Dear forum readers,
This case highlights an approach that many young patients opt for.
Question - When should I go for a hair transplant?
Correct answer 1 - when your hairloss process has stabilised or run its course.
Correct answer 2 - when you are fully aware that your hairloss process will continue and you will require further HTs to keep up with the hairloss. (you should not be having a rapid hairloss progression)
My advise to patients of all age groups, (and level of baldness), is to assume that their hairloss may progress further and they may have to go for further transplants. If you are not ready for that, you are not ready for your first hair transplant.
As a hair transplant doctor, I will not like my patients to carry on their life like an unfinished art piece.
Some famous personalities that are unfinished HTs in my opinion (they are not my patients) - US Vice President Joe Biden, Italian PM (or is it president)Berlusconi and former Pakistan PM Nawaz Sharif.
Please feel free to join in the discussion with your input.
Coming to the current case.
Let me call him by the nickname Young1.
He visited us in 2006. He had gone through a phase of rapid hairloss in last 2 years but had finally managed to slow it down with use of minoxidil.
He had a family history of hairloss. Some members of family on mother’s as well as father’s side had progressed to NW 5, and 1 grandfather was a NW 6.
These are the pictures of Young1 in 2006.
I would request forum veterans to give their inputs. It would be educational for the new readers and patients alike.
» Now that doctors can use body hair as donor, I don’t think it is that big
» of a crime to have hair transplant at a young age, don’t you think?
Sometimes it doesn’t matter you are not using scalp hair but body hair as donor.
Ok, you will not have donor scars on the back of your head and you will save precious scalp hair that you could use in the future BUT you will have always grafts placed in the recipient area and they COULD result unnatural/inappropriate in the future, depending on progression of your hair loss.
» Dear forum readers,
» This case highlights an approach that many young patients opt for.
»
» Question - When should I go for a hair transplant?
»
» Correct answer 1 - when your hairloss process has stabilised or run
» its course.
»
» Correct answer 2 - when you are fully aware that your hairloss
» process will continue and you will require further HTs to keep up with the
» hairloss. (you should not be having a rapid hairloss progression)
Dr. Arvind , the problem is that even if both condition 1 and 2 are met, I still have no idea how to estimate the numbr of donor grafts I can spare (over my lifetime) and thus how how aggressive or conservative my hair transplant should be.
»
» Dr. Arvind , the problem is that even if both condition 1 and 2 are met, I
» still have no idea how to estimate the numbr of donor grafts I can spare
» (over my lifetime) and thus how how aggressive or conservative my hair
» transplant should be.
Dear kk,
That is one of the reasons that planning for the worst case scenario, and, donor assesment should be done before the 1st hair transplant. The doctor and the patient should go over the future hairloss possibilities. It is not difficult to assess the available donor for the individual person (stripFUHT, scalp FUSE, beard and robust body hair).
» » Now that doctors can use body hair as donor, I don’t think it is that
» big
» » of a crime to have hair transplant at a young age, don’t you think?
»
» Sometimes it doesn’t matter you are not using scalp hair but body hair as
» donor.
» Ok, you will not have donor scars on the back of your head and you will
» save precious scalp hair that you could use in the future BUT you will have
» always grafts placed in the recipient area and they COULD result
» unnatural/inappropriate in the future, depending on progression of your
» hair loss.
I know what you are saying but if we can plan ahead to incorporate body or beard hair from the very beginning, we can easily double the donor supply. That makes a huge difference.
» Dear kk,
» That is one of the reasons that planning for the worst case scenario, and,
» donor assesment should be done before the 1st hair transplant. The
» doctor and the patient should go over the future hairloss possibilities. It
» is not difficult to assess the available donor for the individual person
» (stripFUHT, scalp FUSE, beard and robust body hair).
»
» Regards,
» Dr. A
It is not difficult to assess donor availability from beard and body hair cause they are more or less fixed throughout your life, scalp donor is different, it would be like chasing a moving target trying to determine scalp donor supply for someone, a NW2 today can become a NW5 in 3 years.
» »
» » Dr. Arvind , the problem is that even if both condition 1 and 2 are met,
» I
» » still have no idea how to estimate the numbr of donor grafts I can
» spare
» » (over my lifetime) and thus how how aggressive or conservative my hair
» » transplant should be.
