Post Hair Loss Questions and Get Answers

I have some hair in the front of my head and if I were to get hair replacement in the front, is it necessary to shave my head?  I see most hair transplant photos with the recipient area shaved.  Does shaving provide a better chance for survival? Does it make it easier for the doctor to operate?

Though I feel that shaving the recipient area creates an optimal work environment for the hair restoration physician, in my opinion, it isn’t always necessary.

Where shaving appears to be most helpful is when transplanted hair is placed in between and around a lot of existing native hair. Around sparse natural hair, shaving is most likely not going to be as much of an issue.

The type of recipient incision made also may be a factor here. Whereas cases can be made for both perpendicular (coronal/lateral) and paralel (sagital) incisions depending on the hair loss patient, I have heard many physicians argue that sagital incisions do a much better job of sliding in and around existing hairs to avoid transection then lateral incisions. This certainly makes a strong case for physicians who do not require shaving of the recipient area.

At the same time however, those who don’t typically require shaving admit that surgery can take much longer when transplanting in between and around existing natural hair which could then potentially make larger hair transplant megasessions exceeding 4000 follicular unit grafts near impossible to perform in a single day.

Technorati Tags: hair replacement, hair transplant photos, hair restoration, transplanted hair, native hair, hair loss, sagital incisions, lateral incisions, natural hair, hair transplant megasession, follicular unit grafts

How many follicular unit grafts are available for hair transplant surgery over a patient’s lifetime?

This hair loss question was answered on our hair restoration forum by Dr. Paul Shapiro of Bloomington, MN who is a member of the Coalition of Independent Hair Restoration Physicians.  His professional answer is below.

In our experience most hair replacement patients have 6,000 to 8,000 follicular unit grafts that can be safely transplanted over their lifetime.

This brings up the basic question of what we are doing in hair transplantation. We are redistributing a limited amount of donor hair to a potentially expanding bald or thinning hair recipient area.

For the readers of this hair loss blog who are not familiar with the concept of limited donor supply or just want a good review, the Hair Loss Learning Center has a good animated video called “recreating a full look”. This video reviews the concept of moving a limited amount of donor hair and also has an interactive hair graft calculator to help you approximate the number of grafts you will need.

This hair transplant video can be viewed by clicking the link above and explains well the concept of limited donor.

Paul Shapiro, MD

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Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: follicular unit grafts, hair transplant, hair loss, hair replacement, hair transplantation, donor hair, bald, thinning hair, hair loss blog, hair graft, hair transplant video

This insightful hair transplant article was written by Dr. Bernardino Arocha of Houston, TX who is one of our recommended hair restoration physicians.

A survey of this hair transplant patient’s bald head, shows that the lateral fringes and crown have completely been eroded. The lateral humps have been obliterated, and the hair on the temporal areas (sides) is quite low. This isa level 7 on the norwood scale of hair loss country, it is a follicular unit barren real estate , where there is more hair loss, then there is remaining hair!

As if, that is not enough, study of the permanent donor area reveals that the hair density is decreased and the total occipital hair remaining is very diminished by baldness on two advancing fronts. From above, Androgenic Alopecia is eroding the crown, while from below a Retrograde Alopecia is raising the neck hair line.

After careful study, it is determined that a minimum of 2000 follicular unit grafts will be needed to commence the hair restoration process. That is, 500 follicular units to raise the lateral humps. Into which, we can anchored the hair line , which is estimated to need at least 1500 follicular units. We do not know at this juncture, whether, we can achieve the full 2000 hair grafts, much less, any extra to transplant into the area beyond the hair line.

Technorati Tags: hair transplant, norwood scale, hair loss, hair density, baldness, Androgenic Alopecia, Alopecia, follicular unit grafts, hair restoration, follicular units, hair grafts

I emailed one inquiry about hair transplant costs.  I was told by a hair loss doctor in India that I require approximately 6000-8000 follicular unit grafts, which I think is too much.  They said if I want enough hair density, that I require 2000 grafts for the hairline and temples and another 2000 for the crown.  I don’t think I am that bald.  Please tell me what I need to do to lower and add density to my existing hairline, refine my temples, and the expenses involved in a full hair restoration plan.

This hair loss question was posted directly to Dr. Raymond Konior of Chicago, IL, who is a member of the Coalition of Independent Hair Restoration Physicians.  See his professional answer below.

