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HAIR TRANSPLANT
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FAQ
 
Why I need hair transplant i.e. surgery, when medication and other non-surgical means are available?

Medications

  • Medication can thicken and lengthen (regrowth) hair in some and not in all who take them
  • Medication is effective at the back (Vertex) and middle (Mid scalp) but almost ineffective in the front (esp. Hair line) where one needs the hair most.
  • Medication can work only until you keep taking if you stop taking medication the benefits achieved by medication soon start disappearing (because the hormones once again start working their ill effects). Medication although reasonably safe should be taken for lifetime –the idea normally puts off many
  • Medications although fairly safe are not without any side effects

Other Non- Surgical Means

  • Wigs and Concealers are other possible solutions to baldness. Concealers are temporary hair cosmetics, good for thinning hair and as temporary solution such as before going to party. They require regular care and expense. They are not cheap either.

As for the wigs: 10 reasons why people don't choose wig!

  • It gives constant feeling of weight and discomfort in hot days.
  • Sweat cannot be cleaned properly and bad hygiene can lead to skin problems.
  • Its fixing methods like weaving, bonding, pinning etc. can pull on the natural remaining hair and add to your hair loss and can even lead to scarring.
  • It gives same look all the time that looks and feels artificial and unnatural. You have Fixed style all hours of use
  • Its high level of detectability becomes a butt of jokes and teasing by the friends, collogues and media.
  • Its cost run from few hundred dollars to many thousand dollars depending upon quality
  • You need regular maintenance every few weeks for the rest of your life. Attachment may become loose- constant state of low-level paranoia and anxiety about his public discovery.
  • Long-term financial investment because of regular maintenance may be more than that of hair transplant. With life time maintenance & few monthly replacement & frequent visits to wig maker- it becomes very expensive
  • You need to change it every few months
  • Not done by doctors

Surgery by Follicular hair Transplant is better in many respects

  • Transplanted Hair Looks and feels natural unlike wig and concealer
  • Transplanted hair remain undetectable among the other hair
  • Transplanted hair grows and keeps growing permanently unlike the hair of wig and the regrown hair by Medication
  • Do not require extra maintenance or care unlike wig, which require lifetime care.
  • The Transplanted hair can be cut, colored and styled as well
  • Transplantation normally has one time expense unlike medication or wig which require lifetime expense
  • It is a One day Procedure performed by numbing your skin so you can talk with doctor, watch TV, listen to music, read, take a nap, have lunch and juice and even go to toilet!
  • No bandages at the end
  • You can take shoulder bath from same day and can shampoo your hair from 3rd day
  • You can even do light office work from second day
  • If you are from out station you may travel back same or the next day minimum follow-up is required thereafter

What is the guarantee that the implanted hair will grow? Why don't they too fall under the effect of hormones like other hair?

  • The Common Baldness or Pattern baldness in males and Female is programmed by heredity or genes i.e. the hair in the top middle part of scalp become susceptible to the effect of the hormones and the fringe of hair at the side and back remain genetically immune to the effect of hormones. These hairs grow permanently or at least till late age and they also maintain their quality unlike the susceptible hair of middle, which shorten and thin out in caliber as well. These hairs are called permanent hair. If we remove the roots from permanent area and graft them in front or any other part of scalp or body they keep growing like they used to do in their native area. The hormones even in new area don't affect them. Over 90% of the implanted are destined to survive with modern techniques of transplanting.

Do I have to wait till all my hair fall out or can I under go the procedure to increase my density?

  • Like any medical problem, one should not wait till the last stage of manifestation of deformity of baldness. As the density of hairs gets down, one can safely plant the follicles in-between existing hairs, to compensate for the loss, without looking bald.

Can girls and women have this procedure?

  • Yes, girls and women can take benefit of this procedure for the correct indications.

Can it be done if there is no hair on head?

  • Usually the procedure is refused if there is no hair on the scalp. Body hair transplant can be an inferior possibility.

Can it be done for eyebrow, moustache, eyelashes or other body areas?

  • Thinning, total or partial loss of eyebrow, eyelashes, moustache or beard or sideburns since birth or due to other causes like injury or burns can be corrected cosmetically by hair Transplant

At what age one can have HT? Can a child undergo HT? Can a 70 years old person undergo HT?

