Hair Transplantation: What Should You Expect?

Everything You Want to Know Before Having a Hair Transplant

A good head of hair is one thing many people, especially the young, often take for granted – or so it seems. But that’s something others are trying frantically to have. Hair transplantation is one of the options your doctor may suggest if you belong to the latter group of individuals desiring to get their hair back.

This procedure is usually the option of last resort – and for good reasons as well. Are you considering a hair transplant or someone suggested you should have one? It helps to know the pros and cons before proceeding. Here, you will find information on all you need to know about this hair loss treatment.

What is Hair Transplantation?

Hair transplantation is a surgical procedure that involves transfer of hair from one part to another where there is little or none. Hair follicles are removed from one part of the body described as the donor site and transplanted to a balding area. The procedure is mainly used for treatment of androgenic alopecia or pattern baldness.

The approach to hair loss treatment has been around for several decades. Doctors have been performing hair transplants in the United States since the 1950s. Over the years, there has been significant improvement in the methods that are used.

Although what usually comes to mind at the mention of hair transplant is treatment for hair loss on the scalp, it is not only useful for that. Transplantation can also be carried out to correct issues affecting the eyebrow and frontal hairline (without a hair loss condition).

When performing this procedure, surgeons usually remove hair follicles or grafts from the back of the head because the area is more resistant to hair loss. But they may opt for body hair transplantation (BHT) if the hair at the back of your head is not enough.

There are several techniques for extracting or harvesting hair follicles for transplant, each one with its own benefits and downsides. The two main methods of extraction, however, are follicular unit transplantation (FUT) and follicular unit extraction or excision (FUE). We will discuss more about these later in the article.

Who are the Ideal Candidates for Hair Transplants?

Before proceeding further, let’s mention that hair transplantation is not for everyone having hair loss issues. The ideal persons that can consider this treatment include:

  • People with androgenic alopecia or male/female pattern baldness
  • Individuals who have suffered hair loss from a serious scalp injury or burn

The following are some of those people for whom this procedure may not be ideal:

  • Anyone younger than 25 years and without genetic or severe issues causing hair loss
  • Persons lacking sufficient donor sites to provide hair follicles for transplant
  • People with serious medical conditions that can cause hair loss
  • Those using hair-loss promoting drugs or undergoing chemotherapy
  • People with keloid scars from surgery or injury
  • Individuals with hair pulling disorder (trichotillomania)

FUT Method for Transplantation

This is the traditional method of hair harvesting for a transplant. Follicular unit transplantation involves the removal of a strip of scalp from the back of the head. This is then cut up into separate individual grafts.

After removing the strip, your surgeon sews up your scalp. The surrounding hair may hide the donor site after this, depending on the doctor’s expertise and size of strip taken.

The strip of skin removed from your scalp may be divided into tiny grafts numbering between several hundreds to thousands. These are prepared and then put into tiny incisions on the balding or thinning area.

With the FUT technique, it is easier to cover larger areas affected by balding or thinning in less time. The rate at which drafts get cut during removal (resection rate) may also be lower, depending on the expertise of your surgeon.

This method may leave you with significant scarring, however. It may also not be the best option for people with smaller areas affected by balding. The recovery period from a FUT procedure can be rather long.

FUE Method for Transplantation

Many people consider follicular unit excision or extraction (FUE) method as the best approach to hair transplantation. However, greater expertise is necessary to use this cutting-edge technique to produce very satisfactory results.

To perform a FUE excision, the surgeon will shave the scalp at the back of your head. He then proceeds to remove individual follicular units or grafts one by one – not an entire strip. Each unit will have 1-4 hairs.

For the removal, there will usually be need for local anesthesia to deal with pain sensation. The harvesting process involves making very tiny cuts of follicular units measuring around 0.6 mm to 1.0 mm. This suggests that the FUE technique requires extra precision and can be very demanding.

Following the removal of hair follicles, your surgeon will clean and numb the area for transplant. He then uses fine needles or tiny micro blades to make holes or slits in which to put the individual grafts. Utmost care is necessary to ensure natural looking hair pattern when doing this.

