Crown Restoration And Progressive Hair Loss

Genetic hair loss can be unpredictable as to how far the pattern of hair loss will develop; a guide will be any hair loss pattern in your family but as genetic hair loss can skip generations and the pattern alter this is only a guide

The desire to “cure” the problem can lead to trying numerous products in an attempt stop hair loss and regrow the lost hair or in some case resort to surgical hair restoration as the cure, a quick fix

If thinking of a hair transplant managing the goals and expectations of the candidate is vital from the very first procedure be it minor hair restoration or advanced hair loss that is being treated

In respect of treatments, three are FDA approved to treat hair loss, laser therapy, an oral table and a topical lotion or foam; results will vary from person to person and sustained use is needed to continue a positive result

Be honest with yourself and with the doctor you ultimately decide upon; nature can only be cheated to a degree and miracles do not occur; not all individuals make a good hair transplant candidate and as frustrating as this may be it never good to start that which cannot be finished

A perfectly good hair transplant can be performed but if the individual is not happy or does not meet their goals in their eyes it will not be a success and this can lead to recriminations against the clinic and the feeling from the patient they have been let down

One area of hair loss that can create long term concerns is the crown or vertex when looking at hair restoration; deciding how and when to treat the area can have good and bad consequences

Treating the crown or vertex can be a technically demanding aspect of surgical hair restoration, largely due to the changing angles and orientation of hairs to recreate the natural spiral that occurs

It is common the crown is the last area to be treated, due to this the highest number of the safe donor has been used on the frontal and mid-sections, reducing the numbers available to maintain the same even density over the crown

The surface area of the crown can be extensive, equalling the frontal and mid-section combined, dropping on the sides as well as the back of the head, making restoration demanding and sometime not practical

If surgical restoration is chosen it is vital to take into consideration future potential hair loss, treating too early can leave an unnatural pattern of hair growth as hair loss progresses; a better initial alternative may be to stabilise the hair loss with a treatment programme, especially if in the early stages of hair loss

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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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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

One Pass Hair Transplants

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

The terms Mega and Giga sessions have been used to denote 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

Individuals suffering from advanced Male Pattern Baldness (MPB) will require anything from 4000 to maybe as much as 8000 plus 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, other may require multiple sessions

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. This requires a skilled team that work together and understand each other’s role within the process

A hair consultation can measure the quality of the donor safe zone and the recipient area to be covered, from this the plan can be made; when researching always request to see a number of results the clinic has achieved with high graft numbers to ensure they have a consistency and proven track record in achieving restoration on advanced hair loss candidates

A master plan must be made between patient and doctor to ensure this can be achieved and if there are any compromises they are calculated and agreed upon; for example the overall density that can be placed from hair line to crown

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.

Large 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, as well as it being financially more agreeable to the wallet.

Decision Time For A Hair Transplant

Deciding when to commence surgical hair restoration can impact of how successful over time the result achieved will be and the individual’s long term happiness; starting too early when hair loss is minimal can result in long term consequences

As not all individuals will suffer from advanced hair loss some will require less restoration than others, but it is important that the donor supply, which is finite is not totally depleted to ensure restoration in the future can be carried out

If total restoration cannot be achieved in a single procedure then it is important there is no demarcation line between the native hair and the transplanted area; as this will leave an unnatural pattern of hair growth

When initially planning to restore an area of hair loss the surrounding areas also need to be assessed, weak, miniaturised hair that may still be giving coverage will recede in the future; placing into miniaturised areas will help to ensure the first hair transplant achieves a solid result

Restoring relatively small area of hair loss can result in chasing hair loss on a constant basis, requiring small touch-up sessions to camouflage small thinning areas; this can deplete the door area and long term reduce the total number of grafts available

Planning is vital from the first procedure, understanding hair loss for the majority of men is progressive; a genetic hair loss pattern can be a guide but not the rule and it is a gamble to just rely on this information

For the vast majority of men hair loss is progressive, only a small % of men will only recede to have a mature hair line; male pattern baldness follows stages of progressiveness, frontal third hair loss to total loss of hair over the top of the scalp

Only a very small % of men can ever achieve total restoration of a high NW scale hair loss pattern in a single operation; and normally the crown even if covered will have a lower density of hair placed

Planning to cover the largest area possible gives the advantage of restoration in a single procedure and maintains the donor safe zone in the best quality if future procedures are required