  • Age is no bar for Scarring baldness. For pattern baldness unusually surgery is refused before 20 years and if the quality of donor hair is good even at late age transplant can be done

Do I have to undergo tests before the procedure?

  • Yes usually they are 1. Complete blood count 2. HbSAg (Australian Antigen) 3. P.T & APTT 4. Blood Sugar (Fasting and Post prandial) 5. H.I.V.

What care do I take before HT? Pre operative Care Before Procedure

  • In order for us to provide you with the highest quality medical care; the following instructions are important for you to follow:
    1. Medications: Do not take aspirin & other blood thinning agents, Betablockers (for Blood Pressure), anti-inflammatory (like Ibuprofen, etc), Tricyclic Anti depressants & MAO inhibitors, multivitamins including vitamin B, a week prior to your procedure.
    2. Avoid Alcohol for a days prior, & tea or coffee on the day of operation- that may increase bleeding
    3. Don't smoke at least 24 hours prior to operation –that will reduce healing
    4. The morning of your procedure take a bath or shower and wash your hair thoroughly using regular shampoo. After shampooing, please rinse thoroughly and use a fresh clean towel to dry your hair. Do not apply sprays or gels to your hair. If you wear a wig, please make sure it is removed prior to your morning shower and not replaced before your procedure. Wear cap after shampoo to keep the hair free of dust.
    5. Eat light breakfast the morning of your procedure
    6. Wear comfortable clothing the day of your procedure avoid T shirt or thermal. Wear simple shirt.
    7. Please do not bring any valuables to the clinic on procedure day.
You may be receiving medications during the procedure that can make you drowsy. Because of this we strongly recommend not to drive home the day of your procedure. If you are unable to have you driven home. If you are coming from far we will arrange for lodging at a hotel near our office so that you may stay overnight

Can I talk or meet your previous patient?

  • Yes we can arrange that on personal meeting with doctor or in one of our seminars.

How much will it cost?

  • For the scalp area its cost is 35 Indian Rupees / graft in strip surgery and Rs.75 for FUE Metehod per Graft. . The cost is different for special areas like eyebrow, moustache, and beard etc.
  • There is 10.3% GOV.tax applicable on this cost. Blood test and post op. care Kit can cost Rs.2200 more...

How do I make payment?

  • By cash is most preferred other modes you may personally enquire.

I come from outstation can I get pick up facilities from station, or Airport?

  • Yes, on few days' prior information we can arrange that.

Can my accommodation be arranged?

  • Yes, on few days' prior information we can arrange that.

Can HT be done if I am Diabetic or if I have Blood Pressure or other medical problems?

  • Medical problems under good control by medication do not stop you from undergoing the procedure.

What are the side effects and complications?

  • It is one of the safest procedures devised by medical science and leaves you with hardly any long-term problems. Discomfort, swelling of forehead, numbness at the back trouble you only for a while. Serious complication in competent hand is rare

Can hair from other parts of my body be transplanted?

  • Technically that is possible but hair follicle from the other parts of the body when planted on the head, does maintain its genetic characteristics, and hence it does not look, feel and grow as good as scalp hair.

Do I need to get my hair trimmed short before the procedure?

  • Trimmed short hair helps us to judge correct direction of plantation in the gaps between existing hairs without damaging those hairs, This is not easy with long hairs, Short hairs in donor site in strip Surgery will facilitate post op,care of stitches as long donor hair may not allow proper care of stitches

How many follicles will I require?

Number of follicles required is based on factors that vary among individuals.

  • Degree & Progress of hair loss
  • Hair characteristics
  • Area where coverage is desired
  • Expectation by patient

The total number of hair on the head remains the same as before or after Hair Transplantation. The hair root from ‘permanent hair growing area” from the back and side of the head (medically known as Hair Bank or Donor Area) is transferred to the front and /or top of the head. In Hair Transplantation no new hair is grown. Only the transplanted hair roots are arranged in such a way that head looks fuller with hair.

We have approximately 1,00,000 hair on head. In the last stage of baldness i.e. Stage 7 baldness; he is left with almost 25,000 hair on the back and side of his head (medically known as Hair Bank or Donor Area). From this area, we can harvest up to 60 % or 15000 hairs, without looking obvious. One sq. cm of Donor Area contains 100 follicles, but each follicle (Root) may have either 1.2.3 or 4 number of hair. If you have more follicles containing 3 or 4 hair, you will have more density than one having 1 or 2 hair in each follicles. On an average each hair follicle contains 1.5-to2 hairs. So, on an average 100 follicles will contain up to 200 hairs. 15,000 hair means up to about 7 500 follicles are available for transplant from your donor site. These follicles are planted in such an artistic and Staggered pattern to create what is called an Organized Disorder Pattern over the bald area that head looks full of hair. It is the combination of Art and Science both, which gives most natural result.

