Why I Don’t Shave the Head

I was doing this, a female hairline lowering patient this morning and a podcast came to my mind. A lot of my colleagues shaved the top of the head before they begin the surgery. I really never shaved the top of the head where the recipient sites would be made or where the grafts will be transplanted because if you shave the top of the head, you won’t be able to see a few things. Number one, for example, this morning, the reason it came to my mind is this woman, who was born with a very high hairline had some ghost hairs, in other words, hairs that were like baby hairs that weren’t really giving her much density. But these ghost hairs, I was able to use those as a reference to look at the direction of where her hair would have been on that forehead.



It gave me a very good idea of how to create the world. Now, of course, I could have made it myself without those goes hairs. But it’s nice to look at the natural direction of her hairs that how they would have been. And the reason why that’s also important is those ghost hairs also match the existing angles of our existing hairline. So if I just shave down the top of her head, I would never see these ghost hairs. The second thing is that I actually use the hairs that are there for a few reasons. For example, one is if I wet the hair that the hair has become very wet and I start to see a greater see-through. It gives me a guidance in what I need to do in transplantation. If I shave it all off, I could put too many hairs in one area, another area, and not distribute those hairs appropriately.



So for me, a huge part of the design process is allocating the grafts in a way that, or the recipient sites in a way for maximum aesthetic benefit. Because we don’t have unlimited graft. So when I’m placing or designing, I always want to make sure the grafts have the highest impact. So if you have hairs there, you can actually see the natural density both dry and wet, which there’s no way you could see that when the hair is shaved, not to mention the fact that patients hate to have their hair head shaved. Now, If I’m doing fue on the back of the head, yeah, I’ll shave the back. But the top will be feathered in. So it will look natural as the hairs grow in from the back, but the recipient area is left long. It also allows me to avoid transecting the natural hair. 



So if I cut those hairs down, I mean transect through those hairs and that’s another problem and you lose hairs and damage hairs. So that’s another reason why I don’t shave. The other reason I don’t shave, besides the patient’s really hating it and there’s just no reason for it is a fact that it can camouflage those grafts. So if there are grafts there that a few scabbing, those hairs are on top camouflage or during the recovery and it makes the recovery significantly easier for the patient. The other reason is I can see the exit angles of hairs. So when the hairs have a good exit angle, I can see, okay, this is the angle that I needed to be designing to match that existing hair. Or in some cases of that patient has a very bad transplant where the angles are really bad. 



I realized, okay, I’ve got to make adjustments to these angles here and focus on those angles here to overcome the bad transplant in the past. So for all these reasons, there’s no reason to shave the head. Now why do people shave the head? The reason people shave the head is that it’s a lot easier. It’s a lot easier and faster for the surgeon. They don’t have to move the hair out of the way. And it’s significantly easier for my staff to place because there’s no hairs in the way they can easily put the grafts in. But I think the ease for the doctor and the staff is far outweighed by all the reasons I have a numerator. And this is the reason why I simply do, will not shave the head. There’s absolutely no reason for it. And there’s so many detriments to it.