There are now more advanced tools to make this process easier. Surgeons currently have access to automated or robotic assisted devices, which are mechanical. These make it possible to carry out necessary calculations and extract follicular units, with less input from the surgeon. These feature robotic arms and cameras.

There are only such two systems approved at this time by the U.S. Food and Drug Administration (FDA) for automation of the hair extraction process. They are NeoGraft Hair Transplant Machine and ARTAS Hair Restoration System. The use of these devices has not gone without controversy, though.

A major advantage of this technique is that it is more likely to produce satisfactory results with minimal or less visible scarring. It doesn’t require removal of entire strip of scalp, so recovery is faster.

A FUE procedure is a rather long one. You may need to set aside a full day for it because it can take up to eight hours to complete. But there is the option of having multiple small sessions.

Expectations and Postoperative Care

Your doctor will evaluate your scalp, among other steps, before deciding whether you are a candidate for a hair transplant. You should expect discussion on your expectations and preferences. Preoperative folliscopy will be useful in having an idea of realistic results.

Your scalp will likely feel sore and very tender following a hair transplant. Semi-permeable dressing or a bandage that allows fluid and blood to seep through will be applied and needs to be changed at least once a day.

Your doctor may prescribe some medications, including pain relievers, anti-inflammatory drugs, or antibiotics. You will need to protect the treated area from the sun.

Some doctors do advise their patients to shampoo the day following the surgery. This helps to keep scabs from developing around the hair shaft. There is greater risk of you losing the newly transplanted hair follicles if scabs manage to attach to your hair shaft.

Many people are able to resume their normal daily schedule two to five days after having a hair transplant.

You may notice some transplanted hair falling out within days of having the procedure. This is not unusual – it is what some call “shock loss.” The hairs become traumatized by change of their location. Many patients see roughly 60 percent new hair growth 6-9 months after surgery.

While there may be no further hair loss in the treated area, this procedure will, obviously, not prevent other patches from balding in the future.

Choice of Doctor or Surgeon Matters

It is worth noting that the quality of results you will get from hair transplantation depends greatly on the expertise and experience of the professional that will oversee the procedure.

The approaches some surgeons choose to adopt may not deliver the best outcome. Well, these often have reasons for their choices, but at what cost?

For instance, there are doctors who don’t use microscopes or modern techniques that promote precision when working on hair follicles. Hair transplants carried out by such may look irregular and almost everyone can easily tell you had one. This sort of outcome is especially likely among doctors who use older technology.

When working with microscopes, a surgeon or his assistants can be more careful in preventing damage to follicular cells for grafting while removing excess fatty and fibrous tissue.

You may be forced to part with some extra funds to have the shoddy job fixed later on.

It is important to ensure the surgeon you will be working is knowledgeable, or has someone on his team who is, about hairline design. A transplant is a permanent solution for hair loss. You certainly don’t want to be working around with an unnatural looking hairline afterward.

The hairline is a part that easily draws attention and a big factor in how attractive others find you. A competent surgeon can work with you to create a hairline that looks natural and is “future-proof.”

Ensure you find out who will be supervising your surgery. Don’t assume that a particular surgeon you are discussing with would. There are reports of surgeons allowing technicians to perform the procedure when they should ideally only be assisting.

Transplantation Costs

The amounts people pay to have a hair transplant vary widely. Expectedly, the extent or size of area to be treated will be a major determinant.

Surgeries don’t usually come cheap, so you should expect to part with thousands of dollars for treatment. Average cost is about $7,000 to $9,000. The general range is typically from around $4,000 to $14,000, or higher.

You may have to pay the entire cost out of your pocket. Most plans insurance companies offer do not cover this treatment. The usual practice is to use the cosmetic nature of the procedure as an excuse.

Hair Transplantation Risks

Hair thinning is a common occurrence in the days following a hair transplant. But, as most surgeons will have you believe, this is a normal thing.

Some people who had this procedure also developed bald patches. They could lose up to about hundred hairs a day.

Scarring is a worrisome risk with hair loss surgery. Regardless of the method used, you should expect to have scars at the back of your head. The only difference will be the degree of such.

