Take for example an interesting hair transplant case. To see treatment planning guidelines for people with severe baldness problems.

Basic patient information

Male patient, Thai nationality, has problems with thinning hair and baldness. The assessment was at level 5 according to the Norwood-Hamilton Scale, which is considered to be quite severe. There is clearly some hair in the area.

• Mf (Mid Frontal) : middle of the front of the head.
• Vx (Vertex) : Khwan area

From the assessment of the entire area If you want to plant densely throughout the area As many as approximately 5,000 grafts may be needed, which is even theoretically achievable. But in practice, the amount of graft that can be harvested from the occipital area (Donor Area) may not be enough. This type of case is therefore classified as an Advanced Hair Transplant case or a highly complex hair transplant case.

The key to treatment is “Creating balance (Balance)” between

• Quantity of grafts that can actually be stored
• Area and location where you want to plant

Evaluation of hair roots before surgery

On the day of the hair transplant, the condition of the hair roots in the occipital area was examined using a magnifying glass. It was found that the hair roots were strong. Even if the patient has never used hair growth medicine before.

However, not all patients have such healthy occipital hair follicles. In some cases, the hair is thin or has low density. Minoxidil may be needed to stimulate and nourish the hair follicles before surgery.

Hair transplant planning: prioritizing areas
This patient has problems covering 4 main areas:

• Front (Lt / Mf / Rt)
• middle of head
• Kwan (Vx)

1. Front hairline area (Lt / Mf / Rt)

Plant with a density of approximately 50 grafts/sq.cm. to create a sharp facial frame Makes it possible to style your hair with confidence and does not look as thin as before planting

2. Middle area of ​​the head and morale (Mid Mf & Vx)
Planted with a density of approximately 30 grafts/sq.cm. To have evenly covered hair Although not as dense as the front But it still looks natural. In this area, the patient still has the original hair roots remaining. It’s just thinner from genetics. Therefore, use hair growth medicine continuously after surgery. It will help restore and increase the density of the original hair.

It’s a time to take off scales. Before entering the hair transplant phase, Shock Loss may occur, which is a normal process.
In this phase, the clinic will

• Prepare hair growth medicine for continuous use
• Schedule PRP (Platelet-Rich Plasma) injections periodically to stimulate hair follicle recovery.

At the end of 1 year after the hair transplant, it was found that

• The facial frame is clearly sharper.
• Can style hair easily
• The middle area of ​​the head is dense. Even if planted at a density that is not very high

Part of the good results from regular use of medicine Especially DHT Blocker drugs, which play an important role in maintaining both transplanted and existing hair

Conclusion

People with severe baldness, such as levels 5–6–7 according to the Norwood-Hamilton Scale, can still receive treatment and grow hair.
However, this type of case requires

• detailed planning
• Understanding the limitations of graft volume
• Cooperation in post-planting care and continued use of medicines

When doctors and patients work together properly It can create natural results. and increase patient confidence with maximum efficiency

A 35-year-old Thai customer had a baldness problem on both sides of her forehead, which was receding in an M shape, and came to consult with Dr. Peera at MP Clinic Chiang Mai
in May 2023. After coming in, the doctor performed an endoscopic examination of the hair roots to find the cause of the hair loss and assess the severity before planning a treatment.

After the endoscopic examination, the doctor stated that the client had a level 4 baldness problem. The appropriate treatment was hair transplant surgery, using 2,220 grafts.
The health of the hair roots in the Donor area was found to be strong and dense, so it can be treated with hair transplant surgery immediately.

After 6 months of hair transplantation, it was found that new hair began to grow around the forehead.

After 1 year of hair transplantation, it was found that the new hair was healthy and grew densely, giving a clear new facial frame that allowed hair styling.

A 29-year-old Thai client had a baldness problem on both sides of her forehead, which was receding in an M shape, and came to consult with Dr. Peera at MP Clinic Chiang Mai
in April 2024. After coming in, the doctor performed an endoscopic examination of the hair roots to find the cause of the hair loss and assess the severity before planning a treatment.

