What are some of the negatives of a hair transplant in the future?

I'm close to my forties single and insecure with low self esteem. I'm very close to schedule my appointment but worried about what will be repercussion when I'm 50-60 year old

Doctor Answers 3

Most important for hair restoration is not immediate results, but sustaining results long-term, which you are already aware of

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Thank you for your question. You submitted a question without a photo, stating you are in your 40s, have issues with low self-esteem, and are considering a hair transplant. You ask about the negatives of a hair transplant when you get to your 50s to 60s.

I can share with you how I counsel patients in our practice with the very same question. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years where hair transplant has been a significant part of my practice, but more importantly I’m the founder of TrichoStem™ Hair Regeneration Centers. We developed this method of non-surgical hair restoration for both men and women with thinning hair using regenerative technology we initially used to improve the outcomes of hair transplants.

You have to think about how advanced your hair loss is, what outcome you want to see, and how long can that outcome last. When people are treated in their 40s, it’s a very different situation if they were to come in their 20s and 30s. That said, I would say the most single most important strategy is not about the outcome of the procedure, but how to sustain results.

In so many years of doing transplants, the greatest frustration we have was to do a great procedure and get a good result, but then year after year, the person continues to thin their hair. With men, we would try to encourage the use of Propecia (finasteride) to slow things down. Unfortunately, issues with side-effects,compliance, and responsiveness, result in only 60% of men responding to Propecia or finasteride. It lead many people a few years later to need another transplant, and they kept thinking the permanent zone would be able to yield comparable results with the first transplant. Regardless of an FUT or a strip method, or FUE, you are likely to get the best transplant out of your first one if you are a moderate level hair loss patient, which is typically when people seek medical attention. People often don’t seek attention when they’re first slightly thinning, but when their thinning has advanced to the point where they’re getting anxious.

We wanted to improve the outcomes of our transplant so we started using something called Acellular matrix to maximize the healing of the grafts. There’s a certain loss of the grafts even with excellent surgical technique, and all the other variables controlled. We also wanted to improve the healing of the donor area because the scar was also an issue. What was discovered incidentally was thinning hair looked thicker in various patients.

What I did was develop a process and system to do the treatment without the transplant. If you have thinning hair, we have a process called Hair Regeneration which is able to stop the progression of hair loss, reactivate hairs that are not growing, and induce the shed of thinning hairs to allow the growth of thicker hairs. When I started to compare someone getting a transplant versus someone getting Hair Regeneration, it became apparent there was a big opportunity for someone with existing thinning hair to do Hair Regeneration to significantly improve their hair loss and get coverage, often exceeding the results of not one but two transplants. That seems like a remarkable statement to make, but if you think about it, if hair thins, let’s say in the crown and outward, it tends to regrow from the fringe inward, and the volume of hair to cover that area far exceeds any transplant.

When someone comes is strongly considering hair transplant, I advise them to do something to stabilize their hair loss. The donor area cannot continuously yield more hair and will eventually run out. It is very common for us to see patients who have had 3-4 transplants prior to seeing us, with such thin hair coverage from transplants because they’ve lost all of their native hair, so it doesn’t look good. Very often, people will criticize the outcomes of hair transplants and say, “I don’t want to have that pluggy look.” The reality is, they didn’t have a pluggy look while they first had the hair transplant. It’s only after they lost their existing hair that the hair plugs or grafts became more apparent.

I can’t stress to you enough that some stabilization strategy, whether it’s taking finasteride, or technology like Hair Regeneration is very important. You are already thinking proactively, and about the future in your 50s and 60s. Degree of hair loss and rate of progression are two very important factors, but given that we have so much experience doing this for many years, patients come to us from all over the world for Hair Regeneration treatment. It has been remarkable for us to see how people ready for transplant will come, have Hair Regeneration, then ultimately decide they don’t need a transplant. It makes a lot of sense during a consultation - they were thinning for a while, but then one day decided they’ve lost too much and want some kind of help and intervention.

With Hair Regeneration, patients improve to the point where they looked the way they did a few years ago. We have actually helped people avoid a hair transplant, but it doesn’t mean that hair transplant is a bad thing. Hair transplant is a great operation, but it has limitations.Until recently, hair transplant became the first procedure of choice because we didn’t alternatives. Now, we can incorporate Hair Regeneration as part of the strategy. The reality is, many men and women would never do a hair transplant, but they wouldn’t mind coming in for a single injection treatment which can last 5 years and longer. That’s from our own data, where patients we followed for this much time, and we do a lot of these injections every week for patients who come from all over the world.

It’s an interesting time of how hair loss can be managed. If you are already bald,  you have to think limiting frontal recession or diffuse thinning, or just significant advanced hair loss You still want to stabilize whenever you can so you can go into your 50s and 60s look as good as you can. I hope that was helpful, I wish you the best of luck, and thank you for your question.

New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Some "negatives" of a hair transplant surgery is that if you choose the wrong doctor and get poor results it would be permanent.

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Some "negatives" of a hair transplant surgery is that if you choose the wrong doctor and get poor results it would be permanent.

Jae Pak, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 106 reviews

40 year old wanting hair transplants

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For a 40 year old with a reasonably stable pattern of hair loss, depending upon what area you are transplanting, the only issue might be that you continue to bald and require another hair transplant in the future.  This is a risk you should speak with your doctor about

William Rassman, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 29 reviews

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.