What Makes a Good Hair Transplant Candidate

The most important thing a person considering a hair transplant should know is whether they are a suitable candidate for the procedure. You may have come across statements online like, “Any healthy person over the age of 18 can have a hair transplant.” However, this statement is absolutely incorrect. Unfortunately, there are many people who experience disappointment due to hair transplants performed on unsuitable individuals. The primary reason for this is the wrong decisions made during the pre-operative period. Therefore, we strongly emphasize this: determining your suitability for the operation beforehand is the most critical factor for increasing the success of the procedure.

Are You a Suitable Candidate for a Hair Transplant?

Everyone wants a successful result from their hair transplant in the end. For this successful outcome, these 3 criteria must be met simultaneously. These criteria are;

1. The significant growth of the transplanted hair.
2. The ideal density of the grown hair: Meaning at least 35-40 hair grafts per 1cm².
3. Achieving a natural-looking result that is undetectable: Remember, an unnatural result will definitely not make someone who has had a hair transplant happy.

So, how is it evaluated whether you are a suitable candidate for a hair transplant before the procedure? First and foremost, the most accurate way for this is to be examined by an experienced physician.

It is beneficial to consider the following as evaluation criteria.

1 ) Donor Area Capacity

The number of all strong hairs that can be taken from the donor area at the nape of a person’s neck is called the donor area capacity. If the beard and chest hairs are also strong, they can be numerically added to this donor capacity. The thickness and strength of the donor area hairs are an important criterion for suitability for hair transplantation.

An experienced hair surgeon begins the examination with the donor area and seeks answers to the following questions: Is there a sufficient number of grafts in the donor area? What is the quality of the grafts? In total, how many suitable grafts are there in the donor capacity for hair transplantation? How many of these will be used for this operation? How many grafts will remain for a second operation? The answers to these questions will be crucial in determining whether you are a suitable candidate for hair transplantation.

2 ) Age and Genetic Factors

One of the most important criteria for a person considering a hair transplant is the age factor. Remember, deciding to have a hair transplant at an early age is very risky. Androgenetic alopecia, what we call male pattern hair loss, is the leading cause of hair loss. The type of hair loss in the first-degree close relatives of these individuals, such as their father, uncle (paternal or maternal), will be genetically passed on to other relatives.

For example, let’s assume a 25-year-old man with aggressive hair loss wants to have a hair transplant. Let’s say this person’s hair has started to thin and weaken. If his father or uncle has a Norwood 6-7 pattern of hair loss, it is very likely that he will progress rapidly towards his father’s pattern of baldness. Therefore, after a hair transplant performed at an early age, the person’s natural hair will continue to fall out. It is highly probable that in the future, only the transplanted hair will remain.

3 ) Hair Loss Type

The Norwood Scale helps us significantly in determining the type of hair loss. According to this scale, an experienced hair doctor will make a calculation as follows:

1. What is the number of grafts that can be taken?
2. What is the area (in cm²) to be transplanted?
3. The number of grafts, when divided mathematically by the size of the area, gives the number of grafts to be transplanted per 1cm². (Number of grafts / Area(cm²))

For extensive baldness like Norwood 6-7, at least 7-8 thousand grafts will be needed to cover the bald area. Most likely, this number cannot be obtained from the donor area. This means the entire head will definitely not be fully covered, or a sparse appearance will result. This outcome could greatly satisfy someone who is 45-50 years old. However, we do not believe that a person who is 25-30 years old would be happy with this result.

3) The Cause of Hair Loss

It is not correct to decide on a hair transplant without knowing the cause of hair loss. This becomes even more important in a hair transplant to be performed on women, especially.

Because a significant portion of the causes of hair loss in women is related to hormonal and metabolic diseases. For example, in a woman with a thyroid disorder or anemia, the medical treatment of these conditions should be the primary focus. Deciding on a hair transplant without treating the underlying disease will not yield an effective result.

This is because a hair transplant requires taking strong, non-falling hairs from the donor area and transplanting them to the bald area. However, in diseases such as thyroid issues and anemia, the hairs in the donor area are also weak, thin, and prone to falling out. Therefore, in a hair transplant performed on a woman in this condition, the transplanted hairs will either not hold or will fall out again. For this reason, blood tests and other laboratory tests must be performed to determine the cause of hair loss in women.

In men, the cause of hair loss can be determined with a few simple questions and a physical examination. This is because in 95% of cases, hair loss in men is due to androgenetic alopecia and hereditary reasons.

