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    Hair transplantation has can be successful in for Female Pattern Alopecia and the number of females seeking hair restoration surgery is on the rise. In our society it is socially acceptable for a man to lose his hair. He may not like it, but at least male pattern hair loss is considered a variation of “normal”. After all, a majority of men have some degree of noticeable hair loss by the time they reach midlife. Hair loss in females is not as socially acceptable. With female pattern baldness, women feel “abnormal” and find themselves in a position that makes them extraordinarily uncomfortable.

    The incidence of Female Pattern Alopecia (FPA) is greater than most people realize. Norwood recently reported that female pattern alopecia is as high as 30% in females over 30 years of age. Others have reported even higher incidences when females are carefully examined. One reason why this is not generally appreciated is that females are very good at hiding thinning with hairstyles, products and hairpieces.


      • female-hairline

    The pattern of hair loss in FPA is different then MPA in that the hairline is usually not affected but there is diffuse thinning in the central scalp behind the hairline. Ludwig and Olsen described the pattern slightly differently. Ludwig described FPA as occurring in a caudal and centrifugal pattern in which hair in the hairline is maintained, though it may thin to varying degrees. Ludwig created a scale in which she divides FPA into Ludwig Type 1, Type 2 and Type 3 with severity getting progressively worse as we move from 1 to 3. Olsen described a “Christmas tree” pattern of loss which begins as a “widened part” but evolves into a zone of hair loss that is widest anteriorly at the hairline and gradually narrows, with ragged borders, more posteriorly

    Females have some special issues that need to be addressed before deciding if they are a good candidate for surgery. First of all, females are prone to other etiologies of hair loss. If there are any signs and/or symptoms suggestive of an endocrine, metabolic or dermatological cause, they should be investigated and treated appropriately. It is also important to rule out temporary hair loss caused by severe emotional or physical stress leading to telogen effluvium. However the majority of females seeking transplantation for hair loss have no apparent cause other FPB.

    Females are much more susceptible to the postoperative complication of “shock loss” or “telogen effluvium” of existing native hair still present in the recipient area. Post operative shock loss occurs when pre-existing native hair is triggered to go into a telogen (resting) phase by the local stressors of surgery. In men this can occur from 10% to 20% of the time while in females it occurs more frequently, almost 30% to 50% of the time.In general this shock loss is temporary, occurring about 2-3 months after surgery and resolving in about 4-6 months. However in some situations it does not totally resolve leading to a less dense result. Women need to be warned about this before surgery.

    Another abnormality quite commonly found in females is genetically high hairlines that give the appearance of a large forehead. This may be the result of heredity or secondary to a brow lift. Women with this situation feel uncomfortable wearing their hair up or back and often wear bangs. Hair transplants are an excellent tool with which to lower the hairline.An alternative method of lowering the hairline is with the hairline advancement flap discussed earlier in this.


    • female-hairline


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“Thank you very much for your attention. I am very happy with the results of the surgery. After 3 months only I already have full hair coverage in all the affected areas and don’t need to use the hair clips like I used to do for many years. Please give my beast regards to Dr. Shapiro and the team...”Read More

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