Normally, you have density of 100 -follicles/sq cm on the head. We do not see the bald skin until we lose up to 60% of hair in the area. So in view of the limited availability of longer lasting follicles in the bank, we should aim for the maximum density of up to 40% plus /Sq.cm esp. in vital areas like frontal forelock. You do not get the same density all over, as before but you can make it look like near normal density.

It goes without saying for the Number of the hair that “ More the merrier”. But unfortunately you have 4 acres of seeds to be used for 12 acres of land! On an average 6 to 7000 follicles should be distributed for a person with Grade 7 baldness. The number is often the minimum requirement i.e.

What density will I get?

  • Hair Density (mass or fullness) is more with
  • Length of each hair
  • Thickness of hair
  • Number of hairs per sq.cm. (Density)
  • Acuteness of angle of exit of hair from the skin. This factor depend on the artistic ability of surgeon
  • More perpendicular (coronal) direction of hair to the hole while inserting hair follicle. This factor depend on the artistic ability of surgeon
  • Number of Hair per follicle like, 3-4 hair per follicle give more density
  • Curliness of hair
  • Low Contrast between color of hair and color of scalp
  • Time: Hair starts growing after about 8 to 12 weeks from plantation and continues to grow at the rate of 1 cm per month. So, only with the passage of time, the hair mass will increase.

Normally, you have density of 100 -follicles/sq cm on the head. We do not see the bald skin until we lose up to 60% of hair in the area. So in view of the limited availability of longer lasting follicles in the bank, we should aim for the maximum density of up to 40% plus /Sq.cm esp. in vital areas like frontal forelock. You do not get the same density all over, as before but you can make it look like near normal density. DURING

What time it takes?

  • Only a day that you have to spare. It takes 2-8 hours usually depending upon the number of the follicles to be implanted

Do I have to bring some one with me?

  • It is not necessary but you cannot drive back home after surgery. You may hire a vehicle or some one should derive you back.

Will it pain at the time of HT and afterwards?

  • We take utter care so that you remain comfortable while numbing your skin after that the procedure is pain free. Pain killer tablets take care of some discomfort you may have in the donor site for 2-3 days. Grafted site virtually remains pain free.

Will there be any bleeding?

  • After all you cannot cut skin without few drops of blood shedding but it is not significant.

Will there be any effect on my mind?

  • This is one of the safest surgeries devised and it limits itself to the skin your brain remains much deep beneath and safely protected in the natural helmet of your skull.

If operation lasts long how shall I have my lunch?

  • During long Surgeries we arrange lunch for you. You may bring your lunch if your have special requireents

How do you implant the hair? Do I have cuts and stitches?

  • This will reduce the possibility of micro trauma to the follicles. There are micro punctures done but there are no big cuts or stitches taken at the site of grafting.

Do you do Megassion and Dense packing?

  • Megasession of over 1500 grafts usually up to 3500 follicles in one day has benefit of avoiding multiple small sessions for bigger area of baldness. We do it routinely due to our well-trained team of over 8 people. Dense packing consumes many more grafts because one Sq. c.m. is implanted with 25 to 50 grafts. This is normally done in the area of frontal forelock so as to have fullness in the front without exhausting the donor area.
    AFTER