4 ) Chronic Diseases

If a hair transplant is being considered, especially for individuals over the age of 40, potential systemic diseases and any medications the person is using must definitely be examined. For example,

• The heart medications in use may interact with the local anesthetics to be applied during a hair transplant.
• It is not advisable to perform a hair transplant on individuals with clotting disorders such as Hemophilia.
• Furthermore, in individuals using blood-thinning medication, it may be necessary to discontinue these drugs before the surgery.
• In cases of systemic diseases like hypertension and diabetes, it is absolutely not correct to begin a hair transplant without first bringing blood sugar and blood pressure under control.

For individuals with such systemic diseases, obtaining an internal medicine or cardiology consultation before deciding on a hair transplant is the most appropriate course of action.

5 ) What Is Your Expectation From Hair Transplantation?

Remember this: doctors who perform hair transplants do not have a magic wand. Doctors take your hair from the donor area and transplant it to the bald area. Therefore, the basic rules of mathematics come to the forefront here. That is, there is a mathematical proportion between the number of grafts to be taken and the area to be covered. So, if 3000 grafts are taken from you, the resulting number of grafts will be at most 3000 grafts. Consequently, if you expect your entire head to be completely covered in cases of large Norwood 6-7 baldness, the most correct option would be to give up on the hair transplant.

Examples

Below, we will provide a few examples for a pre-hair transplant evaluation. These examples will give you a clue about whether you are a suitable candidate for a hair transplant. We also hope that they will give you an idea about a possible hair transplant result.

Example 1: A 22-year-old male student with Norwood 3 hair loss wants to have a hair transplant. His hair is quite fine and weak in structure, and he is actively experiencing hair loss. His father is 52 years old and has Norwood 7 type hair loss.

(It is not appropriate to perform a hair transplant on this person at the age of 22. He has androgenetic alopecia, and his hair loss pattern is progressing rapidly toward his father’s. If a hair transplant is performed now, he might be happy for maybe 1-2 years. However, his own hair will continue to fall out rapidly, and only the transplanted hair will remain. Perhaps even the transplanted hair may fall out. Therefore, an unfavorable appearance will emerge in a short time. Starting medical treatment would be a more rational solution.)

Example 2: A 25-year-old male with Norwood 3 pattern hair loss. The temple regions have receded. However, the donor area hair is quite strong, with a total capacity of 7000-8000 grafts. His father is 50 years old and has Norwood 5 hair loss.

(This person is a suitable candidate for a hair transplant and requires a maximum of 2500 grafts. Even if his own hair continues to fall out, the donor capacity is sufficient. This means there are enough grafts for a second or third hair transplant session.)

Example 3: A 45-year-old woman with thinning hair, who has hypothyroidism and anemia. The hair in the donor area is also quite fine, but she wants to have a hair transplant. (For this patient, treating the thyroid condition and anemia should be the primary focus. Even if a transplant is performed, there is a high probability that the transplanted hair will fall out after a while. Or a large portion of the transplanted grafts may not survive. Therefore, she is not a suitable candidate for a hair transplant.)

Example 4: A 27-year-old woman with a congenital high hairline who does not experience hair loss. The donor area hair is also quite strong, and she wants a hair transplant.

(She is an ideal female candidate for a hair transplant. The hairline can be lowered with 1700-2000 grafts. This female patient can be very happy with the result.)

Example 5: A 53-year-old male patient. He has Norwood type 6 or 7 pattern hair loss. He also has hypertension and diabetes and is on blood-thinning medication. He knows that his scalp will not be fully covered, but he wants a hair transplant.

(In fact, this male patient can have a hair transplant and can be happy with the result. However, due to his systemic diseases, he first needs to get approval from a cardiology or internal medicine specialist.)

As can be seen from the 5 examples above, age or other factors alone are not sufficient eligibility criteria. They must be evaluated together.

We have summarized the suitability assessment before hair transplantation under 5 main headings. In fact, none of these alone is a single criterion. An experienced hair transplant doctor evaluates all these criteria and tries to find the answer to the following 2 questions.

1. Is this person a suitable candidate for a hair transplant or not?
2. If a hair transplant is performed, will they be happy with the result or not?

If these two questions can be answered positively, a hair transplant can be performed very comfortably.

Result

Before deciding on a hair transplant, be sure to get a consultation from an experienced physician. Do not rely on unrealistic advertisements, especially those found online. And definitely stay away from places that claim they offer ‘unlimited hair grafts’. Everyone has a limited donor capacity, and creating something from nothing belongs only to God. Hair transplant surgeons take your strong hair and transplant it to the empty or sparse areas. Therefore, learn your donor capacity and maintain reasonable expectations.

It is never correct to say that ‘a hair transplant is performed on every healthy person over the age of 18.’ Remember this: A hair transplant is performed only and solely on a suitable candidate. The failure rate is quite high in transplants that are done without research and indiscriminately.

If we have been able to benefit those who read this article before having a hair transplant, that would make us very happy. We wish you all healthy days with plentiful hair.