Surgical planning with different types of hair loss
Since the hair we transplant will usually last a lifetime, we believe that careful planning to fill the needs of the individual patient is the first and foremost consideration. We realize that the decision to undergo a hair transplant is not so much the decision to undergo a medical procedure but rather – a decision to improve appearances and self-image.

For the most natural looking results it is necessary to strike a fine balance between the two considerations of density and coverage. This usually means transplanting above average density in front to frame the face and using less density towards the crown. That said every patient brings a unique set of considerations that will influence the options discussed during the initial consultation. Surgeon Muhammad Nadeem Umar will take into account the patients age, complexion, stage of hair loss and – of course – personal expectations.

There never is a good age to experience hair loss but for younger men, it can be very traumatic. The disturbing fact is that - the earlier hair loss begins, the more extensive it will likely be. Given that we all age differently – there is also no way to predict the extent of hair loss over a lifetime.

The good news is – the sooner a young man develops a plan to address hair loss through medication, hair transplantation or, both – the better the results can be. At our clinic a significant percentage of our clients are young men and we have developed a specific approach that has produced amazing results.

Typically, when it is reasonable to perform a transplant for a younger man, we can recreate a high-density hairline and reduce the angles of the temple hairline. The result is a very natural and youthful look. Keep in mind that all patients have a limited amount of donor hair to use for transplanting. At The Surgeon Muhammad Nadeem Umar Hair Transplant Institute we take the time to make sure that we are making the best use possible of the donor hair available.

Receding Hairline and Crown Hair Loss

In many cases, crown balding is an easy type of hair loss to treat. Many patients are fortunate and have a great donor area with plenty of density and the whole head can be covered with transplanted hair. For patients in the right age group, with crown balding and minimal frontal recession, transplanting hair into the crown can be a great option.

illustration of crown balding (pre surgery)

However, for younger patients and those with extensive hair loss, the crown area becomes secondary. In these cases it is necessary to first treat the hairline and top of the head in order to allow a framing of the face, a very important part of a hair transplant.

A receding hairline is often the first sign of significant hair loss. In these cases the hair become smaller - the hairline starts to creep up and - the temples become more exposed. Panic may also start to creep up but at Surgeon Muhammad Nadeem Umar's Hair Transplant Institute we can help panic recede by properly treating a receding hairline.

illustration of receding hairline (pre surgery)

illustration of receding hairline (pre surgery)

illustration of receding hairline (pre surgery)

illustration of receding hairline (pre surgery)

In cases of a receding hairline –Surgeon Muhammad Nadeem Umar can provide an appropriately dense packed hairline with careful attention to the angles of the temple hairline. Our extensive experience with exactly this type of hair transplant can re-establish a youthful, natural appearance.

How much hair do I need?

The typical answer is as much as possible.  However, the limitation is the donor supply, currently and in the future.  Since we are transplanting and not creating new hair, estimating the donor supply in the planning stage is crucial to a long term successful transplant.

When we assess patients we map out the current and future needs as well as the current and future donor supply. With this information, along with your goals and expectations, we then make the short and long term plans.

 

Regular Norwood Classes
	Type II • Temporal recession < 1" • Mild recession along frontal hairline • "Mature" hairline
	Type III • Further frontal recession • Deeper recession at corners • Earliest stage of balding
	Type III vertex • Hair loss predominantly in vertex (crown) • Frontal hairline recession may be present
	Type IV • Further frontal hair loss and temporal recession • Enlargement of vertex (crown) • Solid band of hair across top separating front from vertex
	Type V • Frontal and temporal areas enlarge further • Band separating the two areas becomes narrower and sparser
	Type VI • Frontal and vertex balding areas merge into one and increase in size

Dense Packing

When we transplant new grafts into the recipient area, it is done at various densities. The definition of what dense packing is varies from one clinic to another.  We feel any density grafted between 30-50 grafts/cm is a realistic definition of dense packing. We will dense pack the hairlines in this range if certain criteria are met.  These criteria include donor density and capacity, age, hair characteristics and ultimately patient goals and expectations. Do note that we use follicular unit grafting exclusively prepared with microscopic dissection to create that ultimate natural hairline. 

Mega Sessions

Just as hair loss presents at various degrees of severity, the treatment graft quantity required will also vary. What was a definition of a mega session years ago has now been surpassed quite easily on regular basis. The number of grafts done in one sitting has been continuingly increasing. We will routinely perform sessions between 2000 (old definition of mega session) to 3000 grafts in one session. Again the patient’s needs and specific situation will ultimately determine the need for grafts.

Suturing Techniques
With strip surgery there will be a residual scar in the donor area. The tricophytic method of donor closure will allow hair to grow right through the scar. This will camouflage the scar and minimize its visibility at shorter hairstyles. We use the trichophytic closure method on all strip patients. See examples below of some healed strip scars.

Tricophytic Scar

Hairline Design

Hairline design is more art than science. There certainly has to be some scientific basis to support the surgical plan, but the end result, will ultimately depend on the artistic approach to designing the hairline. 

We feel that creating a natural looking and absolutely undetectable hairline is the most important aspect of this procedure. Unfortunately not every clinic values this important point, so the patient may end up with more hair, but the design used gives it away as a transplant.

