The mature hairline in men typically forming between the ages of 18-30. During the aforementioned window, with very few exceptions, men’s hairlines recede. When the hair recedes evenly such that the hairline maintains its original shape, it is typically referred to as a mature hairline. When the maturation process results in substantial changes in shape to the hairline or thinning of the hair on the crown, we refer to this as Hereditary pattern baldness. It is important to realize that everyone’s hairline naturally recedes through the same biological process.
The best way to know if you are at an appropriate age to undergo hair transplantation is to book a consultation with Dr. Milchak to discuss your history with hair loss. Typically, until 25, it is recommended that other methods of hair restoration be used while the mature hairline comes in for the best long term aesthetic outcome of the transplant. If the hairline is just beginning to recede, there is a risk that after a transplant, the hair might recede further, in which case there might be a thin region behind the transplant which could necessitate another round of transplantation to reach an optimal result. This is not to say that an 18-year-old cannot be a good candidate for hair transplantation. If the hairline has matured and the hair loss has stabilized, even an 18-year-old can be a good candidate for hair transplantation.
There are 7 primary stages of hereditary pattern baldness recognized by the Norwood scale. Not everyone will progress through all of these stages, you might find that your hair loss stabilizes around any of these stages. The stage at which hair stabilizes can have an impact on the recommendations for transplantation. In stages 6 or 7, where the number of grafts necessary to achieve a full head of hair is much greater than in stage 2, FUT might be better option than FUE because more follicles can be extracted over an individual’s lifetime without overly thinning the donor area or damaging neighboring follicles. FUE might be the recommended option for individuals at lower stages where fewer grafts are necessary to achieve the same effect and it is unlikely that the donor site would have to be noticeably thinned to achieve a strong result. There are many factors that determine candidacy for either procedure, but in general, a larger the area of balding will make FUT a more compelling option to ensure sufficient graft availability.
Hair type is not a disqualifying factor for hair transplant surgery but it can be a factor in the procedure and the outcome.
Very Curly Hair:
For those with curly hair looking to get an FUE transplant it is especially important to find an extremely competent and experienced provider like Dr. Milchak. For the best FUE results, the provider uses the smallest extraction tool that won’t transect hair follicles making them unviable. Every transected follicle represents another dot scar at the donor site that can’t be transplanted. Some number of hair follicles will almost always be transected during FUE, but the risk of transection is much higher with curly hair than with straight hair as the provider has to react to the tactile feedback of the follicle with great skill in order to follow the curve and extract the follicle intact while using the smallest tool.
Although curly hair might require a very skilled provider to get the best results at the donor site, the curly hair has an advantage when it comes to the recipient site. Curly hair is much less sensitive to the angle of hair implantation. The angle and direction that curly hair is implanted is still important but the variability of curl between different hair follicles helps in creating a full natural looking final result.
Straight and Lightly curly hair:
Straight hair is generally easier to extract than curly hair, but this is not to say transections will not occur, transections are a part of any FUE treatment. The risk of follicle transection being lower with straight hairs than with curly hair you may be tempted to seek out a less experienced provider as a cost saving measure, but this can be a mistake. Straight hair is much more sensitive to the orientation and angle of its placement than curly hair. The implantation at the correct angle, with appropriate variation is essential in creating a natural looking result. It is all too common for inexperienced providers to implant hairs in an unnatural way. It can be much less expensive to get a phenomenal hair transplant from a talented provider like Dr. Milchak than it would be to get a transplant from a less capable provider only to be disappointed by a bad result and having to get it corrected.
The way you want to wear your hair after transplant is an important consideration when deciding what type of hair transplant is most appropriate. More specifically, the length at which you would like to wear your hair in the donor region can help you decide if FUE or FUT is right for you. FUE results in small dot scars at the site where hair follicles are extracted. These scars are very small and distributed over large area such that they can be disguised by relatively short hair. Although the appearance can be disguised and the scars will become less noticeable with time, if the donor region hair style is very short like a skin fade for example, these small dot-like scars can become noticeable. If you are looking to wear hair with a style that is extremely short like a skin fade, it is sometimes possible to limit the donor region to those areas you expect to wear longer hair. FUT scars are linear, instead of many tiny scars FUT results in one longer scar. When a large number of grafts are required to reach the desired effect, it can be advantageous to use the FUT method as the number of grafts that can be extracted over a lifetime are greater. FUT because it removes a single strip of skin damages far fewer neighboring follicles at the extraction sites. This FUT scar line can be more difficult to disguise than FUE dots if the hair in the region is expected to be very short, but can be an excellent option to save money and reduce the time of the procedure for those who expect to wear their hair longer in the area especially if a large number of grafts is required.
In general, if you don’t expect to wear your hair short in the donor region you will probably never be able to see the scars from FUT or FUE in your day-to-day life and the choice of procedure will come down to other factors. If you do intend to wear the hair very short, FUE might be the better option.
