Am I a good candidate for a transplant as an African American female? What kind of coverage can I expect? (photos)

African american woman, traction alopecia and damage from relaxers. Assuming I am a good candidate what results can be achieved in terms of coverage, number of procedures, etc? I realize these are just photos I am just trying to understand what I'm working with. Is my hair loss too substantial to be corrected? The closer pictures are more distorted from the lens. The more distant photos are more representative of the size/scale of the hairloss. How many procedures?

Doctor Answers 6

I have transplanted hair on chemically burned skin so it can be done. In your case, you would need at least two hair transplants

Thank you for your question. You state you’re experiencing hair loss due to traction alopecia and damage related to hair relaxers. You’d like to know if you are a good candidate for a hair transplant, and what kind of coverage you can expect from the procedure.
I can certainly help you with your question. To give you a little about my background — I’m a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. I’ve been performing hair transplants for this same amount of time, and I’m also the founder of TrichoStem™ Hair Regeneration Centers, which offer a non-surgical alternative to hair transplantation for men and women who suffer from pattern hair loss. The technology we use in this treatment is actually derived from improving the results and healing rates of hair transplants.
Before performing a hair transplant, I usually measure out square centimeters in the problem area that we will need to fill in. In your case, you have a large area at your temples and at the frontal hairline that needs help. We would then determine how much viable hair is available in your donor area that we can use to fill these areas.
A proper evaluation is certainly important in order to determine how much coverage is realistically possible with one transplant. Based on your photos alone, I would suggest a minimum of two hair transplants. You will need to make decisions in terms of priority of where you want to see proportionally more hair because unfortunately, the donor area is very limited.
The challenge when it comes to the hair of people of African descent has to do with density. Usually, the density of hair is not as high as people who are of Caucasian or Asian descent, and this is probably because the individual hair strands are very curly and cannot, by nature, be that close together. On the plus side, the curliness of the hair does give a good amount of coverage. In terms of the technical side of transplantation, the challenge lies in the proper placement of hairs so they grow in a good direction and don’t become ingrown. Another challenge is getting hair grafts to survive. If you think about it, hair transplants involve making many tiny openings in the skin, and if the skin is damaged from things like hair relaxers, it makes healing more difficult.
Keep in mind that hair relaxers essentially belong to the sodium hydroxide or potassium hydroxide family, which are chemicals comparable to what is used in drain cleaner. This can cause burning of the skin and thinning of the skin.
In our practice, we use a material called extracellular matrix. Extracellular matrix is derived from pig bladder because of its remarkable healing and regeneration properties, which is used for wound healing and for the improvement of the healing of hair grafts after transplantation. It was a fortunate discovery on our part that we learned it could also thicken existing thinning hairs. Today, we use this technology in our treatment called Hair Regeneration where we actually inject platelet-rich plasma (PRP) and extracellular matrix into the scalp to help men and women with pattern hair loss. I think in your situation, we could use variations of this treatment for maximum viability.
An interesting anecdote — hair is certainly remarkably resilient. I once implanted hair in a circular scar which was damaged from chemical hair relaxer and the hair was able to grow out quite nicely. The scar was very thin, and you could go right through it, but thanks to the technology and method and technique of Hair Regeneration, it worked out very well.
That said, I advise that you meet with a hair transplant specialist. Try to seek out someone who is going to guide you throughout the procedure and beyond the procedure. Nowadays, the hair transplant field is full of people either who don’t have a lot of experience and rely heavily on new robotic technologies to harvest grafts, or people who just want to get more procedures done without really thinking of the patients long-term.
I advise you meet with a specialist, and get some realistic opinions. I doubt your donor area will be enough to give you the full coverage you want, so you may also want to consider other options like micropigmentation to improve the appearance of the area.
I hope that was helpful and I wish you the best of luck!
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African American Woman with traction alopecia may be candidate for hair transplant

You have a very typical pattern of traction alopecia in an African American Woman. Restoration is possible but you have to simply be aware of the limitations. You will never restore the original density of your hair nor the original position of your hairline but you can usually push the hairline forward some with reasonable density depending on the amount of donor you have available. As long as you have realistic expectations, a hair transplant may be a good solution. 

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Many men and women with traction alopecia may be good candidates for a hair transplant surgery.

Many men and women with traction alopecia may be good candidates for a hair transplant surgery.  It is best to discuss expectations with a doctor in person.  In general hair transplant surgery will not likely give you your original hair density.

Jae Pak, MD
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Traction alopecia

You have likely lost over 30% of your hair and the remaing hair would have to be thinned out to acheive coverage. It would take multiple procedures. The quickest and most efficient path would be through scalp expandion which is at least two operations. 

Sheldon S. Kabaker, MD FACS
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Hair transplant for traction alopecia

The areas of concern can be restored to a degree.  The extent of hairline lowering would depend on your donor hair density.  

Traction alopecia in African American

This can be transplanted; however, you need to be examined to make sure that your donor supply is adequate for the quantity of hair transplants you need.

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.