Women's Hair Loss

Dear Elvonna - I 
The big challenge in your situation is the quality of your donor hairs - if you have a good density in the back of your scalp, I could anticipate a more impressive result. The other consideration is that, in women of color, there can be a lower percentage of hair growth, resulting in less coverage. The only way to assess the exact amount of hair growth you are likely to experience is to perform a test procedure of say 40 grafts, then waiting 6 months to see how things grow.
The alternative is to proceed with a procedure of 1300 to 1400 or so grafts, filling in both temple areas (500 grafts per side) and placing the remaining 400 or so grafts along the hairline to provide increased density and  perhaps bring it down/forward a bit.  In addition, a second procedure may be desired in the future to provide more density.

I welcome your thoughts.

Posted by Jeffrey S. Epstein, MD, FACS

Yes, it can, to some degree, but most effectively if your donor area (back of the scalp) is somewhat thicker in density and the transplanted hairs are concentrated into certain areas - most commonly the frontal region and partline - to provide the most cosmetic benefit.
I see many female patients who have been told by other hair transplant surgeons that nothing can be done for them, yet in many of these cases the reality is that a procedure can improve their hair loss situation - perhaps not as dramatically as they would want, but it is a definite improvement.

Posted by Jeffrey S. Epstein, MD, FACS

Yes, it can, to some degree, but most effectively if your donor area (back of the scalp) is somewhat thicker in density and the transplanted hairs are concentrated into certain areas - most commonly the frontal region and partline - to provide the most cosmetic benefit.
I see many female patients who have been told by other hair transplant surgeons that nothing can be done for them, yet in many of these cases the reality is that a procedure can improve their hair loss situation - perhaps not as dramatically as they would want, but it is a definite improvement.

Please feel free to send some photos for me to evaluate.

Posted by Jeffrey S. Epstein, MD, FACS

Hair loss and thinning affects the majority of woman particularly after menopause.  It's amazing that the media offers so few stories about this widespread issue.  The first step is to get a regular check-up by your doctor.  Simple blood tests can determine whether you might be having thyroid, hormone or iron issues.  After that, you might require a trip to your dermatologist or facial plastic surgeon for a complete history and possibly a biopsy.  Medical conditions can be treated and the hair loss may be reversible.  If not, your facial plastic surgeon can discuss whether you are a candidate for a hair transplant.

Posted by Jeffrey S. Epstein, MD, FACS

The big challenge in your situation is the quality of your donor hairs-  if you have a good density in the back of your scalp, I could anticipate a more impressive result.  The other consideration is that, in women of color, there can be a lower percentage of hair growth, resulting in less coverage.  The only way to assess the exact amount of hair growth you are likely to experience is to perform a test procedure of say 40 grafts, then waiting 6 months to see how things grow.
The alternative is to proceed with a procedure of 1300 to 1400 or so grafts, filling in both temple areas (500 grafts per side) and placing the remaining 400 or so grafts along the hairline to provide increased density and  perhaps bring it down/forward a bit.  In addition, a second procedure may be desired in the future to provide more density.

Posted by Jeffrey S. Epstein, MD, FACS

  This is not something typically performed on women, due to several reasons: Women tend to have already a low donor density and a high need for as many hairs as possible; and women have no trouble concealing whatever scars are present, typically scars that are 2 MM in witdth or narrower. You can read much more about FUE versus Strip/Fug procedures on the www.foundhair.com Website.

QUESTION:  Can this procedure be done with my hair long? (shoulder length)
  As long as you would like it.

QUESTION:  Will there be any shock loss in the adjacent areas?
ANWER:  I feel that with the experience I have in working with women that I have developed techniques for minimizing any shock hair loss, while maximizing the numbers of hairs that can be placed between existing hairs. That being said, there is always a risk of some shock hair loss, but this has happene in only a very very small number of patients of mine, and none in the past 4 years since I further refined my technique.

QUESTION:  Will I have any small scars or marks in the recipient site (hairline)?
  None

QUESTION:  How long will it take for the scabs and the redness in the recipient site to completely disappear?
Typically 7 to 8 days for all crusts and most pinkness, but this can sometimes take 10 to 12 days - But you will have no trouble concealing the crusts in as soon as 3 days after the procedure.

QUESTION:  Will I have small bald spots at the donor site (back of the head) or will you be taking individual strands from all over my head? 
Only a fine line donor site scar.

QUESTION:  Can I get reasonable density with one procedure? 
  Some of this depends upon the exact thickness or density of your donor area, but you should have a nice cosmetic improvement.

I have a large number of patients from throughout the UK, including at least two who have, in the past, been happy to speak with prospective patients. Please let me know if you are interested in being put in touch with one or more of them.

Posted by Jeffrey S. Epstein, MD, FACS

With women there is a slightly higher risk of “shock” hair loss- however I have found that with the use of very small recipient sites measuring each less than 0.8 mm on average, along with the use of careful technique, I am able to keep this hair loss to a minimum.
Finally-  as far as GH and other similar agents-  there is some anecdotal evidence of a subtle thickening of existing hairs, however, this has not in any way been proven efficacious.

Posted by Jeffrey S. Epstein, MD, FACS

Those are good questions.  The hairline advancement procedure is one in which many of the doctors at the Foundation for Hair Restoration specialize- in fact, I am performing one on a woman from Wyoming today.  Depending upon the amount of lowering desired, anywhere from 700 to as many as 2500 grafts get placed in a single procedure, with the goal being to restore a natural appearing hairline and fill in the areas of thinning.  The cost depends upon the number of grafts.   When performed properly, no one should be able to detect you had the procedure, and there should be minimal to no damage to the already existing hairs in the areas of thinning.  Typically I have 90% plus of my transplanted hairs grow.  In the unlikely and very unusual case where there is more limited growth, I would perform a small touch up procedure to take care of this. 

Posted by Jeffrey S. Epstein, MD, FACS