Good candidate for Hair Transplant? (photos)

Hallo, i wrote yesterday a question about a hair transplant but forgot to add some information. I am 29 years old and i suffer from hair loss since i was 18 years old. I am using Finasterid for about 10 years now and i have androgenetic hair loss. I am on this hair status now since a couple of years. Im thinking about a getting a fut hair transplant. Am i a good candidate for fut? And is my donor area ok? How much grafts would i need? Thank you very much

Doctor Answers 8

Good Candidate for Hair Transplant


Loss of hair is a natural process when it is between the limits that the body can restore them. When the capacity of the body to restore the hair loss is beaten by the excessive hair loss then we can name this situation something that should be treated.  Stem cells are one of the most popular topics in the science area and it is a well-known fact that the life was built on the shoulders of these cells. Stem cells are used in treatment of many diseases today. Aesthetic plastic surgery is another area that stem cells are used for their advantages. Stem cells are obtained from the own adipose tissue of the patient. It can be stated that stem cells transferred to another place in the body yields rejuvenating, refreshing and repairing effects on the tissue. “Organic Hair Transplantation” method uses the advantages of the stem cells at the maximum level.

Trauma of a hair transplant close to your thinning hairs will cause more hair loss - your best option is to thicken your hair

Thank you for your question. I understand you’re 29-years-old and you’ve been losing your hair since you were 18. You’ve been on finasteride for 10 years, and now you’re exploring the possibility of having a hair transplant — an FUT in particular. You’d like to know if you’re a good candidate for the procedure, if your donor area is acceptable, and how many grafts you would need.

Treating hair loss is a big part of my practice. I’m the founder of TrichoStem™ Hair Regeneration centers, through which we offer a non-surgical procedure that makes use of a regenerative technology to treat people with pattern hair loss. This treatment is called Hair Regeneration. In addition to this, I’m also a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years.

You’ve clearly been very vigilant in taking the correct medical therapy for your hair loss, and although there is a controversy surrounding finasteride and the long-term sexual side effects it supposedly produces in men, I can tell you that based on my own experience as a clinician, I have not had any patients in my practice that experienced this. I still prescribe finasteride in my practice, and I think that as long as the patient does not have any adverse reactions to drug, it should be fine.

The challenge with finasteride is that it slows down hair loss progression, but does not stop it. I have seen patients who have been taking finasteride since 1997, and in spite of that, they still turn out to be almost bald. On top of that, according to studies, 60% of men will respond to finasteride, leaving 40% who do not respond at all. It is certainly beneficial when it comes to slowing down hair loss, but it also has its limitations.

In your case, the challenge is you still have hair density, but the hair is thinning. This may not make a hair transplant worthwhile because when you place thicker hairs where the thinning hairs are, you may end up inadvertently damaging and losing your existing hair, which is known as collateral damage. It is this type of situation that I think causes people with existing thinning hair to feel less excited about the outcome of a hair transplant.

Another issue that you may have with a hair transplant is not just about density, but about the number of hairs you have to transplant. You don’t want to get a hair transplant just for the sake of getting one. We’ve had patients who have gotten 4 transplants starting in their 20s, and in spite of that, still lost a lot of their existing hair by the time they reached their late 30s. That said, you can see how limited hair transplants inherently are.

In our practice, I usually recommend a treatment called Hair Regeneration to patients like you. Hair Regeneration is a treatment that makes use of a combination of platelet-rich plasma and Acellular matrix. Platelet-rich plasma is a concentration derived from your own blood, and contains important healing and growth factors that are essential for wound healing. Acellular matrix is also a wound-healing material that we initially used to improve the results of hair transplants, to improve hair graft survivability, and to improve healing of the donor area. Fortunately, a wonderful side effect that we observed was it could also thicken thinning hair.

Our challenge at that point was how to take this side effect and turn it into a predictable and consistent treatment. We spent several years developing a process and a method to be able to systematically customize the treatment dosage based on the individual’s age, gender, and degree of hair loss, as well as a method of delivery that would allow us to get consistent results.

Today, we’ve had so much success with this treatment that we even see patients who come to us from all over the world just to receive Hair Regeneration in our offices in Manhattan and Long Island. At this point, we’ve treated thousands of patients, and many of them are as young as 18-years-old. After the treatment, we follow up with our patients every three months for the next 18 months to document their progress. In some cases, we will do a second injection in order to build upon the results of the first injection, and then follow up with them for another 18 months. We have been able to gather some very good data to help support the results of this remarkable treatment.