What is the after care of HT? Post-operative instructions

  • You will leave the clinic on the same day with no bandages on - but you should wear a cap for a week to protect grafted from dust, sun & heat
  • Take medications as directed. (Avoid Aspirin for 2 weeks)
  • Sleep in the position in which you’re most comfortable but sleep with the head on 2-3 pillows for a few nights.
  • Place wrapped ice pack on your forehead & eyes but not on the graft sites for 48 hours to avoid swelling. Swelling will go away in few days. These days swelling is uncommon due to medications taken post operatively.
  • After 6 hours of the procedure shampoo the graft site & donor site gently without rubbing and wash the head with shower. Blow dry or dry without rubbing the graft site until all scabs fall out.
  • If bleeding occurs apply a light & steady pressure for 20-30 minutes with a clean cloth at the site of bleeding
  • Sutures in the donor area gets dissolved & need not be removed
  • Avoid Alcohol for 48 hours
  • Sutures in the donor area gets dissolved & need not be removed
  • Avoid smoking for as long as you can
  • No swimming in chlorinated water for 2 weeks
  • Rest for 1 day
  • Light work for a week
  • Heavy work, exercise or sex after 2 weeks
  • Visit your hair dresser for hair cut after 3 weeks & for hair styling after 6 weeks
  • Diet: Healthy nutritious diet with more proteins is beneficial. A diet that contains high quantities of animal fat can lead to an increase concentration of testosterone in the blood stream, increasing your risk of hair loss. High protein diet in pulses, milk, and white of egg, red meet and fish are good. Green vegetables and fruits are good source of minerals and antioxidants. A lot of water keeps your hair texture good.
  • Cold laser for 3-6 weeks if prescribed
  • You may be receiving medications during the procedure that can make you drowsy. Because of this we strongly recommend the not to drive home the day of your procedure. If you are unable to have someone drive you home after your procedure and you live near our office we can arrange to have you driven home. If you are coming from far we will arrange for lodging at a hotel near our office so that you may stay overnight.
  • Report to the clinic or call the doctor if
    Any excessive pain or Excessive bleeding
    Any rise in temperature over – 100o F
    Sudden swelling of forehead or eyes.

How will it look?

  • Advantage of Follicular Hair Transplant is that the result is not only natural looking and natural feeling but it remains undetectable.

If it is a day treatment will I have full-grown hair when I leave the clinic?

  • The treatment of grafting the hair roots is over in few hour of the day and you may have short hair sticking out from the roots but it takes 8-18 months for the full grown results (average 1 year)

What time it takes to grow hair after HT?

  • The hair start sprouting by average 3-4 months and it takes 8-18 months for the hairs to grow in length and thickness.

What care will I have to take for the newly grown hair?

  • You don't need any special care for the newly grown hair after transplant, at least not more than your other hair.

What if the implanted hair falls?

  • Implanted hair fall within first month of transplant. The transplanted root form new hair in 3-4 months time. They become of combable length by 6-9 months and grow like any normal hair i.e. in cycle. So they may cyclically fall and in few weeks also start re-growth. The final result is achieved by 1 to 1 and a half year when the texture and thickness of transplanted hair becomes fully mature.

How long do I have to take rest?

  • You may not require rest but rest of 2-3 days may be sufficient. You should avoid heavy exercise or sex, weight lifting etc. for a week or more.

When can I go for swim?

  • After 10 days

When can have my haircut? When can I shampoo, style, and colour my hair?

  • Haircut is possible after 3 weeks and colour and styling after 6 weeks of transplant.

Will I have bandages or dressing?

  • You leave the clinic with no bandage. But it would be wise to use baseball cape when outdoors, to protect from sun, dust and pollution for 2weeks

Can I drive back home?

  • You may be receiving medications during the procedure that can make you drowsy. Because of this we strongly recommend not to drive home the day of your procedure. If you are unable to have someone drive you home after your procedure and you live near our office we can arrange to have you driven home. If your are coming from far we will arrange for lodging at a hotel near our office so that you may stay overnight

When can I work?

  • Usually from next day for the light work but heavy work is avoided for 7-10 days.

When can I take bath?

  • Shoulder bath on the same day and shampoo and shower by patting and without rubbing the grafted site from next day onwards.

When can I go to Gym?

  • After 2 weeks to allow healing and consolidation of stitched tissue. Avoid weight lifting for few months if possible so that your scar does not get stretched.

When can I have sex?

  • After 2 weeks

When can I have Alcohol?

  • Avoid for a week

When can I smoke or consume tobacco?

  • Avoid for as long as possible because it can affect your healing and hair growth.

When can I have tea or coffee?

  • Avoid for a day before and after

What diet should I take?

  • Take High protein with milk, white of eggs, pulses, green vegetables, fruits, lots of water. Avoid fast food, fatty food.

Will I have headache?

  • You may have tightness in the stitch area for a few days but soon it disappears.

Will I have any scar?

  • You will have a thin line of scar from where we remove the strip but rest assured it will remain undetectable because it will be covered under the hair on the top.

