hair transplant

Hair Transplant as Viewed by Women: Wherefore Art Thou Bald, Romeo?

hair transplant

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The biggest concern for most people who battle hair loss is that the opposite sex will no longer find them attractive. Men pursue all kinds of treatments to get their hair back, including creams, pills, ointments, laser therapy, and hair transplant. They may even use pharmaceuticals at the cost of their libido (Merck warns that Propecia may cause sexual dysfunction, though not proven).

But do women really care when a man is bald? Do they find balding men less attractive? If Romeo had been bald, would Juliet have loved him anyway? While we would all like to believe that true love prevails, many blogs, forum discussions, and one online dating experiment reveal that this Shakespearean tale would have ended in tragedy for a different reason. Because hair transplant wasn’t around in the late 16th century.

What Women Say Online about Hair Transplant

Most commentary made by women reports that they don’t care if a man has hair or not, as long as he has confidence. But this is a counterintuitive stance, since hair loss is a major reason men lose confidence and self-esteem. Many men even become depressed and withdrawn due to their hair loss.

“Own that chrome dome,” says one comment. A few even state that men should not undergo hair transplant, but to wear their baldness proudly. However, if you’re not a movie star, it’s hard to maintain the perceived confidence and sex appeal of someone like Bruce Willis. Here and there appear comments from women who prefer a man with hair.

Reactions to Bald Men in Online Dating

A London-based hair company conducted a small study to find out how women view bald men in online dating. The experiment was not scientific, but the results have been published online and are worth some consideration.

The company created two separate dating profiles for the same man. The two profiles were completely identical, containing the exact same interests, age, personal information, and so forth. The single discrepancy was that in one account, the profile picture revealed a slick-bald man, while in the other account he had a full head of hair Photoshopped into place. Both profiles were monitored and kept active for two months.

The results revealed that a good hair transplant could get you a lot more online dates. The profile picturing a man with hair got five times the positive response than the other, with a total of 108 prospects versus only 22. This small study shows that, at least in London, women view a man with hair as more desirable.

FUE Hair Restoration for Younger Patients

Typically, hair clinics will not perform FUE hair restoration (or any other hair transplant surgery) on candidates under the age of 24. This is due to the fact that male pattern baldness is progressive in nature and a premature hair loss would undermine the long-term results. The implanted hair would stay put as the continuation of baldness would persist in surrounding areas, yielding an unnatural-looking island of hair.FUE hair restoration

There are sometimes extreme cases, which create an exception to this general rule of thumb. These exceptions exists for the following reasons:

  • The candidate understands that a second, or even third procedure will be necessary in the future and accepts this likelihood (with has the financial stability to pursue multiple FUE hair restorations)
  • The candidate has already experienced almost all of his hair loss at a young age and is unlikely to progress further
  • The candidate is reconciled to the need for more surgeries in the future and has a good head and nonhead donor reserve to cover for even the most extreme future hair loss. This supposes that a competent clinic capable of harnessing nonhead hair has assessed the patient. It is alos advisable to be conservative in patients that are in their earlier stages of hair loss

Discerning Premature Treatment

Most clinics look to a few telling factors in order to determine if a candidate is too young for surgery. The first of these is the patients Norwood level of baldness, the second is how quickly the balding has progressed thus far, and the third is the family history.

At DermHair Clinc, Dr Umar specializes in the use of nonhead hair and head hair for the restoration of even extreme bald states. The totality of the 3 factors mentioned above is used by him in determining the candidacy of a young patient for a hair transplant. A clinic that is incapable of utilizing nonhead donor hair is most likely to turn away most patients on the basis of a young age of presentation.

Example of Early FUE Hair Restoration

This patient presented to DermHair Clinic at the young age of 23, with extreme balding, and a very limited supply of scalp donor hair. He also had no body hair.  After the necessary questioning and testing, Dr. Umar decided this patient was an exception to the rule. He used FUE hair restoration with a very small graft count to give global coverage to the patient’s buzz cut.

FUE is an ideal procedure for young patients because it produces nominal scarring and minimal damage to the donor area, leaving enough donor hair to supply a future surgery.

Hair Restoration for Past Surgeries: FUE, BHT, FHT

The effects of thinning hair and balding can be detrimental, regardless of the cause. Decreased self-confidence and negative self-esteem may occur. It is even more difficult for a patient when baldness reoccurs after initial hair restoration surgery.

When Initial Hair Restoration Fails

Severe baldness is the increasing result of past hair restoration surgeries. Older techniques often produced extensive scarring and unnatural appearance.

