Thank you for your question.
You’ve submitted some photos and you – you’re
asking about hair transplant. And you – getting
into the question, commonly asked about numbers
of graphs and you’re not interested in taking
finasteride and I suspect – we understand
why. And addition, you’re also asking is,
‘Hair transplant the only option?’
Well, I can certainly assist you with this
question. I’m a board certified Cosmetic
Surgeon practicing in Manhattan and Long Island
for over 20 years. Hair transplant and hair
loss is a big part of my practice. In fact,
I’m the founder of TrichoStem Hair Regeneration
Center, a non-surgical alternative to hair
transplant for men and women with thinning
hair. I’ve been very active in developing
methods, specifically something called hair
regeneration to help people with one of the
biggest issues, that’s a frustration, with
hair transplant. So I can certainly give you
some guidance as to how I look at a patient
when you come in and you ask about hair transplant.
To begin with, it is very important to understand
that in the absence of you not taking a drug
like finasteride which is a DHT blocker or
Dihydrotestosterone blocker; the reason why
a lot of people come to us don’t want to
take finasteride is because of recent concerns
of about long term sexual side effects. The
actual proof and the long term evidence remains
to be fully defined. But certainly there’s
some literature supporting this concern.
So with that being said, it’s very important
to understand that hair transplant treats
hair loss by borrowing from a limited area
in the back of the scalp that we refer to
it as the donor area. Now regardless of the
current noise that is all about the technologies;
whether it is FUE’s or with robot surgeries,
or any other technologies, we have to accept
a certain physiologic reality and that is
the donor area is limited.
Now to understand the math behind this. When
your hair – when you have a lot of hair
– you had about a 100,000 hairs on the scalp.
When you first noticed hair loss, you’ve
already lost 50 percent. From a given donor
area, you may hear numbers from transplant
surgeons that range anywhere from 1,500 graphs
to 5,000 graphs. And regardless of the numbers
and how many can be moved and placed, you’re
still looking at a fraction of what once – what
there once was.
In our practice, what we tell patients is
even if you are interested in getting a hair
transplant, you need something to stabilize
your hair. You need something to try to prevent
what is inevitable which is the progression
of hair loss such that when you see someone
who’s had a hair transplant, you wonder
why they have all of those ‘pluggy’ little
hairs. It’s because they once had hair next
to those transplanted hairs.
Now the younger you are when you get a hair
transplant, it’s almost guaranteed that
you will not have enough hair remaining to
keep the density by the time, a decade or
two decades, goes by. And so it really is
a problem. We’ve had patients who are in
their mid to late 30’s who have had four
hair transplants and when you see them, they
don’t look like they have a lot of hair.
So with this limitation, we first started
working with the material called extracellular
matrix to help improve the appearance of the
donor area as well as the longevity of the
– or viability of the graphs.
Well, long story short, we figured out that
essentially thicker hair has – thinner hair
has became thicker. And so this resulted in
development of something called hair regeneration.
What we do with hair regeneration is we do
an injection using a combination of your – a
product of your own blood called platelet-rich
plasma mixed in a specific way for your situation
with a material called extracellular matrix
which is a wound healing material. We inject
this into the areas of the scalp which is
typically for any male-pattern hair loss,
front to back, all the way to the donor area.
The results of this has been consistently
significant. We’ve had more than 99 percent
of our male patients responding and we have
developed methods and protocols to even optimize
it further beyond that one treatment.
And this is a customized treatment that we’ve
worked very hard over many years and have
applied the most data to support this particular
strategy. The results of our treatment has
actually proved and time and time again to
actually exceed in the right candidate the
results of two hair transplants.
So my suggestion for someone like yourself
who doesn’t want to take finasteride and
we’ve had years of experience since the
concern about finasteride has been going on
for several years; that on its own, hair regeneration
can be very effective.
So understanding this, I think it’s a good
idea to actually learn more about other options;
also factor in your age and get realistic
understanding of what you can expect with
a transplant. If you are going to have a transplant,
you have to assume you’ll need a second
transplant and you’re done the second transplant
in ten years but probably sooner. Again the
younger you are, the younger the onset and
the progression being relatively constant,
it could be – when we see people who are
younger, very often their progression tends
to be very aggressive. And which means that
to you eventually run out of donor to do enough
So I have been – we’ve been very active
in educating people about earlier to – earlier
interventions so that you can actually optimize
the results of your treatment and then consider
hair transplant if at all. Most of our patients
once they’ve had hair regeneration don’t
opt for hair transplant. So it really has
made a huge difference.
So I hope that was helpful, I wish you the
best of luck. And thank you for your question.