Is It Acceptable To Transplant Hair Into Areas of The Scalp That Are Only Thinning?

Do the majority of hair transplant doctors consider it appropriate to transplant hair into thinning areas, e.g., front, mid-section, and/or crown, as opposed to transplanting hair only into bald areas? What are the risks and considerations (e.g., shock loss)? – Robert
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Robert,

Thank you for taking the time to write! I am not sure I can speak for the majority of hair transplant surgeons, but through my training and experience with many of the top surgeons out there, the short answer to your question is; it is a judgement call.

The chief concern, as you identified, is whether you will do more harm to the existing hair, than good! If the existing hair is close to complete loss, I believe many surgeons would choose to help that patient by restoring a conservative area of hair/hairline.

If the hair in the area seems to be salvageable, some surgeons would feel more comfortable trying medical therapy alone for 6-12 months, while others would simply exercise caution during the transplant. Too many grafts at once with the latter approach can exacerbate shock loss, especially if the patient has fine or miniaturized hair to begin with.

If you believe you are in this latter category, it is always best to go with the hair surgeon who levels with you about the risk of shock loss; you will be replacing the hair with permanent hair, so you will have a net benefit, but the risk of significant shedding with more limited re-growth does exist.

All of the above refers to hair on the top of the scalp no matter where it is thinning. I’d like to mention, however, that the crown is a unique area with its own set of problems. If the only thinning area you want to fill in is the crown, a patient should seriously consider going on Propecia or deferring surgery entirely until it is clear that the frontal area will not need the grafts more than the back!

The reason is that the grafts are in limited supply, and you want to be able to place them in the most cosmetically beneficial area possible – get the most bang for your grafts! – so to speak. The most cosmetically beneficial area is almost always the front, since it is a natural balding pattern to have some crown loss but still have your face framed conservatively. So, whether there is some hair remaining in the crown area or not, many hair physicians would think twice about treating this area aggressively.

I hope that answers your question! Remember that the best surgeons will not treat any area that still has hair in it without having a long discussion with the patient about expectations and alternative medical treatments first. Good luck and I wish you good hair!

Warm Regards,
Dr. Sara Wasserbauer
Member, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association

Sara Wasserbauer, MD Dr. Sara Wasserbauer is Board Certified by the American Board of Hair Restoration Surgery and is currently located in the Bay Area, outside of San Francisco, in Walnut Creek, California. She completed her undergraduate studies with a B.A. in Classical Archeology and minors in Chemistry, Biology and Psychology at the prestigious Dartmouth College. She then went on to earn her medical degree from the renowned Medical College of Ohio where she was designated Class Leader. After finishing her training in Internal Medicine, Dr. Wasserbauer discovered she had a natural aptitude and eye for aesthetic surgery. Growing up in a family that experienced severe hair loss in both the men AND women, she found herself drawn to hair restoration and the dramatic change it could have on one’s appearance With the technological advancements in hair restoration surgery over the past 10 years she saw the potential of natural follicular unit hair restoration surgery to transform a person’s outward appearance and inner self esteem. She states, “Hair loss can have debilitating effects on an individual’s self image, impacting all facets of their lives from social to professional.” Dr. Wasserbauer felt that with her surgical skills, training and natural empathy she could make a true difference in her patient’s lives. Dr. Wasserbauer is a member of the International Alliance of Hair Restoration Surgeons and recommended by the American Hair Loss Association. Visit Dr. Wasserbauer's Website: www.californiahairsurgeon.com

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