As hair transplant procedures have gained mainstream popularity and acceptance, more people —both men and women—are exploring their options when they experience hair loss. For those of African heritage, the special characteristics of their hair growth and texture must be taken into account to ensure the best, most natural-appearing result.
Despite the persistent belief that African Americans are not good candidates for a hair transplant, hair restoration surgeons who have this knowledge—as well as the experience—can achieve a successful, aesthetically pleasing outcome that reflects your cultural identity.
Key Considerations for African American Hair Transplants
Considerations for hair transplants in African Americans focus on the unique, coiled structure of the hair and follicles, which requires specific extraction techniques with modified tools and careful handling to prevent damage. African American hair follicles are tightly coiled or curved both above and below the scalp. Since it’s not a straight line, it can be difficult to know exactly where the hair bulb is. When performed by a surgeon with limited experience in hair transplants for Black and African-heritage patients, this poses a greater risk of transection (the surgeon accidentally cutting the hair bulb at the base of the hair follicle) when the follicle is harvested from the donor area for implantation.
Moreover, keloid scarring is a potential complication for African American patients. Keloids are thick, raised scars that can result from any type of skin injury, as well as surgical incisions. African Americans are particularly susceptible to forming keloids, which must be taken into account before surgery. Studies have shown that keloids are 10 to 15 times more common in people of African ancestry, compared to those of European backgrounds.
During consultation, a hair restoration surgeon should ask if a prospective African American patient has a history of such scarring, or any other scarring scalp disorders. Dr. Marco Barusco—Founder and Chief Medical Officer at Tempus Hair Restoration—always conducts a thorough medical history of every patient in order to have a complete picture of the patient’s health and ability to heal after the procedure.
The surgeon should also monitor for keloid scarring post-op, as well as watch for ingrown hairs, which can occur two to three months after surgery, when the hair begins to grow. Dr. Barusco’s YouTube video—“What is Keloid Scarring?”—addresses this issue in detail.
The Main Causes of Hair Loss in African American Men and Women
Androgenetic alopecia (AGA) is a common form of hair loss in both men and women of all ethnic backgrounds. In men, this condition is also known as male-pattern baldness. Hair is lost in a well-defined pattern, beginning above both temples. Over time, the “M” pattern that characterizes the mature male hairline recedes. Hair also thins at the top of the head (vertex or crown), often progressing to partial or complete baldness. This condition is genetic, running in families. In females, hair loss is diffuse, so that the scalp is visible. The center part also widens. Female androgenetic alopecia rarely leads to total baldness.
Black women are particularly susceptible to traction alopecia. This is the term for hair loss from mechanical damage to the hair follicle caused by repeated tension or pulling. This can be caused by wearing the same hairstyle for long periods of time—especially those that tug on the hair, such as tight braids, cornrows and weaves. Tight hairstyles applied to chemically relaxed hair can lead to even greater damage. Of course, black men who wear such hairstyles over a long period of time can also experience traction alopecia. Our blog post—“Is a Hair Transplant a Solution for Traction Alopecia?”—covers this topic in greater detail.
Hair Transplant Procedures for African American Men and Women
Dr. Barusco shares his perspective about hair restoration surgeries he’s performed for patients with African textured hair. In his YouTube video—“African American Hair Restoration”—Dr. Barusco says that either the Follicular Unit Excision (FUE) or Follicular Unit Transplantation (FUT) can successfully be used, depending upon the patient’s desired outcome.
In the FUE procedure, follicular units (hair grafts) in groupings of one, two or three hairs are individually extracted from the back of the head (donor area) using small circular punch blades instead of a scalpel. The grafts are then transplanted to the thinning or balding areas of the scalp. The donor sites are left to heal without suturing. The resulting scars are not readily visible and are easily concealed even by very short hair.
The FUT procedure is also known as the “strip” method. It involves removing a strip of tissue 0.5 to 1.5 cm in width and from 5 to 30 cm long from the back of the head, which after having been removed, is closed with sutures. The strip of tissue containing hair and surrounding skin is then expertly dissected into individual follicular unit grafts that will then be transplanted into the balding areas of the scalp. One advantage of the FUT is allowing a high number of grafts to be transplanted in a single session.
The FUT has undergone significant refinements over the years so that the only evidence is a pencil-line linear scar easily concealed by hair, even at a shorter length. Although many hair transplant practices encourage patients toward the FUE, there are circumstances in which the FUT will produce the more successful outcome—for example, men who wear their hair in long styles (such as dreadlocks) and women. In cases of traction alopecia, hair loss is typically along the hairline and/or the temples.
Whichever procedure is used, the curl and angle of African American hair offers an advantage. African Americans generally have lower density in the donor area, but the curl and angle creates the appearance of denser hair, offering fuller, natural-looking coverage. This means that fewer grafts are typically required to achieve the goal than are necessary for straight, European texture hair.
“All things considered,” says Dr. Barusco, “African texture hair is very good for hair transplant procedures. For male patients, healing is incredible with the FUE. It is a little more challenging because the hair hooks a bit under the skin, so you have to do a bit of a different technique with the punches and FUE settings. But with today’s techniques and punch designs—plus the surgeon’s experience—you can do a very good procedure.
“For female patients, I tend to recommend the FUT, as they don’t like to shave their head for the FUE. It’s not a problem to have a small linear scar at the back of the head because it isn’t visible.”
Choose Your Hair Transplant Wisely for the Best Result
Proper technique for performing hair transplants for African American patients involves specialized knowledge about not only hair texture, but the direction of hair growth. African American hairlines tend to be set lower and straighter across the forehead. Such subtle aesthetic differences require meticulous attention to detail to achieve a natural-appearing outcome.
You deserve a hair transplant that represents your heritage and identity to achieve the image you want to present to the world. If you’ve decided to have a hair restoration procedure, be sure the surgeon you choose has the appropriate experience and has achieved good results. Our website’s Before & After Gallery provides examples of Dr. Barusco’s outstanding work in creating the look of healthy, natural hair growth for patients of all ethnicities.
Ultimately, choose your surgeon based on experience, results and integrity. Dr. Barusco’s long list of accomplishments, his notable artistic ability and his successful surgical team make Tempus Hair Restoration a renowned practice. We understand that the main concern you may have is cost, which is why we offer financing options that can place this important goal within reach.
Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device.
Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more to our Port Orange, Florida, surgical center. No matter how far the distance, we welcome the opportunity to help you on your hair restoration journey!