Do I need to remove the stitches?

  • Usually they get dissolved by 12-15 days

Do I need to take the medication and for how long?

  • Usually we prescribe antibiotics for a week and painkillers for 5 days. Additionally you may take Finasteride and Minoxidil for thinning hair or preventing hair fall by telogen effluvium.

Do you use Laser for Hair Transplant? What is Low Level Laser Therapy or Cold Laser?

  • Few years back Hair Transplant Community used Laser to drill micro holes for implanting Hair roots. They soon found out that the hair growth was poor and Laser was doing more damage to the wall of the hole and its blood supply then it helped. As a result no Hair Transplant Surgeon of good standing in the world uses Laser for Hair Transplant. But for Low Level Laser Therapy (LLL) or Cold Laser as it is called is proclaimed promising for improving the thinned out hair harmlessly are used by us after Hair Transplant to enhance the results.

How soon can the same procedure be repeated in the same area?

  • Theoretically, to increase the density one may repeat the plantation within 6-8 months of the procedure.

Frequently Asked Questions

In this FAQ, you will find answers to commonly asked medical questions about the surgery, controversial issues, and subjects you might not have even considered. If you have a question that still has not been answered, please contact us today to have your specific questions answered directly.
For your convenience, FAQ section is divided into several parts.
  • Introduction
  • Facts
  • Safety
  • Procedure
  • Results
  • Aftercare
  • Cost
  • Complications
  • Ladies and Hair Loss
  • Medications


1. Introduction

  • 1A) I want to learn more about normal hair growth.
  • 1B) What is considered Normal Hair Loss?
  • 1C) Speake a little about gentic hair loss in men?
  • 1D) Does stress play any role in Hair Loss?
  • 1E) Why start now?
  • 1F) Is it better to begin early?
  • 1G) How much hair do I have?
  • 1H) How much hair do I need?
  • 1I) What is the difference between density and fullness?
  • 1J) What is a typical Hair Transplantation Surgery day like?


2. Facts

  • 2A) What is realy a Hair Transplantation Surgery?
  • 2B) Is there any alternative to Hair Transplantation Surgery?
  • 2C) When should I consider Hair Transplantation Surgery?
  • 2D) What qualification should I expect from my physician?
  • 2E) Is it true that all HTS`s Patients are men?
  • 2F) What factors my Doctor consider when evaluate me for Hair Transplantation Surgery?
  • 2G) What makes the Iran Hair Center different from other hair transplant groups?
  • 2H) How do I know if I'm a good candidate for hair transplants?
  • 2I) How long should I wait between hair-transplant procedures?
  • 2J) How many sessions of surgery will I need?
  • 2K) Is the Hair Transplantation Surgery painful?
  • 2L) Is there any pre-operation instructions?

3. Safety

  • 3A) Has Hair Transplantation Surgery been improved in recent years?
  • 3B) Is Hair Transplantation Surgery as a whole dangerous to me?
  • 3C) Is it possible for me to repeat this procedure?
  • 3D) Speake a little about medications I should receive for hair Transplantation Surgery?
  • 3E) I have heared about `Shock fall out`. Clarify this matter to me?
  • 3F) What can be done to minimize the effects of post-op shedding?
  • 3G) Explain things that may increase my risk for complications after surgical hair restoration.

4. Procedure

  • 4A) What must I do befor Hair Transplantation Surgery?
  • 4B) Explain a little about the beginning of the surgery?
  • 4C) What about pain during operation?
  • 4D) How do you remove my hairs from back of the head?
  • 4E) What do you do with the removed strip?
  • 4F) What happens to the grafts?
  • 4G) How long does a normal session take ?
  • 4H) What is Follicular Unit Transplantation?
  • 4I) What is Follicular Unit Extraction Procedure?

5. Results

  • 5A) Will I get to see an actual person who has had the work done?
  • 5B) How long will it take to recover?
  • 5C) Are Dr. Vafaei's results really too much better than other doctors?
  • 5D) Will I be satisfied with the results?
  • 5E) Will I get a full head of hair?
  • 5F) I want to learn more about my hairline creature?
  • 5G) When does the hair grow?
  • 5H) Can you give me an idea about the number of grafts being implanted in one session?
  • 5I) How long does it take the transplanted hair to grow out long enough to fill in the balding area?
  • 5J) How long will the transplanted hair continue to grow?
  • 5K) Do large grafts produce a better, denser result than smaller grafts?
  • 5L) Is removing large amounts of donor hair unsafe?
  • 5M) Is it true that the blood supply of the scalp cannot support a large session?
  • 5N) Do scalp reductions save hair for future loss?
  • 5P) Are Lasers useful in Hair Transplantation Surgery?
  • 5Q) With new surgical techniques, is it possible to restore a full head of hair?

