A 19-year-old gentleman wants to know whether he should get and FUE or the strip method. He wants to know what method has better results and is less damaging to the donor area.
Dr. Amiya Prasad, a hair transplant specialist says that there is a greater yield of hairs in the strip method versus the FUE, and all hair transplant surgeons agree on this. FUEs are almost the way a hair transplant was done in 90s but now they’re just smaller punches. Another disadvantage of FUEs is that by design, surgeons have to go outside the area of genetically resistant hair to retrieve grafts. People are not getting the density that they want out of transplants, lose a lot of hair from transection or cutting of the grafts, and not getting the yield of grafts they were hoping for. This has already been proven by the International Society for Hair Restoration that 65% of hair transplant patients want more density.
As someone who has lost so much hair at a young age, this gentleman has to think about what he would look like if hair loss continues years from now. The hair transplant area is limited and therefore the donor area cannot meet the amount of hair needed to cover the scalp.
Currently in the United States, finasteride and minoxidil are the two drugs used for male pattern hair loss. Finasteride is a drug that is taken orally. It essentially affects DHT or dihydrotestosterone sensitive hair follicles. If hairs are DHT sensitive, they will respond to finasteride. However, many people are concerned about the long-term sexual side effects and dysfunction related to taking finasteride. In Dr. Prasad’s practice, most men who come in are not interested in taking finasteride. Topical minoxidil is not going to stop the progression of hair loss. It can prolong the appearance of thinning hair on the scalp so it looks like there is more hair, but it will not reverse hair thinning.
Dr. Prasad would offer Hair Regeneration first, a method and formulation he developed using a combination of extracellular matrix(ECM) and platelet-rich plasma (PRP) to stop and reverse hair thinning wherever there is existing hair. This is very different from what is currently the standard of care for hair loss. For most male pattern hair loss patients, they learn about hair transplant and then they look for the best possible transplant. However, it is important to understand that no matter how old someone is, a hair transplant is a limited and temporary solution because patients will progressively lose hair. Many people don’t even consider a transplant because they don’t want a pluggy look. A majority of hair transplant patients with obvious plugs used to have more hair, but the problem was that the hair thinned was lost, causing the transplanted hair plugs to become obvious.
In Dr. Prasad’s practice, he does a microscopic evaluation of the scalp and identifies the potential hair that can thicken from Hair Regeneration. He can determine how much they would benefit from Hair Regeneration. He had patients who are very advanced in their hair loss and he has been absolutely impressed by the amount of hair volume they have been able to achieve in spite of how far along they were. He believes strongly that as long as there is potential, there is opportunity to get improvement with Hair Regeneration. He is able to show the benefit of Hair Regeneration as outweighing the benefits of hair transplant in terms of volume of hair. His strategy is to do first Hair Regeneration even if they are a candidate for transplant, allow 18 months to transpire and then see where they are at. With this onetime treatment, the benefit lasts for at least 3 to 5 years. If they choose a transplant, they can be more strategic, efficient and effective with the grafts if they have the Hair Regeneration treatment first.
Dr. Prasad is very hesitant to transplant someone this young. He would rather do Hair Regeneration, wait it out, watch and see if there’s any progression and then consider a transplant if there’s an appropriate understanding of what the limitations are.
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