Transplanted hair folicle properties question

[Johnjo569]

I was wondering if any people with transplants or doctors etc could help.

From their own experience are the hair folicles that are transplanted from the side of the head to the top much coarser, denser, less pliable and easy to manipulate than the native hair on the top of the head?

I have heard somewhere that the hairs have different properties on the top of the head to the hair on the sides and the back and really wanted to know how this affects the feel and the general look of the hair ie. the ability to style it, manipulate it, is it soft to the touch etc like normal top of head hair usually is and whether it just looks different when moved fro the side/back of the head to the top.

Also if so does this mean the folicles will appear thicker and less natural looking than natural top of head hair in the front of hairline reconstruction?

 

[HairDr Clinic]

Hi @Johnjo569

Besides the hairs over the top of the head being susceptible to the hair loss gene and DHT there is no meaningful difference between them and the hair follicles on the sides. Like the sides the follicular units are naturally distributed around the scalp. The hairline for example having naturally single hair units, generally slightly finer hairs which carries around the temples, ears and nape of the neck. The sides there is a greater concentration of single and two hair units around the sides compared to the back. Having more three and four hair units. When transplanted they can be distributed tactfully to make the most of the hair coverage and density.

Hair calibre alters slightly and this can be used with a hair transplant by taking the finer hairs for the creation of the hairline. But, in general hair characteristics are very similar. Some may find their hair maybe slightly curlier in some areas compared to others but this is not an exact trait of donor and recipient, more to do with inherited genetics. When a hair transplant is performed well and no damage to the hairs or skin then the new hair should blend perfectly over the top of the scalp. You should be able to style your hair normally, cut etc, pretty much as you like.The art of distributing hairs using the singles to four hair units correctly will allow for a natural coverage and look of fullness to be achieved, even on higher hair loss patterns. Assuming the person is a good candidate in the first place of course.

 

[Johnjo569]

Thanks for taking the time to come back with a thorough explanation Dr Arshad

I have seen a few cases online, mainly on youtube or the Bald Truth phone in, where people seemed unhappy with the fact their new hairline once it had grown out around 12 months or whatever were complaining that it didn't feel like their old hair did saying it seemed to feel more 'springy', tougher and harder to style, maybe its just the properties of these individuals own hair. They also seem to complain that their hair now just springs upwards at the hairline and they cannot comb it down or keep it flat. That is one of my fears, that the transplanted hair would decide not be pliable and do as I ask and stick upwards revealing my hairline as I have always wore my hair brushed forwards onto my forehead rather than combed back revealing my hairline.

 

[HairDr Clinic]

Hi @Johnjo569, there are two possible aspects to the concerns you mention. Firstly, a hair transplant matures over time. Normally by around twelve months post-op the hair is naturally growing but many people find even as long as eighteen months their hair has matured and improved further in look, quality, lustre for example. The next point though sounds more like placement issue rather than maturity of the hair.

The hair placement is relient of two issues, the Dr making the slit or recipient site and the placement of the graft by the technician into the slit. The slit placement will go a long way to address issues such as depth the graft is placed, the angle and orientation the hair exits the scalp, including the density and the size of the graft being placed, such as single and multiple hair units. This is obviously very important to the look and how the hair grows naturally and allows you to style your hair. The technician needs to be skilled at placing the hair unit into the slit correctly. Not to push or crush the bulb, not to force the graft as this can create issue in healing and hair growth.

Hair grows at different angles over the head. even in a small area like the hairline the hair angles and orientation changes along the hairline and around the temples. The angle the hairs exit the scalp will change from the immediate hairline back over the head, and the crown is different again, with creating a natural spiral. While there is some poetic/artistic licence with a hair transplant necessary to make a relatively small amount of hair go a long way it should still behave naturally. Allowing you to comb your hairline back or forward as you please, for example.

You only have to look at the Clinic results and galleries on this forum to see the styles that different Dr´s and Clinic have. You may prefer one over the other, including a conservative or aggressive approach. It´s worth taking the time to go through the results section here, often you will see a "style" of hairline design, general planning and protocols etc that you prefer over another.

 

[Bigmac]

Hi Johnjo.
I think The HairDr has addressed your questions very well with the facts.
"How it should work for hairlines": the finer hair grafts are selected for the hairline, this may be achievable from all naturally occurring single grafts but sometimes larger groupings may be split to obtain enough finer single grafts to complete the job in hand. It is recommended that graft sorting should be performed under microscopic magnification. Some follicles could be in the resting phase, these are extremely hard to see, near impossible to the naked eye or low magnification. Without proper magnification the selected single grafts could actually have a fine hair attached and therefore grow as a two hair graft in the hairline. Experience and skill by the person sorting and placing grafts will help to minimise unnatural hairlines from happening.
You say you like your hair combed forward. The grafts will be planted following the natural angles if the physician makes the correct angled incisions.

Here is an image showing different hair calibre.

 

[Johnjo569]

Hey Bigmac and Hair DR, Great write ups and information , much appreciated. There are so many key elements in this surgical procedure I can see how all it takes takes is one weak link and you could end up with a bad transplant! For me, as pointed out by Bigmac, the use of a microscope to check hairs/grafts before planting will be a must if/when i decide to get a procedure done as I don't want damaged/ poor quality or doubles in my hairline.

Just a quick question regarding the placement of a hair and its natural or correct angle in the hairline. If for example somebody is a Norwood 5 or above and doesn't have ANY native hair left in the frontal third of their scalp how do you know what the correct angle will be when it comes to placing the hairs all the way along the newly created hairline?

 

[HairDr Clinic]

Hi @Johnjo569, any good hair restoration surgeon will understand the scalp anatomy and hair angles around the head. They will know that the distribution of the hair grafts needs to alter dependent on the area being treated. Taking into consideration the natural hair characteristics. As a hair transplant is part illusion because we can´t literally copy nature there is a little artistic licence that can be afforded to the Dr when making the slits for the hairs to be placed into. From the hairline back, to over the crown, the use of single and multiple hair units. The slit angles and hair orientation is a vital aspect to the distribution of the hair and achieving a natural result, regardless if minor hair loss or advanced stages. Below is a image depicting the changes in hair angles over the scalp.