Interpreting graft numbers can be confusing for patients.  It is understandable why you would think such large numbers are unnecessary.  You need to understand that density is one of the main factors that will influence your satisfaction or dissatisfaction with the end result. 

The final density will depend on how many grafts are placed per square centimeter in the thinning hair zones.  Baseline density in a non-thinning zone has been reported to vary between 60-100 follicular units.  Variations in baseline density are influenced by age, area of scalp, race and other factors.  Your scalp would need to be examined under magnification to determine your exact baseline density in the donor site.  That inspection would also determine if you have any density fluctuations between the occipital donor site (back of your scalp) and the temporal donor site (side of your scalp).

Technorati Tags: hair transplant, hair loss, follicular unit grafts, hair density, bald, hair restoration, thinning hair

I’m 38 years old and suffering from hair loss in the frontal hairline area and slightly behind it with no balding in the crown.  I guess I am approximately a level 3 on the norwood scale.  If I were to undergo hair transplant surgery, how many follicular unit grafts would I need?

At 38 years old and not a great amount of hair loss, at least compared to bald men like me who lost all hair on the top of my head by the time I was 28 years old, based on the photos you’ve posted on our hair loss forum, you may be a good candidate for  hair replacement.

Depending on your goals and preferred hairline placement, a larger session of 3000-3500 follicular unit grafts may be optimal. This will allow for more hair density and coverage and will give you a more cosmetically pleasing result overall. It will also allow the hair grafts to be spread further back into your existing natural hair to add more density in areas of thinning hair.

If you want a more conservative hairline and aren’t as concerned about adding too much hair density behind the hairline, a smaller session of 2000-2500 grafts would most likely be sufficient.

Feel free to use our animated graft calculator which can be used as a tool to help you determine the approximate number of grafts you will need to achieve your hair restoration goals. Keep in mind this should never take place of a physician’s estimate, but it certainly can be a valuable tool to help you in your research.

Technorati Tags: hair loss, balding, norwood scale, hair transplant, follicular unit grafts, bald, hair density, natural hair, thinning hair, hair density

Ultra refined follicular unit hair transplantation is a term to describe the new “gold standard” of hair transplantation where hair restoration physicians are using smaller blades, making smaller incisions, and creating smaller “skinny” grafts. Making smaller incisions and trimming smaller grafts allows a hair transplant surgeon to “dense pack” follicular unit grafts much more closely together than that of standard follicular unit hair transplantation (almost twice as dense in many cases) and when done correctly, produces high hair growth yield and minimizes scalp trauma.

Determining what is “ultra refined” however can sometimes be a little tricky as blade and needle sizes vary and many hair transplant surgeons like to cut grafts somewhere in between “skinny” and “chubby”.

With a “chubby” graft, there is some extra potential that hairs in catagen (resting) contained within the graft will be rescued and thus produce greater hair growth yield.  However, in my opinion, cutting a graft too chubby will result in additional scalp trauma and a need for more than one pass to accomplish the same result.

On the flip side, cutting a graft to “skinny”, makes the graft more vulnerable, so physicians, nurses, and technicians must be extra careful with these ultra-skinny grafts to ensure they are not damaged.  I have found that most patients prefer ultra refined follicular unit grafting because it allows a hair transplant doctor to accomplish more in a single hair restoration surgery. Those who have mastered this technique, such as those members of the Coalition of Independent Hair Restoration Physicians have a proven track record of excellent and consistent patient results.

Technorati Tags: hair transplantation, hair restoration physicians, hair transplant surgeon, dense pack, follicular unit grafts, hair growth, hair transplant, hair growth yield, follicular unit grafting, hair transplant doctor, hair restoration

Hello, My hair started thinning approximately 2 years ago. I take Propecia (finasteride) which has helped, but I am conscious of the hair loss I am experiencing at the front of my head. Is it possible to have a hair transplant while still having a considerable amount of hair left?  Many thanks.

Yes, it is possible to have a surgery in the frontal area of your balding scalp even if you have a good amount of remaining hair. 

A qualified hair restoration physician will have to take into consideration factors such as:

• Your age
• Your current level of balding
• Whether or not you are taking any nonsurgical treatments to prevent further baldness such as Propecia (finasteride) or Rogaine (minoxidil)
• How many follicular unit grafts you will need in a single hair replacement session
• Working with you to formulate a long term strategy in the event you lose more hair. 

