Is it too late for a hair transplant?
How bad is the situation?
If you are almost completely bald, except for the fringe of donor hair around the back and sides of your scalp, you have lost the equivalent of approximately 25,000 grafts. The number of available grafts in the average person utilizing a single harvest method (strip or FUE), is about 6000-8000 grafts. You can see that there is a supply to demand mismatch—you need 25,000 grafts and I only have 6000-8000 grafts to work with.
Is it hopeless?
It depends. If you want a full head of hair and look like you’ve never lost any hair, the situation is hopeless. If you are willing to accept moderate scalp coverage (the appearance that you have some thinning), some bald areas are not covered or have thin coverage, willing to use both strip and FUE graft harvest methods, and consider body hair transplants (beard, chest, and abdomen hair), there is hope.
A single harvest method, FUE or strip, has the limit of 6000-8000 grafts. If you are willing to utilize more than one harvest method, the number of available grafts is increased to 10,000 to 12,000 grafts. This is usually enough to cover all the bald areas with moderate density.
See patient before and after images shown here and then visit Doug’s case study.
That’s great, but …
You already said I’ve lost up to 25,000 grafts and all I have available is 10,000-12,000, I’m still short about 12,000 grafts. Nature gave us a great gift. In the average person, 12,000 grafts appear to be the same thickness as 24,000 grafts—the human eye can’t perceive the difference very well. We use this trick to cover as much of the bald area as we can using fewer hairs than you had in the area originally. Body hair can be used to fill in some of the gaps.
What else do I need to know?
The process of obtaining 6000-8000 scalp grafts or more will require 2-3 procedures. To add a second harvest method may require another 2-3 procedures. Adding body will add more procedures.
Start saving what you have.
If you’ve lost that much hair you should be on medical therapies such as finasteride and minoxidil. You won’t grow new hair with this regimen, but it will help you in several ways:
- Keep the bald area as stable as possible and slow the hair loss process
- It will ensure that the health of the donor hair is maximized give the best transplant result
Scalp micropigmentation and HS Max fibers can also be useful in making the transplant result look thicker. These do this by decreasing the contrast between the scalp and the hair.
The bottom line.
Even in cases of extreme hair loss, a hair transplant is reasonable if you’re expectations are realistic and you are willing to accept multiple procedures, multiple harvest methods, and adjunct products or procedures.