Advanced Hair Loss – Importance of Stopping Continued Loss, and Maximizing Limited Hair Transplants

Advanced Hair Loss – Importance of Stopping Continued Loss, and Maximizing Limited Hair Transplants


Thank you for your question! You’re 29-years-old and you submitted a
very good photo and you’re asking about how many grafts you would need in order to
build a good frontal hairline. I can certainly assist you with this question. And you also stated in your question that
you started hair loss approximately 8 years ago. So my approach to helping you with this question
is to be describing just how we approach patients like yourself in our practice. A little bit of background, I’m a Board-certified
cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. Thank you for your question! You’re 29-years-old and you submitted a
very good photo and you’re asking about how many grafts you would need in order to
build a good frontal hairline. I can certainly assist you with this question. And you also
stated in your question that you started hair loss approximately 8 years ago. So my approach
to helping you with this question is to be describing just how we approach patients like
yourself in our practice. A little bit of background, I’m a Board-certified
cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have
been in practice in Manhattan and Long Island for over 20 years and I am also the founder
of TrichoStem™ Hair Regeneration Centers. This is a method that we developed in our
practice of non-surgical restoration of thinning hair for both men and women with 99% success
rate which was developed from practicing performing hair transplantation which we have been doing
for over 20 years. So in counseling people about hair transplant,
I always start by first asking the question about age of onset and learning about their
rate of progression. So in your situation, you started around 21 which means you probably
started earlier than that. It has been my observation, it’s generally well accepted
that if someone notices hair loss, they’ve already lost about 50% of their hair. Now
that being said, you have very advanced hair loss now at the age of 29. So you have to
ask yourself where will you be a year from now, 2 years from now and that’s where my
concerns about stabilization is what I first bring in front of the patient because you
can transplant hair but the problem and limitation of transplantation is the number of grafts
available from the donor area. And regardless whether you use a strip method, whether you
use follicular unit extractions, whether you use robots, whether you use any technology,
the limitation is the true permanent zone in the back of the scalp. And if you just
think about the baldest person you’ve ever seen, there’s a very narrow band of hair.
Hair loss just doesn’t happen forward in from the front going backward but in the back.
It can actually go from the bottom upward. So you have to think about what do you have
available. That being said, you also have to think about
what makes up a natural hairline. A hairline where there’s continuity between the front
and the sides looks a lot more natural than a hairline that’s just a frontal hairline
and the sides have dropped down. So when you think about it, it’s very important that
stabilization be established. Now how do you do that? Now, there are two medical therapies that
are approved in this country: one is the use of minoxidil and the other is the use of finasteride.
Finasteride is a pill that you take daily and it falls in the category known as DHT
blockers or dihydrotestosterone blockers. Essentially, finasteride systemically will
stop an enzyme called 5-alpha reductase to inhibit conversion of testosterone to dihydrotestosterone.
The challenge is only 60% of men will actually respond and that’s because only 60% of men
may have DHT-sensitive hair loss. In addition, it is generally well observed that finasteride
doesn’t stop progression but rather, it slows it down. Now it’s an option. However,
it has been our experience and it’s probably filtered by people who seek us out, 95% of
men who come to us don’t want to take finasteride and the reason is they’re concerned about
long term sexual side-effects. And not only that, there’s also an issue about compliance. So that being said, we actually help our patients
before doing a transplant with this method we call Hair Regeneration. With Hair Regeneration,
we are able to stop progression, reactivate hair that has not been growing as well as
induce thinning hair to shed and for thicker hairs to grow in. The limitation is salvageable
hair follicles. Basically when someone has male pattern or female pattern hair loss for
that matter, as long as there’s a hair follicle, Hair Regeneration can be of value. If the
skin doesn’t have a hair follicle, it won’t be. So our goal is to stay in front of the
progression so that any hair transplant can be maximally beneficial. Now that being said, when it comes to hair
transplant, in a situation like yours where you fall in a more advanced hair loss situation,
I have to say that you have to be prepared for more than one transplant. There’s essentially
a limit in the number of grafts you can have in one given session in terms of harvesting
and there’s going to be a limit in the density. So when we map out a transplant patient or
surgery, basically I’m drawing square centimeters on the front of the scalp in the area which
we’ll maximally allow for coverage that will help frame the face and I measure the
density and the number of hairs we have available and then we try to maximize any given transplant.
Typically, the strip method generates a lot more grafts than the follicular unit extraction
method and usually, you get the most grafts from your first transplant. Now there’s
going to be lots of people who debates this but again, 20 years of practice and having
a lot of experience, I think it’s still a reasonable statement to make. So I think you need to first think about stabilization
and then think about realistic expectations. When you’re younger, there’s always this
desire to have more volume that is more in line with your contemporaries. There’s something
called the rule of decades that is generally applied. In your 20s, only 20% of your contemporaries
have hair loss. Meanwhile, 80% have lots of hair. When you get into your 40s and 50s and
beyond, well, more than 50% of your contemporaries have hair loss. So there are ways to try to
actually make this so that you actually look good in the long term because you can’t
keep up with the loss. You have to do something for stabilization and you have to be very
strategic with the way the hair is transplanted. So learn about finasteride or medical ways
to stabilize. Learn about the method I described called Hair Regeneration and then look at
that in the context of what a realistic outcome would be for you in terms of transplantation.
You see, it’s not just about the number of grafts. It’s about the coverage and it’s
about where those grafts are placed. Remember, there’s a mismatch. You can’t get enough
from that limited area to cover the whole scalp or even cover the front in a way that
will give you a lot of volume. You want to basically create a natural-looking framing
of the face. So I hope that was helpful, I wish you the
best of luck and thank you for your question!

Scalp Micropigmentation for Women | Testimonial – Before and After | Hair Loss Solution

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3 Replies to “Advanced Hair Loss – Importance of Stopping Continued Loss, and Maximizing Limited Hair Transplants”

  1. hello Dr, using essential oils like coconut, olive, jojoba, sweet almond, emu, lavender, rosemary, cedarwood and etc etc. are these myths that they will restore hair growth? how about taking supplements like pumpkin seed oil, vitamin e, d, omega, flaxseed, fenugreek etc etc? also myths?

  2. Hello Doctor. I'm a 55 year old male with moderate male pattern hair loss. Primarily in the frontal hairline, and mostly in the temple areas. Would I potentially benefit from your hair regeneration procedure? I visited another hair transplant surgeon who said I would need a strip procedure of 2400 grafts. 1400 for hairline, and 1000 in the crown. I started losing hair in my 20s, but the progression was slow. The hair surgeon also told me that the mpb had run its course and would not progress further.

  3. Hello.Im Ali and thanks for your videos.I have a question.my father is 60 and he has wave hair and his hair loss type is norworrd 7.Im 24 and i have soft hair and i have hair loss.It Nw 3 now.is it possible my hair loss gose to him although his har is wave and mine is soft?thanks agane and hope to hear from you soon

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