For many this approach is considered the best, even with a lower crown density as they achieve full coverage from hair line to crown and a natural looking pattern of hair growth. If further density is desired it is still possible to achieve this with a another hair transplant in the future

The age of an individual and hair loss pattern will play a large part when a hair transplant doctor assesses how to approach surgical hair restoration; an ethical clinic will have the individual´s long term well-being in mind and make known any concerns they may have if they feel the goals are ill-advised

Diffused Hair Loss; Meds Or Restoration

Treating diffused thinning with a hair transplant can be problematical, it can be hard to determine how far the pattern of loss will conclude and placing within diffused hair making it hard to create a natural density

Dependent on the extent of the pattern of diffuse loss and the lack of density it may be best to not undergo surgical restoration and wait until the pattern matures and less trauma to the native hair will occur

If the doctor is happy to treat with a hair transplant it is almost always the case the recipient area will need to be shaved; this is to help aspects of the surgical procedure. Shaving allows the quality of hair to assessed much easier under magnification, how miniaturised the hair shaft is; shaving aids the accuracy and speed of the procedure and allows a greater density to be placed

The use of custom made blades for the recipient sites allows for the slit to be customised to the size of the graft rather than one size fits all. This allows for a greater density to be placed and less trauma during the operation as well as improved faster healing post operation.

Diffuse thinning is normally caused by an interruption in the normal hair growth cycle, caused by a variety issues, nutritional, hormone, stress to name a few

The hair also can be weaker, so any trauma from the hair transplant procedure can cause the hair to reject, or shock-loss; this can occur almost immediately or over months post operation in some cases.

It is always advised to try and locate the trigger when possible before undergoing any treatment programme or surgical hair restoration procedure

Diffused hair loss over the top of the scalp can leave an intact hair line but behind a thinner coverage of hair, no actual bald spots just a loss of density and sometimes overall hair quality, miniaturised hair

Hair loss retention treatments can be a good first alternative to treating the thinning, sustaining the hair growth over the area and potentially being able to thicken the hair growth for some time.

Many clinics prefer not to operate on diffuse hair loss sufferers, it is not so much because of the medical complications but their concern for the result and your happiness; so when researching take this into consideration.

Getting The Most From Each Hair

If your characteristics all fall into the best selections then you are very lucky as the majority of candidates do not. Invariably there will be a mix of characteristics and the doctor will assess how to design based on this

An individual´s hair characteristics play a vital role in the hair transplant result, and can make the difference between a WOW result and one seemingly below par; even make an individual not a hair transplant candidate

When researching hair transplant results try to look at people with similar hair characteristics to yourself, this will give you a better indication to how hair characteristics affect the result of a hair transplant

Also research how hair characteristics will change the way a hair transplant is designed by the doctor: fair skin and blonde hair, tanned skin and coarse dark hair, curly, wavy or straight hair.

Hair characteristics cover a plethora of criteria; hair calibre, hair to skin colour variant, the amount of curl in the hair shaft, the donor hair density and the average number of hairs per follicular unit

Your characteristics will determine the density of hair that needs to be placed in strategic areas of the recipient area; they will determine the hair line design and placement taking into consideration your hair loss pattern

The number of hairs in the donor is going to determine how much coverage can be achieved; the follicular units range from 1-4 hairs, averaging around 2.2 hairs per FU. The higher the average the better as more density and coverage can be achieved

Donor hair density is calculated by the number of FU´s per cm², low density can be around 50 FU cm², a high density 90-100 plus FU´s cm². The density will alter around the scalp so it is important to measure in more than one area.

The calibre of hair can vary from very fine to very coarse hair shaft, fine hair covers less surface area so more hairs are required to gain fullness; coarse hair will achieve more coverage but can appear pluggy especially along the hair line Better the calibre more shadow is created over the scalp, more coverage per hair shaft allowing for a better distribution of the follicular units whilst sustaining the look of fullness

A fair skin complexion coupled with dark hair creates a large contrast between the hair and skin making it harder to create the illusion of thickness; fair skin and fair hair is much easier to create this illusion with fewer hairs.

Straight to curly hair; this will affect the density needed to be placed and the orientation and angle of placement. Curly hair gives more body or volume when grown out, straight hair more longer coverage.

It is important to have your hair characteristics assessed correctly and plan how the hair transplant can create the result you are happy with; understanding this will go a long way a happy patient, short and long term