6. Aftercare

  • 6A) Is dressing mandatory after the surgery?
  • 6B) Is it necessary to have a companion guy after Hair Transplantation Surgery?
  • 6C) Speake a little about the first night after surgery?
  • 6D) Tell me about the first days after surgery?
  • 6E) Is it needed for me to take off from my work after Hair Transplantation Surgery?
  • 6F) Explain about aftercare of Hair Transplantation Surgery?

7. Cost

  • 7A) How much does it cost?
  • 7B) Isn`t Hair Transplantation Surgery too much expensive?

8. Complications

  • 8A) Will I scar after surgery?
  • 8B) What about possible Complications?
  • 8C) If I am unhappy with a transplant performed by another doctor, can I have repair work done at Iran Hair Center?
  • 8D) Will smoking affect my hair transplant procedure?
  • 8E) Will Senile Alopecia affect my hair transplant procedure?

9. Ladies and Hair loss

  • 9A) Do women have problems with balding?
  • 9B) How can I find out about female hair loss?
  • 9C) What causes hair loss in women?
  • 9D) Why are some women not candidates for hair restoration surgery?

10. Medications

  • 10A) Will new medications make surgical hair restoration obsolete?
  • 10B) On what parts of the scalp do Propecia and Rogaine actually work?
  • 10C) Propecia(Finasteride)
  • 10D) Rogaine(Minoxidil)

1A) I want to learn more about normal hair growth.

A terminal scalp hair will typically grow 1 cm per month for 2-6 years in the “Anagen” phase then over 2-4 weeks it will go through a transition phase, called the “Catagen” phase, at the end of which begins a resting phase, called the “Telogen” phase, which lasts for 2–4 months. In the Catagen Phase the “root” or dermal papilla shrinks and migrates upward toward the surface of the skin. The hair in the Telogen Phase is club-shaped and does not have the full ball or root that an Anagen hair has.


The hairs you see every day on your brush or pillow, or in your shower or sink are those that are shed in the Telogen Phase. They will be replaced by new, growing Anagen hairs. Research is being done to determine what controls this growth cycle but there is still much to learn.

Most people(including many doctors)believe that hair grows in single strands very closely together. It doesn't !


A magnified look at scalp hair that has been trimmed to 1 – 2 mm long will show you that, in fact, hair grows in small "bundles" of 1,2,3, occasionally 4, and rarely 5 hairs per "bundle". These hairs, along with their accompanying support system (sebaceous glands, erector pilae muscle etc.) form what is now known as the "Follicular Unit".

These 1-5 hair "bundles" usually exit the scalp through just a single pore! When examined under a powerful microscope, these "Follicular Units" are clearly distinct anatomical entities, “individually wrapped” by a layer of (connective) tissue.

Follicular Unit Transplantation requires the precise dissection of each Follicular Unit, keeping all of its elements intact. This ensures optimal survival and growth of the hair and properly transplanted follicular units are indistinguishable from naturally occurring follicular units. Using nature’s own building blocks for hair transplantation with follicular unit hair transplantation provides reliably good, natural results.

1B) What is considered Normal Hair Loss?

Most hair loss is normal and part of each person's individual genetic makeup. We lose hair everyday. Hair grows for a period of time, usually for 2 to 6 years, and then the follicles shed the hair and go into a resting stage for approximately 3 months, then a new hair growth cycle begins. It is normal to lose between 50 to 150 hairs per day from normal hair shedding.

1C) Speake a little about gentic hair loss in men?

Androgenetic alopecia is the scientific name for the genetic predisposition in both men and women for pattern baldness. Pattern hair loss in men is often referred to as male pattern baldness(MPB). Androgenetic alopecia is the cause of over 95% of all pattern hair loss, including baldness in men and thinning hair in women. Pattern hair loss occurs in somewhat predictable stages, and is relentlessly progressive. Usually the earlier in life pattern hair loss begins the more advanced the hair loss pattern will ultimately become. Studies have shown that pattern loss is increasingly evident and advanced as people age.