»
» Dear kk,
» That is one of the reasons that planning for the worst case scenario, and,
» donor assesment should be done before the 1st hair transplant. The
» doctor and the patient should go over the future hairloss possibilities. It
» is not difficult to assess the available donor for the individual person
» (stripFUHT, scalp FUSE, beard and robust body hair).
»
» Regards,
» Dr. A
What is the worst worst worst possible scenario, can I assume that a norwood 6 can spare 5000 grafts from his scalp?
» I know what you are saying but if we can plan ahead to incorporate body or beard hair from the very beginning, we can easily double the donor supply. That makes a huge difference.
Yeah it could be doubled but we were debating on the convenience to have a HT in YOUNG age using body hair as donor.
From that point of view it makes no difference because the young man could be obliged in the future to have other procedures to “adjust” his first result, depending on his evolution of hair loss. And he may not be in the conditions (economic and non) to deal with other HTs.
He has to understand he could be forced to continue on HT route and from this point of view it’s not that important he has used body hair in his first HT. Yes with body hair he could have a richer donor with more possibility to “cover” the empty areas but the concept remains the same: it’s not always advisable or ethic to “force” a young boy in the future to have other procedures (with the costs they entail) just to continue/adjust what was done in first place.
» It is not difficult to assess donor availability from beard and body hair
» cause they are more or less fixed throughout your life, scalp donor is
» different, it would be like chasing a moving target trying to determine
» scalp donor supply for someone, a NW2 today can become a NW5 in 3 years.
Dear Ipod,
The scalp donor area is a fixed zone. Whether a person is a NW 2 or NW 5 does not change the safe donor area from where grafts can be extracted for transplant.
I sometimes come across pictures posted by other clinics where the grafts have been clearly extracted way above the safe donor area (usually the patient is a NW 3or 4 in such cases). This is not good and I sincerely hope they inform the patient that there is a risk that the patient’s hairloss may progress and he may lose the transplanted hair taken from outside the safe donor zone.
Zayden’s case is a classic example. One of his flap was taken outside the safe donor zone. Therefore, when he progressed to a NW 6 status, the non safe part of the flap also lost hair.
Young1 went for a 1500 FUHT grafts (and a test bht session) procedure in his 1st sitting in 2006 knowing that it will leave a strip suture and that he will require to go for further procedures as and when he loses more hair.
» Dr. A, I am confused, the 1500 was done at your clinic? It was part of the
» total 6987 grafts or was the 1500 done at another doctor’s clinic?
Yes, slashed. The 1st 1500 grafts were done at our clinic in 2006. At the time, the patient wanted to go for that much, conserve his remaining donor for future sessions and see the outcome of the first HT.
After his HT in 2006, Young1 visited us in 2008. In the meantime, the transplanted hair had grown and provided a facial framing.
Simultaneously, hairloss had progressed inspite of medical measures.
These are the pictures taken in 2008 when Young1 decided that his hairloss had progressed to a stage that he should go for his next ht.
He had lost hair in the crown as well as the temple points.
Remember always, no matter what your age or your current speed of hairloss, at present, there is no gadget or technology to predict your future hairloss precisely to the last centimetre (or inch). Its best to plan for the worst with your HT surgeon. It pays in the long run. And, if you are one of those that want only 1 HT, atleast I WILL NOT do your HT.
Regards,
Dr. A
Dr. Arvind someone brought up a good point, this guy’s thinning is on top and behind the frontal hairline, it s best to use body hair as filler mixing with regular scalp donor, this will create a nice improvement and thickness for him without wasting precious scalp hair, don’t you think?
» Dr. Arvind someone brought up a good point, this guy’s thinning is on top
» and behind the frontal hairline, it s best to use body hair as filler
» mixing with regular scalp donor, this will create a nice improvement and
» thickness for him without wasting precious scalp hair, don’t you think?
Dear therapy,
Yes, it is possible to use beard and robust body hair mixed with regular scalp hair. This helps conserve scalp donor hair.
We had done so in many patients (finallyfree, Argentine, Zayden, TH etc.).
However, not every patient wants to follow that option.
Regards,
Dr. A
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