Why did I lose my hair?  How can I prevent future hair loss?

     As males age, there is a hormone conversion that takes place where the testosterone in the body turns into DHT.  When this conversion takes place,  it causes sebum (mucous deposit) to build up on the scalp.  This sebum build up miniaturizes the hair follicle and eventually keeps it from making its way through.  When we do a hair transplant, we take the hair from the back of the head.  This hair is genetically pre-programmed not to be sensitive to the same conversion that is destroying the hair on the top of the head.  So we take the good hair from the back of the head and put it on the top of the head where the blood supply is good and it grows normally.  This hair will stay where it is placed for as long as it is genetically programmed to stay, which in most cases is permanent.  There are currently two FDA approved drugs to help prevent future hair loss; Propecia and Rogaine.  Propecia inhibits the conversion of the testosterone from turning into DHT.  It has the highest efficacy and it is taken orally.  Rogaine is a topical vasodilator, meaning it is opening up the vessels allowing more substances to go where they need to go for optimal growing conditions.  Propecia, in my opinion is the better of the two and should be taken for as long as you want to keep as much as possible of your existing hair.  You can use both if you so choose, however if you are only going to use one then my advice is to take Propecia. 

How many surgeries will I need? 

     This is probably the most common question that I receive.  I tell all of my patients the same thing.  Every time we perform a surgery on any patient (no matter what the size of the case), we place the grafts as close as possible without compromising their success rate.  When the grafts are placed too close to one another, they compete with each other for the blood supply and their success rate diminishes.  For this reason, I tell all my patients if there is not any hair in the area we are working on, and you are trying to make that area of your head look equivalent to the sides; plan on two surgeries and you potentially may even want to do more depending on how far you want to go with the density.  This does not mean that you ever have to do more then the one procedure.  However, I just always want to make sure that everybody understands that it is not necessarily a one time shot; and you very well may want to add to it at some point down the road.  If there is hair currently in the area that we will be working on, then that will obviously affect the density of the final outcome and will change the number of surgeries needed.  I will say the majority of my patients only have one surgery.   Although, every one has their own idea as far as how much density they are looking for.  So I never know which of my patients are going to be happy with one procedure or which ones are going to want multiple procedures.  Everybody’s expectations are different!