Patients with Norwood grade5, grade6 and grade 7 baldness require more than 4000 grafts to cover their entire balding area with good density. It requires expertise, experience and a lot of thinking in such mega hair transplants. While planning hair transplant in such patients, one has to consider patient’s age, his pattern of balding, pattern of balding in his family, size of head and size and hair density in donor area.
Mega hair transplant doesn’t mean very dense packing. Many times, to achieve good results, more hair grafts are positioned per square centimeter area. Though initially result is impressive, it sacrifices donor area. This is especially true in young individuals with lesser grade of balding. Since hair loss in androgenic alopecia is progressive, these individuals often require further procedures but then donor area is not available. You have to always keep in consideration that patient’s baldness is progressive and even though transplanted hair remain, patient may lose his existing original hair. For this patient’s age, pattern of baldness in his family and likely progression of his own baldness have to be considered.
When fixed number of grafts are available, a good transplant surgeon positions and implants them to achieve maximum density in strategically crucial areas and moderate density in less crucial areas so that an overall good density is achieved all over with the effect of overlapping. This is much better than spreading available grafts all over the balding area and compromising density & achieving unacceptable results.
The most frequent question that arises in patient’s mind is - should mega transplant be done with FUE or FUT? We have done mega transplant in many of our patients with only FUE and we prefer it if donor area size and density are good. But realistically, in most patients more balding area means in lesser donor area. In such patients only FUE cannot produce required number of grafts without compromising donor area. Then one has to look for other options like body hair which are not ideal for scalp hair transplant. If only FUT is considered then wide strip has to be harvested which may result in stretching of the scar. So, for mega hair transplant in such patients we prefer combination of FUE & FUT. Once 1.3 to 1.5 cms strip is harvested, that area is closed with very fine cosmetic suturing. Then FUE is done in remaining donor area without compromising density and donor area is left in ‘best shape’ for any future procedure, if required, if patient loses his original existing hair.
The advantage of single sitting mega hair transplant is that you don’t need to take off from your work repeatedly, less visits to your hair transplant surgeon, no multiple exposures to anesthesia & medicines and less overall expenses. Our foreign patients are very happy and satisfied with this single sitting mega transplants.
These mega hair transplants typically take 10 to 12 hours and are physically & mentally demanding. But with well equipped infrastructure, graft surviving techniques and specially trained team, good cosmetic/plastic surgeons routinely perform hair transplants with requirement of more than 4500 grafts. These cosmetic/plastic surgeons always take pride and pleasure in doing mega hair transplants because these patients always have a great improvement in their looks after the transplant. Their boosted confidence and happy faces are very encouraging for the cosmetic/plastic surgeons.