Patients often come into an office wondering whether or not they are "good candidates" for surgical hair restoration. Even when told "yes" or "no" by the physician, a patient may want to better understand why they are or are not deemed a good candidate and where he or she may fit into the overall spectrum of candidacy.
While young patients can certainly refer to a helpful publication authored by our practice (view here) that helps provide a ballpark for the ultimate number of donor hairs one may anticipate over their lifetime, it is helpful to know about the "miniaturization" rule. Using magnified images of a patient's donor hair, a physician can determine the number of miniaturized hairs (those of the finest caliber compared to the regular caliber terminal hairs). As a general rule of thumb, young patients who possess 25% or more of their donor hair in miniaturized form are not great candidates for the surgical procedure. Not only will a large number of the transplanted hairs likely not be permanent hairs, but also the donor scarring (either FUT or FUE) will likely become exposed over time if the surrounding donor hair continues its anticipated course of MPB.
The following image depicts a relatively poor candidate for HRS on the left and a better candidate for HRS on the right. This is based on the relatively low number of miniaturized hairs present in the righthand patient's donor area. Both were of the same age.
This next image also compares a poor candidate (left) with a much better candidate for the procedure (right).
There are also a number of more subjective variables that help determine a patient's candidacy: the wave, curl, frizz, and color contrast between the hair and scalp. These can also influence the ultimate appearance of a patient after a full session.
To put it all together, here is an image of a good candidate's donor area, recipient area prior to treatment, and his recipient area after treatment as seen under a magnified lens. The same patient's transformation after a 2701-graft FUE session with me can be viewed in the accompanying video montage.
This 22-year-old male was bothered by the progressive thinning of his hairline and the frontal portion of his scalp. His surgical hair restoration session with Dr. Wesley included included 2507 grafts incubated in platelet-rich plasma (PRP).
In addition to his surgical session, the portion of his mid scalp that did not receive grafts was treated with PRP injection and stimulation with a 0.5mm micro roller. The patient returned to Dr. Wesley's office at 10 months. Early growth from his transplant can be seen and this patient's response to subcutaneous PRP injection is included in a larger investigation currently being conducted by Dr. Wesley's office.
This patient has just returned 9 months after a 2179FU session to his frontal third. He was most thrilled during these summer months to feel comfortable in situations during which he had to get his hair wet (e.g. poolside, beach, etc.). So, while the "wet" look in the right-and-left-side preoperative photos do magnify the thinning prior to the session, they most effectively demonstrate what no longer bothers this particular patient.
This 23-year-old male had a family history of Norwood Type VI pattern hair loss. Using 1854 FU, hairline was designed to not only reinforce his currently-receding hairline and temple, but also address areas of future loss in the lateral humps. He returned less than six months later very pleased with the natural-appearing thickness of his hairline.
This 24-year-old male had lost confidence due to his marked hair thinning. His family history revealed a Norwood Type VI pattern and his physical exam was consistent with this distribution. Rather than advancing his hairline (as he initially requested), we designed an age-appropriate hairline pattern using 2263 FU that would continue to look natural into his 60's and 70's. Addressing areas of future loss lateral to the thin areas atop his head also will prove critical as he continues to thin laterally. As he desires a short-length haircut, a trichophytic closure was most appropriate for this patient and allows him to continue to clip his hair with a #2. After photos depict growth at 6 months and again at 12 months, when the patient returned for a subsequent session to cover the midscalp.