A 26-year-old male would like to have a hair transplant. He wants to know how many grafts he needs to cover his bald areas.
Dr. Amiya Prasad, a hair restoration specialist, explains that this male is assuming that his hair loss will not continue after a hair transplant, but that’s not the case. He is very young and has very advanced hair loss. He explains that it’s very important to understand that hair loss is progressive. The fact that he had onset at a young age and progressed to a very advanced stage means that he will still continue to lose hair. Whatever number of grafts he gets will not likely be enough to get the desired result.
When Dr. Prasad was training in facial cosmetic surgery in the early to mid-90s, it was common standard in his profession to not transplant to someone in their 20s. Men in their 20s, only 20% or so of the contemporaries have hair loss and 80% have a lot of hair. Whether it’s rational or irrational, the expectation is to get a lot of hair from transplant surgery. Doctors and institutions or companies are trying to beat each other and selling hair transplant procedures by the number and costs of grafts.
As a physician and surgeon for 20 years, Dr. Prasad’s job is to counsel patients. The donor area is the limited band at the back of scalp. Whether the surgeon does follicular unit transplant, FUEs or whether they’re using any type of new device including robot technology, doesn’t change physiology. That number is a mismatch with the surface area of the scalp that needs coverage. The International Society of Hair Restoration Surgery survey of membership showed clearly that 65% of patients wanted more density.
Many patients have surgery after surgery to try to cover the scalp with as many grafts as they possibly can. If they continue to lose hair, the scalp still looks like they’re losing hair which is not a desirable result. In other people, if they concentrate the hair grafts in that particular area in a particular way, when existing hairs thin out, they look pluggy. They look like they have hair grafts and that gives hair transplants a bad name.
In Dr. Prasad’s practice, he developed a treatment as an alternative to hair transplant. For people in their 20s, he always advocates based on experience that the earlier a patient comes, the better it is. He calls this treatment Hair Regeneration that uses a wound-healing material that appears to halt the progression of hair thinning and causes a reversal at various levels depending on how advanced the hair is thinning. He can save the dying but he can’t bring back the dead. He has treated people as young as 18-years-old with very nice results because the earlier he catches them, the better it is.
Dr. Prasad also suggests to consider any medical therapy to stabilize his hair loss whether it’s finasteride or minoxidil. Currently, a lot of males are not taking finasteride because of concerns of long-term sexual side effects. In Dr. Prasad’s practice, he has been put to the test of using Hair Regeneration as a standardized or standalone treatment in the absence of using any support from using finasteride and he has had excellent results. Close to a 100% of his male pattern hair loss patients do get results.
When people are exploring options, it’s very important to understand the limitations of hair transplantation and to stabilize their hair loss. Whether they do it with medical therapy, with technology like Hair Regeneration, it is critically important for them to stabilize their hair loss progression. Before they start shopping for grafts and costs, they must learn about their options and be realistic. Dr. Prasad has seen a lot of patients who are in their 20s who have had transplant in their early to mid-20s and they are still losing hair. They are coming to him to try to find a solution because they realize that they can’t transplant enough hairs to get the results they want. At the same time, they are stuck because as they are losing their existing hairs, it’s become obvious that they had hair transplants which is not a good place to be socially.
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