A gentleman in his early 20s has no history of baldness in his family. However, he had a high hairline all his life. He is looking to get at an FUE (follicular unit extraction) transplant and wants to know how many grafts he would need.
Dr. Amiya Prasad, a hair restoration specialist and cosmetic surgeon, explains that this man is dealing with male pattern hair loss. He emphasizes that most men will have some type of male pattern hair loss.
Hair follicles which are protected by certain substances are literally choked by something called dihydrotestosterone (DHT). Many men mistakenly believe that they have hair loss because of too much testosterone in the body. However, it is the conversion of testosterone to dihydrotestosterone that causes hair loss. To diminish DHT a drug named Finasteride was introduced during the 90s.
In 2011, research that was done in the University of Pennsylvania discovered that certain adult stem cells called progenitor cells are responsible for the hair growth process. When they stop working, hair follicles are more vulnerable to DHT. In addition, the researchers noticed in the scalps of bald men that hair follicles are present but they did not continue to grow.
In Dr. Prasad’s practice, he has developed an injection using a wound healing material called extracellular matrix (ECM) that stimulates the body to produce progenitor cells. This is used in combination with platelet-rich plasma to stimulate and reverse thinning hair. This material also causes healing at the cellular level and protects the hair follicles from the effects of DHT.
The number of grafts in a hair transplant depends on the area that needs to be covered. Generally, Dr. Prasad transplants about 1500 to 2000 hairs. However, he is always hesitant to perform hair transplants in young patients. This is because people who are in their 20s continuously loose hair even after a transplant. The new hairs are still vulnerable to the effects of DHT. He usually suggests first the regenerative technology injections before the transplant to protect the hair. After a year, he observes how much re-growth the patient has and then decides from there. If a hair transplant is done, injections of the regenerative technology are done so that the donor area heals beautifully and so there is increased survivability of the new hairs.
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