the hair is so much thicker it covers a lot more.
So a person with fine blonde hair needs a lot more grafts to cover an area compared
to someone who has dark, thick hair.
That being understood is a part of the factor.
That's why when you look for opinions by so many photos, the things that we can't comment
on have to do with measuring hair thickness to give you an idea.
In addition, in the hair transplant field, it's kind of a free for all where people make
all kinds of claims about the number of grafts that they are able to deliver and the density
of the grafts they place in a given square centimeter.
Something for you to understand is probably intuitive of a surgeon but also is easily
translatable.
When you place a hair graft, you are literally placing an organ.
This is a combination of the hair shaft, the follicle, the tissue around that area.
A graft needs blood supply and in order for the blood supply to reach the graft, there
literally has to be an island or the graft is an island and there has to be coverage
around the area.
We call that covering 4 sides of the graft with good circulation for it to take.
When people try to put many grafts in an area, a certain amount of those grafts are going
to go and disappear because they are not going to have enough nutrition.
It's almost like when you are gardening, if you put the plants too close together, you're
going to be sacrificing some because the available nutrition and viability will be compromised.
So when you go beyond submitting a question and do the consultations, you have to take
that into consideration.
In addition, from my experience, when it comes to female hair loss and lowering of the hairline,
we try to do as much as we can with transplant but it is typical to need more than just one
transplant in order to get the maximal density to mimic what nature creates.
You see, when a male has a transplant, it is acceptable to have a little bit of less
density.
But for women, you need a lot of density otherwise, the hairs look to far apart and creates an
artificial look.
In our practice, when we do transplant, we use a material called A-cellular matrix or
extracellular matrix that helps aid in the healing of the transplants as well as in treating
the thinning process.
A lot of our patients, just to kind of go on a slight tangent right now, a lot of our
patients who are coming are women who do have some type of female pattern hair loss and
the only currently approved FDA drug is minoxidil.
So they have been coming to us to have Hair Regeneration treatment.
And our Hair Regeneration treatment is the combination of extracellular matrix with platelet-rich
plasma.
Now this is relevant to you in that, if we want to maximize the benefit of a transplant,
we also want to maximize the longevity of the existing hair.
And if there's a thinning process going in, would it be great to make that thinning process
stabilized, reverse and thicken.
So you want that combination so that if you are getting a transplant, you want to get
the maximal yield of the transplant in terms of survivability of the grafts as well as
the stability of your thinning process.
To summarize, this is a simple question with a complex answer.
And if you haven't have a medical work-up yet, you should move forward with that and
then learn about the options related to both transplant as well as Hair Regeneration before
you move forward with having a procedure.
I hope that was helpful, I wish you the best of luck and thank you for your question!