What is hair transplant surgery?
Hair transplant surgery is performed to restore hair to areas of the scalp that are bald or that have thinning hair. There are multiple types of hair replacement surgery. Most commonly, these involve hair transplantation, but flap surgery, tissue expansion of the scalp and scalp reduction surgery, are also methods used for hair replacement. Each of these types of surgeries can be used alone, or in combination, to provide the patient with the best possible outcome for hair replacement.
Hair transplantation involves removing small pieces of hair-bearing scalp from a donor site and using them as grafts to be relocated to a bald or thinning area of the scalp.
What hair transplant procedures are recommended for women?
Some doctors estimate that one in five women will experience some degree of hair loss usually caused by aging, illness or hormonal changes after menopause. Women tend to experience a subtle thinning all over the scalp rather than losing hair in patches as is common in men. To correct the problem, some women choose to wear a wig or hair extensions. Others have had some success using a topical prescriptive drug. The effectiveness of such drugs varies in some patients and simply prevents further hair loss without stimulating any appreciable new growth. Hair transplant surgery may be the answer for those who feel uncomfortable with either of these options.
Because mini-grafts are usually the surgical treatment of choice for filling-in thinning areas, good candidates for this procedure should have dense hair growth at the back of the head. Mini-grafts are harvested from this dense area and replanted in thinning areas to create a fuller look. Occasionally flap and tissue expansion procedures may be used if the individual is judged to be a good candidate.
If you’re considering a hair transplant procedure, it’s important to understand that you will never have the coverage you had prior to your hair loss, but surgery may camouflage the thin areas and give you more fullness.
How should I prepare for hair transplant surgery?
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly. If you smoke, it’s especially important to stop at least a week or two before surgery; smoking inhibits blood flow to the skin and can interfere with healing.
You should arrange for someone to drive you home after your surgery. Plan to take it easy for a day or two after the procedure and arrange for assistance if you think you’ll need it.
What are the steps of a hair transplant procedure?
Hair transplantation involves removing small punch grafts from the hair bearing scalp or a larger piece of this scalp from a donor area and cutting this into smaller pieces to use as grafts. These grafts are then relocating to a bald or thinning area of the scalp. The grafts created in this manner differ in size and shape. Round-shaped punch grafts usually contain about 10-15 hairs. The much smaller mini-graft contains about two to four hairs; and the micro-graft, one to two hairs. Slit grafts, which are inserted into slits created in the scalp, contain about four to 10 hairs each; strip grafts are long and thin and contain 30-40 hairs.
Generally, several surgical sessions may be needed to achieve satisfactory fullness, and a healing interval of several months is usually recommended between each session. It may take up to two years before you see the final result with a full transplant series. The amount of coverage you’ll need is partly dependent upon the color and texture of your hair. Coarse, gray or light-colored hair affords better coverage than fine, dark-colored hair. The number of large plugs transplanted in the first session varies with each individual, but the average is about 50. For mini-grafts or micro-grafts, the number can be up to 700 per session.
Just before surgery, the “donor area” will be trimmed short so that the grafts can be easily accessed and removed. For punch grafts, your doctor may use a special tube-like instrument made of sharp carbon steel that punches the round graft out of the donor site so it can be replaced in the area to be covered—generally the frontal hairline. For other types of grafts, your doctor will use a scalpel to remove small sections of hair-bearing scalp, which will be divided into tiny sections and transplanted into tiny holes or slits within the scalp. When grafts are taken, your doctor may periodically inject small amounts of saline solution into the scalp to maintain proper skin strength. The donor site holes may be closed with stitches—for punch grafts, a single stitch may close each punch site; for other types of grafts, a small, straight-line scar will result. The stitches are usually concealed with the surrounding hair.
To maintain healthy circulation in the scalp, the grafts are placed about one-eighth of an inch apart. In later sessions, the spaces between the plugs will be filled in with additional grafts. Your doctor will take great care in removing and placement of grafts to ensure that the transplanted hair will grow in a natural direction and that hair growth at the donor site is not adversely affected.
After the grafting session is complete, the scalp will be cleansed and covered with gauze. You may have to wear a pressure bandage for a day or two. Some doctors allow their patients to recover bandage-free.
