Poor Hair Transplant Results Require Planning And Understanding

Often a hair transplant repair has to be planned over multiple procedures, especially if the donor area has been seriously impaired and restricts the graft numbers that can be safely harvested in each procedure

Dependent on the severity of the initial procedure is may be possible to repair many or all areas and achieve a totally natural looking result and improving the donor area if and when future hair transplants are required

An individual who has gone through a bad experience is understandable cautious before getting back into the chair; but they must also understand that a hair transplant has limitations and clear priorities need to be made

Prioritise areas of cosmetic importance in the recipient area to treat as it is unlikely all areas can be treated at once, so each hair transplant needs to focus on maximising how natural the hair growth, coverage and density appear

The individual needs to understand there are often limitations and as much as it may be hard to live with it is a reality and the end result may not be what the individual first visualised but the priority must be to create as natural look as possible with the limited resources available

In many repair cases the best results can be achieved combining both techniques, FUT and FUE. Combing the techniques opens the possibility to reduce visible scarring and increase the graft numbers attainable in a single procedure

A hair transplant repair requires added skills by the doctor; often there is scarring in the recipient area and this can impair the placement and regrowth of new hair; also poorly angled grafts will need to be removed or camouflaged

All due care must be taken as the trauma and anxiety of a repair patient is high; why a solid education, balanced expectations are required and dialogue between doctor and patient.

A hair transplant repair patient should take their time when researching, also to keep an open mind as to what can be achieved from the repair surgery and how long it may take. At this stage it is important no more mistakes are made


High Norwood Scale Treated In A Single Session

Surface Area = Supply & Demand

So called Mega and Giga Hair Transplants when performed to the highest standard allows the individual to achieve the maximum aesthetic result in the shortest time frame, less down-time away from work and excuses to friends, family and colleagues

The large movement of grafts in a single session; much is dependent on the quality of the donor zone characteristics on how many grafts can be removed safely and maintain the quality of the donor area as best as possible

Technical ability and planning is required to ensure the grafts can be harvested, divided into the natural follicular units, the recipient sites made and the placement of the grafts administered efficiently

The patient must also be prepared when undergoing a large hair transplant procedure; the day will be relatively long and the individual will need the virtue of patience to allow the medical team to perform the operation with efficiency but care

Prior to any surgery the donor and recipient area will have their best properties; the donor having the best density, laxity, no scarring and the recipient has also never been touched or impaired.

For individuals with a high Norwood pattern, Nw4 and above a normal goal is to cover as much of the balding surface area as possible and ideally in a single session to achieve a result in one pass

Individuals suffering from advanced Male Pattern Baldness (MPB) will require anything from 4000 to maybe as much as 8000 grafts or follicular units to achieve total restoration; some candidates will not be able to achieve these numbers due to deficiencies in the donor hair safe zone

There are often compromises that need to be made to achieve a balanced coverage and natural looking density; most common is the hair line position and design

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Minimise The Look Of Hair Loss And Scarring Post Hair Transplant

A hair transplant cannot replace like for like hair lost so relies greatly on creating the illusion of fullness and natural density; this is achieved by strategically placing and distributing the grafts over the surface area

The obvious purpose of a hair transplant is to give more fullness of hair in an area of hair loss over the top of the scalp; and with this when the result has grown out is the question of hair style and hair length

A degree of hair length is required to enhance the illusion of fullness, the longer the hair gives greater coverage and blocks the light from reflecting off the skin

The better the hair characteristics the more flexibility in hair styling and hair length is available; coarse hair and a low hair to skin colour contrast help and allow for a shorter hair cut

The shorter the hair the less coverage is produced per hair and the scalp becomes more visible, this is true in the recipient area as well as the donor area

Regardless of technique, FUT or FUE, no one can promise that there will not be visible scarring in the donor area, and the shorter the hair cut the more obvious this may become; either the linear scar from FUT or cylindrical white dots by FUE

With either technique donor management is important to minimise any visible scarring, to not over-harvest with FUE and thin the donor and with FUT respect the laxity to ensure a neat closure

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Hair Loss And Donor Hair Miniaturisation

Hair loss can be slow and in the initial stages not recognised; the hair follicle goes through gradually stages before it stops producing hair. The first signs can be the hair shafts becoming finer and shorter

Hair loss is generally associated with the top of our heads, from the hair line to the mid-section and then the crown or vertex.

Certain hair loss types can make surgical hair restoration a bad option, especially when hair loss affects the traditional scalp donor area

Unlike MPB, Male Pattern Baldness or Androgenic Alopecia DUPA does not sustain a localised stable safe zone of hair to be able to harvest from via a hair transplant

MPB can be combined with DUPA hair loss sufferers, with a normal pattern of recession occurring over the top of the scalp and if the hair loss progresses to a high Norwood stage ending with the horseshoe pattern

With DUPA there is a general decrease in hair density of hair randomly but evenly over the scalp, sometimes combined with the miniaturisation of the hair shaft at the same time

Another sign of hair loss, more traditional MPB can sometimes be increased shedding of hair; it´s not uncommon for us to shed around 100 hairs per day, this is not a problem as long as 100 hairs regrow the same day, and then a balance is achieved

Because the initial changes can be subtle they can sometimes only be visible under magnification. Under magnification it is possible to compare various areas of the scalp and the hair calibre

An obvious sign of hair loss is loss of hair density, making the scalp more visible and the recession of the hair line and temples, enlarging the size and surface area of the forehead

When you have a consultation any miniaturisation can be assessed, not just over the top of the scalp but also the sides and back, known in hair transplantation as the donor area. It is usual to have a little miniaturisation in the donor

If a hair transplant is being considered too much hair miniaturisation in the donor area can make a hair transplant not credible. Miniaturised hairs should not be used as they are weaker and may not regrow when transplanted

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Getting Hair Transplant Planning Right The First Time

Before deciding to undergo a hair transplant research thoroughly, become hair educated and do not always believe what you want to hear, base your decision on facts and logic, not solely emotion

If hair is spread over the recipient area in a diffused pattern although coverage is achieved the result never looks natural or cosmetically desirable, a minimum density of hair is required to block the light from reflecting off the head

As it is impossible to replace like for like hair a hair transplant procedure relies on artistic and medical skills to achieve the desired coverage and look of density or fullness.