Past methods:

  • Scalp reduction
  • Temporoparietal-occipital flaps
  • Punch graphs
Current methods result in a more natural appearance, but some still produce scarring difficult to conceal. The common follicular unit strip surgery (FUSS) technique produces large, unsightly scarring. This strip scar is a main cosmetic drawback of the surgery. Patients may opt to have surgery again to correct botched surgeries, stretching and scarring with hair transplant repair. Additional hair loss is one of the most common reason.

Cosmetic issues from previous surgeries:

  • Strip scars
  • Asymmetry
  • “Doll’s Hair” appearance
  • Harsh hairline
  • Poorly placed or/and angled hair

Another hair restoration surgery also requires more donor hair. For many patients, the first procedure used all sufficient donor hair on the head or left excessive scarring. Lack of donor hair on the head initially made a second surgery impossible.

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A second hair restoration surgery may be required to fix botched surgeries, scarring and stretching. This patient is no longer able to conceal a strip scar due to additional hair loss.

Hair Repair Surgery Options

Today, hair transplantation is available for the severely bald and those who lack tradition donor hair. The advancements in follicular unit extraction (FUE) expanded donor areas. Body hair transplant (BHT) harvest non-head and  increases with sources for follicle extraction.

Both allow for a more precise placement of grafts due to the smaller size and creates a natural-looking hairline. Scarring is also minimal with the tiny, round holes not visible.

For successful hair transplant repair, patients must first address reasons for hair loss. Once current issues are addressed, the patient can make a plan for a second hair transplantation surgery. While burdensome and expensive, new options for restoration allow a second chance.

What to Look for in a Surgeon

Hair transplant repair requires an exceptionally skilled surgeon. A second surgery involves more variables and risks to address for a successful procedure. Trusting the surgeon is also important since the second surgery may be a more emotional journey, so trusting a surgeon is paramount.

What’s Your Greatest Hair Transplant Concern?

You want the best results you can get out of your hair transplant. But before even getting to that point, you have to take a leap of faith—faith in the FUE technology (or otherwise) you’ve researched, faith in the surgeon you’ve chosen, faith in the testimonials you’ve heard, etc. There’s no doubt you’re going to have concerns, and you’re not alone. Surgical hair restoration is an emotional journey with many ups and downs, and you don’t want to end up as one of those horror stories you’ve heard. Perhaps an objective response to some common concerns will help you take the leap of faith.

Hair Transplant is Expensive

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This cannot be denied, however it can be planned for. We make many investments in ourselves—university tuition, a new car, the wedding day—and these things cost thousands of dollars. Usually, hair restoration surgery is far less expensive and just as rewarding professionally, socially, and romantically. So why isn’t an investment in our outward appearance worthwhile when it affects us so deeply on the inside? Hair loss has a huge impact on our psychological and emotional well-being. The results of this investment are, in fact, worthwhile; because your happiness and life quality are worth any expense.

I’m Not a Good Candidate for Hair Transplant

Thankfully, FUE technology takes care of one of the biggest reasons a prospective patient is considered inoperable—depleted scalp donor source. Men without enough hair on their head to source their surgery are considered poor candidates for many techniques, but not follicular unit extraction. FUE enables the use of non-head donor hair from almost anywhere on the body, including the beard, legs, chest, shoulders, stomach, and arms. This is called body hair transplant, and makes it possible for people with severe hair loss to undergo successful hair restoration surgery.

Other reasons for being a poor candidate may include poor health, allergies to anesthesia, scarring proneness, and blood clotting difficulties. These factors need to be discussed with your surgeon.

I’m Afraid it won’t Look Natural

Technology has evolved a long way since the days of punch grafting, which still gives surgical hair restoration the “pluggy” stigma. FUE technology especially circumvents the appearance of plugs or doll’s hair because the punch tool used is only about 1mm in size (as compared to the 4mm size punch of the past). This device enables microscopic follicular units to be implanted into thousands of slits in the recipient area, making for remarkably natural results. Furthermore, FUE hair transplant has a wider donor pool selection than any other method, so hairs can be specifically selected by the surgeon with a purpose to best match the area of implantation.

I’m Afraid of Scarring

Scarring is inevitable with any surgery, however, a well-chosen surgeon will be skilled enough to create cosmetically negligible scars. Again, FUE technology is particularly ideal because the tiny wound-size and diffuse graft excisions make any scarring extremely difficult to detect. FUT produces a long, thin scar called a strip scar, which is disguisable with a certain hair length. For people whose strip scar stretches and widens over time (due to skin elasticity), the scar can always be filled with a few hundred FUE grafts later on.

