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Hair Thickness- Just when you think you’ve heard it all!
I’ve been in practice now for almost 20 years. Over that time I have fielded thousands of questions, to the point that I get surprised when I come across a question I have not already answered or pondered before. I met with a gentleman yesterday considering hair transplant for male pattern baldness. He had seen other doctors and had done a good deal of research. I like it when patients have done their own research, it makes going over details and our own approach easier. We spoke about strip graft versus follicular unit extraction and the robot. We discussed a day of the procedure. Do you make an age appropriate hairline he asked? yes, I replied. Do you make the hairline irregular so it looks more real? yes, I replied Do you angle the hair grafts in a natural direction? yes, of course. How do you account for the fact that the hair that you transplant from the back of the head is thicker than what exists in the front?- That’s the one that got me. I had never been asked that question before and frankly had not really thought about it. Hair from the back of the head is indeed thicker (in diameter) then hair in front of the head certainly by the time most people get to us. I thought about the question and here’s what I told him: You’re right, the backside hair is thicker, and while technically it may be less authentic than thinner shafts of frontal hair at the moment it is really our only tried, true and reproducible option. In the years we have been performing hair transplants, I have never had a patient even be concerned about thicker frontal hair, in fact I think most see it as an asset. From a surgical perspective, when inserting one or two hairs at a time it would provide better coverage of the scalp. I also think that before we (yes, me too) begin to lose our hair, the frontal hair is indeed more like the back. So what he perceived as a problem, I see in may ways as an asset when we are using a limited hair source from the back of the scalp to cover what we need in the front. It is robbing Peter to pay Paul. Nonetheless, I love getting a good question.