When designing the hairline, Surgeon Muhammad Nadeem Umar takes into consideration as much information from the patient as possible.  This will include age, hair characteristics; current and future level of hair loss, ethnic background, facial features and of course the patient’s realistic goals.

By using this information Surgeon Muhammad Nadeem Umar has the eye and the talent to create a hairline with the proper placement height and the proper temple angle closure.

illustration of receding hairline (post surgery)

Temple Angles

Proper approach to dealing with the temple closure can separate an extraordinary hair transplant surgery from a merely good one. The small percentage of grafts used to close the temples will provide a huge return in the youthfulness and naturalness of the end result.

Every patient’s design is individualized. The plan to whether close or not to close the temple angles, is discussed with you at length as part of the surgical planning.

illustration of temple point hair loss pattern

Temple Points

There are patterns of hair loss where the temple points have receded.  In the right patient characteristics restoration of temple points is possible and is recommended to achieve a very natural overall appearance.

illustration of temple point angles

Donor Site Laxity Exercises

During strip surgery we like the donor area to be as mobile as possible. This ensures minimal tension during closure and ultimately a thinner scar.  This is especially important when there is scar tissue from previous surgery. By massaging the donor areas on regular basis prior to surgery will increase the mobility. We will explain to you how to do this as part of the pre operative instructions.

Treating Female Hair Loss

Hair loss in females is less understood. It is also of hereditary nature but the hormonal influences may differ from males. Ongoing research is still being performed to understand this better.

THE LUDWIG SCALE FOR WOMENS HAIR LOSS

FAQ’S

Who is a candidate?
Any male or female with hair loss may be a candidate for hair restoration. Age, expectation and medical conditions will have to be considered.

Why should I consider a hair transplant?
Quite simply - hair transplantation is the only method that gives you your own hair growing naturally and permanently. Limited medications available may be effective but require a lifetime commitment and considerable expense.

Does a hair transplant really work?
Yes and we have legions of happy patients that will agree. Hair transplant surgery involves moving healthy hair from the “donor area” of the scalp to areas where the hair is lost.

Where is the procedure performed?
Hair transplantation by Surgeon Muhammad Nadeem Umar Hair Transplant Institute is performed in our comfortable, upscale, fully integrated surgical suite, located on the premises of our private centre in Lahore and Kharian Cantt. Highly experienced, qualified staff members assist Surgeon Muhammad Nadeem Umar throughout every procedure.

Is a hair transplant painful?
Hair transplantation is only a minor "skin surface" procedure. Many other medical and dental procedures could be more uncomfortable than a hair transplant. At the clinic, we use a combination of oral tranquilizer and local anesthetic. Most patients fall asleep during the procedure. After a hair transplant procedure, most patients feel minimal discomfort and always have the option to take pain medication (personally prescribed by Surgeon Muhammad Nadeem Umar if necessary).

Should I expect much bleeding?
The scalp is a very vascular region of the body and there will be a very negligible amount of blood. The good news is - this minimal amount of blood actually helps to secure and bring nourishment to the newly transplanted grafts.

How many grafts will I need?
Every persons needs are different and - the number and type of grafts can be only determined upon consultation. This is usually based on the extent of hair loss, hair characteristics and patient expectations. Our typical procedures range from hundreds to thousands of grafts per session.

How dense will my new hair be?
Hair transplantation is actually a redistribution of follicles from the donor area to the recipient sites. Since we are not creating any new hair, the density will never be as thick as it once was. However, the transplanted hair, when expertly done, can give the illusion of more hair. The result will be most pleasing to you. Keep in mind, that (in the expert hands of Surgeon Muhammad Nadeem Umar) a little hair goes a long way. The change in appearance can be dramatic.

How long will the procedure take?
Surgery times vary from one person to another depending on the quantity of grafts required to meet patient expectations. Typically procedure times range from 3-8 hours.

How much will a hair transplant cost?
The total cost depends on the number of grafts and sessions required in order to meet a patient's expectations. Hair transplantation is a meticulous and tedious process, which requires certain costs which are identified before the operation. The reward of the initial investment is that you will be comfortable and satisfied in knowing that you will have your own growing, permanent hair. Ultimately, this procedure is more cost-effective than non-surgical forms of hair replacement.

Are there any risks that I should be concerned about?
Hair transplantation is a minor form of surgery and is considered quite safe. However, as with any other surgery, there may be some potential for minor complications. These will be discussed in great detail during your FREE consultation. Rest assured Surgeon Muhammad Nadeem Umar would never perform surgery on any patient if he anticipates any possible dangers to the patient's well being.

What is the most frequent question Surgeon Muhammad Nadeem Umar's patients ask after having their procedure?
Why didn’t I do this sooner?

What if I have more questions?
Beyond the above frequently asked questions, you may still have others.  Surgeon Muhammad Nadeem Umar feels that no question is too trivial. We highly recommend that you write them down prior to your initial consultation.

You are about to embark on a journey that will forever change your appearance and your life.  It is therefore imperative that you are comfortable with us and confident about your procedure.  However, you will find, as many other patients before you have found, that the only regret you will have is not having done it sooner.

If you would like to pursue other questions – a FREE consultation can be arranged where we will be happy to answer any questions you may have.