Q: I have been reading about hair transplantation and I have a question concerning FUT (strip-harvesting). I understand, in this method, a strip is excised from the back of the scalp, the wound then closed. I wonder, then, is not the overall surface of the scalp reduced in this procedure? After two or three procedures, especially, (or even after one large session) will not a patient’s hairline also be shifted? That is, the front hairline would move back by the amount of scalp excised, or, more likely, the “rear hairline” (which ends at the back of the neck) must certainly be “moved upward.” At least, this is how I imagine it would be. Is my logic flawed? I’ve been trying to understand this in researching the procedure, but the point still evades me.

A: The hair bearing area is much more distensible (stretchable) than the bald area and just stretches out after the procedure. As a result, the density of the hair in the donor area will decrease with each hair transplant session, but the position of the upper and lower margins of the donor area don’t move much – if at all. As a result, the major limitation of how much donor hair can be removed is the decreasing hair density, rather than a decrease in the size of the donor area.

Q: Can the crown be transplanted first instead of frontal area? Why is the crown the last choice? Any reasons behind it?

A: The crown can be transplanted first in patients who have very good donor reserves (i.e., high density and good scalp laxity). Otherwise, after a hair restoration procedure to the crown you may not be left with enough hair to complete the front and top if those areas were to bald.

Cosmetically, the front and top are much more important to restore than the back. A careful examination by a trained hair restoration surgeon can tell how much donor hair there is available for a hair transplant.

Q: I have been told a number of different ways to massage my scalp. What do you suggest?

A: We have found that the most successful technique is to perform the exercises: once a day, for at least 15 minutes, and using three different hand positions.

Q: Is it more important to do scalp exercises before the first procedure or the second? A: When the scalp is tight, it can be useful for either the first or the second hair transplant. Keep in mind, however, that the scalp will naturally stretch between hair transplant procedures, so that if exercises were not [...]

Q: How long should I do scalp exercises before the procedure? A: To get the most benefit from scalp exercises, one should stretch vigorously on a regular basis for at least eight weeks prior to your hair restoration procedure. However, this will vary based upon the individual and upon how much the laxity needs to [...]