Mark A. Bishara, MD

Southlake,TX Mansfield,TX


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Below is a list of some frequently asked questions, but please feel free to call our office if you need additional information.

Will a hair transplant cause my original hair to fall out? (Shock Loss)

Shock loss is a possible risk of hair transplant surgery, and is one that all patients should be aware of before undergoing their procedure. The trauma of surgery on the scalp may cause natural hair to fall out in some patients. This is most likely to occur when transplanted hair is being placed near a large area of natural hair. The risk of shock loss can be reduced by angling the incisions so as to not damage the nearby natural hair follicles.

When it does occur, most cases of shock loss are temporary and will resolve on their own within a few months, allowing patients to enjoy the results of their procedure with no additional worries.

Understanding “Shock Loss” and Its Risks

Shock loss is a temporary condition in which the trauma on the scalp during surgery causes additional hair loss. This condition may occur in both the donor and recipient areas of the scalp, up to a few weeks or few months after surgery. Patients with only minimal amounts of hair loss are at the highest risk of experiencing this condition.

There are several factors that can lead to shock loss during hair transplant surgery. The most common cause of this condition is transection of the natural hair during transplantation. Other causes may include

While most cases of shock loss are temporary, permanent shock loss is possible, although it is considered rare. For most patients, shock loss will resolve itself within a few months. The risk of shock loss can be minimized by using smaller incisions that cause less trauma to the scalp, and by using conservative placement and avoiding dense packing of transplants near existing hairs. Patients can also take finasteride to reduce the risk of shock loss during hair transplant surgery.

Dr. Bishara will discuss the risks of shock loss with you prior to your surgery so that you are aware of the potential outcomes of your procedure.

What is the average ratio of hair counts in Follicular Unit Hair Transplantation?

Follicular Unit Hair Transplantation involves the transplantation of follicular units that contain one, two, three or four individual hairs in each follicle. While the specific number of each type of graft used during the FUT procedure varies depending on each individual patient, there is a general standard ratio used for most patients.

The standard ratio of hair counts during the FUT procedure is usually:

  • One Hair Units – 20%
  • Two Hair Units – 50%
  • Three Hair Units – 25%
  • Four Hair Units – 5%

Dr. Bishara will work with each patient to develop an ideal treatment plan to maximize your results.

Using someone else’s donor hair for a hair transplant?

Finding someone with similar hair who is willing to provide donor hair for your transplant surgery would make this procedure much more fulfilling for many patients. Unfortunately, it is not possible for patients to use someone else’s hair as a donor for their hair transplant procedure. Since the hair is not your own, it is therefore not a genetic match and will be rejected by the body. This can be theoretically performed successfully in genetically identical twins.

The Role of Hair Characteristics in Hair Transplant Surgery

The individual characteristics of our hair play a major role in determining the outcome of hair transplant surgery. These characteristics may improve or worsen the results of treatment, which is why each patient undergoes a customized transplant operation that takes into account their specific needs and goals.

Your hair’s color, texture, density, thickness, styling options and more all contribute to the techniques and results associated with your procedure. Patients with fine, thin hair often require more grafts than those with thick, coarse hair.

Because of each patient’s individual hair characteristics, it is important to not compare results directly with others, as your results are based on a unique combination of factors, including your amount of hair loss, scalp laxity, skull size and more, in addition to your hair characteristics. Dr. Bishara will work with you to determine the best treatment approach specifically for you.

Recipient Incision Size: Is Bigger or Smaller Better and Why?

The best incision size for Follicular Unit Hair Transplantation does not have a clear-cut answer, and instead depends on many different factors for each individual patient.

Perhaps the most defining factor in determining incision size is the size of the graft. Larger grafts (containing three or four hairs) require a larger incision than smaller ones. The characteristics of the hair, including density, texture and coarseness are also considered when determining the ideal incision size.

A larger incision often increases the risk of scalp trauma during surgery, and also eliminates the ability for dense packing of the donor follicles.  The ideal technique for FUT surgery involves using a custom blade so that incision size can be fully customized for each individual patient. This helps ensure the most effective results while also reducing the risk of complications.

To Shave or Not to Shave the Recipient Area for a Hair Transplant

Shaving the recipient area before surgery is recommended in certain situations, depending on the location of the recipient area, incision technique being used, and the personal preference of the doctor performing the procedure.

When the recipient area is located around an area with an abundant supply of natural hair, shaving is suggested to ensure that the donor hairs are placed in the correct area with a much lowered risk of complications. Many patients worry about what their scalp will look like while waiting for results to develop. If the recipient area is shaved, it can be easily covered with a hat after surgery.

Dr. Bishara will offer you his recommendations on whether or not to shave the recipient area before your hair transplant surgery. Since each patient’s case is different, it is best to listen to your doctor’s recommendations rather than compare your situation to those of other patients.


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