Is Hair Transplant Surgery an Option for Those with Severe Hair Loss?

Unfortunately, we are not at the point where we can grow unlimited hair follicles. Every year new research on the molecular mechanisms and signals which affect hair growth are being learned. We are getting closer but not there yet. A person with extensive hair loss that wants the illusion of a full head of hair can easily consume 6000 to 8000 follicular unit grafts or more. If you calculate an average area of 150 cm squared at 40 grafts per cm squared, that gives you your 6000 grafts. If you have a larger head with 200 cm squared that’s 8000 grafts. To achieve cosmetic density you would want to transplant at the highest density amount. Previous studies have shown that cosmetic density can be achieved with an average of around 25 to 30 grafts per cm squared.

There are sacrifices in patients with severe balding and that is coverage vs. density. You can cover a lot of area but perhaps not get the density you are looking for. Look at this older hair transplant patient for example. He had close to 4000 grafts in an area well over 200 cm squared. Excellent coverage and age appropriate. This is an approximate average of 20 grafts per cm squared to get coverage not density for this patient. When I show this to younger patients, they say it is not enough for them. Consequently, for me they are not a candidate for hair restoration because their expectation with density far exceeds what can be achieved with their limited donor area which in some cases is maxed at 6000 grafts.

Yes, body hair transplantation is available for those that have a lot of body hair and a big financial budget. Body hair is extracted with the follicular unit extraction (FUE) method. Body hair does not seem to be as hearty as your donor scalp hair and the results may be less than desirable. For many it is a good complement when you have already exhausted the donor supply. But it my practice it is not a first choice.

Young patients with severe Norwood 5 hair loss will progress to 6 and or 7. Consequently, proper hair restoration goals must be set with patients to assure they understand coverage vs. density and the limitations. This is why in many cases we have alternative options such as frontal forelocks or just focusing on the anterior 1/3 of the scalp. I have hooked these patients up with others that have shaved their heads or gone into a hair system so they can see firsthand the differences and can be happy with either choice. The bad thing about starting with a hair transplant is, once you start, you are somewhat committed to maintaining it for the rest of your life. The best thing about shaving your head is, if you don’t like it, it will always grow back to a point where you do like it. No harm done. You don’t have to go cold turkey. Every time you get your hair cut, trim it shorter and shorter so it is a gradual progression to baldness and easier to accept. If not, then consider the limitations above or wait until hair cloning is perfected and start saving money because I am sure it will not be cheap. These companies need to make their money back from millions of dollars of lost research.