Hair Loss - All You Need to Know About Hair Transplantation

All You Need to Know About Hair Transplantation

Author:

Assistant Professor of Clinical Dermatol

New York University School of Medicine

Medically Reviewed On: December 04, 2001

Hair transplantation is a relatively simple operation that can do wonders for people who suffer from hair loss-whether it is hereditary, due to an illness or accident. Getting a full head of hair often provides the confidence that allows people to feel better about their appearance. Below, Dr. Michael Reed answers some common questions about this procedure.

Why have a hair transplant?
Men get hair transplants to achieve a more or less permanent correction of hair loss in order to restore a more youthful self-image and improve self-esteem.

Who can get a transplant?
Any person with noticeable hair loss-including thinning hair and bald areas-and whose remaining hair is capable of growing in a transplanted location (called a donor-dominant condition), is a candidate for hair transplantation. A donor-dominant condition is one in which transplanted hairs are able to survive at a new location, and will live and produce hairs as they would have in their previous location.

The most common condition treated is so-called male-and female-pattern androgenic alopecia (hereditary hair loss). However, other conditions such as scarring disorders resulting from injury, diseases, or previous surgery of the scalp, can also be treated with hair transplantation.

When should a hair transplant be done?
A hair transplant can be done any time after there is sufficient hair loss in a particular area-such as the front, middle, or top of the scalp-so that noticeable thinning is present on casual examination. Hair loss actually begins long before it is noticeable; Approximately 50 percent of the hairs in a given area are lost before noticeable thinning becomes apparent.

How is a hair transplant done?
A variable sized section of living scalp containing live hair follicles is removed from the back of the head (donor area) and subsequently microdissected into small follicular unit grafts that are implanted into small surgically prepared recipient sites in the balding area (recipient area). The surgical sites heal in 7 to 14 days, and after a delay of 8 to 12 weeks, the transplanted hairs begin to produce new hair shafts.

Where is a hair transplant done?
Hair transplants are done in an outpatient setting. Patients walk in and walk out the same day. They are given oral, or in some cases inhalant or intravenous sedation, followed by local anesthesia to the donor and recipient sites.

What are the main difficulties experienced by a patient before, during, and after a hair transplant?
The main problems encountered by patients before hair transplantation are usually concern about the cosmetic down time in the postoperative period, and varying degrees of anxiety about potential discomfort during and after the procedure. During the procedure, the patients often become restless due to the prolonged time required to achieve the results and because of this, sometimes have difficulty refraining from talking and moving, which makes the procedure more difficult for the surgeon and the assistants. Finally, after the procedure, the patients experience variable degrees of discomfort at the donor site and variable degrees of swelling of the forehead that resolve in a few days. Also, patients often experience self-consciousness caused by the tiny scabs that are present in the recipient sites.

Which regions of the scalp are best suited for hair transplantation?
The frontal scalp and the midscalp are the areas best suited for microsurgical hair restoration. The so-called bald spot (vertex) can also be corrected, but is somewhat less desirable.

Can a completely bald head be completely restored by hair transplant surgery?
The answer is no, but this is a trick question. Obviously, a completely bald head cannot be transplanted, because it has no donor hair to transplant! Even a very bald scalp cannot be completely transplanted since the size of the donor area and the number of hairs present are smaller than the potentially bald area on the top of the head. However, if the potential donor site is sufficiently large and reasonably dense, a surprisingly large number of hair follicles are available for transplantation to the top of the head, and fairly large areas of balding scalp can be covered adequately with hair that is both natural and reasonably dense in appearance.

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