Developing a long term hair restoration plan is highly critical as hair loss is unpredictable and progressive.  Propecia and Rogaine may not work forever, which means subsequent surgical procedures may be necessary.

I recommend consulting with at least 3 high quality hair transplant surgeons and using our hair loss forum as a tool to see what their patients are saying.

Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: Propecia, finasteride, hair loss, hair transplant, balding, hair restoration, balding, baldness, finasteride, minoxidil, hair replacement, Rogaine

The Hair Transplant Network is a patient driven hair restoration community giving hair loss sufferers and patients a chance to learn about and share their hair restoration experiences, results, and photos online.   Balding men and women seeking real hair loss solutions can view these photos or share their own experiences by visiting www.hairtransplantnetwork.com/blog.

We will be featuring a few balding blogs each week for our newsletter subscribers.

This hair transplant patient received 2053 follicular unit grafts with Dr. Ron Shapiro, a well respected member of the Coalition of Independent Hair Restoration Physicians.  At only 5 months after surgery, this patient already has grown a good bit of hair.  Be sure to follow his hair restoration journey on his blog.

Dr. Epstein, also a well respected member of the Coalition transplanted 2700 follicular unit grafts over the balding frontal half of this patient.  Though 5 months is far too early to determine the final result, his new hair is already starting to blossom quite nicely.  Be sure to encourage this patient by posting comments on his weblog.

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Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: hair restoration, hair loss, Balding, balding blog, follicular unit grafts

This insightful information was posted on our hair restoration forum by Dr. Martin Tessler Southfield, MI who is an elite member of the Coalition of Independent Hair Restoration Physicians.

I have thinning hair on my crown and have been losing my hair for about 3 years now. I am 25 and it is really starting to disturb me and curb my social activities. I am worried about continuing further hair loss and it getting even worse.  I want to get a hair transplant to thicken up the crown area and perhaps look at adding something to the receding hairline.  I’m currently on Propecia (finasteride) and Rogaine (minoxidil) for about 1.5 years.  Any thoughts would be appreciated.

Without examining you in person it is difficult to give you a definitive answer. From the photos you look like you have a fairly dense donor area and that your hair has some curl to it. Also, if you have a lot of finer, shorter hairs in the crown that are only an inch or so in length you could be a candidate for a relatively small hair restoration procedure even though you are only 25. Over the past 10 years I have done a single smaller surgery on hundreds of young balding men who are willing to take Propecia. The surgery and the Propecia work together, where we see very significant hair growth that exceeds expectations. Most of these hair transplant patients have had minimal further hair loss as long as they continue Propecia. Since a very small amount of donor hair is used, in many there is no real downside. They return for refills on their hair loss medication, not more surgery.

Technorati Tags: thinning hair, losing my hair, hair loss, hair transplant, Propecia, finasteride, Rogaine, minoxidil, donor area, hair restoration, balding, hair growth, hair transplant patients, donor hair, hair loss medication

Hair Transplant Patient Photo Albums of the Week

Get past the hype of commercialized claims and come to our hair restoration forum to see “real deal” before and after hair restoration pictures posted by real hair transplant patients.  In a world of uncertainty and commercialism, what you see is what you get on our hair loss forum.

Well respected forum member “NervousNelly” shares his 6 month hair transplant photo update.  NervousNelly had his hair replacement surgery performed by Dr. Ron Shapiro and received approximately 2900 follicular unit grafts.  Though he still has a lot more hair growth to come, he is already seeing the great benefit of hair transplantation.  Be sure to congratulate him on his new head of hair.  See also his before and immediately postoperative hair transplant photos by clicking here.

Forum member “Avrian” received 3000 follicular unit grafts with Dr. Wong and has returned to our hair loss forum to share his one year hair transplant result with us.  Click here to see his photos and congratulate him on his new hair.

Click here to see over 5 years of hair transplant patient posted photo albums and experiences shared.  To create your very own free hair loss blog, click here.

Bill - aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: hair restoration, real hair transplant, hair loss, hair replacement, follicular unit grafts, hair growth, hair transplantation, hair transplant photos, hair loss forum, hair transplant patient, hair loss blog