Why Your Hair Grafts are “Weird” After Hair Transplant

Many cosmetic surgeries provide somewhat instant gratification as to the results of the procedure. After a couple weeks of healing, breast augmentation, liposuction, tummy tuck, rhinoplasty, etc display an immediate improvement or change in the recipient’s appearance. With some other types of surgery, the gratification comes a little later and requires patience. Hair transplant is one of those procedures that are worth the wait. A new, full head of hair or advanced hairline will not spring up instantly. In fact, you won’t even see new growth for about four months post-surgery, and the optimal outcome won’t arrive for about 18 months.

On this journey, your scalp and hair grafts will likely go through some weird phases. And though these phases are a perfectly normal part of the process, they can be alarming. If you’ve noticed any of the following happening to you, you’re not alone.

Hair transplant using beard hair that was well-blended by Dr. Umar.

Hair transplant using beard hair that was well-blended by Dr. Umar.

The New Hairs Are Shedding After Hair Transplant

You just got new hairs implanted, you’ve taken every precaution to “tread lightly” with showering, sleeping, avoiding your favorite baseball cap, and so forth. But the new hair is falling out. What did you do wrong? You’ve done nothing wrong. This hair was never meant to stay in place and was only the vessel, so to speak, for transplanting the follicle to a new place. Once the follicle has taken root, the attached hair grafts will shed around the third or fourth week after surgery to make way for new hairs to eventually grow in their place.

The Hair Transplant Growth Has a Wiry Texture

After about four months have passed, you should finally start to see the new hairs growing in. But they will often seem like they don’t belong on your head. They might be wiry, coarse, brittle, or even wavy. In any case, they don’t match the surrounding hair. That’s because the follicles have gone through a big change and need time to adjust. It may take two or three growth cycles for the hair to smooth out and resume its normal soft texture. Hence the reason hair grafts are not expected to reach full maturation until 18 months after surgery.

The Hair Transplant Yielded Growth That Doesn’t Match

Sometimes, in the case of BHT (use of non-head donor hair), the hair may not match exactly with the surrounding scalp hair. It may be a slightly different color, slightly coarser in texture, or grow at a slightly different speed to a different maximum length. This is something you need to be aware of before accepting the use of non-head hair. If your surgeon mentions the use of this non-traditional donor source, it’s usually because there’s no alternative—your scalp donor source is too depleted. A good surgeon, however, will be adept at blending beard or other body hair grafts in such a way that the variations are not noticeable to others.

Dr. Umar’s Use of Leg Hair for Hairline Refinement Featured in Dermatology Times

The majority of men struggling with male pattern baldness take note of hair loss occurring at the hairline and temple points first. Indeed, crown thinning will shortly follow, but hairline recession arguably remains the worst of it all. Suffice it to say, the hairline is the frame of the face—the first thing people gaze upon when looking at you. Hair transplantation, particularly hairline refinement, is available to help. The Dermatology Times features the distinctive practices of widely respected hair transplant expert, Dr. Sanusi Umar. Using his developments in follicular unit extraction (FUE), he can construct a gradual, natural-looking hairline with leg hair supplying the donor grafts.

Dr. Umar practices FUE exclusively and has worked for nearly a decade to develop an excision device that would be able to harvest outside the mid-occipital donor area with maximum accuracy and minimal risk. The outcome is his one-of-a-kind uGraft Harvester, described by The Dermatology Times as, “a rotary tool mounted with modified hypodermic needles and special tips that allow for customized follicular unit extraction.” The groundbreaking uGraft makes body hair excision achievable without damaging the follicles or harming the area, regardless of the angulation of hair growth.

Leg hair matches the texture of hair that grows naturally at the hairline. Thus, hairline refinement sees remarkable improvement, owed to this viable new donor area. This development makes hair transplant with uGraft effectively untraceable. A completely bald hairline can be reconstructed to look totally natural. And as for the donor zone, Dr. Umar methodically excises the hair in a dispersed pattern to avoid any bald patches—any scarring or other tells of surgery are undetectable.

With regard to design, leg hair is clearly the best choice for hairline refinement, but it is also convenient for hair loss sufferers whose scalp donor hair is depleted. For these cases, the uGraft can use leg hair (and other body hair) to account for the severity of extreme hair loss, which would be impossible to restore by any other means.

