Hair Transplant: A Detailed Guide

Hair transplant has become a frequently preferred procedure today. Hair, as an extension of the skin, significantly impacts people’s social lives and appearances. Especially among men, having hair is seen as an important factor when examined from a psycho-social perspective. Numerous studies have observed that hair loss negatively affects individuals’ psychological states. A study conducted in Korea found that men with hair are perceived as healthier and more attractive compared to bald men. Additionally, research in the United States has shown that the appearance of sales personnel affects their success rates. While baldness may seem insignificant to those who do not face this issue, it can be a serious problem for those who do. Friends and family of bald individuals often dismiss the issue with general remarks like “don’t worry about it” or “being bald is better.” However, the problem of baldness requires understanding and empathy.

When individuals start losing their hair, they typically begin by researching the topic online. The process starts similarly for almost everyone. After their research, people usually start using products like “rosemary oil,” “hair serums,” and “dermarollers” on their own. Although some may see results in the initial stages, these applications are insufficient in the long run, leading individuals to seek medical support. When looking for medical support, they often encounter suggestions for supportive treatments and hair transplants. If these treatments are not applied in the correct order, individuals can fail and end up with poorly looking hair for life. You cannot imagine how many people contact us in such situations!

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Where Should I Start? Which Treatment Is Right for Me?

In this article, we will try to answer these questions for you.

First, it’s important to understand that our bodies have two main types of hair: short and fine “vellus” hairs (peach fuzz) and longer, thicker “terminal” hairs. Vellus hairs protect your skin and help regulate body temperature. You can find these tiny hairs on your face, neck, arms, legs, and torso. Examples of terminal hairs include the hair on your head, facial hair, eyelashes, eyebrows, genital hair, chest hair, and abdominal hair. Hair growth begins at birth and almost takes its final form during puberty with the shaping of beards due to the increase in male hormones. We are explaining the types of hair to help you understand their structure and thus better comprehend the treatments.

The hair on the temples, middle, and crown of our head contains receptors that detect male hormones. Androgenetic alopecia is a genetically determined disorder characterized by an excessive response to androgens (male hormones). This condition involves the progressive loss of terminal hairs on the scalp, which can start anytime after puberty. It can affect up to 50% of both men and women. Generally, there is no permanent cure for hair loss. (For other types of hair loss, click here.) Medical options can slow down and temporarily halt hair loss. In some individuals, home treatments applied after hair loss can increase hair growth on the scalp. However, contrary to popular belief, this growth is not a revival and increase of terminal hair follicles that make up our hair. The increase in the “vellus hairs” mentioned, which are found all over our body, gives people hope. Unfortunately, these hairs only grow 1.00-1.50mm over 6-8 months and never grow as long and thick as “terminal hairs.” They do not give the appearance of full hair.

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Beware of Those Who Exploit This Process

There are many cosmetic manufacturers and practitioners who take advantage of this process. With applications targeting vellus hairs, people are given some hope, and various substances are applied to the scalp over multiple sessions. After a while, the response ceases, and the individual does not achieve the desired hair. The length and effort of the process drive the person away from these treatments. Ultimately, the individual does not achieve the desired full hair appearance, and the money spent is essentially wasted. Setting our goals accordingly will protect us from both effort and financial loss.

In this article, we want to be clear to you, so you can understand our sincerity and ethical perspective: “Hair transplantation is not a procedure that stops hair loss.”

Hair loss in men typically manifests at an early age with thinning at the temples and crown, slow growth, and hair strands that are lighter in color compared to the hair at the nape. In this situation, the first choice is not hair transplantation. There are two drugs proven by the FDA to affect hair loss. These drugs, when started early, stop hair loss “for as long as they are used.” However, it should be known that hair loss may resume once these drugs are discontinued. Supportive clinical treatments applied alongside these medical treatments increase the likelihood of success. Thus, the individual can maintain their hair “as long as they continue the treatment.” If hair loss starts at an early age and the forehead and temple areas have significantly receded, hair transplantation can be considered only for these areas.

