Basic guide for hair transplants

[chrisN]

Summary of procedure

Hair transplant surgeons use 2 main techniques:

FUT - Follicular unit transplantation

FUE - Follicular unit extraction (most common)

A follicular unit is basically a group of hairs on your scalp that contain a few terminal hairs (thick hairs). These are what is used for the donor follicles in a transplant and are often found in non-alopecia sites like the back of your head.

To be specific, the donor site is found between upper and lower protuberances
(picture for reference), each square centimetre in the region contains 65-80 Follicular units (usable follicles for a transplant) which can be used for the transplant.

Depending on how bad your Norwood is, it is estimated you need 600 - 3000+ to fix it.

This is where the first problem comes in. Depending on how dense and thick your hair is naturally this can become a limiting factor in how many actually usable follicles you can use, the more dense and thick your hair is, the more you can get away with because the donor site will still look normal once you recover, however if your hair is on the thin side, the site will become more obvious and unappealing when healed. As a result surgeons are advised to only take 15-20 follicle units per square centimeter, anymore is risky and can cause thinning at the site.

Some surgeons combat this by using follicles from different regions of the body like the chest though this is not ideal and risky because the hair wont share the same characteristics as your scalp.

The total number of grafts needed is calculated by multiplying the recipient (target) area by the desired density (this is for FUE) but FUT is different I wouldnt bother showing because I wouldnt reccommend getting FUT in the first place

How to know if you should get it and are a good candidate
One good thing about this place is that the norwood scale is common knowledge so you can easily tell if you need it or not. Most doctors will work on you whether you are 1-7

HOWEVER transplants past stages 6+ are very difficult and require over 5000+ grafts to provide optimal results so extracting it from the you wont be easy and not all doctors will bother.

The most ideal candidates have naturally thick and dense coverage as the results are more likely to be aesthically pleasing and less obvious. Candidates with donor sites that contain over 80 follicles per square cm in the donor site are excellent and below 40 are poor candidates.

Hair colour is also quite important for the candidate. Light skinned people with light hair are more ideal because the contrast is less noticeable and results will look more pleasing than a person with dark hair and light skin.

Ideal candidates also have knowledge when it comes to treatment i.e fin, minox RU etc

More characteristics of poor candidates
-hair loss history
-skin conditions
-diabetes
-thyroid problems
-use of specific medications (propanolol, amphetamines, coumadin)


Red flags for doctors:
-mental illness (just try to be nt for the process otherwise he'll think you have bdd or some shit)
-unrealistic expectations


What is the difference between FUT and FUE?
FUE removes individual hair follicles to transplant whereas FUT cuts a strip of skin from your scalp and uses the skin to remove the follicles leaving a noticeable scar on the back of your head which you will obviously be able to cover once you grow out your hair but it forces you to rock a cut that has long sides and back.

FUE so much more ideal bhais if you consider getting a transplant I would stress getting FUE over FUT


FUT scar:

FUE scar (camoflaged and far less noticeable):

FUE advantages over FUT

-more grafts (follicles) are can be used
-your hairstyle wont matter since scarring isnt as obvious
-its is not as important to have dense and ideal hair characteristics
-less painful
-healing time is quicker than FUT
-other body hairs can be used
-specific hairs with specific colour and diameter can be harvested (more ideal)

FUT advantages over FUE
-Operation time is shorter
-Easier for doctors to learn
-Quicker to harvest follicles



Local anaesthetics are used (1% lidocaine + epinephrine + 0.5% bupivacaine) though I assume by special request and the right doctor you may be able to get it done under general.


Process
1. Targetted area is marked/draw on your head

2. Donor site is shaved

3.Anesthesia is administered via local injections (injections into the donor area and targetted region)

FUT
4. Incision is made and a strip of your skin is cut out of the back of your head
5. Donor strip is prepared by removing excess tissue
6. Individual follicles are then harvested from the strip
7. Follicles are then transferred/transplanted into the targetted area
View attachment 2400727

FUE
4. A device is used to remove hair follicles from the donor site or it can be done by removing indivually using forceps
5. They are then cleaned and transplanted


Complications

-Edema (5%) - basically just swelling because of too much fluid trapped (can be treated)
-Folliculitis - inflammed follicles
-temporary numbness
-infection
-hair transplant fails because hair follicles are too thin and hairline just ends up looking weird

 

[NumbThePain]

Good thread. I pinned it

 

[chrisN]

Good thread. I pinned it

gonna do hairline reduction next and slowly work my way down the face and body

 

[TheBrownOne]

Probably botb

 

[Acne Victim]

Remember to take your daily 1mg finasteride, boyos.