Dr. Umar has performed FUE using leg hair on 10 patients, one of which was a woman. With a growth rate of 75 to 80 percent, each patient saw a remarkable improvement along the hairline within nine months after surgery. “My patients are extremely happy with the aesthetic outcome of the procedure,” Dr. Umar said. This article in The Dermatology Times follows a similar article on Dr. Umar’s innovative approach to hair transplant published in the February publication of The Archives of Dermatology.

Deciding Between FUE and FUT For Hair Transplant

Making the leap into hair transplant can be incredibly overwhelming. There is so much research to be done, so many choices to be made, so many goals to be fulfilled. The process involves an exhausting list of variables to be considered, which includes:

  • Your age
  • How bald you are/how many hair grafts you’ll need
  • What surgeon/hair clinic you choose
  • How much you’re willing to pay
  • The technique you choose

All of the above take part in the final results—and each one has the potential to make or break your hair transplant. Last, but certainly not least on the list, technique is like the vehicle you choose on the road to restoration. One will get you to your final destination while another may not be able to make it all the way.

FUE for Hair Transplant

FUE stands for follicular unit extraction. This method of surgical hair restoration got its big boost in the 1990’s, when development took off in full force. Hair surgeons wanted to improve on the existing techniques (one of them being FUT) in order to create the best outcomes possible.

FUE is a tedious, labor-intensive surgery that removes the hair grafts one at a time from the donor area for implantation into the recipient area. The donor area is usually comprised of the back of the head, but now with body hair transplant, FUE incorporates donor hair from almost anywhere on the body. FUE results in minimized scarring, quick healing, and optimal results—especially for hairline design.

FUT for Hair Transplant

FUT stands for follicular unit transplant. This method came before FUE, and thus it is a more antiquated method of hair transplant. Its development came about in the 1980’s but it still continues to be a popular method today. FUT removes the hair grafts by excising a linear strip of flesh from the back of the patient’s scalp. This creates the infamous strip scar, and also limits the number of hair grafts that can be transplanted as well as the caliber of hair that can be used. Ultimately, it is a quicker surgery, though more invasive, and hairline design suffers.

How to Choose

Each procedure has its pros and cons. While FUE creates superior results, FUT is more affordable for most people—and both require a skilled and experienced surgeon for the best possible results.

Why Treatments for Hair Loss Are So Important

Image courtesy

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We have doctors to treat us for all kinds of ailments. Some of them specialize in the ears, nose, and throat while others specialize in treating kidney problems and yet others target just the heart, brain, eyes, or feet. Problems with hair fall under the care of dermatologists, who are generally considered specialists of the hair, skin, and nails. While thinning hair is mostly disconcerting for cosmetic reasons, it’s time we start thinking of treatments for hair loss as an important part of our overall health.

What Your Hair (Loss) Can Tell You

Thin, brittle hair is considered unattractive, and thus we want to know how to tackle hair restoration head-on. But before you go straight for the Rogaine, or other hair restoration solutions, consider this: there’s a lot that hair loss can tell you about your health. If you notice you have thinning hair, make an appointment with your dermatologist to find out why. Pursuing the right treatments for hair loss starts with knowing the underlying cause. While hair loss can be a symptom of the typical androgenic alopecia diagnosis, pattern baldness isn’t the only threat to your tresses. Hair loss can be a sign of serious underlying illnesses. To name a few:

  • Anemia
  • Diabetes
  • Thyroid dysfunction
  • Malnourishment/vitamin deficiency
  • Lupus
  • Alopecia areata
  • Scalp infection
  • Emotional shock/stress/depression

Many of these are not permanent causes of hair loss, and hair restoration will naturally occur with the treatment of the illness itself. However, only your dermatologist can start to determine what’s causing your hair to fall out.

The Beauty of Hair Loss

Although it tends to be cosmetically displeasing, the beauty of hair loss is that we can notice it fairly quickly and do something about it. If you’re losing more than 50 to 100 strands per day, this is your body’s way of telling you that it’s giving in to genetics and aging (pattern baldness), or that something is wrong. Don’t ignore these signs. Pursue your treatments for hair loss under the care of a doctor, just as you would for any other ailment. The more quickly you go to the dermatologist, the more quickly you will know what’s happening and be on a safe and healthy road to hair restoration.

Once the cause is determined, clinically proven treatments for hair loss may include Rogaine (minoxidil), Propecia (finasteride), or hair transplant.

