This is a patient only a few months following surgery of 1622 grafts. He had grafts transplanted to the hairline and sideburns, and while it is unusual to have this much growth at only 4 months, I expect it will get even fuller over the next 4 months. I’m often asked what a hair transplant will look like at various monthly intervals until it is fully grown in, so I wanted to show a unique case.
After only 4 months (1 procedure of 1622 grafts):
Before:
Snippet from the article:
Androgenetic alopecia affects both men and women. In men it produces male pattern hair loss with bitemporal recession and vertex baldness. In women it produces female pattern hair loss (FPHL) with diffuse alopecia over the mid-frontal scalp. FPHL occurs as a result of nonuniform hair follicle miniaturization within follicular units. Diffuse alopecia is produced by a reduction in the number of terminal fibres per follicular unit. Baldness occurs only when all hairs within the follicular units are miniaturized and is a relatively late event in women.
The concepts of follicular units and primary and secondary hair follicles within follicular units are well established in comparative mammalian studies, particularly in sheep. However, discovery of these structures in the human scalp hair and investigation of the changes in follicular unit anatomy during the development of androgenetic alopecia have provided a clearer understanding of the early stages of androgenetic alopecia and how the male and female patterns of hair loss are related.
Read the full abstract — Hair loss in women: medical and cosmetic approaches to increase scalp hair fullness
This is an interesting article published in the British Journal of Dermatology (December 2011) which covers the subject of hair loss in women. The recommendations in treatment suggest early medical intervention with drugs like spironolactone, minoxidil, and finasteride. When the hair loss becomes advanced, hair transplants work well if the hair in the occipital area (donor area) remains relatively unaffected by the process found in the balding area. The article also suggests women should use camouflaging agents to help give the appearance of thicker hair. There’s nothing particularly groundbreaking in here, but it’s a good overview.
Based on our experience at NHI though, unfortunately the donor area is often not spared in the woman with advanced balding so that the number of good candidates are limited. We have found that if the donor area has significant miniaturization, transplanting this hair to the thinning area often fails to give full benefits. Many women aren’t surgical candidates for this reason.
How long after a HT do you think i would have to wait before i could climb 14,000 feet mountains again?
Give it a week or so, then whenever you feel ready after that should be fine! I generally tell people that they could even run a marathon a week after a hair transplant. One man thought that was great, because he never was able to run a marathon before he had a hair transplant.
This site is great, and I’ve learned a lot from it.
My question is – I am a young man (mid 20s) thinning in what appears to be evolving into a NW 7 pattern, given a family history of NW7’s, and I am taking finasteride.
Is it possible/advisable to get a conservative hair transplant with a Norwood Class 3 hairline? I have accepted the fact that I will lose my hair someday, but I would like some hair in the front/top to frame the face, would such a course of action be advisable?
I’m glad that you’ve found the site to be a useful resource.
You might be able to get to that Norwood 3 hairline through surgery, but what you need is a Master Plan that takes the following into consideration:
With that information and a great doctor, the question can be refined with an appropriate answer catered to your needs.
Since birth, I’ve had a large bone/lump where my head meets the neck. I think its called the occipital bone? I was wondering if I could still have a FUT surgery? My concern was basically would the area be more difficult to close after the strip was removed?
No problem at all! We see larger occipital bones in many patients who have had FUT (strip surger). We just saw a patient in the office with this same question and there is no issue.
Is it safe to use minoxigel 5% after hair transplantation? my transplanted hair falling down. its just second month after my transplantation.
It’s very common for transplanted hair to fall out after the surgery and go through a dormant phase. It will regrow in a few months. Talk to your surgeon about aftercare. I’m surprised your doctor didn’t explain what to expect following your hair transplant.
I’m not familiar with minoxigel (unless you mean minoxidil), but if you’re two months out of surgery it should be safe.
Hello Drs.,
I am a 35 year old male (of Korean descent) and I currently have a Norwood 2 hairline (by checking the top of my hair with a mirror).
My question is in regards to hair transplantation for those who are at the early stages on the Norwood scale. I know that most responsible hair transplant doctors will not treat Norwood 2 patients. Thus, my question is what is the minimum stage a person must be at on the Norwood scale for a serious consideration of hair transplant surgery? Thank you.
I’ve been asked this before, but I’d have to advise a one-on-one consultation. Each case is different. It is possible that a non-balding person does not like the shape or the height of the hairline and wants it altered. Such cosmetic surgery is not hair transplant surgery for balding.
My question is about coping with hair transplants. It seems like one of the biggest challenges/inconvenience of transplants is for patients to go out in public and resume their daily responsibilities after surgery because of the physical appearance of the scalp and how it initially is red, scabby, and punctured after surgery. I find this a very unappealing aspect about transplants and Im wondering how do patients cope considering the gruesome appearance of the scalp after surgery- do they take time off work and just lock themselves in their house until their scalp starts healing?
The scabbing can be easily addressed with good techniques and small wounds by the surgeon. Add good daily washes and most patients will have no significant crusting after the surgery. Everyone is different, but in regards to redness, only a few patients develop this. You can usually find out if you are one of them by performing a scratch test on the skin of your forehead. If it turns red 2-5 minutes after the scratch is performed, then you run a high risk of redness after surgery. The scratch incites histamine release at the skin level.
Remember, no matter how you want to look at it, a hair transplant is a cosmetic surgery. Just like any nose job, face lift, etc, there will be healing time needed. Some patients might get permission to wear a hat to work, others might adopt a new styling method to cover any initial redness from the surgery. Many of our patients go back to work fairly quickly after surgery (usually 2-5 days).
