Balding Blog

I am thinking about getting a hair transplant. Most places that I have consulted with recommend me getting between 1200-1800 grafts. I understand that the more grafts that I get, the higher they are paid. However, I am concerned about a few things. I am concerned how my donor area will look afterwards and I don’t want to lose donor area hair if the doctor did not do a great job. How would I know how many hairs were actually transplanted? I wouldnt mind doing another transplant if the first time was a good job. What percentage of those harvested get transplanted? thanks for advice.

Of course you can request a certain number of grafts, but you want to ask the doctor what makes sense when you take such a step. I believe strongly in a Master Plan as hair loss is a progressive process and the donor supply of permanent hair is limited. I refer to this as a Hair Bank where you can only make withdrawals. You need to find a doctor who believes strongly in a Master Plan, as hair loss is a progressive process and the donor supply of permanent hair is limited. What has to be done is to: (1) predict your short term hair loss pattern, (2) estimate your long term worst-case hair loss pattern and (3) give you quantitative number for how many hairs (grafts) you have in your hair bank. As you make withdrawals, it is a one-way process. I also like to give my patients a plan for surgery and an estimate of what they can expect in terms of result. I spend a lot of time with my patients just in the consultation and then similar amounts of time are spent prior to the surgery. We give hair washes after the surgery to make sure that there is no crusting so that my patients can go out in public immediately after the surgery (see here: https://baldingblog.com/one-day-post-op-with-photo/ and here: https://baldingblog.com/post-op-photos-6-days-after-3320-grafts/) . These patients can go back to work quickly using what hair they have to cover up the surgical recipient sites. We also use a special tape to prevent swelling in the few people that get it.

There are a number of ways to fix this problem. Since I was the first doctor to perform large sessions of small grafts, I must have fixed hundreds of such patients. The first way to address this is to remove the pluggy grafts provided that there are not too many of them. If they take up the entire frontal area, then it is best to have another hair transplant and overwhelm the pluggy grafts creating a new nature hairline. These pugs can be s source of donor hair as well, as the surgeon can take hair using FUE techniques from the plubs to thin them out. These hairs can be relocated to soften and normalize the look. Longer hair works better than shorter hair once this process is complete. Here is a patient that had terrible plugs and how I fixed fixed it with a series of photos and linkes for you to follow: https://baldingblog.com/2005/10/07/repairing-pluggy-transplant-with-photos/

This is probably a dumb question to ask but I don’t understand balding. I have thinning hair and possibly new regrowth on my temples. I’ve read that your hair thins out slowly until that area stops producing hair.

So my question is should I be expecting finasteride, and minoxidil to help keep those thin hairs and possibly thicken them or should I be expecting that area to be bald shortly. There’s so much conflicting information when it comes to thinning hair that I’ve read online and I’d really just like to know if I’m going to keep those hairs or lose them so I can stop stressing over it.

I’m a 22 year old male if it makes any difference.

Hair loss or balding in men is mainly due to genetic predisposition/ inheritance. It may not follow an exact father to son path but it is nevertheless a genetic trait. There are medications such as Propecia or Rogain to address the genetic male pattern balding and it works better in some men. However it does not stop or reverse the balding completely. Eventually your genetic balding pattern will take shape. Many men take these medication to slow the process down and some have great results. The bad news is that the medications do not work for the front hair line or front corner / temple hair loss in (what I would guess to be) roughly 95% of men. They also do not work in the temple peaks. Only a hair transplant offers this solution.

Minoxidil is not effective to stimulate recipient area hair growth. I studied this on 50 patients with minoxidil on 1/3rd of the head and none on the other side. Both sides grew equally fast and well. What is the best way to get good growth is to have an excellent surgeon and surgical team do your hair transplant. There is nothing that will stop a good hair transplant from growing.

If you keep plucking the grafts and sooner or later the hair will not return. In those grafts that you pluck you will eventually kills these hairs. We call this traction alopecia but it may take quite a few pluckings to kill these hairs.

My son takes this drug for stressful times. I thought that you were suggesting that you wanted to use if for treating your hair loss. I know that Propranolol can, in rare circumstances, brings on genetic balding or makes it worse if that is what you have. If it helps you, then, by all means, use it.