Overall 20- 30% of women with hair loss are suitable for hair transplant. The followings are good candidates :
Female pattern hair loss ( FPHL ) FPHL is a form of Androgenetic Alopecia accounting for 20-30% all hair loss in women.
Traumatic Scar
The scar may be from birth injury, accident, cosmetic surgery especially face lift.
Surgical Plan in Women
The approach depends on the extend of hair loss and donor hair quality.
Ludwig’s Pattern
For the Ludwig's type the thinning is progressive from front to crown along the mid-line or part-line. Thd hairline on the other hand remains intact. This accounts for 87% of hair loss in pre-menopausal women. Plan: The adding of density to the part-line can create good cosmetic result and allow more styling.
Norwood's Pattern
Similar to AGA in men with receding hairline or thinning crown, affecting 13% of pre- menopausal and 37% postmenopausal women. Plan: This is the best candidate for hair transplant.
Oslen’s Christmas Tree Pattern
The hairline is affected. The hair loss is widest in front at the hairline with gradual narrowing and ragged borders more toward the crown. Plan: Restoring the hairline can greatly improve the look.
High Hairline
Some ladies are born with a high hairline and large forehead. Plan: Hair transplant can lower the hairline for a more feminine look.
Add hair to scar
Final result depends on local blood supply. Scar tissue is usually poor in circulation and unable to support too many grafts. Plan: A lesser density is transplanted to allow best survival. Subsequent session may be required on demand.
Realistic Expectation
Selected Areas
Women usually has a much larger thinning area. Even a limited donor supply enables some densing of strategically chosen recipient area to achieve an illusion of fullness. Priority areas are hairline zone, part line, and central vertex. Whatever improvement achieved should be considered worthwhile by the patient in relation to the inconvenience, discomfort, and cost of the procedure.
Seeing the Scalp
Hair transplant creates density but not thick hair. “ Do not want to see their scalp “ is an unrealistic goal as even women without significant loss can see their scalps.
Number of Sessions
Women usually demands denser and thicker hair for styling. Their finer hair and risk of shock loss would not allow very dense packing. Also hair loss may recur after menopause. Further sessions may be necessary to achieve or maintain the desired density.
Shock Loss
25-50% of patients may experience temporal hair loss adjacent to donor area and/or in recipient area. Shock Loss happens about 3 weeks after surgery and hair regrows approximately 3 months later. Loss can be reduced by applying Minoxidil to the recipient and potential donor area before and after surgery.
Hair loss can also be camouflaged with the use of a skin-coloring agent such as Toppik, or wearing a wig for a few weeks. Shock loss is highly unpredictable. Patients who cannot tolerate shock loss should not consider hair transplant.
Poor Candidates for Hair Transplant
Extensive thinning of hair over the entire scalp
Miniaturization of 50% or more of the hair.
Unable to tolerate temporary hair loss immediately after transplant.
Adjuvant Medical Therapy
Donor hair is permanent but limited. Hair transplant only redistributes hair. It cannot change the progressive nature of FPHL. The miniaturization of existing hair may offset the cosmetic results over years. To enjoy a full coverage for decades the use of topical Minoxidil should be discussed with our doctor.
