Q. What comes to mind when you think of a hair transplant?
A. The result on top of the head, a new hairline, hair coverage, looking younger maybe? What about around the back and sides of your head?
Often forgotten, not bothered or thought about as an important part of a hair transplant result.
The hair used comes from the area called the “donor area”. Where the hair is genetically healthy and strong. Immune from the male/female pattern hair loss gene. Some of this hair can be removed and placed in the area of hair loss.
With careful planning and surgical skills, multiple hair transplants can be performed over the years which can treat advanced hair loss stages that can´t reach a result in one procedure or for when hair loss progresses as you age and you need to cover new areas of hair loss.
At the time of the first hair transplant, the donor region is pristine. No surgical scarring is present, the skin laxity is untouched. The hair density is at its maximum. With either Follicular Unit Transplant (FUT) or Follicular Unit Extraction (FUE) hair transplant technique. It is a chance for the maximum grafts from the donor. Grafts can safely be removed. With planning the harvesting of the grafts can ensure the donor is left in the best condition possible. To sustain healthy hair growth with minimal change to the skin and hair.
So, what would stop you from having another hair transplant?
There are two main reasons that could hinder future hair transplant procedures. Once an individual has undergone the first hair transplant.
- The donor was never good enough in the first place. The individual was not a good candidate for any hair transplant to be performed.
- The donor area has been seriously impaired and damaged. To the point, it hampers or makes it impossible removing more hair. Without making to the area worse.
Signs of a good hair transplant candidate
A good hair transplant candidate will have some of these positive donor area signs:
High follicular unit density.
An average number of hairs per follicular unit. Ranging from one to four hairs.
Average to good skin laxity.
A defined safe zone to remove hair from.
Being able to sustain long-term hair loss needs.
Unless on very rare occasions. If only one hair transplant can be performed. When the donor area is only good for one hair transplant procedure. They are not a good hair transplant candidate. For one procedure or more. If this is the case then surgical hair restoration should be discounted as a hair loss treatment possibility.
What can impact the donor area so much to stop hair restoration?
Poor healing and post-operative care, poor planning. The management of the surgical procedure by the Doctor or a combination of the two.
Regardless of the technique used, FUT or FUE care and skill is required to ensure the minimum change occurs to the donor area quality, basically the visible signs hair has been removed are kept to a minimum, scarring and hair density. This requires surgical skills and understanding of skin healing regardless of the size of the hair transplant session to ensure minimal changes occur.
The larger the hair transplant session the greater the risks are involved as this will require entering the donor area more times and more aggressively to reach the high numbers. These large sessions sometimes known as mega sessions are possible on the right candidate but are not the norm.
The FUE hair transplant technique is by far the more popular of the two techniques used today. When performed at the highest standard it produces perfectly natural looking results. For the right candidate. Due to unscrupulous marketing tactics by some, and publicising the medical procedure as non-scarring and implying, not even a surgical procedure it has given the impression it is simple to perform, non-scarring and can give a limitless supply of hair.
When hair is taken from around the back and sides of the head for an FUE hair transplant it does not grow back and every hair taken the remaining hair density is lowered.
With planning and taking into consideration the natural hair characteristics, it´s possible to calculate the safe number that can be removed at that hair transplant and a good approximation for the future also. But, if this does not matter to the Doctor and it is more important to achieve high numbers then there will always be negative consequences to not caring for the surrounding hair and skin.
The donor area will be left with an uneven pattern of hair growth caused by the sporadic removal of hair from around the area. There will be an obvious change in the hair density from the areas left untouched and those over-harvested. Scarring, white dots, pitted and ridged areas of the skin are visible due to the damage caused to multiple punches to the skin. Regardless of hair length, the area looks thin and unhealthy due to the cosmetically unnatural pattern of hair growth that remains.
But, you may say, I don’t care as long as I have more hair on top of my head
Well, besides being a short-sighted approach it encourages unethical Doctors to perform a medical procedure to a substandard quality.
The other side of removing so much hair in one session is it not only affects the hair remaining around the donor area it affects the hair removed also. So, in effect a lose-lose scenario.
The trauma caused to the hair grafts will damage the delicate hair follicles and reduce the amount that survives the procedure. This could mean you have 5000 removed and only half that number actually grow over time.
There is no way to avoid this damage either to the donor area of the grafts removed simply due to the very high and poor management of the donor area. There are no special techniques or innovations in medical tools, robots or proprietary methods that can stop the damage caused. Unfortuenly once the damage is caused there is little to nothing that can be done to rectify the problems that arise. Scarring is permanent, the hair does not regrow the existing hair is often also damaged and one solution is to camouflage the area with a cosmetic procedure such as scalp pigmentation.
So, if you are not careful you end up with less hair than you thought you were getting and you can´t have any more hair transplants because there is little to no more that can be taken. Not a good scenario.
Be careful and do your research before believing the highest numbers are best and new techniques allow for more grafts to be removed safely. Check with multiple clinics when you do your research to receive many replies and opinions to double and triple check. And, an old adage, if it sounds too good to be true it´s often because it is. Good researching!