Hair transplant: Why there is a recommended minimum age for surgery

Is there an ideal age for a hair transplant surgery? This is a question that is often asked by the younger clients who come into hair loss clinics usually within the earlier stages of hair loss wanting to rebuild the shape of their receded frontal hairline. In answer to the question on whether there is a minimum age the answer is yes. The preferred minimum is 25 years of age however 30 years or older is preferred. Why is this? Let’s explain this in detail:
1. Difficulty in forecasting long term hair loss

When being assessed for a hair transplant surgery there are two important things that need to be determined during the consultation. The first is the number of grafts that they require right now in order to treat the thinning area and secondly the number of grafts (via additional hair transplantation) that they may require over the long term as they lose more hair.

As an example, a 23 year old male want hair loss treatment to thicken and recreate their frontal hairline back to what it looked like a few years earlier. As far as treating the area is concerned, it may be estimated that he needs 2500 grafts to complete the transplant properly. So giving them the result that they are after is not difficult. However the inability to forecast how much hair they may lose over the next 15 years can create a problem in the longer term. Donor hair is in limited supply because whatever is extracted for surgery does not grow back. If it was evident that the patient was going to become completely bald within 15 years, the hair transplant surgeon is going to be more conservative with the hairline position (meaning that the hairline would be positioned higher up in order to reduce total surface area on top). A strong probability of being completely bald also means that more total grafts will be required during their lifetime to maintain some level of coverage over the top.

If it concluded that a patient will end up with a very bald area the Doctor must decline requests for too much density or a very low hairline as this will severely deplete donor hair supply for future surgeries. Forecasting long term hair loss is very difficult in a 23 year old and quite easy in an older patient that is in their 30s.
2. Unrealistic Expectations in Young Patients

Young patients in their early 20s still hold onto the glimmer of hope that they can bring back the level of density as well as the hairline shape that they had during their teenage years. To them it was only a few years ago when they owned such a thick head of hair so they figure it is still possible and reasonable to request this during their consultation. Hair transplant patients generally end up with a hair transplantation density that is around 40% as thick as the density per cm of their donor region. To put things in perspective a completely bald man with a newly created frontal hairline and a medium density will be very satisfied because it is a significant improvement to what they had for so many years.

The young patient who ends up with a medium density 15-18 months after the surgery will express that they are not satisfied with their result and will blame a lack of growth. But the real reason for not being happy is a lower density compared to what they used to have and to what they were hoping to achieve. This is unrealistic expectation. Sometimes clients come in with a photo of David Beckham and ask, “Can you make my hair look like this?”... Enough said.

A young male will often demand a low hairline as well as a thick density. There are two main concerns about agreeing to this. The first is that the low hairline may suit them in the short term but will look very unnatural as they enter their 40s and 50s which can become a giveaway that they had surgery. The fact is that the older male will have a higher positioned frontal hairline in most cases. Along with this a low hairline increases their total surface area on top limiting the overall density they are capable of achieving should they need additional procedures in the future.

The other issue in relation to wanting a high density comes down to supply and demand. If 3000 grafts were dense packed within the frontal third of their scalp and they require more surgery, it may be possible that 5000 grafts is the most they can extract over their lifetime. This leaves only 2000 grafts to treat the remaining two thirds of their scalp which will produce a density that is only 33% of the frontal third that was initially transplanted at a high density. If a patient is going to transplant the whole top they will want to maintain a relatively consistent density from front to back. They certainly don’t want one region to be double or triple the thickness of the remaining transplanted areas.

3. Young patients don’t think about the long term

A common mentality is that in 10 years they will not care about their hair anymore and therefore they are living only for today. This is commonly heard when a Doctor Recommends hair loss medication for 12 months before proceeding with hair transplantation surgery. Many young patients who are still in the earlier stages of hair loss convince themselves that they will not lose anymore hair. They notice that the existing hair still looks thick and due to this doubt they could ever lose an extensive amount. Being recommended medication, a high hairline design and a medium density to preserve grafts for later do not interest the young patient. However it is up to the hair transplant surgeon to use their experience and to educate the client properly about all the risks and the potential of longer term hair loss.

Hair Transplantation Recovery

The length of Hair Transplantation Recovery period can vary depending on the type of surgery you choose and the size of the procedure. So there are a few things to consider and plan to ensure your recovery period is a positive experience says Hair Transplant Surgeon and Cosmetic Physician of Melbourne, Dr Rhett Bosnich.

“Today’s surgeries are capable of delivering many more grafts in a single session than was previously possible in years gone-by. This is great for the hair transplant patient because it means less sessions are required to deliver their final result in hair loss treatment.Hair transplant patients of today also get to appreciate the almost undetectable results when first doing their research and choosing the right clinic that is purely and fore-mostly dedicated to Hair Transplantation alone.” says Dr Bosnich. “Larger-sized surgery also means, though that there are a few things for them to consider regarding the Hair Transplantation Recovery period so they can plan and be prepared, thereby minimizing distress and anxiety.”

