How effective are hair transplants in African American patients?
Like in all other ethnic groups, hair transplantation in individuals of African-American or other African ethnicity is a procedure designed to restore permanently growing hair to areas of hair loss. The donor hairs come from the back and sometimes sides of the scalp, where a single donor strip is removed then the incision sutured closed. Once transplanted, the hairs first fall out at 2 to 3 weeks, then for the next 3 months, the scalp looks essentially like it did prior to the procedure. Three to four months later, the hairs will begin to grow, and over the next year the density will gradually increase as more and more of the hairs grow to their normal density and length.
There are however unique differences when working with the typically more curly hair – some advantageous, some disadvantageous, while others are just what they are. For advantages: because the hairs are curly, larger grafts can be used, many containing 2 to as many as 5 hairs, without compromising naturalness – this means more hair coverage per graft. Naturalness in general is the easiest to achieve with these curly hairs. The disadvantages: because the grafts are inherently larger due to their curl, they cannot be placed as closely together and fewer grafts are able to be transplanted in a single procedure. This often means that patients will desire a second procedure 8 -plus months later to achieve greater density by placing the second round of grafts between the prior placed original grafts. The other disadvantage is a greater risk of donor site detectability – the scar itself typically heals as a fine line, but for some reason the curliness of the hairs results in some patients in a slight parting of the hairs from both sides of the incision, something that can be detectable when the hair is cut short… Once the procedure is performed, patients are unable to shave the hair short, otherwise the donor site will be visible.
There are few risks with the procedure, and most are those associated with standard hair transplants. The donor site incision typically heals as a 2 mm wide incision, easily concealable with hair that is cut with anything longer than a razor with a #2 or #3 guard. Hair growth seems to be not as reliable in certain cases, especially in women who have a combination of traction alopecia (from tight hair pulling due to certain hair styles or from the application of hair extensions and weaves) and genetic hair loss, with often another etiology of the hair loss which can sometimes be difficult to diagnose. It is for this reason that Dr. Epstein will sometimes suggest a test procedure of 30 or so grafts to assess after 4 to 6 months the rate of hair growth before the undertaking of a larger definitive procedure.
Finally, despite the curliness of the hairs, transplantation of the beard and eyebrows is possible amongst individuals of this ethnic group. Similarly to transplantation of the scalp, a smaller number of grafts are utilized than that used in other ethnic groups.
Most of our patients travel from out of town to have it performed on a fly in/fly out basis. The entire procedure can be scheduled by phone and email, with Dr. Epstein able to evaluate photos sent by the patient.
Posted by Jeffrey S. Epstein, MD, FACS