Can a man with severe hair loss and limited donor hair have a hair transplant in the front and use a hair system in the back in order to create the natural look of a full head of hair?
Although someone may commit to wearing a hair piece forever, surgical planning must take into consideration the reality of the patient eventually deciding to abandon his hair system. An important point relating to this is the relatively confined nature of the transplant zone that is created using the transplant/hair piece integration plan. Knowing that many hair piece users have an advanced pattern, the primary concerns of hair piece abandonment are future graft availability and the ability (or inability) of the hair transplant surgeon to restore the bald scalp to the patient’s satisfaction for density and coverage.
Men who choose to wear a hair piece often have high density expectations. Unfortunately the inverse relationship between supply and demand will only allow limited coverage and/or density in someone with an advanced Norwood Scale pattern. Preoperatively, men who opt for the transplant/hair piece integration option need to understand the following: 1) they may one day decide to abandon their hair piece despite their present day commitment to a lifetime of wearing it; 2) additional surgery may be required to extend the graft zone toward the midscalp and crown if they abandon the hair piece; 3) coverage and density will undoubtedly be limited as compared to what was realized with the hair piece; 4) the final goal will be to produce the most natural end result.
Fortunately, most long term users who eventually decide to abandon their hair piece are content with lower density and less overall coverage. The key to preparing for unexpected hair piece abandonment is to properly educate the potential transplant/hair piece integration candidate prior to beginning the restoration process about what will be possible should additional surgery be required.
I realize this is not an option for everyone, but it is a good option for well-selected, properly educated and highly-motivated patients. The average patient will require 2500-3000 grafts to achieve a satisfactory integration depending on the size of the zone and the density objectives.
To view photos of a patient who has integrated a hair piece with hair transplant surgery, see the following discussion on the Hair Restoration Forum and Social Network:
Dr. Raymond Konior