Here is a patient I recently saw in consultation who had received a FUE hair transplant of over 3000 grafts at age 21 from another physician. He is now age 24 and wanted me to evaluate his results and ask my opinion about his options moving forward. I was dismayed to see how his donor region had been completely depleted to the point where it was almost see through at a #4 haircut. When FUE is done properly in a patient with average density you should be able to cut your donor hair to at least a #2 haircut without seeing any sign of thinning. In addition, his hairline had been transplanted in a very aggressive pattern (meaning very low). To perform a hair transplant on a 21 year old male who is predicted to advance to a severe hair loss pattern is never a good idea. To to this to a 21 year old patient with an aggessive hairline is just plain wrong.
After more questioning the patient shared that he was treated by a local plastic surgeon who does not specialize in hair transplants. The surgeon had purchased the Neograft machine and had technicians perform the entire procedure. I was not surprised to hear this after seeing his results. Beware of other specialists that do not specialize in hair transplant procedures with the Neograft machine offering hair transplants through their clinics. I have seen many cases over the past few years of botched hair transplants and routinely I hear the same thing. They went to a physician who is well known for another specialty and got sold on having their technicians perform the entire procedure with their Neograft machine.
Hair transplant surgery is both an art and a science. it is not a specialty that one learns in a weekend course, and it is not an art that should be taken lightly.
In this patient’s case he does not have enough donor hair to fill in the massive area of balding below his unnaturally low thin hairline. In addition, he is only 24 and will lose all his additional hair on top of his head over the next 8-10 years. His options include removal of the unnatural hairline via FUE and recycling of the grafts further back. His donor on the back and sides is almost depleted so his best option is to use beard and body hair for increased density.
In the photos below I have drawn in where his hairline should have been transplanted to show the contrast to where it actually was. I always say it is better to have a higher hairline with higher density versus a lower hairline with lower density. No one has unlimited donor hair and especially in young patients predicted to proceed to advanced hair loss there is never enough donor hair and it all needs to be used very judiciously.
This patient looked like he had less than 1/3 of his harvested grafts actually grow. Received a very unnatural hairline. Should not have had a procedure at age 21 to begin with.
Beware of having a hair transplant under the age of 24 and when done it should be in a very conservative fashion. Also, beware of physicians that do not specialize exclusively in hair transplant surgery.
All the best,
Marc Dauer, M.D.