Hair Transplant On a Budget - Getting The Most Out Of Your Surgery

Written by Michael Beehner, MD on March 5, 2009

I am a 54 year old man who has been experiencing hair loss for many years. Using the Norwood scale I would say I am a five. My question concerns how much hair I want replaced. I do not want a full head of hair. In other words, I do not want to look like I am 25 or 35 again. I just to fill in some of the places where the hair is thinning. Is this a reasonable request when fiances are an issue?
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Your preference for having a limited size transplant session is perfectly okay, but it is important that, whatever is done, is done in such a way that it could “stand by itself” for the rest of your life if you never had another session done. I would exclude doing the rear vertex/crown area and perhaps even some of the rear aspect of the midscalp on top, but it is important that whatever is done in the front extends across the breadth of the head and isn’t placed around some hair you happen to have still in the central areas. The problem with simply placing grafts in the “bare spots” adjacent to your native hair is that, when that native hair disappears due to the progression of male pattern baldness, the fill-in hair that was placed will look very strange and abnormal. Earlier in my career I did this a few times and always came to regret it when the patient would return a few years later with the now bare areas next to the grafts that were patched in various places. It’s important to “march through” the frontal area, even in the region of present existing hair.

Another way to have a limited amount of work done is to have a “frontal forelock” pattern transplanted. This is usually an oval area of relatively dense hair in the front-central part of the scalp, with sparser follicular unit grafts off to both sides and the rear to help “blur” the space between the forelock and the side fringes. This can look quite natural and frame the face, especially if the man chooses to style it back and to one of the rear corners.

Your best bet is to tell the hair surgeon you go to in your area that you want to limit the size of the transplant and want your face framed in whatever way will look natural and would be of limited size and expense. Hopefully that surgeon will have the artistry, experience and good judgement to set up a plan for you that will work fine. While it is possible to create a pattern with a single session that you could live with for life, most relatively full patterns do require a second session, so be prepared to hear your surgeon probably recommend such.
Good luck!

Mike Beehner, M.D.
Member, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association

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