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Views on using nape hair for HT?


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  • Senior Member

Hi, i have noticed more and more cases recently of surgeons like Dr Umar showing some impressive cases of HT having used nape hair as well as what is classed as the safe zone. Was just curious to what people on the forums views where on using nape hair?

 

Regards :)

Hair Transplant Dr Feller Oct 2011

 

Hair Transplant Dr Lorenzo June 2014

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  • Senior Member

Good question. The idea of using nape hair for the hairline is great because the doctor doesn't have to split grafts into 1 hair grafts if he needs them for the hairline, therefore saving you some money and maintaining the follicular unit intact. I really like the results of Dr. Umar's nape to the hairline procedures. They look very natural.

 

My only concern (as it is with certain FUE procedures) is the longevity of that hair. Is it in the safe zone? I certainly don't know. It is below the area where strip is usually taken (which is what traditionally has been the safe zone) so maybe it can be permanent, although I've heard the nape can thin out over time. That said, I probably would feel more secure using nape hair for a transplant than using hair above the strip area as we see in some FUE procedures.

 

It would suck for a patient to transplant hair that will fall out in time anyway. I don't want temporary hair but hair that has the best chance of staying permanent.

 

Maybe Dr. Umar himself can comment.

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  • Senior Member

Using nape hair for anything is a gamble at best. Yes, some cases have been presented where it looks fine (pardon the pun) but there is absolutely NO evidence that these hairs last for a few years much less for several years or longer. On the other hand there is ample evidence that nape hair is not permanent and will thin or disappear over time. I've seen several cases where some genius decided to take a strip from the nape of the neck for the very same reason that some FUE clinics do so today, because of the finer hair for the hairline. Now they have a visible scar along the nape and their hairline has disintegrated thus making the effort a complete waste of time and money.

The Truth is in The Results

 

Dr. Victor Hasson and Dr. Jerry Wong are members of the Coalition of Independent Hair Restoration Physicians

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  • Senior Member

As Joe says, controversial. Nape hair is definitely not categorically "safe" as some men do lose their nape hair, but not all. But as Joe points out, if you take it out via FUT and then it does disappear, you've got a transplanted hairline that erodes away AND a balding nape revealing a clear strip scar.

 

I have seen doctors use nape hair and sometimes it can look good. To that extent, if you're not genetically disposed to losing it, it can be great. But nobody can tell for sure how your nape hair will turn out and so even in the hands of experienced doctors nape hair transplantation is a risk and an unnecessary one! Dr. Umar does good work but he's absolutely bound to have some disappointed patients coming back in years to come telling him that their hair transplant isn't permanent. I guess if that's a risk he and the patient are willing to take then I guess that's fair enough, but it does seem to me an unnecessarily large risk to take in your hair transplant planning.

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  • Senior Member

The nape issue via FUE probably varies from patient to patient. I have heard nape can thin over time but I don't know if this is necessarily the case in every patient. In my opinion, FUE from any area outside of the FUT safe zone is a better bet in an older patient whose hair loss pattern is fairly well-established.

 

Definitely wold like to hear Dr. Umar's thoughts about his reasoning for using nape.

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  • Senior Member
The nape issue via FUE probably varies from patient to patient. I have heard nape can thin over time but I don't know if this is necessarily the case in every patient. In my opinion, FUE from any area outside of the FUT safe zone is a better bet in an older patient whose hair loss pattern is fairly well-established.

 

Definitely wold like to hear Dr. Umar's thoughts about his reasoning for using nape.

 

I had nape hair used in my hairline and temple points. The men in my family on both sides have guerilla type nape hair in to their 80's and 90's. I often see old men who have thinning hair on top, but have all kinds of nape/neck hair almost bursting out of their shirt collars. I have observed nape hair to be quite hardy in some people. One of the forum members here recounted having had 5 or 6 professional hair removal sessions done on the nape hair, only to have it grow back. He then had that hair trasplanted into the hairline.

 

In the end, I think the doc along with the patient need to assess each individual situation on nape hair usage and applicability. Also, it takes a VERY skilled doc to successfully remove nape hair intact. The use of custom tools in this instance is optimal.

 

My own results will be shown via video early this year I am guessing. It will show my grown out results post op five years.

 

Happy New Year!!!!!!!!

 

Atticus :)

 

P.S. I just thought about my neighbor. He is balding on top, but his wife has to shave his neck/nape area every other day to keep it from getting bushy.

600 FUE - 12/07 - Performed by Dr. Umar of Redondo Beach, CA

*****300 leg hair FUE implanted 7/12 to the eyebrows - 150 each eyebrow. Performed by Dr. Umar.

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  • Senior Member

If the patient shows any signs of retrograde alopecia than using nape is a definite no-no. But as atticus says, not everybody is the same and I've seen a number of monkey backs in my day.

Dr. G: 1,000 grafts (FUT) 2008

Dr. Paul Shapiro: 2,348 grafts (FUT) 2009 ~ 1,999 grafts (FUT) 2011 ~ 300 grafts (Scar Reduction) 2013

Dr. Konior: 771 grafts (FUT) 2015 ~ 558 grafts (FUT) 2017 ~ 1,124 grafts (FUE) 2020

My Hair Transplant Journey with Shapiro Medical Group

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  • Senior Member
Definitely wold like to hear Dr. Umar's thoughts about his reasoning for using nape.

