3 Things you Must Accept before Your Hair Transplant
written by Matt Dominance
In the following article, we will break down each of the 3 things you must accept before your hair transplant!
- Your transplanted hair density can never be the same as your receded once hair used to have
- Your new hairline can´t be positioned as low as where your “old hairline” used to be
- Your hair loss won´t stop just because you got a hair transplant
1. Transplanted hair density can never be the same as it used to be because of your donor area limitations.
Why is your donor area so limited?
The donor area is the area on the back of your head, which becomes the donor of your new hair follicles once you decide to get a hair transplant.
Which type are you on a “balding scale” from 1 to 7?
Scientists found out, that after a man with predisposed hair loss condition reaches the last hair loss stage (Norwood 7 on the Norwood and Hamilton scale). The only hair left ends up being the one on the sides and back of his head creating the typical horseshoe pattern you see in so many bald guys.
If you ever go bald, the hair on your sides and back of the scalp will likely remain there for ever. That´s why hair transplant doctors use it for the hair transplants and call it the donor area or donor zone.
How many grafts can be extracted with FUE?
The average donor area has around 12,000 to 14,000 hair follicles (grafts) in it. From these 14,000 hair follicles only about 30-35% can be “safely” extracted with the FUE (follicular unit extraction).
Safely = no over-harvesting of the donor area. Technically, even 50% of the hair follicles in the donor area can be harvested with the FUE.
Unfortunately, this will disrupt the homogeneous pattern of grafts extractions performed over time. This makes the donor area look patchy and hairless.
FUE and FUT – 2 main hair transplant procedure types
There are two main types of hair transplant procedures: FUE (follicular unit extraction) and FUT/FUSS (follicular unit strip surgery).
If you decide to get FUT, the doctor will only harvest the grafts from the “safe donor area” (*see the picture above), which has the most DHT-resistant hair.
By choosing the FUE, the doctor can selectively harvest some of the grafts also from the areas of thinning which tend to have permanent/semi-permanent hair.
The best overall results can be often achieved by a clever combination of FUT and FUE procedures in order to maximize the whole potential of the donor area. But later about that…
How many grafts can be extracted with FUT?
With the FUT/FUSS (follicular unit strip surgery), doctors choose an area on the donor with particularly high hair follicle density per square cm and extract the whole area together with the skin tissue and then sew it back.
Patients end up with a linear scar across the back and sides of their head.
Strip surgeries generally lead to higher number of grafts (hair follicles) extracted over time in comparison to FUE.
The reason for that is: FUT doesn´t affect the overall density of the whole donor area. FUT only reduces the hair density on a small portion of the donor area.
Utilizing the FUT method for one hair transplant and additional FUE for 2nd or 3rd hair transplant usually leads to the best results for men with advanced baldness like NW-5 and higher.
This combination is likely to provide the most clever utilization of the whole donor area capacity.
Hair transplant usually give only 50% of your original hair density! Why?
Hair transplant doctors found out, that if they restore the new hair in a density which is approximately 40% – 50% of the previous hair density, hair transplant will look natural and almost undetectable.
Higher density is possible, but not advisable in most cases.
Instead of that, hair transplant doctors all over the globe learned to selectively place different types of hair follicles (single, double, triple, quadruple, etc.) on various spots of the balding scalp in order to create a better illusion of full head of hair. In reality, hair transplants are not about choosing the highest possible density, but rather creating an illusion of full head of hair by:
- Implanting the hair under the right angles which differ based on their positioning on the scalp (temples, frontal hairline, central region, crown area, etc.)
- Combining the thinner single grafts with the thicker double and triple grafts in a clever way to create a natural and well-blended result
- Utilizing patient´s skin-color contrast and hair properties for an optimal hair implantation plan
The gentleman could have done 2 things to prevent this situation from happening:
- He should have chosen a more conservative hairline for his first hair transplant
- He could have waited with his 1st hair transplant until his hair loss stabilized first
- He should have started with hair loss management way earlier in order to prevent his native hair from miniaturizing almost to a point of no recovery (as you can see on the photo)
2. Transplanted hairline should never be positioned as low as where your old one used to be
Maybe you have heard hair transplant doctors saying: “He´s too young for a hair transplant” or in your case: “You are too young for a hair transplant. Please go on medication first!”
Risk of positioning your new hairline too low
Technically, hairline can be positioned to the lowest point of your previous hairline (where you forehead muscles stop moving). It is not recommended though.
By designing a new hairline, you have to ask the following questions:
How likely is my hair loss to progress in the next years/decades of my life from where it is now?
How will I be able to cope with it in the future? Do I have enough donor hair to keep up with future baldness?
Will I enjoy having this adolescent hairline also 10-20 years from now?
What if the hair loss medication I am on stops being effective after couple of years and I start losing more hair?
Because of this risk, not every hair transplant doctor is willing to design adolescent hairlines for his patients. Because of these risks, some doctors don´ accept young patients with unstable hair loss – which is the right thing to do. Once you have been successfully managing your hair loss with hair loss medication for at least a year or two, the doctors are more likely to come up with a hair restoration plan for your situation despite the young age.
No matter in which age you decide to get your hair transplant, you should always aim for a conservative hairline with a sign of temporal recession. You´ll realize, that such a hairline will be more and more suitable for your age as the years go by.
3. Your hair loss won´t stop just because you got a hair transplant.
Even after you get a hair transplant, you´ll need to take hair loss prevention seriously and do everything you possibly can to avoid further hair loss.
In order for you to successfully manage your hair loss also in 2020, make sure you read my latest article on hair loss prevention – “How to use Finasteride, Dutasteride, Minoxidil and other topicals in 2020 for effective hair loss prevention!”