Author: Dr. William Rassman

At 10 weeks, many of the grafts will have shed. This may give the appearance of gaps that may not be real. Wait until the 8th mont. By then, you will see 80% of the growth and know if the gaps are real or not.

I am 26 and I lost a lot of hair giving me a huge forehead. How many grafts will this take?

First, what I need is a frontal picture with your hair pulled back and your eyebrows lifted high so that your forehead creases. That shows me the anatomic point that allows me to determine the proper place of the hair line. Once I know this, I can give you a recommendation on the number of grafts you would need for a hair transplant. Keep in mind that fine hair takes more grafts than coarse hair. In addition to the picture, I would want to know the thickness of the hair in the back of your head.

I have a few questions about getting a hair transplant as a 26 year old. Before I get the “just go bald” comments, I’m not gonna do that, so save your breathe. Call me vain or whatever.

Anyway, I’m currently on finasteride, but I started after my temples had already receded and my hairline is just….a mess. I really, really want to get a transplant on my temples/hairline right now, while my looks actually matter to me. I know waiting till I’m in my 30’s makes more sense, since the balding will likely have completed by then and I can repair it all at once, but my looks are important to me now more than ever. It really hurts my self-esteem…

I guess what I’m wondering is, will it be okay to get a transplant on my hairline now and then just get another one when I’m older/in my 30’s to fix the rest once the balding has completed? The finasteride should keep the rest from falling out until then, right? (It’s been working for me thus far)

By this age, you can transplant the frontal hairline. What you need is a Personalized Master Plan for this process. I would do a HAIRCHECK test (https://baldingblog.com/haircheck-test-how-it-is-done-video/ ) to determine your present balding pattern and try to predict your future hair loss pattern. Then I would quantify your donor supply to know just how many grafts you have in your lifetime so that good planning can start now. With this information, you can be intelligent about how many grafts that doctor is going to use up now, and how many grafts your doctor will leave behind. There is an interesting problem that most men don’t recognize. Too many doctors push graft numbers high because they charge by the graft so they profit from more grafts at the time of the surgery. I have seen many patients that had twice the number expended for a frontal hairline and then down the road they might run out of hair. Get a doctor who understands this process and cares more about his/her patient than their pocketbooks. If you stay on finastetride, you will prevent shock loss and hold on to your native hair.

You could do Scalp Micropigmentation (see here: https://scalpmicropigmentation.com/thinning-hair-gallery/) or a hair transplant like I did for my hair.

If the finasteride has not solved the problem by this time in your crown and you have some hair present you have three options.
1- Do nothing and live with it
2- Get a hair transplant which may solve the problem as that is what I did. My bald crown is now full looking
3- Get Scalp Micropigmentation which will make your thin crown look full as shown in this website photo below (click image to enlarge)

Yes, at age 27 with a Class 3A pattern of balding, you are an excellent candidate for a hair transplant. I would think that it would take about 2000+ grafts (less if it your hair is coarse, more if it was fine hair).

I can now see through to the scalp in the back of my head, which looks like it is balding now. Will the hair grow back in the donor area?

After an FUE, the hair that was removed is gone forever and will never regrow. In African hair, the donor supply is numerically lower than both Asians and Caucasians by as much as 10% to 40% respectively. As a result, the limits for FUE are much more restricted in people of African decent. If you are a typical African American, then the limit for FUE should have been 1,400 grafts (see this link which explains this: https://newhair.com/donor-area/). You have what we call donor site depletion. Since you now have donor area depletion, the only thing that you can do, which works very effectively, is Scalp MicroPigmentation (see here: https://scalpmicropigmentation.com/scar-covering/).

At your age, you might find that you could lose some of your existing native hair following the transplant. From the pictures, I see a low crown balding area which suggests that you might develop an advanced balding pattern in the long term. The use of the drug finasteride reduces this risk, but balding in men is progressive. Ask your doctor where your balding pattern might end up. Find out what your donor density is, so that some calculations of your reserve donor hair can be made now, before you start your transplants. Keep the hair transplants to the frontal area only, because if it goes into the crown, then you will be caught in a conundrum with patches of hair transplants in the front and in the crown will leaving you not normal looking. These steps will be the best approach to minimizing the risk of getting into multiple hair transplant surgeries as you lose more hair, which you should expect to happen. Your goal should be that just a single surgery will stand on its own and that is why I am suggesting that you only transplant the frontal area at this time.

Is it worth getting a HT? from tressless

You should get a HAIRCHECK test to find out if there is any loss that you can’t see in the top and crown area of your head. You need to know there is the possibility that you might develop hair loss elsewhere. I call this a Master Plan which every male having a hair transplant should have. You look, on the surface, to be a great candidate, but if the HAIRCHECK test reveals hair loss behind the hairline, it is something you MUST know (See: https://baldingblog.com/value-haircheck-bulk-measurements-two-patients-seen-today/)

I have been to 4 different doctors about my hair loss and none of them gave me a diagnosis or treatment recommendation other than Rogaine. I am not happy with the results of the Rogaine and I want a solution to find out what is wrong with me and what can I do about it. Any suggestions you might offer will be helpful.

You most likely have some component of female genetic hair loss. I look at you and would ask: How can I help you if you came to see me. Assuming that your blood tests and medical history was clear of causes for hair loss, I would do the following:

1- Perform a hair transplant in the frontal 1 1/2 inches where there is clear balding

2- Perform Scalp Micropigmentation for the rest of your scalp where your hair is thinning as hair transplants don’t do well with thinning hair in women (see here: https://scalpmicropigmentation.com/smp-for-women/)

See if you can find a doctor who can do both of these processes. If not, consider coming to Los Angeles, as we do offer travel subsidies.