By the time you notice it, half of it is gone
This is the most uncomfortable fact and the most useful one: an area of the scalp has to lose roughly 50 % of its density before baldness becomes visible to the naked eye. When a patient arrives saying "I started going bald this year", he has almost always been losing hair for years. What changed was not the disease. It was the threshold at which it became visible.
That carries a hard practical consequence. Hair already lost to androgenetic alopecia does not come back with any medication. What can be done — and it is a great deal — is to keep what remains. And to keep it, you have to know what is being lost, where, and how fast. That is a number, not an impression.
So the correct order is: measure first, decide second. The reverse — graft first, ask later — is how the results people post online to warn others get made.
Not all hair loss is the same hair loss
The word "alopecia" bundles together conditions that look alike in a mirror and look nothing alike under a lens:
The study exists precisely to separate them, because each has a different path and some are an absolute contraindication to grafting.
- Androgenetic alopecia — the common, hereditary, progressive one. The follicle miniaturises: hair comes in finer and shorter until it stops coming in at all. This is the one that gets grafted, when appropriate.
- Telogen effluvium — dramatic diffuse shedding after childbirth, surgery, illness, an aggressive diet or a period of major stress. It frightens far more than it damages: it usually recovers on its own. Grafting here would mean operating on someone who was going to get better without surgery.
- Alopecia areata — round patches, sudden onset. It is autoimmune. See the alopecia areata page: grafting is contraindicated.
- Cicatricial alopecias — the follicle is not miniaturised, it is destroyed and replaced by fibrosis. A graft will not take on active scarring. Catching these early is the difference between halting the damage and losing the area.
- Medical and nutritional causes — thyroid, anaemia, low ferritin, others. These are investigated in the clinic’s own laboratory, and if that is what it is, that is what gets treated.
What the study will tell you, whether you want to hear it or not
There are three sentences this study says often, and each one costs a sale every time it is said. They get said anyway.
"You are not a candidate for a transplant." It happens. It happens when the donor area is poor and cannot cover what needs covering; when the loss is in a fast, active phase; when the pattern makes it predictable that in five years new baldness will surround whatever was grafted; or when what you have is not androgenetic at all. Grafting anyway produces a strip of transplanted hair ringed by fresh baldness. It looks worse than doing nothing, and by then there is no donor left to fix it.
"First we stop the loss, then we talk about grafting." This is the most important one and the least popular. A transplant does not cure androgenetic alopecia. It relocates resistant follicles; it does not stop the native hair around them from miniaturising. Graft without treating the underlying process and the disease carries on — carrying on underneath freshly transplanted work. Supportive medical therapy is prescribed and supervised in consultation; it is not prescribed from a web page.
"What you have is not operated on. It is treated." And then there is no surgery, and it is right that there is none.
What the study is actually like
It takes one appointment. Nothing is shaved — and that matters, because classical trichoscopy required shaving a window into the patient’s scalp in order to count. It does not hurt, nothing is injected, there is no recovery: you walk out exactly as you walked in.
Images are captured from defined scalp zones — typically the area where the loss shows and an occipital reference zone, which androgenetic alopecia characteristically spares. The system counts and calculates: hair density (hairs per cm²), mean shaft thickness, number of follicular units, and the proportion of miniaturised hair, which is the real early marker of androgenetic loss.
Comparison against the reference zone is what turns a number into a diagnosis: if the affected area has lost thickness and units relative to the occipital zone, there is miniaturisation; if both fall together, a diffuse systemic cause has to be looked for — and at that point the path is no longer a surgical one.
The study is archived. That archive is half the value: at six months it is repeated and compared. It is the only honest way to know whether a treatment is working, because at six months no patient — not one — can judge his own hair in a mirror with any objectivity.
What happens after the study
The study is not a product. It is a fork in the road. Depending on what it shows, the path is one of these, and it is explained in writing:
- Supportive medical therapy, where there is active miniaturisation. Prescribed and supervised in consultation. It is the foundation any later result rests on.
- Investigation of a systemic cause (thyroid, iron, others) where the pattern is diffuse — with the clinic’s laboratory in the same building.
- Hair transplantation, where the donor area is sufficient and the loss is controlled. See hair transplant, and the guide how many grafts do I need?.
- Robot-assisted grafting with ARTAS iX, where the case calls for it — image-guided follicular extraction. See ARTAS iX transplant.
- Beard and moustache — same principle, different zone. See beard and moustache transplant.
- Nothing, for now — with a review at six months. It is a legitimate outcome and it is more common than the hair industry admits.
