Hair loss stages are categorised in useful guides to help diagnose the extent of hair loss. For both men and women. With the Norwood Scale being a classification for men, from remedial thinning to progressive hair loss. This makes it easier to understand the present hair loss stage and determine the potential future loss. The Scale starts at 1 at its most minor up to 7. With the number rising the more aggressive the hair loss pattern.The female version is known as The Ludwig Scale. This works in a similar way to categorise the stages of thinning. Although, the hair loss pattern is generally different. But helps to give a broad overview of the problem.
As there are many causes of hair loss, some systemic, traumatic, chemical. It is important before any treatment is started, that a full consultation assessment is made.
Hair characteristics make a difference
Hair charactericts play an important role in the distribution of hair. Aspects such as hairline placement, density and thickness can vary from, genetic background and hair characteristics.
These hair characteristics can range from hair colour, calibre or diameter of the hair, fine or thick. Whether the hair is curly or straight to the contrast of the hair against the skin complexion. These aspects and more play an important role for the doctor when planning your hair transplant procedure. As well as impact the density and coverage achievable. Whilst maintaining a natural looking coverage and blending with the existing hair.
Ideal hair characteristics include a thick hair shaft, curly or wavy hair. A lax scalp and a low contrast between your skin colour and your hair colour. With good hair characterics even high Norwoods´can achieve the appearance of coverage and density. Without getting close to the original hair density of a full head of hair.
Supply and demand
The areas of hair loss can be divided into three regions: the front, the mid-scalp, and the crown or vertex. With the front including the hairline.
The total area of hair loss may vary from 5 to 250 square centimetres. This is an approximate measurement as the scalp is not flat but contoured and measured in volume. For instance, the growing size of the crown can reach as large as 175 cm2. Even if a minimal density (15 FU) was transplanted to a fully bald crown (175 cm2). Roughly 2600 FU would be used. Transplanting a higher density, 40 FU, the number would be close to 7000 grafts. This is more than the average candidate has available in their donor area.
As it´s generally impossible to match like for like hair density as the pre-hair loss stage. One art of a hair transplant is to create the illusion of fullness much much fewer hairs. Trying to match the pre hair loss density often results in trauma to the skin and hair. As well as going through the avaiable safe donor in no time at all. As a result minimises the hair coverage achieved over time.
The art of creating hair coverage for advanced hair loss stages
A hair transplant is largely the illusion of a full head of hair. With much of the surgical and artistic skills going into the careful distribution of the hair. However aspects such as hair length also play a role. When the hair is longer it blocks the reflection of light on to the scalp. However, the shorter the hair allows light to relfect back off the scalp. This is often true regardless if a hair transplant or natural head of hair.
Therefore the skill comes to place a hair density to look natural and block the light reflection off the scalp. But also maintain safe donor hair management and use the avaialble hair wisely. Allowing progressive hair loss to be successfully treated. Using the hair characteristcs and surgical skills to place the hairs in such as way they maximise the hair coverage.
However, some may need to be content with less coverage. All be it a natural looking hair density over the treated area. Rather than spreading the hair over a larger area with a lower hair density. Resulting in a thinnner head of hair, which inevitably looks unnatural.
Do I need more than one surgery?
On average an hair transplant candidate will have two sesssions. Often many years apart when planned well. There is a safe limit to the size of the donor area. As well as a safe limit how many can be transplanted per session. Sometimes dependent on the techniques used or other issues. Even treating advanced hair loss, best not to use all the resources in one session. While it may take longer to achieve the desired goal. It will ensure a better and sustaiable result long-term.
With careful donor management allows the sensible and ethical distribution of hair to gain the maximum result for the patient. The best healing and look, for the donor and recipient areas. For instance, with the combination and use of both FUT and FUE techniques. It is now possible to widen the harvest area and increase the overall graft number potential. Each techniques has pros and cons. When used to their best can help to maximise the donor supply. As well as acheive the best hair coverage and natural looking fullness of hair.
Improvements in surgical hair restoration
FUE or Follicular Unit Extraction removes the hair units individually. Subsequently every hair removed lowers the remianing donor hair density. As long as the hair removal is carefully spread, along with capping the amount taken. Then a clean looking donor area can be maintianed. However, when too much is removed or an uneducated pattern of extraction. The results can be patchy areas, with obvious changes in hair thickness around the donor area. Because of this, FUE becomes harder the higher the hair loss pattern. Trying to achieve the desired hair coverage without it being at the expense of a depleted and scarred donor area.
The Strip or Follicular Unit Transplant technique is less preferred today. But that does not mean it is less effective as a hair transplant technique. Especially in expert hands for larger sessions and high NW cases. Strip has the ability in a one day session to efficiently and safely move a high number of grafts. It will leave a linear scar but then any hair transplant has limitations. If this is a concern, the Trichophytic Closure has greatly rediced the visibility of the linear scar. Even with shorter hair.
Advances in hair transplant surgical hair restoration techniques are well suited to treat even advanced hair loss stages. With careful planning undecatable hair restoration is possible. With both the recipient and donor areas in the best possible condition. The best hair restoration doctors will plan. Using your natural hair characteristcs, their surgical and artistic skills to achieve the best long-term result. This planning from the first session is critical.
