Who is suited for hair transplantation? Assessing donor hair availability and progression of hair loss

Whether hair transplantation is suitable depends not solely on the extent of hair loss. The decision is made by assessing both the amount of donor hair available for transplantation (your own hair taken from the back of the scalp, etc.) and how hair loss will progress in the future.[1]. If the density, thickness, and stability of hair in the donor area are insufficient, it may not be possible to fully cover the desired area in a single surgical procedure.[2].

What should we look for in donor hair?

During the consultation, we examine the density of hair follicles (the roots that produce hair) in the back of the head and temporal areas (sides of the head), the number of hairs, thickness, and quality.[1]. Density is measured using specialized equipment, counted as the number of hair follicle clusters (in follicular unit terms). Also, thicker and thinner hairs will show different apparent density even if the same number of grafts are transplanted.[3].

Can I undergo the procedure even if hair loss is still progressing?

It is possible under certain conditions. However, with ongoing AGA (androgenetic alopecia), the original hair surrounding the transplanted hair may thin out later. Guidelines also emphasize that it is important to consider long-term results with AGA where progression can be controlled with medication or has naturally stabilized.[4].

Should younger people have the procedure done earlier?

No. Whether surgery is suitable is not determined by age alone. If you only lower the current hairline, when the area behind it thins in the future, additional donor hair will be needed. The basic principle of surgical planning is to consider your wishes, the progression of hair loss, and the quantity and quality of donor hair together.[1].

With extensive hair loss, what should be prioritized?

There is a limit to the amount of donor hair that can be harvested. Therefore, it is not always possible to achieve the same density in the hairline, frontal area, and crown.[2]Whether to prioritize the front area that significantly changes facial appearance, or to supplement the hair part or crown, depends on your usual hairstyle and preferences.

Consultation: Confirming whether surgery is suitable

First, we diagnose whether the cause of hair loss is AGA or another type of alopecia or scalp disease, and then consider surgery. You should also confirm with your doctor the measurement of donor hair quantity, prediction of future progression, medical treatment history to date, and whether there is room for additional surgery in the future.