Do I need PRP or hair transplant? (Photo)

I had hairfall issues since 2008/09 I guess and slowly and steadily the density of my hair has gone real down. I had a medium broad forehead with good hair line on the sides but over the my forehead has become more broad and the side hairline has gone a bit deep inside. However I am not worried about the sides its the hair between my head a complete strip from my forehead right till the crown is falling like crazy so much that the comb hurts cause there are only few hair left. PRP or Transplant?

Doctor Answers 3

Do both hair transplant and PRP

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Because you lack hair follicles where you are receding, you need to do transplant. But tranplanting by itself, without using fertilizer like PRP will also eventually fall out.  The soil, or in this case, your scalp needs PRP which has growth factors which will attract stem cells and increase vascular supply and increase nutrition to the scalp area which will make the transplanted hair more likely to take and grow, vs falling out.

Bellevue Family Physician

Hair transplant is not advised for you because you have high hair density - you can thicken your thinning hair for more coverage

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Thank you for your question. You’ve submitted several very good photos from the top of the scalp and different views of your hair, describing you’ve been losing hair since 2008 to 2009. You are concerned about hair thinning and hair loss progression, and ask about the better option between PRP or hair transplant

I can share with you my approach to situations like yours, which we see every day in our practice. A little background: I’m Board-certified cosmetic surgeon, and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan Long Island for over 20 years, I am also the founder of TrichoStem™ Hair Regeneration Centers, which uses a technology we developed over several years, as a non-surgical alternative to hair transplant that uses PRP. I will share with you our approach to situations like yours.

It’s very important to understand what your options are and certainly you cover two significant ones: PRP and hair transplant. We should also cover the option of medical therapies such as minoxidil and finasteride. Minoxidil is a topical drug with some potential benefit in prolonging the growth cycle of thinning hairs, and stimulate short-term growth of finer hairs to help improve coverage. Minoxidil requires daily use, and does not stop the hair loss progression so you can still have continued thinning, but it does have a role. The other drug to consider is finasteride, better known by trade name Propecia. This is drug has been around since the late 90s which blocks an enzyme that converts testosterone to dihydrotestosterone (DHT). This drug is very popular, and prescribed for many years. Unfortunately people have become afraid of using this drug, which started several years ago because of reports of long-term sexual side effect after stopping the drug.

PRP (platelet-rich plasma) does have some benefit in hair loss as it does stimulate hair growth, but, in my experience, the results of PRP are relatively short-term. The injection is done so you get a little growth, but you have to come back typically every month to keep pushing the hair to continue to grow. PRP also doesn’t stop hair loss progression.

Hair transplant, which we have been doing for many years, is probably not the best choice for you because you have decent hair density. If you actually place hair grafts in areas of thinning, you will actually lose a lot of your existing hairs.

I’ll discuss the option we developed in our practice called Hair Regeneration. Hair Regeneration evolved out of treating hair transplant patients with the goal of improving outcomes in terms of the grafts, as well the healing of the donor area with Acellular matrix, a material for advanced wound healing. The material serendipitously caused thinning hairs to actually get thicker in some cases, and hair got thicker in areas where we weren’t transplanting.

This became very interesting thing for me, so I decided to work on developing a process as a standalone treatment without hair transplant. I worked on this for several years, and developed an algorithm and a system. People like yourself come to us around the world for Hair Regeneration, which is a combination of Acellular matrix and platelet-rich plasma, in a single episode injection.

In some patients, we do a booster injection to improve the growth of very fine hairs that were revived and reactivated when the first treatment was done, usually around 15 months later.

Basically with Hair Regeneration, we’re able to stop progression, regrow hair that’s not growing where hair follicles are present. There’s a certain percentage of hair follicles not growing because because of a prolonged resting stage called a prolonged telogen phase. The treatment stops hair loss progression induces the shed of thinning hairs to allow for the regrowth of thicker hairs.

What we have observed from 5 to 7 years of experience is that 5 years out, 99 percent of men and women have had improvement and have been stable. We follow our patients very closely, so we see them every 3 months. We are able to document this for the duration of 5 years. It’s been extremely successful for us, and I think someone like yourself will probably a very good candidate for our technologies such as Hair Regeneration.

Distinguish PRP alone from the Hair Regeneration technology and learn about this method. I think it is important to not completely discount the possibility of using hair loss drugs, but unfortunately lot of people are afraid of taking finasteride. Refusing to take it means you have no option other than allowing hair to fall and disappear, then undergo hair transplantation. We’ve been able to stop that cycle and help people with Hair Regeneration to get a sustainable result for at least 5 years. I hope that was helpful, I wish you the best of luck, and thank you for your question.

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Amiya Prasad, MD
New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Restoring Moderate Hair loss

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Thanks for posting your question and the photos. You have fronto-temporal recession with a retention of your frontal core (in plain english --> the sides on the top of your head have receded, and the central part is thinning though remains). For patients in this scenario, I would perform a hair transplant. I would try to restore and reinforce your hairline. I would feather the transplant into your existing hair so that as time passes, you remain natural appearing without a gap between the transplant and your receding hairline. Rogaine and propecia may help prevent further loss. I am not sure PRP will do much for your type of loss. This would better determined during an examination of your hair and scalp. You should see a hair restoration surgeon to help guide you.

Benjamin C. Paul, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 40 reviews

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