This is known as Stage IV or V of Male Pattern Hair Loss, measured by something called the Norwood Scale. This means you have experienced hair loss for some time. Is it too late to do anything about this or to “fix” it? Definitely not. First, there are plenty of men (including famous Hollywood celebrities) who simply opt for going bald, so that is certainly one solution to the “problem.” However, some men may not want to go that route, and if you are one of them and you have it in your budget, there are ways to restore some of your former hairline.
The first thing you want to do is make sure you can maintain the hair you still have left on the top of your head. The way to do that is through the maintenance procedure as outlined in this section. You must consistently apply the well-tested treatments of finasteride, minoxidil, and/or low-level laser light therapy. (Using a combination of treatments seems to produce the most powerful effect. See this study, for example.) If you skip this step, you may lose the remaining native hairs you have on the top and crown of your head.
The second step is to consider replacing the hair you have already lost. The primary way to do this involves filling in the bald spots with your own hair via a procedure known as hair transplant surgery. In short, this involves extracting hair follicles from the back and sides of your head (called the “donor site”) and transferring those hair follicles to the places where there is no hair. Because this hair is taken from the back and sides of your head (which is “protected” from the hair loss caused by DHT), the hair that is transplanted will continue to grow the rest of your life. There are three concerns to be aware of, however:
1. Because you have a limited hair supply in the back and sides of your head, you may not be able to completely fill in every spot of your head that used to have hair. In addition, the new transplanted hair will not be as dense as the previous hair that grew on your head. However, a good hair transplant surgeon can make the results look very close to what you had originally.
2. There are two types of transplant surgeries: FUT and FUE. The FUT transplant procedure involves harvesting hair from the back of the head, so that will leave a thin but permanent scar on the back of your head. However, if you don’t keep your hair too short, it probably won’t be an issue, because the hair will cover up the scar. FUE does not result in any long scar, as it involves taking smaller “bunches” of hair rather than taking a strip of hair. Nowadays, hair transplant surgeons have developed ways to minimize or virtually eliminate scarring.
3. There is a possibility of experiencing “shock loss,” which is the destruction of hair due to the trauma of the hair transplant surgery. Usually, this hair that is lost eventually grows back as your body recovers. However, in some cases, the hair is lost permanently. Just be aware of this risk. In order to avoid this, make sure you find a surgeon with very good Before & After photos and talk to several surgeons about the risk of you in particular experiencing shock loss. There are many successful hair transplant surgeries, so this may very well be fine for you, but it is also good to be aware of the possible risks.
The benefit of hair transplant surgery is that it involves using your own hair and there is no chance of losing that hair again, since the hair strands from the back of the head (which are moved to the places you lost your hair) will always be “immune” to hair loss caused by DHT.
The second option to gain back the hair you lost is via a method known as Hair Replacement, in which human hair (other than your own) is almost “grafted” into your scalp to provide a full head of hair. One example of a clinic that offers this solution is Graff Technology in Riverside, California. The benefit of this is that unlike in hair transplant surgery, there are no restrictions on how much hair you can use or what hairstyle you want to have, since there is a full supply of hair available. Also, you will have a full head of hair, giving a very natural look. And since there is no surgery involved, there are virtually no risks.
The downfall is that it requires maintenance and that it is not your own hair. However, if you want to have hair and cover up bald spots, this is an excellent and satisfying option.
Based on your stage of hair loss, you can choose to either do hair transplant surgery or the hairpiece. The hairpiece has no limitations as to what kind of hair you want, but it is not your own hair; the transplant surgery is limited by how much hair you have lost and how much you have available from your “donor site” (the sides and back of your head), but it uses your own hair, giving the most natural result.
Maintaining Hair For Men 