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Hair Transplant Study
Dr. Sternberg Written by David Stelzer Published on 17 Feb 2021
Pattern Baldness and DHT
Additional Hair Transplants
Medically reviewed by Dr. Sternberg Written by David Stelzer on 17 Feb 2021
How long does a hair transplant last? This is one of the most common questions asked by individuals curious about hair transplantation. The short answer is yes, but if you would like to know how lasting results are achieved continue to read on.
We will explain the science behind hair loss and donor areas, as well as why some patients receive additional surgery despite the permanence of the surgery.
Time Until Result 6 - 12 Month
Lifetime Infinite
Multiple Transplants Possible
The vast majority of individuals will suffer from some degree of hair loss in their lives. The most common cause of hair loss is male pattern baldness, or androgenetic alopecia, which affects the hair of both men and women. The effects of pattern baldness usually have a gradual increase with age. Hair loss from this condition is characterized by an initial thinning of hair at the hairline before it begins to recede. Eventually there will be bald spots at the temples and on the top of the head.
Pattern baldness is a hereditary condition caused by a genetic predisposition to hypersensitivity of the hair follicles. The hormone dihydrotestosterone (DHT) is responsible for the breakdown of hair follicles. DHT is produced by testosterone conversion in the hair follicle with the enzyme reductase.
DHT then binds to the hair follicle after conversion. This is a normal process, yet it causes hair loss in individuals who are overly sensitive to DHT. The DHT weakens susceptible hair follicles over the course of time, the hair follicles will grow back smaller and smaller each time. Eventually they will die and fall out, leaving behind bald spots.
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The objective of a hair transplant is to transplant hair grafts to fill in the balding regions permanently. In order to create lasting results hair grafts must be extracted from hair that is resistant to DHT.
DHT affects hair around the back of the head and on the body differently than hair on top of the head. For many individuals, DHT encourages the growth of hair on the body.
This is why during a hair transplant surgeon extracts hair to use as grafts that are resistant to DHT. This resistance means the hair will continue to permanently grow for the duration of the patient’s life. If hair is taken from an area that isn’t resistant to DHT then it will only be a matter of time before that hair will fall out after the procedure.
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If a hair transplant is properly performed than the hair transferred to the hairline and scalp will continue to grow permanently. This hair is resistant to DHT and will not weaken as the hormone is produced. The transplanted hair will retain this quality after the procedure.
Patients will likely experience a shedding affect after the hair transplant procedure which will cause all of the new hair to fall out. This affect is caused by hair follicles being cut off from the supply of blood and nutrients for an extended period of time during the surgery. This is a temporary affect however. Generally, hair will begin to grow back three months after the surgery and will grow continuously after that. Full results of a hair transplant will be seen around a year later.
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If a patient has not sufficiently stopped the progression of their hair loss, particularly young patients, then there is a greater risk of the results from a hair transplant not lasting.
Young individuals experiencing hair loss have not progressed far enough in most cases for a hair transplant to be a suitable option. It will be difficult for a surgeon to accurately identify a donor area where the hair is resistant to DHT. In order for a young patient to pursue a hair transplant they should be able to prove they have stopped their hair loss using medication. Finasteride and Minoxidil are two FDA approved drugs which stop the progression of hair loss. They cannot however regrow hair in bald areas.
Many hair transplant patients pursue additional surgeries because their balding progresses and they need secondary procedures to fill in the new bald spots. This is why the medication should not be stopped after getting a transplant, but should be used in conjunction with the procedure. This will ensure the transplanted hair and natural hair will not fall out and provide lasting results.
Occasionally patients may need multiple procedures to obtain the results they desire. This is often the case for patients who have extensive hair loss, a Norwood scale 4-6. It is unwise for the surgeon to transplant more than 3,000 grafts per session. They will become fatigued and are more likely to make mistakes as they work.
The results of a hair transplant will be permanent so long as the surgeon accurately identifies an appropriate donor area. The hair follicles extracted from here will be resistant to DHT and won’t fall out as time goes on. To improve these lasting results, it is strongly encouraged patients take Finasteride or Minoxidil and stop any further hair loss.
Hair transplants have an average success rate of 98%. The hair grafts are created from a patient’s own hair so there is no risk of rejection.
Is a hair transplant reversible?
Hair transplants are permanent if performed properly. The transplanted grafts will continue to grow forever. There are no reverse hair transplant procedures, however there are procedures to correct a poor hair transplant.
Guarrera, M.; Cardo, P.; Arrigo, P.; Rebora, A.: Reliability of hamilton-norwood classification, In: Int J Trichology, Nr. 1, 2009, S. 120ff.
Rassman WR, Bernstein RM, McClellan R, Jones R, et al.: Follicular Unit Extraction: Minimally Invasive Surgery for Hair Transplantation, In: Dermatol Surg., Nr. 28 (8), S. 720–770
Venkataram, A., & Mysore, V. (2018). Logic of Hair Transplantation. Journal of cutaneous and aesthetic surgery, 11(4), 169–172.
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