Is it safe to transplant hair into thinning areas, or do you risk damaging existing hair in these regions?

This is an excellent question and the answer ultimately depends on your doctor’s judgment and your personal hair and hair loss characteristics. The major concern, of course, is whether a transplant will damage the existing hair in the thinning area. If the existing hair is very limited, and likely to fall out eventually anyway, most surgeons would feel comfortable performing a transplant and implanting grafts into this region to restore some density. Even if the existing hair is lost, the net benefit of having it replaced with permanent hair will be worth it.
On the other hand, if the existing hair is relatively dense and/or in good condition, most surgeons would prefer that you first try medical therapy for 6 to 12 months, to see if you can slow your hair loss or even restore some hair. Some surgeons, however, may feel comfortable proceeding with a hair transplant. In this case, your doctor must be careful not to place an excessive number of grafts in this delicate region because this could lead to increased shock loss. Make sure your surgeon speaks honestly with you about the risk of shock loss and limited re-growth if you choose to go this route.
Don’t forget that everyone has only a limited supply of donor hair on their scalp. You do not want to jump into anything, particularly if you are not sure how your hair loss will progress in the future. Top hair transplant doctors will discourage you from rushing into anything and will help you create a long-term plan for combating your hair loss.

This class 3 vertex patient has medium caliber, dark brown hair with well above average donor density. Dr. Cole’s treatment plan for this patient was to transfer 740 CIT/C2G grafts into the vertex. C2G is a CIT (non-strip) preparation method where advanced technology allows our surgical team to harvest over 1500 grafts in an 8-hour day, without exposing any scalp. This method gives our patients the option to leave our clinic without any trace of extraction/harvesting in the donor area. The goal of this patient was to improve the overall appearance and density in the vertex that once existed. Subsequent to the CIT procedure, the patient received a small session of micro/mini grafts. The pre-existing mini grafts may require redistribution to eliminate the grafted appearance.

Transplanting too high of a density into a recipient area that is already relatively dense can cause fatal trauma to the pre-existing (native) follicles. High densities placed into an already progressively thinning crown can create a bigger problem than most patients seem to know prior to the procedure. For example, a surgeon transplants 200 multi-hair grafts on a patient who only has a 50 sq. cm. size area of recession, the patient will have a great risk of having an unnatural appearance.
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I am now 19 months post surgery from a body hair transplant with you. I noted significant improvement at the 9 month mark, but minimal since then. Can I expect more growth and more density from the body hair transplant I had with you 19 months ago. I live in Spain.

You have to understand the dynamics. Head hair is 80 to 90% in anagen. Body hair is 40 to 60% in anagen. Therefore, in reality, the best you should see from a head hair transplant is 80 to 90% and the best you should ever see is 40 to 60% from body hair. That does not mean that 10% of head hair and 40 to 60% of body hair died. It means that those percentages should always be resting or in telogen. As one hair cycles out, another cycles in and begins to grow. That’s the dynamics.

I think that most body hair transplant results to date seem to follow scalp hair in terms of growth, though we did recently get a 4 year photo of a patient that certainly seemed much better than his 14 month photo. What this means is that at about 8 to 12 months, the result probably peaked with minimal improvement thereafter.
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When and how does the new hair grow in after my hair transplant ?

Many people ask this question during and after their hair transplant; some actually think the hair will all continue to grow and they will have their “new head of hair” immediately. Unfortunately, most individuals have to accept delayed gratification as part of the transplant experience!

When the grafts are placed in the balding areas, they indeed may continue to grow for a few weeks. However, by about three weeks, the hairs begin to rapidly shed and soon most all of them are gone. The good news is that the follicle cells, the ones that make the new hair shaft that grows up and out, are still lying dormant under the skin.

At about three to four months, the first hairs begin to sprout through the scalp. At first, all new hairs will be finer, and slightly less pigmented than they will eventually be after some growth time. It is important to note that the grafted hairs do not all begin to come in simultaneously; they generally sprout in a “staggered” fashion, which means that each month some new sprouts will be noticed emerging from the scalp, until they all have grown in! Full growth will have occurred, on average, after about 10 to 12 months; full ingrowth may sometimes take a little longer on second and subsequent procedures.

Of course, the full cosmetic effect may not be apparent right away. This is because length and caliber of hair, as well as density, contribute to coverage. Once the hair has grown long enough and each shaft has become thick enough, then the full coverage will be apparent and the welcome decrease in the appearance of thinning and baldness will be noticeable.