 

It would have been nice for him to have explained his criteria for patients requesting nape hair transplants when he was being considered for recommendation.

Dr. G: 1,000 grafts (FUT) 2008

Dr. Paul Shapiro: 2,348 grafts (FUT) 2009 ~ 1,999 grafts (FUT) 2011 ~ 300 grafts (Scar Reduction) 2013

Dr. Konior: 771 grafts (FUT) 2015 ~ 558 grafts (FUT) 2017 ~ 1,124 grafts (FUE) 2020

My Hair Transplant Journey with Shapiro Medical Group

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  • Senior Member

I asked my doctor ( Dr. True) the same question and he repeated what was said above. Of course , I too see people who are very bald on top but possess a large "supply" of nape hair.

JOBI

 

1417 FUT - Dr. True

1476 FUT - Dr. True

2124 FUT - Dr. True

604 FUE - Dr. True

 

 

 

 

 

 

 

My views are based on my personal experiences, research and objective observations. I am not a doctor.

 

Total - 5621 FU's uncut!

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  • Senior Member

Hello and Happy New Year, all. :) I am posting on behalf of Dr. Umar. His reply to this thread is this:

 

For most individuals, nape hair* is more DHT resistant than the hair in the area of baldness. In other words, nape hair is not necessarily lost in all cases of MPB. What more? The safe donor area (SDA) is functionally the area bordering the fringe of hair that would be left in a terminally bald person. (NW7+). yet we know that the majority of individuals do not experience this degree of baldness. The role of nape hair has hitherto been defined by:

1. The notion that it is generally DHT susceptible

2. It is not typically an area subject to harvest given the limitations of the strip harvesting methods available.

The second factor has been cancelled by the advent of FUE. Since then nape and temple hair (donor areas outside the SDA) have been widely used in successful repairs of strip-donor- depleted patients. These would be patients whose capacity for further strip surgeries has been exhausted. It is the extension of these experiences with repairs that opened the prospect of using nape hair as the vanguard hair of transplanted hairlines. Obviously, patient selection is key. Using criteria such as the degree of baldness relative to age, visual evidence etc. nape hair can play an important role in hair transplantation.

* For the purpose of this discussion, nape hair use in hairline and temple creation refers to hair in the area below the SDA including areas around the ears.

Representing Dr. Umar of DermHair Clinic.

 

Dr. Umar is recommended on the Hair Transplant Network

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  • 3 years later...
  • Senior Member

Here is relevant new information on this discussion:

 

Dr U has objectively presented his findings on the use of nape hair in transplantation in a peer reviewed journal. In it, he describes how to screen for suitable candidates and the outcome of such methods in 128 patients.

 

Read more about Dr U's application of his "FUE Shave Test" here:

 

https://www.dermhairclinic.com/drus-work-on-natural-hairlines-and-temples-creation-with-nape-hair-published-by-the-aesthetic-surgery-journal/

Representing Dr. Umar of DermHair Clinic.

 

Dr. Umar is recommended on the Hair Transplant Network

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  • Senior Member
Hello and Happy New Year, all. :) I am posting on behalf of Dr. Umar. His reply to this thread is this:

 

For most individuals, nape hair* is more DHT resistant than the hair in the area of baldness. In other words, nape hair is not necessarily lost in all cases of MPB. What more? The safe donor area (SDA) is functionally the area bordering the fringe of hair that would be left in a terminally bald person. (NW7+). yet we know that the majority of individuals do not experience this degree of baldness. The role of nape hair has hitherto been defined by:

1. The notion that it is generally DHT susceptible

2. It is not typically an area subject to harvest given the limitations of the strip harvesting methods available.

The second factor has been cancelled by the advent of FUE. Since then nape and temple hair (donor areas outside the SDA) have been widely used in successful repairs of strip-donor- depleted patients. These would be patients whose capacity for further strip surgeries has been exhausted. It is the extension of these experiences with repairs that opened the prospect of using nape hair as the vanguard hair of transplanted hairlines. Obviously, patient selection is key. Using criteria such as the degree of baldness relative to age, visual evidence etc. nape hair can play an important role in hair transplantation.

* For the purpose of this discussion, nape hair use in hairline and temple creation refers to hair in the area below the SDA including areas around the ears.

 

Hi Abbie,

 

Dr. Sanusi Umar used nape hair in my hairline back when I was 39. I am 49 now, and it is holding strong. Still looks good. There is a picture of my in than peer review article you posted. I am the guy with the "Dracula" hairline, figure 5.

 

Thanks Dr. Umar!

 

Atticus

600 FUE - 12/07 - Performed by Dr. Umar of Redondo Beach, CA

*****300 leg hair FUE implanted 7/12 to the eyebrows - 150 each eyebrow. Performed by Dr. Umar.

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  • Senior Member

This is where family history can be of some benefit. Because some guys lose their nape hair as they get older and some do not. I have seen some men in their retirement years have thick white nape hair and they usually have hairy backs and shoulders as well.

 

So if the men in your family retain their nape hair in their older age, then chances are, you will too.

 

However if they lose it later in life, the same is true, you probably will too.

 

Sometimes nape hair can change in characteristics over the years. For some, it can get more wavy as you age and may present some visual compatibility issues if used on the commencement of the hairline.

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: The Hairloss Doctors in New York, NY

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