Question: I am a 56 year old male with major hair loss, what I believe is a NW 5.5 or somewhere close. I have worn a hairpiece for the past ten years, have never had a transplant, and my hair loss seems to follow the same pattern of my father and older brothers. I am in excellent health, with wavy hair that is dark to medium brown and flecked with gray. I'd like to no longer rely on a hairpiece, and am hoping to find a solution that will provide sufficient coverage but also a ‘mature' hairline. Do you have any suggestions for me that would keep in mind the age-appropriate results that I would like to achieve?

Answer: I've had several other patients in your situation, and basically we perform a procedure which concentrates on the front one-third to one-half of the scalp. The goal is to provide you with a natural-looking receding or mature hair line, along with sufficient density that will give the appearance of a nice head of hair on all but the view from the back of the head. Though the hairs can be spread out over a wider area, that will result in less density. For more density or wider coverage, a second procedure can be performed 6 or more months after the first procedure. For the second procedure, there is no hairline work and the concentration is on increasing the density and filling in at the crown. If you are concerned about the progression of hair loss in the crown, and given your relatively young age, I would recommend that you consider either minoxidil or Propecia.