Hair transplants are taken from other parts of the scalp and moved to bald spots. The donor spot is repaired and the transplanted hair can then create new hair to fill in the empty places. Dermatologists can remove large sections or individual follicles to perform a hair transplant.
Baldness and Hair Loss
Alternative treatments have not been proven effective in treating hair loss. They may also have dangerous side effects. You can, however, take care not to damage your hair with excessive blow-drying or tight ponytails.
Your surgeon will provide specific instructions on how to prepare for surgery. Preparation will include guidelines on eating, drinking, smoking, which vitamins you should take and which vitamins and medications you should avoid. Following these instructions will help ensure that surgery goes smoothly. If you smoke cigarettes, it is especially important to stop at least a week or more before surgery. Smoking inhibits blood flow to the skin and it can slow healing.
You should wash your hair the night before or the morning of surgery. Don't bother getting a haircut before the procedure. Surgeons say moderately long hair helps to conceal the donor sites just after surgery.
Hair transplants rarely require a hospital stay. You should arrange for someone to drive you home following surgery. Plan to take it easy for a few days and arrange for help if you think you will need it.
Hair replacement surgery is an individualized treatment. It is important to make sure every surgical option is available to you. Doctors who have experience performing all types of replacement techniques - not just the one procedure that he or she claims will solve your hair loss problem - offer the best options.
In your first meeting, with the surgeon he or she will evaluate your hair growth and loss, will ask about any previous hair replacement surgery and will review your family history of hair loss. The surgeon will also ask about your lifestyle and discuss expectations and goals. You need to discuss any medical conditions that could create problems during or after surgery - including uncontrolled high blood pressure, problems with blood-clotting or the tendency toward excessive scarring. Be sure to tell the surgeon if you smoke or are taking any medications, especially aspirin or other drugs that might affect clotting.
Once you and the surgeon have agreed on the best procedure for you, your doctor will explain anesthesia, the place where the surgery will happen (usually in the surgeon's office or in an outpatient clinic) as well as the risks and costs involved. This is not the time to be shy - ask as many questions as you can think of. Make sure you understand every procedure that will be used and how long each procedure will take. The number of surgical sessions required depends on each individual patient, the extent of that patient's baldness and the number of grafts performed in each session.
Find out if your doctor does megasessions - which are single sessions in which up to 3,000 grafts are perfomred at once - or if the surgeon uses more traditional short sessions that include fewer implants. This is a hot topic of debate currently in the hair replacement industry.
It's always a good idea to ask your surgeon to give you an idea of what you might look like after the procedure. You might also ask, in the case of grafts, what you will look like after each stage of treatment. The surgeon will give his or her best estimate. Try not to hold the surgeon to it.
For years, tissue expansion has been used by plastic surgeons to repair burn wounds and injuries with significant skin loss. Use of tissue expansion in hair replacement surgery has had dramatic results with significant hair coverage in a relatively short time.
In this technique, a balloon-like device (a tissue expander) is inserted beneath hair-bearing scalp. The device is gradually inflated - filled with salt water - over several weeks. This causes the skin to expand and grow new skin cells. Eventually, a bulge will form beneath the hair-bearing scalp.
When the skin beneath the hair has stretched enough - which could take about two months after the first operation - another surgery is performed to pull the expanded skin covering an adjacent bald area.Helpful? 1 person found this helpful.
In scalp reduction surgery, which has become fairly common, sections of hair-bearing scalp are pulled forward to fill in a bald crown (the procedure is not useful for covering frontal hairlines).
During the procedure, the scalp is injected with a local anesthetic and a segment of bald scalp is removed. If a large amount of coverage is needed, the doctor can remove a section of scalp in an inverted Y-shape. Scalp removal can also be shaped like a U or a pointed oval.
The skin surrounding the removed area is loosened and pulled. Now, the surgeon can take the sections of hair-bearing scalp and bring them together. The seam is closed with stitches. The patient will probably feel a strong pulling at the stitches that might include some pain. Usually, multiple scalp reductions are performed; their success depends on the scalp's laxity and the degree of hair loss. The patient's age also becomes a factor. Almost all scalp reductions are performed in combination with hair flaps surgery or hair grafts.
For success, multiple surgeries are usually required. The skin on most heads is not very elastic. Removing more than a few square inches of scalp in each surgery is not common. The procedures may take months. Each session includes pain and healing cycles. Between each procedure, scars may be very noticeable and the skin of the head may feel very tight for quite a while.
Hair transplantation these days is performed with much smaller grafts than in years past. The only major controversy in the field today is whether surgeon should use staged restoration or megasessions.
Traditionally, surgical hair restoration has been staged in multiple surgical sessions. A typical session would average between 150 and 300 grafts. Each session is spaced three to four months apart. Depending on a patient's degree of balding, four sessions or more could be scheduled. Using staged sessions, the full effects of the transplant could take up to two years to be seen.
In more recent years, there has been a trend toward placing more grafts in each session - as many as 3,000 per session. Technically, these megasessions are more demanding on surgeons and allow a slimmer margin for error. Because they are so lengthy, they require more staff. For example, a large session that might involve 2,000 grafts may take more than eight hours and may require up to four or five assistants. In many cases, the physician will remove the sections of hair-bearing scalp then close the resulting wound. He would hand the donor hair to assistants, who are responsible for preparing the grafts for transplantation and placing them (the doctor makes the holes where the grafts are placed).
