Q: What is your opinion on having a hair transplant to restore the hairline and then wearing a hair system behind it to regain the appearance of a full head of hair? K.Y. – Hackensack, New Jersey
A: It is my personal feeling that one should not use a hair transplant to supplement a hair system, especially at a young age. We have occasionally performed this procedure in older men and women.
In my view, a main purpose of a hair transplant is for it to be low maintenance. The combination of a hair transplant and a hairpiece is extremely fussy.
In addition, hair systems cause traction alopecia (hair loss from constant tugging) and the hair loss will become permanent over time, limiting the ability to have a hair transplant in the future. If one needs to have the high density of a system — i.e. for a career — then just use the system. It will give you more long-term options.
Q: Over the years, I have worn my hair in braids and extensions. My hair is not growing at my hairline and temples. Can the braids be the cause and can this be treated with a hair transplant? — Williamsburg, Brooklyn, NYC
A: The name for hair loss is this area is called alopecia marginalis. It is almost invariably caused by continued traction from braids or hair extensions. When this is the case, the condition is also called traction alopecia. If the problem is long-standing, the hair will rarely come back, even if the braiding is stopped, and a hair transplant would be indicated.
If there is enough hair loss on the sides of the scalp that the donor supply is significantly reduced, surgical hair transplantation may not be possible.
Q: What are your recommendations for wearing a hairpiece following a hair transplant? — P.K., Long Island City, Queens, NYC
A: First, some clarification. It is OK to wear a “hairpiece” (one that is attached to the hair with clips or to the scalp with tape) so that it can be removed each night, but NOT a “hair system” (that is woven to existing hair or glued to the scalp and must be removed by the salon).
Patients should wait a week before they resume wearing their hairpiece, although some patients use it as soon as two days later (but keep it on for very short periods of time).
After the first week, I don’t have any restrictions with regard to duration during the day, as long as the person removes the hairpiece at night and shampoos the scalp thoroughly at least once a day.
The hairpiece should be kept clean and it helps if the person has a spare. The piece should be attached with clips. A stiffening rod can be inserted along the front edge to keep it from lifting up. One should avoid using glue. Tape can be used in conjunction with clips only if the area of attachment of the tape is away from the implanted grafts.
Here are some resources for after your hair transplant:
After FUT Hair Transplant
After FUE Hair Transplant
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