Transplanting Stage V and VI hair loss
Men with advanced hair loss may wish to cover both the front and the top of the scalp. if the area is large, two transplant session may be required to achieve adequate coverage. Many patients want to know how long to wait between sessions and should they do the front or top first?
Should the front or top be transplanted first?
There is no right answer, but 95 % of my patients start with the front and I usually encourage this. The front of the scalp is so important to framing the face. In fact, sometimes all that is needed for some patients is just to add a small density of hairs to the front and middle of the scalp and they achieve a huge difference in their look.
Rarely, a patient will want to start with the top or 'vertex'. Provided the patient is over 35 this is sometimes a reasonable plan. Some men want to leave some degree of thinning in the front but fill in the back. For these men, it's the hair loss in the crown that really bothers them. That's a good plan for these men.
How long to wait between sessions?
Generally I recommend waiting 9-12 months for a second surgery. By this time hair has grown in to significant levels and patients can really see the coverage. And because the front is so important in the overall 'look', some men will feel that their changes are sufficient to hold off on adding more hair in the crown. In addition, it becomes much easier to see where to add new hairs by waiting a few more months.
For men having strip surgery, waiting to 9-12 months allows scalp exercises to be started once again to help with laxity in the donor area.
Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Vancouver office at 604.283.9299