In MPB the hairs on the top of the scalp have a genetic sensitivity to the male hormone testosterone (DHT). DHT is believed to contribute to:

1) Shortening of the growing phase of the hairs,
2) Progressive miniaturization of hair follicles,and
3) A decrease in the number of visible hairs
The hairs on the sides and back of the scalp do not possess this genetic trait and therefore are not affected. For this reason hairs removed from the sides and the back(donor hair)will maintain their genetic predisposition when transplanted and continue to grow when moved to the top of the scalp where hair loss has occurred.

Another interesting aspect of male hair loss is the inheritance of the gene for baldness. Note that many years ago we were taught that genetic hair loss was sex-linked and thereby transmitted from mother's side only. We have since learned that this was only the tip of the iceberg. Like a political investigation, as the research goes deeper, more and more players(in our case, chromosomes)are implicated. Although male pattern baldness is definitely transmitted on the X chromosome(XY is a male, XX is a female), there are numerous other chromosomes(humans have forty-six)that help determine the age of occurrence, rate and degree of hair loss. So just because your maternal grandfather is bald doesn't mean you will be also.

1D) Does stress play any role in Hair Loss?

Stress can speed up the rate of hair loss. Although it usually does not cause permanent loss in an area not meant to bald, it can considerably speed up the time frame in which genetically doomed hair dies.

Stress such as the loss of a loved one can similarly speed up hair loss. Physical stress such as heavy athletic training as well as even the simple stress of moving to a new country with a new language can push the fast forward button on male pattern hair loss. It's important to understand that stress can help cause hair loss other than that determined by heredity. We see this in alopecia areata as well as other more dramatic forms of baldness, such as that which occurs during chemotherapy. What is important to remember is that with the exception of hereditary and exotic causes for balding, hair will generally grow back.

1E) Why start now?

If you have been determined to be a candidate for restoration by a NHI physician, and if you are uncomfortable with your hair loss, why not start now? With your restoration completed, you can get on with life without this distraction.

1F) Is it better to begin early?

A hair transplant should begun when your degree of hair loss is unacceptable to you. Not when you are only worried about future loss or "So no one will notice." Starting early will often require multiple small sessions, and your expectations may be unrealistic.

1G)How much hair do I have?

The Norwood classifications were adapted from the patterns described by Dr. O'Tar Norwood. There are seven classes of hair loss in the main series and five variations of these classes called the 'A' series. If you compare your hair loss pattern with these diagrams, you can probably see the pattern you are in now. Discussion with one of NHI's knowledgeable physicians can help you determine how extensive your hair loss may become. Please see Assessing Your Hair Loss for more info.

1H) How much hair do I need?

When you have your consultation with a NHI physician, he will suggest how many grafts may be available for your first procedure (and subsequent procedures if they will be needed). This number will be based on your present balding pattern, what it may become in the future, and how much donor hair is available. When an individual has high donor density, the follicular units usually contain multiple hairs, and when an individual has low donor density the follicular units often contain only one hair. If an individual has a very loose scalp, a larger donor strip can be removed, while an individual with a tight scalp will have a smaller donor strip. When an individual has a relatively small amount of hair that can be moved, our physicians take great pains to distribute the available hair in ways that produce the best coverage. Please see Assessing Your Hair Loss for more info.

1I) What is the difference between density and fullness?

The word fullness rather than density, more accurately describes the visual phenomenon in what we perceive as thick hair vs. thin hair. The concept of fullness is broader and more inclusive. Density, the number of hairs/cm2, is only one of several contributing factors that are responsible for the visual impression of hair that appears "thick". Other factors include hair shaft diameter, color, texture, and curl, which may be of equal of even greater importance than density, in contributing to the visual appearance of a "full" head of hair.

In the early stages of balding the "thin look" is caused by a process called "miniaturization" where hair is reduced in size, but not actually lost. Therefore, the density (the counted number of hairs/cm2) remains the same, although the persons look of fullness can be dramatically reduced.

1J) What is a typical hair transplantation surgery day like?

  • The patient signs a consent form for surgery.
  • Antibiotics are given to prepare for surgery.
  • The area for transplantation is confirmed and the new hairline design is drawn onto the scalp.
  • Photo documentation
  • The patient enters the operating room and changes into surgery clothes.
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