The equipment behind the measurement
The study is performed with HairMetrix, by Canfield (United States): AI-assisted digital trichoscopy. It measures density, thickness and follicular units without shaving, and delivers what no patient can judge alone in front of a mirror: whether the hair treatment is actually working — a number instead of an impression.
Where the path is surgical, extraction may be performed with the ARTAS iX robot (Venus Concept), and the surgery is performed by Dr. Arístides Arellano Huacuja, plastic and reconstructive surgeon, a member of the International Society of Hair Restoration Surgery since 1996. The study and the medical management of hair loss belong to the clinic’s consultation, founded in 1971. On this site each person appears with the specialty they actually hold; to understand which specialist matches which problem, read dermatologist or plastic surgeon?.
The cost of the study is defined at the consultation; see the price list for other procedures.
Dr. Arístides Arellano is a plastic surgeon holding a specialty licence: he practises under a Mexican medical licence (D.G.P. 1125959) and a specialty licence in Plastic & Reconstructive Surgery (0002008), both issued by the Directorate General of Professions (DGP), which reissued his certificate of professional standing in 2025. His career began before Mexico’s present-day specialty-board system existed: he belongs to the founding generation of plastic surgery in Puebla, the second generation of a surgical tradition started in 1971 by Dr. Francisco Arellano Ocampo. Trust is verified, not promised: both licences are public and anyone can look them up in the DGP’s National Registry of Professionals.
Trust is verified, not promised. All 210 scanned documents —degree, licences, diplomas, publications and certificates, from 1977 to 2025— are open in Dr. Arístides Arellano’s credential archive, alongside an explanation of the difference between a specialty licence and a board certification.
The plan · what happens after the study
- Same dayThe study is performed and the numbers are explained in the same visit: density, thickness, follicular units and the proportion of miniaturised hair, compared against the reference zone. No shaving, no pain, no recovery.
- Week 1The written plan is issued: what kind of loss this is, what is causing it, and which path applies — medical, surgical, systemic investigation, or none for now.
- Months 1–3If there is supportive medical therapy, this is the adherence phase. Nothing is visible yet. It is precisely the phase in which most people quit — which is why most people do not improve.
- Month 6 — the review that mattersThe study is repeated and the numbers are compared against day one. This is where you find out, with data rather than impression, whether the treatment is working. If it is not, it changes; if it is, it continues.
- Month 12 onwardIf a graft is indicated, it is planned on top of loss that is already controlled — the only way a transplant ages well. Annual hair review for life: androgenetic alopecia is controlled, not cured.
Frequently asked questions
Does my head have to be shaved for the study?
No. That is precisely what distinguishes the system used here: digital trichoscopy measures density, thickness and follicular units on the hair as it is, without shaving a window into the scalp. You walk in and out unchanged.
Does the study hurt, or need recovery time?
Neither. Nothing is injected, nothing is cut, and there is no recovery period. It is an imaging study: captures are taken from defined scalp zones and the system counts and calculates on them.
If I have the study done, am I going to be told to get a transplant?
Not necessarily — and that is the whole point of doing it. A fair number of studies end in "you are not a candidate", in "we stop the loss first", or in "this is not operated on, it is treated". If the study could not say no, it would not be a study. It would be a sales argument.
Does a transplant stop the hair I still have from falling out?
No. A transplant relocates resistant follicles into the bald area; it does not stop the native hair around them from miniaturising. That is why, in active androgenetic alopecia, the loss is first controlled with medical therapy prescribed in consultation, and only then is a graft considered. Grafting without controlling the underlying process produces, over the years, a transplanted strip ringed by fresh baldness.
I have been shedding heavily for three months, after an illness. Should I get a transplant?
Almost certainly not, and it is worth knowing that before spending. Dramatic diffuse shedding appearing weeks or months after childbirth, surgery, illness or an aggressive diet suggests telogen effluvium, which generally recovers on its own. The study exists precisely to tell it apart from androgenetic loss — because the treatment, and the decision not to operate, are opposites.
How often is the study repeated?
The key review is at six months, because that is the first point at which real change is measurable. After that, annually. The comparison is the value: one study tells you where you are today; two studies tell you where you are heading — which is the question that actually matters.
Every case is different. Discuss yours in a personal consultation.
Book a consultation on WhatsAppEvery figure published on this site is approximate and is not a quote. Any procedure or treatment first requires a private assessment consultation with Dr. Arístides Arellano —$800 MXN, charged separately— and it is at that consultation that the definitive cost of your case is determined.
Educational content; it does not replace a medical consultation. Results may vary from person to person.