Transitioning From a Hairpiece To a Hair Transplant

Written by Bradley Limmer, MD on January 14, 2008

I’m recently divorced and thought that getting some new hair might help me to fair better in the dating scene. My problem is that I currently wear a hairpiece and I’m afraid to go through all of the expense and discomfort of surgery only to be disappointed with the outcome. Is it possible to hair transplant enough hair to make by own hair as thick as my hair piece. I currently wear about 65% density so you can see some scalp. Please let me know.
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The answer to the question of whether you can get someone out of a hair system using hair transplantation and achieve a density of ~65% of normal is YES. Problem is that while the answer seems simple, there are a number of factors that have to be considered when attempting this.

First, what is the underlying Norwood pattern? If it is a pattern 3, 4, 5, or even 6 (that has high parietal hairlines) it can be done. If you are a full blown Norwood 7, I don’t believe it can be accomplished.

Second, how much donor is available for harvest? Most guys have 7-10 thousand grafts that can be harvested over time. However, some don’t and without these types of numbers the outcome will probably not achieve the desired coverage and density that is wanted.

Third and sometimes over looked, is what’s the quality of the donor hair? To achieve the look you are wanting, the hair needs to be of average or greater than average shaft diameter. Course curly hair with a low contrast (meaning good hair color skin color match) can play a big part in the success of a transplant. If the hair is fine, silky and striking different in color than the skin (high contrast) it will be much more difficult to accomplish the set goal.

Fourth, you need to be committed to the process. This is not going to be accomplished all at one time. The good news is that you can continue to wear your system in some form or fashion during the process. Also, you will need to be able to spend anywhere between 25-35 thousand dollars. Obviously, the number of grafts and the money spent on them depends on how extensive your loss is. Also, I think most will need to be committed to long term medical therapy.

One final thought. Transplanting hair to the front half of the scalp provides the vast majority of cosmetic benefit seen from surgery. That said, if you are a Norwood pattern 6 or 7 and are willing to be a natural looking Norwood 3-v or 4-v (meaning a natural hairless round crown left non-transplanted) much can be accomplished with less grafts/surgery/expense while still getting the vast majority of cosmetic benefit.

Brad Limmer, MD
Member, International Alliance of Hair Restoration Surgeons

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