There are a few things you should take into consideration to determine if you are a good candidate for a hair transplant.1,2
One of the most important factors to consider is expectations. If you are expecting to regain your adolescent hairline or a full head of hair, you are setting yourself up for unrealistic expectations and disappointment. The goal is multifaceted. Density is without a doubt, one of the top priorities for most patients; however, other factors should also be considered.
Naturalness should be the most important factor to consider. A good hair clinic will give you the appearance of a natural adult hairline and naturalness throughout the mid-scalp and crown (including recreating the crown whirl).
Symmetry would be the second most important consideration – a patient with a high density frontal 1/3 and thinning mid-scalp and crown is less visually appealing than a patient with a moderately dense frontal 1/3 and good coverage in the mid-scalp and crown.
Coverage is also an important consideration and is linked with symmetry. There are limitations to how much hair can be transplanted from your donor area to the area of hair loss and the expectations should be managed both from a patient’s perspective and the hair clinic. Almost any top clinic can transplant 70 FU/Cm2. Just because one can, does not mean one should. You should discuss your expectations with your hair surgeon so that realistic goals are established, not only to satisfy your expectation today but to ensure that your future goals are met as you age. Establishing reasonable expectations is very important prior to the transplantation through pre-operative consultations.
Although there is no specific minimum age requirement for hair surgery, it is easier to determine the progression and severity of hair loss with increasing age. Typically, the younger you start to lose your hair, the worse it gets with time. For instance, if you experience significant hair loss during your 20s, you may be able to get a transplant, but eventually, the hair loss may become so drastic that there may not be enough hair follicles in the donor area left to finish the job as you age. This is why a younger patient should strictly adhere to the FUE procedure – as the head can be shaved in cases of more severe hair loss in the future. As such, the ideal age for a FUT/STRIP is the mid 30’s to late ’40s. If you want to determine how your hair loss will progress, take a look at your father and uncles and/or grandfathers on both paternal and maternal sides – assume that their most severe hair loss will resemble yours at their age. It is better to be conservative rather than too optimistic and to wait if you are unsure about how your hair loss will progress.
Ideal candidates for surgery are:
- Men and women in their mid-30s to late 40s, have been experiencing hair loss for many years and whose hair loss pattern has stabilized. If you are in your 20s and are severely impacted by the hair loss from a quality of life point of view, then this should be discussed with the doctor.
- Men who have been losing their hair due to male pattern baldness for several years or who have progressed to a late stage 2 or above in the Norwood scale. Patients with Norwood 1 hair loss should initially consider non-surgical treatments such as 5% minoxidil (Rogaine) or low-level laser therapy. Oral Finasteride may not be recommended in men of childbearing age due to potential negative side effects such as impotence.
- Men and women with realistic expectations understand that their hair loss might continue to progress even after hair surgery.
- Men and women who have lost hair due to traction, other trauma, or burns, or due to other cosmetic procedures such as face-lifts.
Other factors to consider:
- Is your hair straight or curly? When transplanted, curly or wavy hair usually looks denser and gives the impression of more hair.
- What colour is your hair? Based on the colour of your hair and how it contrasts with your skin colour, it may give the appearance of a fuller, more natural hairline (e.g. the hairline of a Caucasian individual with light hair may look fuller than the hairline of a Caucasian individual with dark hair).
- How much hair do you have in your donor area? The amount of hair that can be transplanted depends on the amount you have available at the back of your scalp, in your donor area.
Individuals with certain types of scarring alopecia, autoimmune disease, telogen effluvium, trichotillomania, or body dysmorphic disorder, are generally not considered good candidates.
In order to determine if hair surgery is right for you, please consult a good hair doctor at a well-respected clinic for an in-depth consultation and evaluation.
- Avram, MR. 2012. Hair Transplantation. Cutis; 90(6):317-20.
- Rose, PT. 2012. Hair restoration surgery: challenges and solutions. Clin Cosmet Investig Dermatol; 8: 361–370.