 

[raystar66]

lebron james got infinite money but still got a bald spot. Why isnt a hair transplant successful for him?

 

[chrisN]

lebron james got infinite money but still got a bald spot. Why isnt a hair transplant successful for him?

Lack of donor follicles maybe, black hair type too. It’s not really for much to do with the surgery it’s more the response his body has to the new follicles,

I would have thought Lebrun would be able to source the best follicles be they his or not.

If I had to guess his allopecies is concurrent and that’s what causes it

 

[betaface37]

Good thread. I pinned it

Who's the girl in your signature?

 

[Foreverbrad]

Would doctors agree to do a HT on something like this where there’s no progressive balding at all and just a stable but not-perfectly straight hairline to give me a perfect straight teenage hairline or would that come under mental illness?

 

[chrisN]

Would doctors agree to do a HT on something like this where there’s no progressive balding at all and just a stable but not-perfectly straight hairline to give me a perfect straight teenage hairline or would that come under mental illness?

I do think they would do it provided you justify it and act nt during the process, some may reject you because they won’t see the point though.

You hair’s density and colour would be ideal for good results too.

 

[bradpittshairline]

Also important to know that hair transplants aim to give 50% of natural hair density which is a limitation. There are only a handful of doctors in the world who can give you 60-75% of natural density which isn't a good idea for males with aggressive baldness and rather a good idea for males with no MPB and large foreheads or females. If you've stabilized your hairloss for long enough then you can consider high density transplant at your risk since donor hair is limited

 

[wadsef]

Also important to know that hair transplants aim to give 50% of natural hair density which is a limitation. There are only a handful of doctors in the world who can give you 60-75% of natural density which isn't a good idea for males with aggressive baldness and rather a good idea for males with no MPB and large foreheads or females. If you've stabilized your hairloss for long enough then you can consider high density transplant at your risk since donor hair is limited

The density percentage depends on your hair's native density.

The absolute maximum density that a reasonable doctor would transplant is ~75 grafts/cm². So, if your native density is around that number and you have enough hair, it's possible to have a transplant mimic your native density. Less than NW3, stable MPB, and native density < 75g/cm² -- a unicorn-- can get a practically indistinguishable transplant from a reputable clinic.

 

[bradpittshairline]

The density percentage depends on your hair's native density.

The absolute maximum density that a reasonable doctor would transplant is ~75 grafts/cm². So, if your native density is around that number and you have enough hair, it's possible to have a transplant mimic your native density. Less than NW3, stable MPB, and native density < 75g/cm² -- a unicorn-- can get a practically indistinguishable transplant from a reputable clinic.

The thing is for 75/cm square you’re gonna need more grafts, and it can’t be predicted to be more or less than 25% more because like you said, it depends on hair caliber, graft survival, single/multi grafts. For a young guy who is destined to reach NW6-7 it’s a bad idea but for guys with normal recession it’s not a bad idea under NW3. And in reality 75 is very unheard of, I’ve seen only 1 result with estimated 70cm/square density on Reddit and guy had 0 hair loss history at 30 and used up 3000 grafts to lower this hairline by about an inch

 

[Deleted member 19064]

You left out the fact that FUT grafts are on average much higher quality than FUE grafts with a highest survival rate

 

[chrisN]

You left out the fact that FUT grafts are on average much higher quality than FUE grafts with a highest survival rate

I did not read that in the studies I read, thank you for bringing it up

 

[Deleted member 8758]

Would doctors agree to do a HT on something like this where there’s no progressive balding at all and just a stable but not-perfectly straight hairline to give me a perfect straight teenage hairline or would that come under mental illness?

Wave some cash money, you'll find someone to do it. If you're wishy washy they might be like "kids indecisive, Id feel bad operating on him if the results dont meet his expectations, he might even be spiteful in the reviews."

If you're decisive without being an autistic schizoid as in "yeah, Id like to fill in these spots, I understand it might not meet my expectations but any change I see will be a net positive in my eyes, doc. Maybe when Im older, Ill schedule with you again if it gets worse." Better outcome, probably.

You could keep in contact with a consultant, mine knows me on a name basis and I get a little bit more negotiating power than other places.