ภายหลังการตรวจส่องกล้องคุณหมอระบุว่าลูกค้ามีปัญหาศีรษะล้านระดับ4 การรักษาที่เหมาะสมคือการศัลยกรรมปลูกผม ใช้กราฟต์จำนวน 1,900 กราฟต์
ซึ่งสุขภาพรากผมพบว่า บริเวณ Donor area มีความแข็งแรง หนาแน่น จึงสามารถรักษาด้วยการศัลยกรรมปลูกผมได้ทันที

After 10 months of hair transplantation, it was found that the new hair was healthy and grew densely, giving a clear new facial frame that allowed hair styling.

A 28-year-old Thai client had a baldness problem on both sides of her forehead, which was receding in an M shape, and came to consult with Dr. Peera at MP Clinic Chiang Mai
in June 2024. After coming in, the doctor performed an endoscopic examination of the hair roots to find the cause of the hair loss and assess the severity before planning a treatment.

After the endoscopic examination, the doctor stated that the client had a level 3 baldness problem. The appropriate treatment was hair transplant surgery, using 1,583 grafts.
The health of the hair roots in the Donor area was found to be strong and dense, so it can be treated with hair transplant surgery immediately.

After 5 months of hair transplantation, it was found that the new hair was healthy and grew densely, giving a clear new facial frame that allowed hair styling.

A 37-year-old Thai client had a baldness problem on both sides of her forehead, which was receding in an M shape, and came to consult with Dr. Peera at MP Clinic Chiang Mai
in June 2024. After coming in, the doctor performed an endoscopic examination of the hair roots to find the cause of the hair loss and assess the severity before planning a treatment.

After the endoscopic examination, the doctor stated that the client had a level 4 baldness problem. The appropriate treatment was hair transplant surgery, using 2,490 grafts.
The health of the hair roots in the Donor area was found to be strong and dense, so it could be treated with hair transplant surgery immediately.

After 10 months of hair transplantation, it was found that the new hair was healthy and grew densely, covering the front of the scalp, creating a new clear facial frame that could be styled.

A 23-year-old Thai customer had a baldness problem on both sides of her forehead, which was receding in an M shape, and came to consult with Dr. Peera at MP Clinic Chiang Mai
in May 2023. After coming in, the doctor performed an endoscopic examination of the hair roots to find the cause of the hair loss and assess the severity before planning a treatment.

After the endoscopic examination, the doctor stated that the client had a level 4 baldness problem. The appropriate treatment was hair transplant surgery, using 2,191 grafts.
The health of the hair roots in the Donor area was found to be strong and dense, so it could be treated with hair transplant surgery immediately.

A 34-year-old Thai customer had a problem of baldness on both sides of her forehead, which was receding in an M shape, and came to consult with Dr. Peera at MP Clinic Chiang Mai
in August 2023. After coming in, the doctor performed an endoscopic examination of the hair roots to find the cause of the hair loss and assess the severity before planning a treatment.

After the endoscopic examination, the doctor stated that the client had a level 3 baldness problem. The appropriate treatment is hair transplant surgery using 2,500 grafts.
The health of the hair roots in the Donor area was found to be strong and dense, so it can be treated with hair transplant surgery immediately.

A 27-year-old Thai customer had a problem of baldness on her forehead and had a high receding hairline. She consulted with Dr. Phira at MP Clinic Chiang Mai
in September 2023. After coming in, the doctor performed an endoscopic examination of the hair roots to assess the severity of the hair before planning a treatment.

After the endoscopic examination, the doctor stated that the client had a level 3 baldness problem. The appropriate treatment was hair transplant surgery, using 2,740 grafts.
The health of the hair roots in the Donor area was found to be strong and dense, so it could be treated with hair transplant surgery immediately.

A 32-year-old Thai customer had a baldness problem on both sides of her forehead, which was receding in an M shape, and came to consult with Dr. Peera at MP Clinic Chiang Mai in October 2023. After coming in, the doctor performed an endoscopic examination of the hair roots to find the cause of the hair loss and assess the severity before planning the treatment.
After the endoscopic examination, the doctor stated that the customer had a level 3 baldness problem. The appropriate treatment is a hair transplant surgery using 2,000 grafts.
The health of the hair roots showed that the Donor area had thin and fine hair. The doctor therefore recommended initial treatment by injecting PRP and using medication first. After 3 months of treatment, the patient’s hair was thicker and larger, ready for a hair transplant.