Plastic Surgery

Hair transplantation

What is the Hair transplantation?

Hair transplantation is a surgical technique that involves moving individual hair follicles from one part of the body (the donor site) to bald or balding parts (the recipient site). Since hair naturally grows in follicles that contain groupings of 1 to 4 hairs, today’s most advanced techniques transplant these naturally occurring 1–4 hair "follicular units" in their natural groupings. This hair transplant procedure is called Follicular Unit Transplantation (FUT). The older hair transplantation procedures used larger grafts and often produced a pluggy, unnatural look.

Hair transplanting is most commonly performed for Male Pattern Baldness (MPB) and Female Pattern Hair Loss (FPHL). However, it can also be used to produce hair in scarring secondary to surgery, trauma or burns.

What is the procedure?

FUT technique is actually a two-step procedure.

During the first step, donor hair is harvested. Donor hair can be harvested in two different ways:

1) Strip harvesting - a strip of scalp is removed under local anesthesia, the wound is then sutured back together and this piece of scalp tissue is then cut in to small pieces of tissue called grafts which are then transplanted back in to the thinning area of the patient's head. This method will leave a linear scar in the donor area, which should be covered by a patient's hair (if long). The recovery period is around 2 weeks and will require the stitches to be removed by medical staff.

2) Follicular Unit Extraction or FUE Harvesting. This is a direct extraction of follicular units from the patient's donor area is performed. It allows the surgeon to select individual follicular units from a donor region in a pattern that virtually solves the potential problem of visibly lower donor area density after the procedure. The surgeon uses a small punch (a sort of a special needle) (0,75 - 0.9 mm diameter)to pluck out the follicular units, eliminating the need for excision of skin from the back of the head. Benefits of FUE are: a quicker healing time, far less trauma, no strip scar, and the surgeon's ability to individually select follicular units (by selecting the healthiest follicles the re-growth in most patients can be pushed to 100%). Discomfort in the donor area has been practically eliminated.

As soon as the grafts are extracted, they are prepared for their placement in the recipient area under a state of the art technology stereo microscope.

The second part of the procedure is the Follicular Implantation. The surgeon uses a fine needle to puncture the sites for implanting the grafts, creating micro-holes (incisions) with predetermined density and pattern, and angling them in a consistent fashion to promote a realistic hair pattern. This is then followed by the final phase when the surgeon inserts the grafts in the prepared incisions.

Usually hair transplant surgeries are performed on an outpatient basis, with mild sedation (optional) and injected local anesthesia.

What kind of result can you expect?

There are several benefits of having a hair transplant which include a relatively quick procedure, an improved physical appearance and a much needed boost to your confidence and self-esteem.

If done correctly the end result is a fine head of hair which is indistinguishable from the rest of your natural hair and in many cases, is thicker. In fact, many people will be unable to tell the difference.

Recovery period and recommendations

After the surgery, it’s likely that your scalp will be sore and swollen; and in some cases this swelling will have reached your forehead and eyebrows and feel tender to the touch.

If you have undergone micro grafting then you will have a bandage in place at the back of your head where the donor strip was removed. This bandage must remain in place for at least a day after the transplant but can be removed after then. Any stitches in place will be the dissolvable type but if not then you will be asked to return to the clinic 2 weeks after surgery to have them removed.

The vulnerable recipient area must be shielded from the sun, and shampooing is started two days after the surgery. Shampooing is important to prevent scabs from occurring around the hair shaft. Scabs adhere to the hair shaft and increase the risk of losing newly transplanted hair follicles during the first 7 to 10 days post-op.

During the first ten days, virtually all of the transplanted hairs, inevitably traumatized by their relocation, will fall out (“shock loss”). After two to three months new hair will begin to grow from the moved follicles. The patient's hair will grow normally, and continue to thicken through the next six to nine months.

Possible side effects and complications

A hair thinning, known as "shock loss", is a common side effect that is usually temporary. Bald patches are also common, as fifty to a hundred hairs can be lost each day.

Other side effects include swelling of areas such as the scalp and forehead. If this becomes uncomfortable, medication may ease the swelling. Additionally, the patient must be careful if his scalp starts itching, as scratching will make it worse and cause scabs to form. A moisturizer or massage shampoo may be used in order to relieve the itching.

Several years after the surgery, more hair loss can occur, with the transplanted patches staying in place. This results in odd patches of hair, unless they are removed, or unless more hair is transplanted.

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