Hypothetically can Finasteride for shock loss be discontinued after a period of time has elapsed after the Hair Transplant operation and the risk of shock loss has receded?
Yes, you can take finasteride temporarily to just protect against shock hair loss. I generally tell patients to take it for 8 or so months to bridge the gap between the transplant procedure and growth from the new grafts.
This well known Los Angeles radio host has an advanced Class 6 balding pattern. The bald area is huge (as well as his hat size), and the 2700 medium weight hair grafts were distributed so that it would take advantage of weighting to cover the large balding area. In other words, more hair was placed in the front and on the left side than elsewhere. Utilizing weighting so that a left to right combing style could be used to maximize the value of the 2700 graft he received in his first session, he remained see-through in the central and right areas of his scalp where the amount of hair was not great.
Had we been able to remove 4000-5000 grafts safely, we could have filled up the central area and addressed what was to be thin coverage. As you can see in the pictures, the coverage was good for that number of grafts, but he needs another session to complete the process, bringing up the number of required grafts to the 5000+ range.
If you look at our photo albums, you will see many patients who had 3500-5500 grafts to cover the Class 6 pattern adequately. We are limited to what can be safely transplanted in each session. Still, when you look at the photos below, the change with strict styling and the use of a comb-over produced a remarkable change in his appearance and he is very happy with stage one of what will certainly be a two stage process.
Click the photos to enlarge.
After (1 procedure of 2700 grafts):
Before:
Bonus – head shot:
The following post is by UK-based physician Dr. Bessam Farjo:
 Written by:  Dr Bessam Farjo United Kingdom |
While I have discussed my reservations in previous blogs with regards to younger men undergoing hair transplant surgery, I felt that the most effective way to raise my concerns is by offering examples of cases I’ve dealt with in the past.
I’ve been liaising with a patient for several years who first came to me at the age of 19. After a couple of consultations at our practice, we advised him that he should try a course of Finasteride or Propecia before surgery. The patient went away and, after a couple of years, returned to the practice having undergone extensive scalp reduction surgery in Europe.
Scalp reduction surgery is a surgical hair restoration procedure that surgically removes bald scalp and stretches hair-bearing scalp upward and across to replace bald scalp that has been removed. While this is considered an effective treatment for sufferers of hair loss especially in the past, it was not the appropriate surgery option for this patient at the time.
He was 21 when he came back to our practice and had since suffered further hair loss. Once again, we advised he was still too young to undergo more surgery as the full extent of his hair loss was still unknown at such a young age. Against our advice, the patient had a further two hair transplant procedures at another clinic which he was unhappy about. He is now 24 and we’re still in regular contact as his hair loss has severely affected his confidence and self-esteem.
While we’re working with him to try and rectify his situation, it’s imperative that potential patients are educated correctly on the future consequences that may result from premature surgery as well as the, potentially irreversible, damage that can be done.
This patient has dark hair and white skin, and visited our office to repair his hairline. He had the old pluggy hair transplants that were common in the 1980s and 90s. He’s a Norwood class 6 pattern with slightly wavy, fine hair.
The repair took 2 procedures totaling 3401 grafts. These pictures show the entire story of building a frontal transition zone in front of the old plugs to camouflage and hide the deformities. He is very grateful that he now has a natural looking hairline, recently stopping by to say hello and show me the results of his repair. Click the photos to enlarge.
Before on left / After hairline repair on right:
More photos:
Left– Another angle before repair / Center– 8 months after 1st session / Right– Less than 4 months after 2nd session:
I have had 5 hair transplants. All were done by way of the strip method and I am very pleased with the ultimate outcome. However, the linear scar from my 4th surgery is horrible. It is very wide and red. The scars from my prior surgeries and the one subsequent surgery look fine. Because of concerns about elasticity issues, between the 4th and 5th HT I did scalp exercises to improve the donor elasticity which I found on Youtube. My Doctor said that the elasticity between my 4th and 5th surgeries was greatly improved and attributed it to these exercises. With this improvement, I am considering a scar revision with the hopes that the scar from my 4th surgery can turn out like the one from my 5th surgery. Is this realistic?
Lastly, in general would you recommend a plastic surgeon for the scar revision or a hair transplant Doctor? I traveled some distance to have my last hair transplant and don’t plan on making this trip again for a scar revision so I would look for local Doctor to do this procedure.
Thank you for your time
Scar revisions in the hands of an experienced surgeon that deals with hair transplant scar issues on a regular basis is generally better than a plastic surgeon for this type of work. Experience is everything in this process. I don’t know what is realistic to expect, as each case is unique and I haven’t seen you.
If you want to find a doctor in your area, I’d suggest using the physician search at ISHRS.org.
Hi there,
Im 8 weeks post op…I had 4200 grafts done…Everything went well and i seem to have had no problems at all really other than my head feels like i have sunburn…It only stings for a few second if i touch it,other than that its not sore….Just wanted to see if thats normal? Would greatly appreciate your advice on this…Thanks
At 8 weeks after your hair transplant, you should feel normal without pain. I suggest that you see your surgeon and get his opinion.
This 31 year old man saw himself in a TV spot and then panicked as he never realized that he had a huge bald spot in his crown. 15 months ago, he had 1870 grafts into his crown and the results are shown in the photo below. He also had a very small scar from the donor strip measuring 1-2 mm wide, a photo of which I’ve also included.
Click the photos below to enlarge:
After (1 procedure of 1870 grafts):
Before:
