Hair transplantation is an operation that takes hair from the back of the head and moves it to the area of hair loss. The fringe (back and sides) of hair on a balding scalp is known as donor dominant hair which is the hair that will continue to grow throughout the life of most men. The transplantation of this hair to a bald area does not change its ability to grow. Donor dominance is the scientific basis for the success of hair transplantation.

Candidates for hair transplant surgery are those individuals with hair loss that have sufficient donor hair from the fringe of the scalp to transplant to the balding area. In the past, many bald patients were not suitable candidates for hair transplant surgery but modern techniques have advanced the art of hair transplant surgery so that many more men are candidates.

Hair transplantation surgery has improved in leaps and bounds over the past decade. The days of the "plugs and corn rows" are gone and the age of single hair-, micro-, and mini- grafting has arrived. Through the use of the these variable sized hair grafts along with new and improved instrumentation, the accomplished hair transplantation surgeons can create a natural hair appearance that is appropriate for each individual patient. Single hair-grafts have the finest and softest appearance. Although they do not provide much density, they do provide the critical soft hairline that is the transition to thicker hair. Reconstructing a new hairline is a skill requiring surgical as well as artistic skill. It is critically important to get it right the first time and thus requires considerable forethought and planning.

Examining the hairline of a non balding person will show the presence of numerous single hairs in the very frontal hairline. Micro grafts are small grafts containing 2-3 hairs that are placed behind the hairline to provide a gradually increasing hair density. Lastly, mini grafts contain 4 or more hairs are placed well behind the hairline so that the single hair and micro grafts can blend naturally into the density provided by these larger grafts.

The side-effects of hair transplantation surgery are relatively minor consisting of mild pain and discomfort after the operation, swelling which may move down to the eyes, and the formation of scabs over the grafts which take approximately one week to resolve. Serious problems of bleeding, scarring, and infection are rare. Modern hair transplantation surgery is comfortable, predictable, and the results are pleasing to most patients.

What causes hair loss?

The most common cause of hair loss is inheritance. Men and women inherit the gene for hair loss from either or both parents. Men are most commonly affected by the inherited gene as the hormone, testosterone, activates the genetic program causing loss of hair follicles. Currently there is no known method of stopping this type of hair loss. The age of onset, extent, and rate of hair loss vary from person to person. Severe illness, malnutrition, or vitamin deficiency can accelerate this process. When applied incorrectly, permanent hair color and chemical relaxers damage the hair and follicle to the extent that hair loss can be permanent. Causes of hair loss do not include wearing a hat, excessive shampooing, lack of blood flow, or clogged pores.

Do hair transplants really work?

Yes. The transplanted hair is removed from one area of the body (donor site) and transferred to another (recipient site). The transferred tissue is not "rejected" as it is not foreign tissue. The transplanted hair maintains it's own characteristics; color, texture, growth rate, and curl, after transplantation and regrowth. The vitality of the grafted follicle is maintained by the rich blood supply to the scalp. Originally, large circular grafts containing 15-20 hairs were transplanted resulting in noticeable and unnatural results. Over years, instruments and techniques have been developed that allow us to achieve truly natural results by transplanting small grafts very close together. We have found that hair grows from the scalp in groups of one, two, and three hair follicles. We transfer these groups of follicles after eliminating the excess surrounding fatty tissue. This allows the grafts to be placed closer together resulting in a denser and more natural result.

What can be expected after hair restoration surgery?

The post-operative course will depend on adherence to the instructions given after surgery. Small scabs will form on the scalp at the graft sites. Generally speaking, these scabs disappear in 4-7days. Shampooing can be resumed 24 hours after surgery. The suture (stitch) used in the donor area is undetectable as it is completely covered by your existing hair. An appointment will be made for the suture to be removed one week after surgery. It is advisable to take at least two days off work after surgery. A baseball type cap can be worn at anytime after surgery. Patients should avoid strenuous physical activity for at least five days after surgery. Typically the grafted hair will shed in 2-4 weeks. New growth will begin in 3-4 months and length will increase approximately 1/2 inch per month.

Are hair transplants painful?

Most people are surprised at how little pain there is during the procedure. Some discomfort is to be expected as the anesthetic is injected into the scalp. Once the skin is anesthetized, there is no pain. If the numbing medicine wears off during the course of the procedure, more is injected to re-anesthetize the area.

What will it look like after the procedure?

The grafts form small scabs in the days after the procedure. If one has enough surrounding hair, these scabs can be camouflaged with creative styling. If not, the small scabs may be visible but do not attract much attention. By keeping the scalp moist, the scabs usually come off in about a week or so.

When can I go back to work?

Depending on the type of procedure you have done and the type of work you do, it is often possible to go back to work the next day. Your hair restoration surgeon will discuss this with you during the consultation.

Are hair transplants expensive?

Hair transplantation is more expensive than a hair piece or some alternative treatments. However considering that the results are permanent, most people consider it a good investment in their future happiness.

How many sessions will be required?

The number of the sessions will depend on the 1) area of scalp treated 2) the number and size of grafts used and 3 )the density which the patient desires 4) the individual characteristics of the patient, e.g. coarse hair will provide a more dense look than fine hair. The estimate of the number of sessions can be discussed during the consultation with your surgeon.

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