Why Hair Transplants May Not Be Appropiate
People are often surprised when I tell them about how many patients to whom I do NOT recommend hair transplantation. Not every person who comes in for a hair loss consultation is a good candidate. Why?
There are several instances where I turn patients away from surgery. They include:
Donor area density is too low in order for them to have an adequate cosmetic result.
- With hair restoration, it is a supply and demand situation. If the supply (donor area) cannot meet the demand (the bald area today and into the future), then they are not good candidates.
Patients’ expectations are not realistic.
- If patients expect more than can realistically be achieved, then they are not good candidates.
- For example, if a bald guy with limited donor quantity wants a full, thick head of hair from his hairline to his lower bald spot area, it probably cannot be achieved. Therefore, he is not a good candidate.
If younger men with male pattern baldness in the crown present are looking to transplant that area and are doing nothing to stabilize progression (no Propecia, no Rogaine Foam, no Capillus272 therapy), then they’re not good candidates for transplantation.
- It is critically important that progression is arrested before transplanting in the crown. If not, hair loss likely will continue over time. This area would be at high risk to have transplanted hair intact and growing, with baldness surrounding these newly transplanted hairs. Not a good look!
The same holds true for other areas of the scalp. For example, in the frontal receded areas, young patients (or older ones who are not using the Capillus272 device or Rogaine Foam in the frontal area) will continue to recede back away from the transplants. This will require more and sooner subsequent transplant sessions.
- Stopping progression is so, so important! Hair transplantation only provides new hair; it does nothing to treat the existing hair loss.
Recently, I have observed an increase in other dermatologic conditions that cause hair loss in a very different way than the much more common male pattern baldness or female pattern hair loss.
- These conditions cause scarring of the scalp and destruction of the hair follicles. Hair transplantation is usually not the treatment of choice in patients with these conditions.
- These patients require scalp biopsies by a dermatologist in order to properly diagnose and treat these uncommon conditions.
I teach all of our consultation patients about the progressive nature of hair loss. I tell them that if they do nothing to stop this progression with the very effective non-surgical treatments for balding, then they definitely will have less hair at next year’s examination.
By performing hair transplant surgery on patients who are not good candidates, the hair restoration surgeon is doing his or her patients a disservice.
- Always be wary if the doctor is too quick to schedule a procedure if you are not already on these treatments or if you are too young to be a proper candidate as above.
- Patients’ best interest should be the primary reason for moving forward with the wonderful surgical options such as strip harvesting of the donor area and the Artas Robotic Device procedure.