Areas of Surgery

Hair

If you are suffering from hair loss, you should know some facts.

The common male pattern hair loss occurs from a combination of family history of baldness, aging and exposure to male hormones (testosterone). Sometimes, this problem is seen in females as well. The earlier that hair loss begins in a person, the more severe the loss will be.
Hair loss can also occur along with loss of the scalp as in trauma or burns. In such cases, it is considered as a reconstructive surgery and may be covered by insurance. This write up is meant to give you a basic idea of issues involved in hair transplant to correct hair loss. It is unlikely to answer all your questions, since a lot will depend on individual circumstances.

Q: Who is the right candidate for hair transplant?

Though a hair replacement surgery will significantly enhance your self-confidence and looks, the results may not necessarily match your ideas. Hence, it is necessary to be clear about your expectations and discuss them with the surgeon.

The person needing hair replacement procedure must have healthy hair growth at the back & sides of the scalp to be used as a donor area. Donor areas are the areas from which hair grafts/flaps are taken. Other factors with a bearing on the final result include the colour, texture and waviness of the hair.

There are a number of techniques used in hair replacement surgery; sometimes two or more techniques may be used to give the best results. Usually minigreafts, micrografts are used when a modest improvement in hair fullness is desired. Techniques such as scalp reduction, flap surgery or scalp expansion are needed when a more dramatic improvement is needed.

There are always limits to what medical science can achieve. A person with sever hair loss and very little hair may not be a good candidate for hair replacement surgery; as is someone with very minimal hair loss.

Q: What exactly is hair transplantation?

The most commonly performed procedure involves mini and micro hair grafts. A strip of skin from the backside of the scalp is removed, avoiding damage to the tiny roots. The edges of the resulting wound are pulled together and stitched up to give an appearance of a normal scalp.

The strip of skin is then separated into tiny pieces of skin, each having about 1-4 hair in it, each with it's follicle and root intact. Each such unit (called follicular unit) is placed into small openings made in the scalp at the site of hair loss to complete the hair transplant procedure.

During an initial period of consolidation of the hair roots, the visible hair (shaft) is initially lost before a new one grows over 3-4 months. This is permanent and managed like normal hair-it can be styled, combed and cut like usual.

Q: How long does the surgery take?

Usually 800-1000 grafts can be done in about 4-6 hours. The procedure is done under local anaesthesia; and the patient can take a break in between the procedure and have some light liquids.

Q: Do the results of the surgery look normal?

The distribution of the hair grafts and new hairline are can be chosen by the patient before surgery with suggestions from the surgeon. The density of the hair transplant can be improved by a second procedure after 6 months if needed, as the grafts cannot be placed too close together in a single procedure.

Once the new hair starts growing in 3 months, it can be styled, combed, shampooed, cut and managed like normal hair.

Q: What all is considered in the initial discussion with the surgeon?

Please mention frankly your expectations in the initial consultation with the surgeon, including details about the desired hairline, hair density.

The surgeon will give an opinion on the same issues, after examining the area of hair loss as well as the quality and quantity of available hair.

Q: What are the risks/complications associated with the surgery?

General complications associated with any surgical procedure such as bleeding and infection are usually not a problem with this procedure. Specific problems include mainly inadequate density of the hair, which will be explained on a case to case basis when relevant.

Q: Will the scars of the surgery be seen?

There are no scars where the hair has been transplanted. If the donor area has been removed as a strip of skin, the fine scar is hidden between the hairs.

Some details of the procedure.

The procedure begins with an injection of a local anaesthetic into the donor area at the back of the scalp. Once the skin strip is removed, the patient can relax while the hair grafts are prepared from the skin strip.

Q: What preparations are required before the surgery?

Smoking is to be stopped 2 weeks prior to the surgery.
Aspirin and blood thinning drugs may need to be stopped few days prior to the surgery.
Few hours of fasting are needed prior to the surgery.
An adult accompanying is needed for the duration of the procedure.

Q: What can I expect immediately after the surgery?

There will be a dressing and bandage to the entire scalp. Medicines are to be taken immediately on completion to prevent soreness to the operated part if any.
On completion, a dressing and bandage is given for 3 days and the patient is allowed to g home. After a week, a regular head shower can be taken. Stitches, if any, at the back of the scalp any are removed in 2-3 weeks time.

Q: How is the recovery after the surgery?

About 3 days rest after the procedure is sufficient, till the bandage is removed. The transplanted hair grafts are seen as black spots, which will disappear in a few days once the hair falls off.
Local care with a few lotions and some pills will suffice till the new hair starts to grow.

Q: What is the long term outcome after the surgery?

The only alternative to this procedure is the use of wigs or hair weaving, which cannot be compared to the results of a hair transplant procedure. The alternate remedies are temporary, cannot be managed like natural hair and may use hair that comes from someone else.

The confidence gained from the natural look after a hair transplant gives a new confidence and zeal to life.