How to keep native hair?

[MAGNUMpi]

Hi All,

I have an uneven MPB hairline (see picture) and was wondering the best way to save the native hairs when going through a FUE HT.

Should I ask the doctor to work around the native hairs being careful not to plant too close?

Or should he plant new hairs between the native (to go for density)?

 

I have seen lots of pictures where they planted right around the native and it seems the naturalness of the hairline was lost to the HT and it became a thinner area in general.

I am very interested in achieving a natural looking HT that would be potentially undetectable.

Any suggestions from those who have experience?

Thanks

[chrisdav]

If the hairs were miniaturizing and on the way out, a transplant will potentially knock them out and they will not return but if any hairs which were healthy fall out, they will return in the following months.

 

You can probably find a thread regarding shock loss which would be beneficial to read.

 

If you are not on finasteride pre op, some surgeons will suggest you go on it for a short period of time before the op to help minimise the shock loss as it is unpredictable and even if you are in the best hands, it can still potentially happen.

[nikemata]

If the hairs were miniaturizing and on the way out, a transplant will potentially knock them out and they will not return but if any hairs which were healthy fall out, they will return in the following months.

 

You can probably find a thread regarding shock loss which would be beneficial to read.

 

If you are not on finasteride pre op, some surgeons will suggest you go on it for a short period of time before the op to help minimise the shock loss as it is unpredictable and even if you are in the best hands, it can still potentially happen.

 

 

SO it is necessary to have fin prior to this procedure?

[Dr. Michael Beehner]

If you have early signs of classical patterned male pattern baldness, then many if not most of the hairs within the U-shaped area on top will be at some point of the spectrum of miniaturization. Our hairs typically live in 4-5 year long life cycles, are then shed, and then the follicle pushes out the next generation of hair. If it is in the area of MPB, then this next hair will be a little wispier, will grow to a shorter maximal length, and will have a shorter anagen (growth) cycle.

So when you have a hair transplant procedure, the trauma of the surgery can "spook" some of the follicles in the area and send them into a 3-6 month hibernation with the hair falling out. The great majority of those hairs will re-emerge, but will have a little less "mass" to them and will be a little more "see-through."

I would make four points that I think would help hang on to your native hair a little longer:

1) Have your surgeon plant the FU grafts at a lower than maximal density (probably 30/cm2 or less)

2) Using the smallest possible sites helps (this task and the planting step are both best carried out with very high magnification, 4.5x or higher).

3) The surgeon should use the minimal amount of epinephrine (Adrenaline) that is necessary to control bleeding. Most hair surgeons believe that too strong of a concentration of epi can promote shocking.

4) A corollary of point #1 is that the task should be divided into two sessions instead of one. The cumulative "insult" to the follicles on top will be minimized.

 

One final point: It is my belief that a small amount of shocking to native hairs occurs with every hair transplant procedure and is only noticeable or complained about when the number of hairs affected is quite significant.

 

Mike Beehner, M.D.

[zenmunk]

Great info! Thanks, Dr. Beehner.

[chrisdav]

Great post Dr Beehner,always better to hear it from the surgeon.

[MAGNUMpi]

Thanks Chrisdav.

Dr Beehner about point #4

A corollary of point #1 is that the task should be divided into two sessions instead of one. The cumulative "insult" to the follicles on top will be minimized

.

In your opinion would the next day be an okay amount of time for the health of the follicles (2 day session) or would it be smarter to wait 8 months or more?

P.S. thank you for your very interesting reply.

[Dr. Michael Beehner]

Dividing a large, dense transplant session into two sessions a day apart I think would inflict the same amount of surgical trauma and shock to the scalp as doing it on the same day. The only advantage to be gained in dividing up a large session into two days is to avoid staff fatigue, which is a significant factor in long, large cases. This is especially true for FUE cases, where the fatigue on the surgeon can add up after 8 hours of work.

Mike Beehner, M.D.