Surgical Hair Restoration for Permanent Hair Loss Causes

Male or female pattern baldness is number one among hair loss causes. By the age of 50, 85% of men will struggle with this unfavorable cosmetic fate, while 50% of women will endure it to some degree by the age of forty. However, pattern baldness, also known as androgenic alopecia, is not the only permanent cause of hair loss. There are various other disorders and situations that lead to permanently thinning hair. And one of today’s best treatments for such cases is surgical hair restoration.

Pattern Baldness and Other Hair Loss Causes

Traction alopecia. Image courtesy of

Traction alopecia. Image courtesy of

Pattern baldness develops as a weakness within the genetically inherited androgen receptors, which eventually leads to DHT sensitivity amid hairs on the scalp. DHT (dihydrotestosteron), the hormone metabolite of testosterone and the enzyme 5-alph-reductase, is the main culprit for the cause of this condition. However, new variables are now in question, such as the involvement of certain prostaglandins.

Other hair loss causes that may lead to permanent baldness, and thus require surgical hair restoration, include:

  • Lupus
  • Chemotherapy (hair grows back in most cases, but occasionally does not)
  • Traction alopecia
  • Trichotillomania (a psychological disorder resulting in obsessive plucking of hair)
  • An accident or burn

Why Surgical Hair Restoration Is The Solution

In cases of permanent damage, the loss of hair is irreversible. At the early onset of pattern baldness, the condition might be mitigated by the application of Rogaine or a Propecia prescription, but in its advanced stages the hair that is lost is gone forever. Likewise, in the event of Lupus-related hair loss, traction alopecia, trichotillomania, or an accident/burn, there is either a chemical barrier or the barrier of scar tissue preventing the hair from ever growing back naturally.

The idea behind surgical hair restoration is to take viable, DHT-immune hairs from a donor zone on the patient’s scalp (non-head donor sources are now an option) and implant them into the balding recipient areas. Here, the harvested donor hairs will take root and grow anew.

Surgical hair restoration can safely correct all listed hair loss causes, with minimal invasiveness and with natural-looking results. Follicular unit extraction is the leading method of hair transplant due to its ability to treat severe cases, its freedom to design the hairline more effectively, and its minimized resultant scarring.

Large Volume FUE Body Hair Transplant Procedures With The Help of uGraft

Real Self ( a popular site for patients to ask questions that are answered by real doctors) recently asked Dr. Umar about the phenomenal results his patients experience as a result of body hair transplant.

According to the site, most hair transplant patients who participate on Real Self say they received between 2,500-5000 grafts. But many of the individuals treated by Dr. Umar receive 10,000-20,000 grafts using hair from different areas of the body.

Body hair transplant gave excellent results in this patient

Body hair transplant gave excellent results in this patient


before and after images of body hair transplant procedure performed by Dr. Umar

before and after images of body hair transplant procedure performed by Dr. Umar


The key to being able to accomplish this lies in using the uGraft technology. This was developed by Dr. Umar himself.

The large volume results that body hair transplant  achieves using uGraft is amazing. And it offers much promise to patients with severe forms of baldness. But what is also interesting is that these procedures make excellent use of hair that is normally considered to be undesirable.  According to Dr. Umar,We seek to use a perceived disadvantage of body hair (namely thin caliber) to our advantage … to feather out what was hitherto considered a good hair transplant derived hairline … in order to give the hairline the subtlety that is expected in natural form.”

This patient video which was featured on Real Self shows the results of a patient body hair transplant procedure that used 20,000 grafts. Initially, 15,000 grafts were reinserted. And a year later, Dr. Umar touched up areas of low hair density using 5,000 grafts. The donor pool of these two procedures consisted of 5500 grafts from the head donor area and 14,500 grafts from other areas of the body: nape, beard, chest, abdomen, legs and arms.


The use of body hair for transplant procedures can offer wonderful results.  However there are a few considerations to be aware of. The follicles taken from other regions of the body will grow hair that has the same qualities as before:

  1. Difference in color between head and body hair.  In some patients, head hair is a different color from body hair. Once body hair follicles are reinserted into the scalp, they will continue to have the same color
  2. If non-beard hair extracted from other regions of the body are used, they will continue to grow at the same length. For example chest and leg hair will continue to be short once used on the head
  3. The texture of body hair will not change once they are transplanted into the scalp.

Body hair transplant is essentially an advanced form of Follicular Unit Extraction.  Although FUE technology like Neograft and Artas is available to help facilitate different aspects of the procedure, they are not ideal for harvesting follicles from body regions.