Category: Hair Transplantation

Sorry for my ignorance on the matter but I’m a little confused.

I have heard people mention donor hair running out. Why is this exactly? If it is immune to balding, why can’t you harvest an unlimited supply from it to transplant?

Once hair is removed from the donor area to be placed elsewhere in the scalp, it does not regrow in the donor. So let’s look at the numbers….

If we take the most advanced balding pattern, for example, the patient having lost most of his non-permanent hair will have 25% of the original hair left. That would be 25,000 hairs, or 12,500 follicular units. If you need to keep 50% of this permanent hair, that means that you can harvest 6,250 grafts in a person with a birth hair population of 100,000 (Caucasians are good examples of this).

Taking more than 6,250 follicular units as two hair grafts might leave you donor depleted. This is especially true if you are Asian, Indian or come from the Middle-east where birth hair numbers often run 80,000 birth hairs or the hair is fine.

Is lighter hair color or darker hair color better for a transplant and why is that the case?

Hair transplants work on any color hair; however, a lower contrast between hair and scalp color makes less hair look like more hair. That means that a blonde with light skin is ideal. Brown hair against brown skin and black hair against dark skin also looks better and takes less hair to accomplish a good sense of fullness. For example, a 1000 graft surgery on a blonde hair , pale skin tone person will look fuller than the same 1000 graft surgery on a pale person with black hair (with the same hair loss pattern).

Also note that hair texture (fine vs coarse), hair length (long vs short), hair wave (straight vs curly) also play a BIG part. These characteristics are not only for hair transplantation itself, but how one’s hair looks in general. If a blonde hair pale skin patient who keeps their hair long and wavy has a hair transplant and decides to cut their hair very short, straighten their hair, or dye it black, often the results of a hair transplant would not appear as good.

hello dr.rassman. I am an east indian male, 31 years of age. I have been on proscar for over a decade with decent results. I wanted to know if you or any of your colleagues have had any experience doing surgery on indian men and what has your experience been like? When I mean experience, I mean do they generally require less hair to cover a bald or thinning area, what are the hair characteristics and scalp laxity, hair thickness etc. I know it differs from each patient but there must be a general consensus on what type of hair indian men generally have. I don’t see to many pictures of indian men getting transplants so it is hard to judge.

Mine hair is black and wavy and then generally gets curly when its very long. I guess I am at an advantage because I am assuming I would need less hair to cover up my balding areas because my wavy hair would cover up the areas.

Thank you.

There is no difference to treating men from India than fair haired Caucasians from Minnesota. In fact, Indian men with the darker skin and dark hair have reduced color/contrast between hair and skin, which makes for a better hair transplant. The state of the art for hair transplants in India is not as advanced as in Europe or the US, so perhaps there are less Indian men going for hair transplants in India.

I have done hair transplants on many Indian men and they have done very well, referencing results.

Dr. Rassman,
Thank you for helping hundreds if not thousands of people in understanding hair loss. Because of your blog I went to a dermatologist and got a miniaturization study done. Here is my question:

Would you say that a large percentage of hair transplant surgeons are patients of hair transplants themselves?

Cheers

Some hair transplant surgeons are themselves patients; however, I would not say that the majority are so.

Hi great doctors,

I’m planning to go for a hair transplant. However I need to go back to work about 1 week after my transplant, and my job requires me to wear a helmet for 4-5 hours each day. What are your thoughts on the helmet affecting my donor area or grafts?

Appreciate your kind advice. Thank you

I would need to know what your balding pattern is, where the transplants will be going, and what type of harvesting technique (FUE or strip surgery) you plan on having. It would also be helpful to know the type of helmet that you intend to use. I might be able to ascertain your situation from this information.

In the past, we’ve had patients that are firefighters, daily motorcycle riders, race car drivers, pilots, and other professions that wear helmets on a regular daily basis and they have had no issues with having a hair transplant surgery. We generally recommend one to two weeks without wearing a helmet following a hair transplant, though.