Surgical hair restoration in East Asians (Chinese, Japanese, Korean) is similar in most respects to surgical hair restoration in white Caucasians. In hair transplants, especially, there are anatomic and cultural differences between East Asians and white Caucasians that may influence the choice of procedure.
East Asians have thicker individual hairs than Caucasians, but fewer hairs per square centimeter of scalp (lower hair density). However, the thickness of East Asian hair follicles gives an impression of greater hair density. In hair transplant surgery, a larger donor area must be harvested in the East Asian to obtain the number of hairs needed for transplant.
The characteristic shape of the East Asian head is “rounder” than the long, narrow head of the Caucasian. The placement of hair on the East Asian head must be adapted to head shape, as it is for white Caucasians.
East Asian females have a higher incidence of diffuse alopecia (diffusely thinning hair) than Caucasian females.
To a lesser extent than people of African ancestry but to a greater extent than white Caucasians, East Asians have a greater chance of developing keloids in response to skin injury. A history of keloid formation requires evaluation prior to a surgical procedure.
Culture and custom influence a person’s choice regarding hairline placement, scalp coverage, and other elements of hair restoration. The East Asian may have different expectations regarding the “look” that should be achieved by hair restoration. It is essential for the patient and physician to come to full mutual understanding of the outcome that can be expected after a hair restoration procedure.
While loss of scalp hair is more likely to concern East Asian men, some East Asian women and/or their husbands are concerned by the loss of female pubic hair. Loss of pubic hair, or failure to grow pubic hair, is somewhat more common in East Asian women than in women of other ancestry. Transplants of pubic hair may be considered as a procedure to help an East Asian woman recover satisfactory self-esteem.