As hair loss progresses it becomes harder to treat the surface area; high Norwood Scale hair loss sufferers, NW6-7 may not be able to achieve a full coverage, dependent on the quality of their donor hair

To achieve coverage on a high NW candidate will require 6000 plus grafts or follicular units from hair line to crown, dependent on hair line placement and hair characteristics of the candidate, but not everyone can reach these number

A Master Plan is required to ensure that if hair loss progresses a balanced coverage can be achieved, fixing a low aggressive hair line may seem a good idea initially but if the coverage cannot be balanced it will look unnatural

The appearance of thickness is aided by the placement of the follicular units, the angle and orientation and the curvature of the hair shaft following the natural lay of the hair. Placing the hair at the correct angle can increase coverage and block reflection of light off the scalp

This can make a huge difference in the coverage achieved in a single procedure, with a well-placed hair line can result in total restoration and a full result being achieved in the minimum time frame and least inconvenience.

Large Sessions allows the patient to achieve the maximum aesthetic result in the shortest time frame, less down-time away from work and excuses to friends, family and colleagues, as well as it being financially more agreeable to the wallet.

Can total restoration or a full head of hair be achieved? The answer to this is yes and no, replace like for like hair lost, no, but have the cosmetic illusion of a full head of hair, yes

Hair Transplant Technique: FUT, FUE or Both?

When deciding on the technique to best use; remember:

The harvesting method is not a matter of taste but a matter of necessity. Every patient has different characteristics and these should be taken into account when deciding on the best technique that should be employed

To gain the best long term result it must be thought about from the first session, then the optimum and maximum utilisation can be made of the donor area as it is untouched and has the greatest potential. Prior to surgery the donor and recipient area will have their best properties; the donor having the best density, laxity, no scarring and the recipient has also never been touched or impaired

Achieving high numbers is not only about the characteristics of the patient. The Doctor´s & Medical Team must be able to work together efficiently and with high skill to ensure graft survival and patient care is the priority

The hair loss pattern will determine the number of grafts required to cover the surface area. Each technique has pros and cons and before deciding on the technique to first use it is important to access the long term donor management.

If hair loss has progressed to an advanced state the need for grafts is high to cover the surface area. The larger the surface area the harder it is to treat the entire area in one procedure with either technique

The options is to treat the area over multiple procedures, starting with the hair line and working back over the frontal third and mid-section and later to treat the crown; this will require maybe 2-5 procedures dependent on technique and the quality of the donor resources

There are 2 recognised hair transplant techniques in use today, the FUT and FUE techniques. They differ mainly in the donor management and the manner the follicular units are removed from the scalp

Utilising the benefits of both FUT and FUE and combine the techniques to maximise the graft numbers in a single procedure; allowing for the potential to reach total coverage and possibly a “home run” result

By combining the two there is the potential to reach in excess of 8000 grafts on a good candidate; on an average candidate that would maybe only achieve 4000 grafts increase the number to 6000

Combining the techniques can also be of great benefit to repair hair transplant candidates; when the donor area has been impaired by improper previous surgery. Being able to remove a strip and widen the extraction zone at the same time can provide the maximum graft numbers to correct the pattern of hair growth over the recipient area

Hair Transplant Donor Size And Extraction Protocol

The safe zone, especially in the early stages of hair loss can be hard to define when using FUE as there are no obvious signs where it may be demarcated; if the lateral humps or crown drop later the safe zone is reduced

Progressive hair loss can mean hair loss drops down the sides and back of the head, extending the surface area of the crown, also known as the vertex; this will potentially eat into the size of the safe zone, especially with FUE

The demarcation line could still drop so it is important to leave a little leeway and not harvest the follicular units directly up to this line; this makes for a more safe an educated harvesting protocol.

Long term planning is a vital component to the success of the hair transplant, present and in the future; understanding the donor limitations, what each technique is safely capable of and accepting limitations

As the FUT donor is located centrally within the overall potential donor zone there is very minimal chance that any hair extracted is unsafe to transplant

The FUE technique relies on a wide surface area to extract the hair from as FUE reduces the hair density left in the area; so the wider the area hair can be removed from the lower the density change occurs

The hair transplant donor area is the band of hair around the back and sides of the head, for a man or a woman; an area that is genetically strong and the follicles do not suffer from genetic hair loss properties

Unsafe hair can be miniaturised hair in the donor, this should not be extracted, or even adjacent strong hair and hair outside the safe zone that can suffer from loss in the future

As FUE does rely more on a wide surface area, if a candidate has generally weaker characteristics in the donor it will reduce the total overall FU´s that can safely be extracted; assuming an educated extraction pattern is adhered to

FUT relies more on skin laxity when removing the strip, when performed well with good healing a further strip can be removed from the same area, englobing the first line and still reaching high graft numbers