With the FUE technique, the scars may be so small for people to notice them easily. This is understandable because the method is less invasive and involves removal of tiny individual follicular units.

Others will usually find it easier noticing these scars in the case of the FUT extraction method. The area where a strip of scalp is taken at the back may become rather conspicuous after healing.

Scarring can cause donor sites to become bald. Scar tissue is not favorable for hair growth. So, you may need to part with more money to get the scars fixed.

Other issues that can arise from having a hair transplant include:

  • Lack of sensation on areas of the scalp treated
  • Hair that looks unnatural
  • Infection or inflammation of the hair follicles
  • Swelling of the scalp
  • Bruising around the eyes

Consider Other Options for Hair Loss Treatment

The truth is that hair transplantation is not the ideal solution for everyone. As we mentioned previously, there are specific kinds of people who may find surgery helpful.

Besides, the costs of having a hair transplant may prove too high for many to afford. There are still other groups of people who may be too scared to have this treatment because of the risks that come with it.

There is also no guarantee with hair transplantation that you will not lose hair in other non-treated areas that appear good enough at the time of treatment.

Below are some other options you may want to consider first before thinking surgery.

Medications

Doctors will usual consider drugs first for treatment of hair loss before proposing hair transplantation as an alternative. Medications can help to deal with an underlying condition that may be responsible for shedding. Inflammation is one of the issues you can find them useful for combating.

Finasteride (Propecia) and the topical solution minoxidil (Rogaine) are two popular drugs that are recommended to people suffering from hair loss. Although they are not without side effects, these have been proven to work.

Other medications include dutasteride, spironolactone, oral contraceptives, and prednisolone, depending on gender.

Laser therapy

Just like medications, this is another treatment that your doctor may recommend, even after having surgery. This may be necessary to guard against hair loss in areas that currently do not require treatment.

Low-level laser treatment can be beneficial to people experiencing hair loss due to genetic makeup. A number of studies have found this to improve hair density. A device used for this therapy has the approval of the FDA.

Supplements

You see, hair transplant is more or less about treating the superficial or the surface. Most cases of hair loss are due to hormonal issues – precisely, the conversion of testosterone into dihydrotestosterone (DHT).

This means the best way to better treat hair loss is by addressing this hormonal problem, not just the outside.

Medications, specifically oral drugs, can help deal with internal problems. However, the side effects that come with them are the main concern. So, you may want to consider use of natural supplements instead for this purpose.

Another option you have, although superficial, is to use a disguise. This may take the form of a special styling technique, hairpiece or wig.

Conclusion

Hair transplantation can help to combat hair thinning and shedding. But this is not the first option to consider or may not be ideal for you at all. The procedure is best for people with androgenic alopecia or those who have suffered severe scalp injury or burn.

The cost of a hair transplant may be rather prohibitive. And, as with most surgical procedures, there are risks, including scarring, infection, and hair tufts that do not look natural. Although both can result in scarring, you are more likely to end up with visible scars at the back with the FUT approach than FUE.

It is better to prevent your hair loss worsening to the extent of you requiring surgery. You should commence the use of medications or, better still, good natural supplements as soon as you notice thinning or shedding. Laser therapy is also among helpful options.

If a surgical procedure is inevitable, it is vital to ensure that you will be working with a highly skilled and experienced surgeon. You should also make sure that they will carry out the transplant – not leaving it to technicians to handle.

REFERENCES

Hair Transplant: Procedure, Recovery & Side Effects (https://www.healthline.com/health/hair-transplant)

FUT or FUE — Which hair transplant is right for you? (http://www.thehealthsite.com/beauty/what-kind-of-hair-transplant-is-right-for-you/)

The Importance of Hairline Design in Hair Loss Treatment (https://www.hrbr.ie/blog/the-importance-of-hairline-design-in-hair-loss-treatment/)

Hair loss – Diagnosis and treatment – Mayo Clinic (https://www.mayoclinic.org/diseases-conditions/hair-loss/diagnosis-treatment/drc-20372932)

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