I think someone like you would not be a good candidate for a hair transplant, but would be a very good candidate for Hair Regeneration. Through this treatment, we would be able to address your hair density concerns without damaging existing hairs. I should point out, however, that the more hair we have to work with, the better the long-term benefits and outcome will be. Over the years of using Hair Regeneration, we’ve observed that the treatment will not work on hair follicles that are not there anymore. Once hair is gone, and the scalp is completely smooth, Hair Regeneration will not be able to cause any regrowth, so the earlier we treat you, the better the results.
So learn more about this option or similar treatments because I think there is certainly an opportunity for you here. I hope that was helpful and I wish you the best of luck!

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Amiya Prasad, MD
New York Oculoplastic Surgeon
4.3 out of 5 stars 59 reviews

To be a good surgical candidate you have to understand and accept realistic outcome of a treatment that is recommended.

To be a good surgical candidate you have to understand and accept realistic outcome of a treatment that is recommended. Photos do not indicate if someone is a good hair transplant candidate. To be a good surgical candidate, you need to see a doctor for an examination. 

Jae Pak, MD
Los Angeles Hair Restoration Surgeon
4.9 out of 5 stars 83 reviews

Crown restoration

Would recommend minoxidil if not already using daily.  Massage into the scalp.  

The restoration would depend on level of discomfort with your crown.  If youre okay with its appearance and looking to improve, PRP, stem cell with prp, and minoxidil is the solution. 

If you are looking to significantly improve it, HT will be the solution.  However restoration of the crown is a bit tricky as the crown expands centrifugally.  Typically -32 procedure will be needed to achieve desired density over your lifetime and keep up with continued hair loss in the crown. 

You do have a good donor region based on the pictures and have like 6000-7000 grafts available to you over lifetime.  Best to use them judiciously. 

Good luck.

Baubac Hayatdavoudi, MD
Beverly Hills Physician
5.0 out of 5 stars 41 reviews

Good candidate for Hair Transplant

ı dont recommend you a hair transplant because you have not a AGA caused serious loss to cover at vertex and frontal gulf areas. You will not happy with result ıf you decided to get HT at all.
secondly dont think FUT, just 1000 grafts may be enough to restore crown that harvested and transplanted with FUE which is causes almost no visible scar.
Thirdly, and most importantly, will you keep to use finsasteride all your life through? What happened after you quit to get that medication . You are still under affcet of propecia and we dont know how much hair you will loss in future and what will be grade of your loss.. 

Ilhan Serdaroglu, MD
Turkey Plastic Surgeon
4.9 out of 5 stars 9 reviews

Should I have FUT?

With your hair so short in the back, I really don't think FUT is a good option.  You might see the scar.  Also, you have minimal loss if at all.  You use a lot of light on the crown, which can make anyone with a lower density appear to be thinning.  If indeed you have androgenic alopecia based on physical exam or biopsy, then you might consider a few options as follows:  FUE hair transplants in the person with short donor hair, Minoxidil, Propecia, Minoxidil and Propecia, Nizoral shampoo, PRP, or a Wnt activator.  Remember that crown restoration requires the most number of grafts and that crown loss often gets worse over time and that will require more surgery later on to fill in advancing loss and perimeter loss.  I would definitely avoid FUT because the width of the scar is unpredictable.  It could be that your crown appears thin because you have a generalized lower density and this can be evaluated by your physician should he have the tools to measure all of your parameters.  

John P. Cole, MD
Atlanta Hair Restoration Surgeon
5.0 out of 5 stars 10 reviews

Good candidate for FUT?

I answered you yesterday and appreciate the additional information and photos. What had appeared to be thinning of your donor area now just looks like a fade; if that is the case, it would be interesting to see what the back of your head looks like with your hair grown out a little longer. But even though you are almost out of your twenties (and not 18, as another doctor thinks), I don't see enough hair loss to suggest that youo would benefit from a HT, regardless of the method used to obtain the donor hair. I still think you best bet would be medical management. (NOTE: I am looking at very small photos on my iPhone – RealSelf does not have pinch-to-enlarge functionality. It would also have been helpful if you had taken photos that showed your whole head from standard photography angles.)

Jonathan Ballon, MD
Atlanta Hair Restoration Surgeon
5.0 out of 5 stars 11 reviews

18 year old rewrote another add on question

I answered you and told you that at 18 years old with what you are looking like, you should absolutely not have a hair transplants. I further told you your biggest enemy is the progressive thinning leading to a balding pattern that is not evident at this point in time. The degree of thinning that you are showing would suggest that you should see a doctor who most likely will get Bulk Measurements of your hair to determine the degree of the thinning that you are presently having. If the diagnosis is early genetic hair loss (the most common cause of hair loss in young men), then the best treatment would be the drug finasteride which is highly effective in men of your age and may not only stop the hair loss but possibly reverse it. If you are developing a more advanced balding pattern the best test to get will determine the Bulk Measurements of your hair and this will show, over a one-year time frame, how effective the treatment will be. Once you know this information, then you and your doctor need to develop a MASTER PLAN which will define what you need to do over the years to come.

William Rassman, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 25 reviews

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