The Patient's Guide to Hair Restoration - New Hair Institute

lose 70% of the hair on the top of the head and not look bald because of the
aesthetics of color, contrast and layering. An “afro” on a person with dark skin will
produce more fullness than an Asian’s black straight hair on light skin. Bleaching
the hair or adding white, gray, silver or blonde streaks can add the appearance of
fullness to those who are thinning. Such color alterations tend to inhibit the eye’s
ability to discriminate the details of the balding or thinning process. The doctor
and patient must design a personalized hair restoration Master Plan that will be
aesthetically pleasing for the patient, throughout his life. All of the following
elements are critical in this process:
•Current balding pattern,
•Projected hair loss,
•Hair density,
•Hair and skin color,
•Thickness of each hair shaft,
•Hair character: straight, wavy, or wiry, and
•Scalp laxity.
To illustrate the complexity of predicting the final appearance, two
examples are presented. Both patients received about 3,500 grafts and had
advanced balding patterns.
Patient A's transplant is weighted to the front and the left side where his
natural part originates (see image on the right). He prefers to keep his hair long,
and it is of average thickness. His hair is groomed carefully and styled to layer
from the part side across the front. When hair can be styled like this, it gives the
best coverage (just like a thatched roof protects a house from rain). By layering
the hair, the light does not pass through the scalp hair easily, so the lower
transplanted density appears more full.
Patient B’s transplant is distributed more uniformly over the scalp. He has
shorter hair that tends to stand up rather than layer from side to side. As the hair
stands up, the light penetrates through the hair to the scalp more easily and
making the lower density more apparent. Patient B prefers to keep his hair short;
it does not exceed one inch at any point. Since his hair is finer and curlier than
Patient A, the amount of hair available to cover the scalp is less. In addition,
Patient B does not take advantage of his curly hair because he chooses to keep
it short.
Setting Realistic Expectations
While each patient’s healing and hair growth profile will dictate the actual
course of the post-operative period, it is important to understand the differences
seen in patients with different hair characteristics. All prospective patients should
view the finished work of people who have had a transplant. No two people are
alike; therefore, two hair loss patterns require a different amount of work, hair
distribution and budget. It is critical that hair transplant candidates make their
own assessment of the process with a physician who works with them to
establish realistic expectations.