Hair transplantation involves removing a strip of permanent hair-bearing skin from the back or sides of the scalp (donor area) and then, using various techniques, the strip is usually dissected into microgratfs (containing 1-3 hairs) and minigrafts (containing 3-6 hairs) each. The micro/minigrafts are then meticulously planted into the bald or thinning area of the scalp (recipient area). The creation of very small micrografts (follicular units) has allowed very natural, feathered hairlines to be grafted and avoids an abrupt “pluggy look”, that was typical many years ago. A minigraft can be used behind the hairline for added density.
Depending on the degree of balding for the frontal area and similarly for the crown area, 1-3 proceedures involving several hundred or perhaps 1000 or more grafts may be required to achieve the desired density (of course, more procedures could be done if hair loss progresses or greater density is desired. Within 24 hours small crusts will form on each graft which are shed in approximately 7-10 days. The grafted hairs will often start to grow by 6-12 weeks after the procedure and will continue to grow for a lifetime.
Who benefits from hair restoration surgery?
- Anyone who has experienced permanent hair loss may be a candidate for hair restoration surgery, including:
- Men with male pattern baldness,
- Some women with thinning hair – female pattern thinning,
- People with areas of scarring from injuries or hair loss after face lift procedures, and, People who want to thicken or restore eyebrows and beards.
What happens during a hair transplant surgery?
Hair transplant procedures generally take from 2-6 hours and are performed using a local anaesthesia on an out-patient basis. Patients are often awake but feel relaxed as they are given a mild sedative. There is usually little or no pain during the surgical procedure. If a turban-type bandage is placed on the scalp at the end of the procedure in order to keep the grafts snug and secure overnight, it will be removed the next day. Many surgeons use no dressings. The donor area, where the permanent grafts are taken from, is closed with either sutures or surgical staples that are removed in 7-12 days. Dissolvable sutures may be used in order to eliminate the need for you to return for suture removal.
What happens after hair transplant surgery?
Hair transplantation is a very safe, relatively minor surgical procedure. Patients are provided with a mild analgesic to relieve any discomfort felt the night following the procedure. Patients may be asked to use moist compresses or sprays and to sleep in a semi-upright position for 2-3 days following the procedure to minimise swelling and bruising. Small crusts may form on each graft that can be camouflaged by any existing hair that can be combed over the recipient area. These crusts will flake-off by 10-14 days after the surgery. The transplanted hair seen above the scalp will initially be shed, however the roots will remain dormant for 6-12 weeks, at which time the new hairs will begin to grow. Numbness that may occur in the donor area or recipient area usually disappears in 2-8 months following surgery.
Complications are rare. Minor infections can occur around a newly transplanted hair follicle, similar to an infected ingrown hair or pimple, and responds easily to antibiotics. Minor scars that occur in the donor scalp as a result of the removal of donor skin are narrow and can be easily hidden by the surrounding hair. The graft sites in the recipient frontal area heal with almost no visible scarring and are covered by the transplanted hair. Patients may experience mild swelling to the forehead area for a few days following surgery and on rare occasions may actually experience a black eye if the frontal scalp is transplanted.
When should I start treatment?
Patients may have hair restoration surgery at any age. It is often better to start when you are not completely bald so that you can use existing hair to help camouflage the procedures. However, because hair loss tends to be both gradual and progressive, it is often unwise to start surgical treatment in a patient who is very young. Medical treatments such as Finasteride and Minoxidil may be offered to men with mild to moderate hair loss to help preserve thinning hair in the crown. Hair transplants can be used to fill-in the front hairline and thicken the front half of the scalp, and medical treatments can be used to maintain hair behind the transplants and to possibly enhance the long-term results of hair restoration surgery. Your hair restoration surgeon will work with you to design an individualised plan to fulfill your specific needs.