Crown Hair Transplant 5 Years Down the Road.

Here is my case: I am 30 years old, I have been on Propecia for almost 10 years and have a moderate hair loss. I would like to get more density on the crown though. I have tried Rogaine which coupled with Propecia really worked but Rogaine was giving me headaches, so I was forced to stop.

My question: if I get a hair transplantation to get more crown density, the newly implanted hairs will remain on my head while the non-transplanted hairs will keep on vanishing: the result might look poor in 5 years post surgery. What do you think? — S.W.

Thanks for question, S.W. Likely the Propecia has been effective in reducing or stopping your hair loss. If your donor hair is sufficient and it would not put you at risk down the road, a transplant to the crown would be an option. The grafts would be blended into the existing hair to provide a bit of a buffer zone should you continue to lose existing hair around the transplanted hair. If your loss continues, there would be the possibility that another procedure would be required to add hair to the areas exposed around the transplanted area.

For the most part, patients on Propecia usually don’t lose enough hair around the transplants to warrant another surgery in that area. An important factor in the equation is your donor supply and final hair loss pattern. These two variables will ultimately play an important role in determining what is safe to do in your case. If the overall donor supply will meet any potential future demands, grafting in any areas is safe. If the supply may not ultimately meet potential future demand, then we must be careful how we distribute the grafts.

In some cases, a transplant to the frontal zone and mid scalp will provide an excellent cosmetic result, but work for the crown must be avoided when limited donor supply exists. In the end, a careful evaluation of your donor supply and final hairless pattern will determine whether crown work would be a good idea in your case.

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— Victor Hasson, MD