Guidance For Prospective Asian Hair Transplant Patients

I’m Asian, Chinese to be exact, and was curious about any distinct traits of “Asian hair” that may present unique challenges for hair transplant operations. I understand that Asian hair is typically comprised of 1 or 2 follicular units which is the reason the why most Asians have very straight hair. Does this mean it’s harder for Asians to receive a cosmetically successful hair transplant since they have less follicular units? What challenges does this present for the performing hair transplant surgeon? Does this mean “dense-packing” is really important for Asian hair procedures? Would Asians need more grafts to cover a similar area compared to non-Asians since they have less follicular units? Any comments on these issues and any specific guidance for prospective Asian patients would be greatly appreciated. - Alex
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Dear Alex:

Thank for your letter. You certainly have a grasp of the unique traits and “Asian hair” and you bring up some interesting questions about the implications of hair restoration in the Asian population.
You are correct that in Asians the follicular units tend to have one or two hairs on the average rather than two, three, and four hairs, but I don’t necessarily believe that that is the reason that Asians have straight hair. Read more

Female Hair loss at 24 Years Old - Is a Hair Transplant Right For Me?

I am a 24 year old African American female. I noticed approximately 3 years ago that my hair was thinning at my temples (more so on the left than right). Approximately 2 years ago I notice that my hair line (top-middle) is receding and has now gotten to the point were it is noticeable to others (it is still pretty minor, but has progressively gotten worse). I initially thought that the thinning around my temples was due to traction alopecia and immediately changed my hair styling routine. I didn’t expect the thinning to get better but, as it continues to progress I am more convinced that this is genetic (even though no females in my family this problem). I was recently informed by a dermatologist that my loss is not consistent with female pattern hair loss and that Rogaine probably would not help.

If my hair loss is not of female pattern loss, can it still be considered genetic? And, as I’ve described my loss, do you think I could be a candidate for a hair transplant?

Please know that this has caused and is causing severe emotional distress and I need to know if there is anything I can do about it.

Thank you.
A. Smith
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Hair loss at a young age can be very devastating for anyone.  This is especially true for women who never expect hair loss to be a problem for them. Read more

How Successful Are Hair Transplants In Women?

How successful are hair transplants in women? - Wanda
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In short the answer is Very successful female hair transplantation presents its own set of distinct challenges and the surgeon needs to be aware of the specific differences in the transplantation process between men and women, but there is no reason to believe that hair transplantation is less successful in women vs men.
The main challenge we face in dealing with the female patient is making sure we have the right diagnosis prior to moving forward with a surgical solution.

The most common cause of hair loss in women is still androgenetic alopecia or in women referred to as female pattern hair loss but there are many more potential problems that can cause hair loss or thinning in our female patients. As a rule a number of different medical problems should be ruled out first prior to resorting to a surgical solution. The real issue in creating a nice result in my female patients is to have a realistic approach to what their goals are. Read more

Can a Hair Transplant Be Performed on an African American?

Can a hair transplant be performed on an African American? Every video or before and after photo I see has a Caucasian guy with minimal hair loss. He will have hair around the side and maybe slight balding around the crown. An African American male cannot hide their balding issue, or better yet doesn’t have the hair to spare for a hair transplant while maintaining a short hair cut. Has a successful hair transplant ever been performed on African American male to continue the growth of hair where it was lost mainly around the middle or back of the crown?
Thank you,
Mark
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Mark:

Thank you for your question.  Yes, hair restoration surgery can be successfully performed on African Americans and /or people of other ethnic origins.  The African American patient in particular requires careful pre-operative assessment in several areas.  Does the patient have a tendency to develop hypertrophic and/or keloid, (heavy, thick) scarring? Read more

Hair Loss Since 14 Years Old - Am I Taking The Right Course of Hair Loss Treatments?

Since I was around 14-15  years old I have experienced hair loss, I’m now 17 and still losing hair. I have attempted minor treatments through a clinic, which determined I had male pattern baldness. When I was younger (15-16), the clinic suggested a hair loss treatment, I believe it contained minoxidil, and involved rubbing it on the scalp. After a year and little change except for irritation on the scalp, I quit.  The clinic suggested a Propecia pill when I was 18, and then a hair transplant at 21. After the scalp treatment I feel I have been tricked and should not trust them. Please help answer the questions, is this the right course of treatment or is there a better alternative, and is it possible to lose hair at such a young age from male pattern baldness? - George
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Thank you for your question. Male pattern hair loss is a condition in which a pattern of hair is inherited, in which the hair is sensitive to DHT. Once puberty starts, testosterone production increases and it is metabolized into this DHT. Read more

Does Cold Weather Have Any Negative Effects on Hair Transplant Grafts?

