Hair transplant may be a permanent fix for hair loss, yet it has its own limitations just like any other cosmetic procedures. 

Some may think that they are able to have as many sessions done as long as they can afford to pay for them. As a matter of fact, it is not always possible as there are some restrictions involved.

Hair transplantation is an effective treatment for genetic hair loss which is the most common culprit causing hair to fall out. Whether the ultimate results can be reached or not, it depends upon the patient’s understanding the nature of hair loss and their willingness to compromise.

Here are the major limitations of hair transplants:

1. Bald surface area expansion

2. Limited amount of donor hair supply

3. How many grafts are needed for each bald area?

4. What happens if you don't have enough scalp donor hair to transplant?

5. Budget

6. Patient’s mindset and expectation

7. A compromise is worth an exchange for getting hair to grow back

By nature, Androgenetic Alopecia can occur at any age in life, It may start in adolescent ages and progressively invades into adulthood as time goes by. 

Some may start out as a Type 2 in young ages and the thinning areas can certainly turn into baldness eventually as they get older with age. 

It is unpredictable how much hair loss a person will have and by what age it will stop; no one, even a doctor, knows.

When people start losing hair in their early ages between 18-30, their conditions are more likely to progress to Type 6 or 7 in the future. 

People with hair loss may wrongly assume that their hair losses will not become overly serious since their ancestors only had thinning hair. As a matter of fact, there is no guarantee if their hair loss situations will become more or less serious than their ancestors did.

As the hair loss progresses, the bald area increases, and the more hair grafts for hair transplant are needed as a result.

Since there are about 7,000 grafts of permanent hair available for hair transplantation, a person may not have enough permanent hair supply to cover all areas needed. 

Some areas may have to be partially opted out, e.g., a 7,000 grafts may be used for the frontal and most of the top of the head areas (2,500 + 5,000 = 7,500 grafts), or for the top of the head and some for the crown areas (5,000 + 5,000 = 10,000 grafts). 

Once the available 7,000 grafts are used up, there will not be any more permanent hair to be used for subsequent sessions. 

Consequently, it is likely impossible for people with very large areas of baldness, as shown in the images, to rely solely on hair transplant to actually achieve the full coverage they desire. 

While patients who are seeking medical attention may only have a type 3 or 4 at the time, their conditions can possibly progress to Type 6 or 7 eventually.

When scalp donor hair supply runs out, instead it is necessary to use hair from other parts of the body (e.g., mustache hair, beard hair, or chest hair) 

The downside is that it may not create as natural looking effect as hair on the scalp does due to the differences in quality and characteristic, such as its bigger size, sturdiness, curliness, and being programmed to grow to a certain length. 

As a result, it may grow in different directions from surrounding scalp hair, making it harder to manage. Once these hair follicles have been transplanted, they are also harder to remove. 

Therefore, it is important that we conserve and reserve the scalp donor hair; use only what we really need and save it for subsequent sessions when advanced baldness keeps on progressing.

The average cost for each hair transplant session is between US$ 3,000 and US$ 20,000. When multiple sessions are needed, the cost can accumulate to a much higher expense. 

In addition, the cost of transplanting hair from other parts of the body to head is usually higher than that from head to head. 

So people who depend upon hair transplant as the only option need to have a lump sum of budget set aside for the entire process. 

However, budgeting alone is not a promise that they will have full coverage when their donor hair supply is insufficient.

To minimize the cost of a hair transplant and the risk of lacking a permanent hair supply, taking hair loss medication as an alternative or a combination treatment is another good solution to consider. 

Keep in mind that the larger bald area it is to cover, the more permanent hair is needed, the less it is left for future sessions.

That said, only opt for the hair transplant option as the last resource when all else fails, for example, in the frontal area where it is a cosmetic necessity and hair loss drugs do not work at receding hairline. 

But for the top of the head and the crown areas, try medications first. If they do not deliver a satisfactory result, then hair transplant will be the next option.

Hair transplant can be effective and safe without having to pay a whole lot more money than necessary if patients are willing to modify their mindsets and expectations in order to have their hair restored.

Examples of unrealistic mindset and expectation:

• WANT A LOWER HAIRLINE TO RESEMBLE THE PREVIOUS ONE 

Usually, patients overlook the fact that the lower the hairline they want, the bigger an area it becomes for transplanting, and the more donor hair is needed. Designing a new hairline should be planned by the surgeons, not by the patients, because surgeons create them with the consideration of each patient’s donor hair availability in mind. It is important for the patients to understand that hair transplant is merely a pathway to improving their images not to duplicate the hair they once had.

• WANT THE TRANSPLANTED HAIR AS DENSE AS IT WAS BEFORE 

It is no surprise that patients want greater density and more grafts. Most of the hair transplant doctors charge per graft which means more grafts mean higher surgical fees. Placing many grafts with a high density are what many patients think they need, and there are plenty of hair transplant doctors willing to provide them.

• WANT A HAIR TRANSPLANT ON THE INITIALLY THINNING AREA RIGHT AWAY 

It is best to try medications first. Getting a hair transplant as soon as the thinning hair is first seen does not always solve the problem in the long run because the existing surrounding hair may shed further as time goes by. 

All in all, people want their hair to grow back without any compromises. But everything in the world, hair transplantation included, has consequences; we need to look at both sides of the coin. 

Even though hair transplantation helps regain hair, it creates scars on the scalp. Patients who wore short hairstyles before may need to wear a little longer hair in order to conceal them. Indeed, longer hair could give an illusion of a thicker appearance.

First and foremost, people with hair loss are recommended to try hair loss medication, which may come with minimal side effects, instead of getting multiple sessions of hair transplant right away. 

It can save them money, avoid them from having the risks and side effects from the surgeries, and possibly save them time from missing work.

Patients who insist to have only hair transplantation and who refuse to use hair loss drugs because of their chemical ingredients, their side effects, and the inconveniences must be aware of the following risks associated with the post-operative hair transplantation.

In the event that the patient had had a hair transplant done on a thinning area before the existing surrounding hair fell out later on, this area can look funny or strange in appearance.

Hair from other parts of the body other than scalp hair may have to be used on the scalp. Whether it be mustache hair, beard hair, or chest hair, it may look unnatural.

Multiple sessions require bigger expenses. The cost for transplanting hair from other areas to scalp is usually higher so budgeting for the procedures is absolutely necessary.

Multiple sessions are likely possible. Patients may experience some side effects and pain to a certain degree inevitably in each and every session, time after time, when they need to have a number of sessions done.

Some say they may shave their head if any of these issues happen to them. Well, they may not realize that each transplanted hair is bigger in size than the surrounding hair in the front and the top of the head. 

Even though they shave their heads or wear very short hairstyles, it becomes detectable that they had a hair transplant done before. The skin on the recipient area is also not as smooth as usual because larger pores were created by the needles or micro blades, instruments used for transplanting hair follicles during the surgery. 

Furthermore,  the scarring area on the back of the head is also visible no matter if it was done with the FUT or FUE method. 

Essentially, patients should take these hair transplant limitations into account to see if they’d rather follow their surgeons’ recommendations than their own mindset before considering a hair transplant.