Dr Bosnich says that there are a few common side-effects of surgery that can influence such things as timing of your surgery – you may wish to take some annual leave from your job, or utilize Christmas holidays or public holidays to minimize the amount of sick leave you use

“The following things are minor, but could be enough for you to consider whether or not to remain housebound, alone or have a friend or family member with you during your recovery which can be up to 14 days depending on the effect,” says Dr Bosnich. “For example, facial swelling may be possible in people who have their frontal hairlines heavily worked on because oedema (fluid from inflammation) can track down the forehead to the eye area for a few days. If you don’t want certain people to know you’ve had surgery, you may wish to forewarn them that you’ll be “out-of-town” for a while, and simply just remain housebound for a week until the swelling resolves.”

Dr Bosnich also says that other effects can be experienced to you may wish to plan ahead for and these include: wound healing (tiny scabs form in the area of transplantation in the first few days – patients are encouraged to wait for about a week before they can start to massage them off according to strict instructions); bruising; temporary numbness and tenderness of either the donor area or the recipient area; tightness at the back of the scalp for those who have large-sized strip surgery; temporary redness during the wound healing phase that can be disguised if necessary with hair or cosmetic product; temporary ingrown hairs/pimples as the new hair push through the scalp.

Call +61 3 9693 9200 for a personal appointment with Dr Rhett Bosnich in Melbourne, Sydney or Internationally for a confidential discussion about your suitability for hair transplant and planning your surgery.

How To Groom After Eyebrow Transplant Surgery

Regardless of whether you have had an eyebrow hair transplant procedure or not, the ‘cutting method’ is preferable to the ‘plucking method’ because you will retain hair density within your desired eyebrow zone, says Dr Rhett Bosnich, Hair Transplant Surgeon of Melbourne and Sydney, Australia.

Dr Rhett Bosnich MBBS, ABHRS, FFMACCS, an internationally renowned Hair Transplant Surgeon, of Melbourne and Sydney is one of the few Hair Transplant Surgeons in Australia performing eyebrow transplant surgery in Melbourne, called Newin Institute. He is one of the only surgeons capable of performing eyebrow transplant surgery using either of the two common harvesting methods: FUG (donor strip incision) and FUE (ultra-fine punch).

“Eyebrow transplant surgery may appeal to you because you have thin or non-existent hairs from years of over-plucking over the years. A skilled eyebrow hair transplant surgeon can reconstruct your brows whatever your age, face shape or eye shape, however, you do need to know how to groom and look after the following the procedure.” says Dr Bosnich. “For the bet results, transplanted hairs usually come from the scalp rather than other parts of the body. So they will continue to grow quite quickly and regular cutting is required for optimal maintenance.”

 “Whether you have had an eyebrow transplant or not, when grooming the browsthe ‘cutting method’ is preferred over the ‘plucking method’ because this allows you to maintain hair density within your desired eyebrow shape.” He says. “One should never pluck individual hairs out of your desired eyebrow zone. These hairs are far too precious – especially if they have been transplanted. You should reserve the plucking method for stray individual hairs that fall outside the actual eyebrow shape you want to maintain.”

Dr Rhett Bosnich and his team have been performing eyebrow transplant surgery in Melbourne for many years. Dr Bosnich regularly attends workshops by fellow ABHRS Surgeons, so he continues to hone his skills and techniques, including Hollywood eyebrow transplant surgeon to the stars: Dr Sara Wasserbauer of San Francisco. The majority of eyebrow transplants that Dr Bosnich performs occur in his Melbourne Hair Transplant Clinic, but the occasional surgery is performed in Sydney. Most interstate patients are quite happy to travel to Melbourne to ensure the best surgery. It’s an investment you can’t skimp on and ongoing post-surgical maintenance and grooming is part of retaining that investment.

“We summarise our guideline for grooming after eyebrow transplant surgery into 6 steps. Firstly, if you have chosen surgery to fill-in prexisting eyebrows that are a little on the thin side, then you may have some stray hairs in the upper eye lid area. It’s okay to pluck these up to your desired eyebrow zone. Anything within the desired eyebrow zone should be cut with scissors. Take a clean eyebrow comb or wand and brush downwards. Carefully trim a little of the excess length. Next, brush the hairs upwards and once again trim a little of the excess. You can repeat these steps until you are happy with the look, but always compare left and right sides to ensure they match.”

Dr Bosnich also recommends gently massaging the eyebrow area once the transplanted follicles heal. He says that although they implant the follicles with careful consideration to angulation, depth and direction of hair growth, some training is required to assist obtaining the final result several months down the track.

“Long gentle strokes from the inner corner to the outer corner with a little wax or gel can help train the direction of growth of hairs and keep them in place during the working day. It doesn’t hurt to apply it at night, too if you can.” Says Dr Bosnich.

The duration of an eyebrow transplant procedure is not very long – about 4 hours, butthe length of surgerydepends on how many grafts are required to be transplanted to restore your eyebrows. Usually about 150 follicles per eyebrow is enough for a really great result. Prices vary depending on the size of surgery, but are on average around $4000.

For more information and a personal consultation please contact Dr Rhett Bosnich on 1300 360 764