I work as a police officer in New Jersey and at times need to be outside for my job. If I were to have a major transplant procedure (5-6,000 grafts) during the winter months (such as December), how long after the last day of the procedure will it again be OK to be outside for an extended period of time (as long as 1 hour)? What I mean is, will the cold weather of December here in New Jersey have a negative effect on the newly transplanted grafts if I am outside for too long? Can I simply wear a wool head cap (after a week or two of recovery time from the procedure) to keep my head protected from the cold weather and related elements? Thanks, Jay
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I am not aware of any adverse effects of the cold air on the survival of grafts planted. They are nested well down into the warmth of your scalps warm blood supply and tissues. Just because no one knows the answer for sure and to have a little “cushion” of time, I would recommend waiting 2-3 days maybe until being outside below freezing without a hat on. Read more

What Are The Risks of a Hair Transplant For a Patient With a Ventriculoperitoneal (VP) Shunt?

What risks,  if any should be told to a patient with a VP shunt before doing a hair transplant procedure, and should the risk of disconnection be mentioned, and/or should patient not be allowed to do a hair transplant? - John
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Dear John,

Thanks for taking the time to write!  Let me try to answer your question as best I can.  Ventriculoperitoneal shunts are rare.  Basically they channel excess fluid from around your brain to elsewhere in the body.  These shunts do not typically involve blood or the circulatory system.

For most patients, the presence of a shunt like this should not pose a problem for surgery, but I would check with the neurosurgeon who placed it or neurologist that the patient sees for specific recommendations because the location of the shunt can vary from patient to patient.  It may or may not even be in the area that the surgical plan involves. Read more

What Is Your Opinion of Replacing Propecia With Avodart?

I was wondering what your opinion is on the idea of replacing Propecia (finasteride) with the newer drug Avodart (dutasteride). Both Finasteride and Dutasteride have originated as Prostate medications. Dutasteride reduces the two enzymes responsible for the conversion of testosterone to DHT. Finasteride only blocks one enzyme. By blocking both with Dutasteride, could the results be better?

Thanks for your input,
Stephen
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Avodart the brand name for dutasteride does lower the DHT by 90% whereas Propecia only lowers it by 65% so it would seem there is no argument as to which one is better for protecting the hair from DHT. I routinely prescribe Avodart for men who are in the 15% who do not respond well to Propecia as well as to young men such as the 20 year old who is showing signs of extensive baldness with a father with only a one inch fringe of hair. That young man wants to do everything possible now to prevent the balding genes from being expressed. Even with Avodart a young man of 20 and with an inherited Norwood type VII pattern can expect to get thin just as his sister might with the same inherited balding genes but with less Testosterone and therefore less DHT.

DHT is the bad guy. Dutasteride works better to lower the DHT and gives better results for protecting the hair and increasing density.

Peter Panagotacos, MD
Member, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association

What Is The Typical Cost of An FUE Hair Transplant In Canada?

I live in Canada and I am planning on having a hair transplant.  The procedure is going to be non strip (FUE)  and I am wondering what should be the cost of 5000 grafts. Please provide me with a rough idea so that I can compare mine because I think my doctor is asking for too much.
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I do not currently perform FUE hair transplant sessions, the main reason being that it is a “blind” procedure. This means that the surgical punch which removes the graft is placed over the shaved donor area at the angle in which the doctor thinks the hair is growing and then the graft is “punched out.” There is a risk of damaging the follicle by performing this procedure, whereas with the strip method of harvesting, the donor hair is meticulously dissected under the microscope ensuring preservation of intact follicular units. Also, with strip harvesting, the head does not have to be shaved, only the hair in the strip area is clipped, allowing the patient to maintain their current hairstyle.

FUE is more expensive than hair transplantation, because it is exceedingly time-consuming. 5,000 FUE grafts will take a long time to harvest & re-implant. When thinking about hair restoration surgery, it is important to realize that donor harvesting is only one part of the procedure. Read more

Is 18 Years Old Too Young For a Hair Transplant?

My son just turned 18 and he has had alopecia since he was ten, we had tried everything. Is he to young for a hair transplant? ~Lidia
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Hello,

First, let me say that we would need many additional details to give an accurate answer to this question, so I will confine myself to an answer based on educated assumptions.  The youngest patient I have ever seen with male pattern hair loss was 14.  To have it at 10, prior to puberty, would be extremely unusual, if not impossible, so I am going to assume this is not the case.  The most likely cause of hair loss at this age would be alopecia areata so I will confine my comments to this disorder.  If there has been a problem with alopecia areata and there are several patches of hair missing, and these have been stable over a period of several years, then hair transplantation could be a good solution for your son.  Read more