Proponents of megasessions say it is appealing because it requires fewer surgeries over a shorter period of time to achieve hair restoration. Since many doctors charge less per graft when larger numbers are placed, patients might also see financial advantages with this option. If someone is traveling out of town to have the surgery, he probably wants as few sessions as possible.
Surgeons opposed to megasessions say grafts are packed very close together during megasessions, therefore overall graft survival is not as good. Critics also say, since hair loss is an ongoing process, multiple smaller sessions allow for more flexibility as the future unfolds.
Wouldn't it be nice to wake up tomorrow morning with a full-grown frontal hair line made of your own natural hair? Well, only one procedure offers that possibility.
A surgical technique called "flaps" is about 20-years old procedure. It uses a much larger portion of hair-bearing skin - called a flap. The flap is transferred from hair-bearing parts of the head (like the sides or back) to the balding area. The flap's size and its placement depend mainly on the patient's needs. A hair-bearing flap (which replaces the need to use about 350 punch grafts) is sewn into its new position. As the flap heals, the scar will be hidden by relocated hair. That hair grows to the very edge of the incision.
Flaps transfer the greatest amount of hair in the least amount of time. But the surgery is more extensive and doctors who perform the procedure must have very specific training and experience. The treatment requires general anesthesia, and it does leave scars both above and below the flap. Adding another disadvantage, the angle of hair growth could remain the same as it was on the side of the head. This might look strange.
Recently, plastic surgeons have made significant advances in flap techniques. They can combine flap surgery with scalp reduction to create better coverage of the head's crown or they can combine flaps with tissue expansion to provide better frontal coverage resulting in a more natural hairline.
Hair transplantation involves the removal of small pieces of hair-bearing scalp from one site (the donor site) and relocating those pieces to holes in a bald or thinning area. This is usually done to the top of the scalp. Modern hair grafting techniques are performed by many physicians in many clinics throughout the world. New hair is not added during this procedure. Existing hair and skin are simply relocated. Grafts can vary in size and shape:
- Punch grafts are round grafts usually containing about 10 to 15 hairs
- Mini-grafts are much smaller grafts containing 2 to 4 hairs
- Micro-grafts are tiny grafts containing 1 or 2 hairs
- Slit grafts are thin grafts that contain about 4 to 10 hairs
- Strip grafts are long, thin grafts containing 30 to 40 hairs
Many surgical sessions may be needed to achieve fullness. A healing interval - of several months between each session - is usually recommended. It could take up to two years before final results of the transplant series are seen.
Just before surgery, the donor site will be trimmed short. This is to ensure the grafts can be easily removed. The donor and recipient sites are treated with a local anesthetic. If the surgeon is making punch grafts, he or she might use a special tube-like instrument constructed from sharp carbon steel to punch a round graft out of the donor site. The surgeon must be very careful to remove and place grafts so the transplanted hair will grow in a natural direction. Hair growth at the donor site also must not be negatively affected.
With other types of grafts, the doctor will use a scalpel to remove portions of scalp that have hair. These will be divided into tiny sections and transplanted into small holes or slits within the scalp.
The donor site holes can be closed with stitches (a single stitch usually closes each punch site). Stitches are usually concealed by the surrounding hair. Other types of grafts may cause a small, straight-line scar. To maintain healthy circulation in the scalp, grafts are placed about an eighth of an inch apart. In later sessions, the spaces between plugs will be filled in with additional grafts.
After grafting is complete, the scalp will be cleansed and covered with gauze. Depending on the doctor, patients might be required to wear pressure bandages for a couple of days or patients might be allowed to recover bandage-free.
Non-surgical hair additions can be added to existing hair or to the scalp to give the appearance of a full head of hair. Hair additions include hair weaves, hair extensions, hairpieces, toupees and partial hair prostheses. Devices can consist of human hair, synthetic fiber or both.
Partial hair additions, which are more popular than full wigs, can be attached in several ways. All techniques use either the existing hair or the skin to anchor the new hair. Weaving, fusion, bonding and cabling are all techniques used to attach the new hair to a person's existing hair. They are all dependent on the growing existing hair therefore they have to be reattached or tightened as the existing hair grows. This can cause a problem. Techniques that stress your existing hair, including weaves, can cause permanent damage if done incorrectly or if put on an inappropriate candidate.
Techniques using the skin as an anchor site include adhesives (like two-sided tape) and water-proof liquids. Most adhesives are safe. Still, it's always a good idea to have a dermatologist perform a patch test to check for skin allergies.
On the down side, these hair systems can be very high maintenance and, in the long run, can be more expensive than options such as surgery or medicinal hair growth solutions. Depending on materials and design, hair additions can cost from $750 to $2,500 or more for a quality custom-made piece. Although insurance generally doesn't cover the cost of hair replacement products for male or female pattern hair loss, it can sometimes cover the cost of a hair addition when the hair loss is the result of a disease or other abnormality.
The expense for hair additions is not limited to initial cost. You will always need two hairpieces - one that is worn and one that is being re-styled. And in about a year to 18 months, you need to replace both. The hair piece is constantly being dyed, brushed and permed so it will match your natural hair. After a while, just like natural hair, each strand will break or become over-processed.
You also have to visit the hair center at least once every four to six weeks so your hair can be trimmed and the piece can be reattached and blended.