Early Stage Hair Loss and Hair Transplantation:

Let’s examine the following patient together:

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Example 1 : Hair loss in temples

A 23-year-old patient contacted us from Italy with complaints of hair loss. As seen, there is a receding hairline and thinning at the temples. However, there are no signs of hair loss in the middle and crown areas at this time.

Example 1 – Thinning at the Temples

Patients with this type of hair loss can opt for a hair transplant only in the temple and hairline areas since the hair density in these regions is less than 50%. However, since the patient is young, there is a risk of future hair loss in the middle and crown areas. You might be wondering, “Can’t hair be transplanted to these areas as well?” Unfortunately, since these areas currently have hair, they are not suitable for transplantation. The patient was advised to use the aforementioned medical treatments for these areas, and a hair transplant was performed on the front hairline. Depending on future hair loss in the middle and crown areas, a second session of hair transplantation can be planned.

Since hair transplantation is a surgical procedure and involves financial costs, some patients might ask, “Can’t we transplant a bit in the middle and crown areas as well?” This is akin to wanting to cast an arm before it’s broken. Transplanting hair in these areas does not stop hair loss in those regions and can, in fact, exacerbate hair loss due to the trauma caused by the procedure, ultimately leading to unsatisfactory results. However, in such situations, patients often tend to choose sources that tell them what they want to hear rather than the correct and ethical information. Regardless of the source chosen, the result remains unchanged. When hair loss begins in these areas in the future, a second session of hair transplantation will be inevitable.

 

Advanced Stage Hair Loss and Hair Transplantation:

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Example 2 : Advanced Baldness

The second most common issue encountered in hair transplantation is the dilemma of how much of the bald area can be covered depending on the level of baldness. The patient below has what is known as Norwood-7, the most advanced stage of hair loss. Patients with this level of hair loss typically ask the following question.

Example 2 – Advanced Baldness

“Can’t we cover it even in two sessions?” The answer is still no. However, these patients also tend to choose sources that tell them what they want to hear. Despite spending a lot of time and undergoing multiple procedures, they still don’t achieve the desired look. Think of it this way: you have enough grass seeds to cover 100 square meters, but the area you want to cover is 1000 square meters. The questions that arise from this situation are:

  • Can you cover the entire area with the desired density using that amount of seed?
  • If you scatter the same amount of seed twice, can you cover the entire area?
  • What will the appearance be like if you spread 100 square meters’ worth of seed over a 1000 square meter area?

Now the situation should be clearer in your mind. For individuals with this type of hair loss, the hair transplant is planned differently. The height of the hair increases towards the middle part of the head when viewed from the front, and it decreases again at the very top of the crown (vertex). Therefore, when you look from the front, you only see up to the point where the height is the highest. You can try this in front of a mirror. Place your hand on the highest point of your head and mark a point slightly behind this with a pen. When you stand straight in front of the mirror, you won’t see this point. Using the anatomical structure of the head in this way, a hair transplant can be planned. Now, we will share an image that clearly demonstrates how the front hairline can change a person.

“Having realistic expectations may be disappointing at first, but it brings happiness in the long run.”

In the image on the side, you can clearly understand what we are trying to convey

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As seen in the image, the small hair area on the hairline provides a completely hair-covered appearance when viewed from the front.

As seen in the image, the small hair area on the hairline provides a completely hair-covered appearance when viewed from the front.

This appearance can be achieved with hair transplantation in individuals experiencing advanced baldness. Depending on the efficiency of the donor area, this appearance can be enhanced. However, such a surgical plan creates a realistic expectation that contributes to the person’s current appearance through hair transplantation.

 

Conclusion

In the above article, by examining the curiosities and examples related to hair transplantation, we tried to enlighten you about:

  • The role, timing, and contributions of medical treatment in hair loss
  • The medium and long-term plan for early-stage hair loss
  • The expectations that should be set for advanced hair loss

We would like to thank Dr. O. Gürcan ERGEN for his academic contribution to this article and wish you healthy days.

For all your questions about hair loss and hair transplantation, you can contact us.