Surgical Hair
Transplantation
The most common cause of hair
loss in both men and women is hereditary balding or thinning known
as androgenic alopecia (hair loss). Male Pattern Baldness
(MPB) in men and Female Pattern Baldness (FPB) in women is secondary
to genetics and hormones. More than two-thirds of all men and
women have some form of hair loss during their lives. In the
more severe form, a male may lose all his hair extending from his
forehead hairline and continuing back beyond the crown leaving only
a horseshoe-shaped area of hair located in the back and along the
sides. In females, typically there is a thinning in the mid
scalp and crown regions of the scalp. This hair loss is all
pre-determined before birth in our genetic blueprints and may be
inherited from either the mother or father's side of the
family. Usually the person's age determines when their hair
loss will begin, although the onset can be altered by many
factors.
The
Principle:
The only permanent, safe and
effective solution for significant hair loss is Hair Transplant
Surgery. At the onset of hair loss when we first notice a
slight thinning, the application of Rogaine (Minoxidil) may be
helpful in slowing down the process, but unfortunately only about
10% of the patients notice some benefit.
The success of hair transplantation
depends on the fact that transplanted hair follicles (roots moved
from their original location to another area) will behave as they
did in their original site. In Male Patterns Baldness (MPB),
even in the most advanced cases, a horseshoe-shaped fringe of hair
persists. Hair follicles moved from the hair fringe to a bald
area on the same patient's scalp will take root and grow.
Continuing hair growth in such transplants has been observed since
1956 and have proven to grow a lifetime. Many of the less
common types of hair loss can be helped by this
procedure.
The innovative use of mini, micro
and conventional sized grafts have allowed us to recreate what has
been lost, but the artistic development of a natural realistic
hairline by a skilled and creative practitioner is essential to an
excellent result; one in which your hair can be combed in a natural
way, even straight back. This can only be accomplished by
placing the single, finer micro grafts toward the anterior hairline
and more dense grafts in the back part of the scalp.
In women, baldness is usually less
severe and some hair is resent in the sites to be
transplanted. As a result, only the smaller transplants are
used.
The Procedure:
- Pre-op; the patient is
given a mild tranquilizer (Valium) either orally or
intravenously. This minimizes anxiety, reduces discomfort,
and helps to prevent or decrease any side effects that might be
caused by the anesthetic itself.
- The donor area (area
at the back of the scalp from which the hair follicles will be
taken) is prepared by clipping a narrow row of hair, being sure
that the hair above will completely cover the surgical site.
The recipient area is never shaved and thinning hair in this area
acts as a natural camouflage.
- The donor area and the
recipient area (the bald or thinning area into which hair will be
grafted) are anesthetized by injecting a local anesthetic with a
tiny needle. By our use of ice and topical anesthetic
sprays, there is minimal discomfort. Most patients find the
"freezing" easier that going to their dentist. Anesthesia
occurs very rapidly and normally wears off in about four to six
hours after the procedure.
- The donor tissue
holding the hair follicles is then removed with a specially
developed surgical instrument. The donor area is then
sutured completely closed and is easily hidden by the remaining
hair in the area. It is from this strip that our trained
technicians meticulously harvest, clean, and trim the grafts to be
used in the recipient areas. These include single hair
grafts, micrografts (1-2 hairs per graft), and minigrafts
(normally 3-6 hairs). In most patients, to achieve the most
natural results, a variety of graft types are now used in the
receptor area, including the standard smaller punch combined with
mini and micro grafts. The sites are placed approximately
one graft apart assuring a good blood supply. During
subsequent sessions these areas may be filled in.
- The receptor sites are
then prepared and the grafts are inserted. Our technique has
all by eliminated any bleeding. The grafts are firmly held
in place by the coagulated "blood and gravity."
- The donor site is then
bandaged with a dressing, much like the headbands athletes
wear. The dressing is removed the next morning, in
preparation for shampooing.
Creating The Desired
Results:
Using today's advanced micro
transplant technology, the creative and skilled practitioner can
offer each patient a most natural hairline modeled according to the
needs an wishes of that patient. Many factors are taken into
consideration when planning the transplant session including the
texture and color of the hair, its density, and even the relative
straightness or curliness of the hair.
The type and thickness of the graft
itself is also carefully considered; in women, as an example, the
tinier micrografts are more frequently used since hair loss is less
complete in women than in men. The smaller grafts, therefore,
are more usable and more easily camouflaged.
Number of Transplant Procedures
Needed:
The number of transplant sessions
that are required for any individual patient is quite variable and
depends, of course on the size of the balding area that the patient
wished to have treated. This degree of thickness that the
patient desires is also a factor and often is dependent on his or
her lifestyle and age. Sometimes patients are completely happy
after a single session when they see that their stark baldness had
been remedied. As many as five sessions may be suggested or
required by on average two to three sessions more than
suffice. Estimates will be made at the time of the
interview.
The interval between transplant
sessions may vary from a minimum of four months for a fill-in to
years. Most all patients, however, opt for the minimal
interval and want to complete the sessions and achieve the desired
end result as soon as possible.
Healing:
Individual crusts or "dot-scabs"
form around the graft sites within hours after the session.
They remain for as long as ten to fifteen days but become less
visible each day with shampooing. Most patients do not find
them to be so unsightly as to interfere with their social
activities.
As the crusts begin to shed,
patients will observe a few small hairs in some of the crusts.
This is expected and represents only the resting parts of the
transplanted hairs. The actual living hair roots (follicles)
will begin to produce your new hair in about eight to twelve
weeks. In rare instances patients may not see full hair growth
for eight or nine months. But the hair will always grow!
The differences in the time it takes the follicles to recover fro
the shock of transplantation are determined by individual
genetically determined hair growth patterns and do not relate to
surgical technique. Your new hair will continue to grow for as
many years as it would have had it remained in the donor area,
usually the rest of your life.
If a hairpiece was worn prior to the
transplant it may be worn after the third post-op day. We
recommend that the hairpiece be worn as little as possible until all
the post surgical crusts have sloughed off.
When a large area is transplanted in
one session, swelling of the forehead frequently occurs. While
this swelling is usually mild, and lasts only two to four days, it
occasionally can be severe enough to cause a large amount of
puffiness around the eyes that can result in "black eyes."
Generally the swelling begins two to three days after the procedure
and is most noticeable after the first session. It is
important to understand that swelling is always temporary and has no
harmful affect on the healing of the transplants.
When a transplant session is
preformed with the intent of thickening existing hair there is the
possibility of the prior existent hair going into a "shock" or
"resting" phase, much like newly placed grafts. This effect is
in no way harmful to the hair roots and they too will regrow at the
same time as your newly transplanted hair.
As related earlier, a great deal of
skill and artistic ability is needed to give natural looking
results. Each patient is given our complete attention during
each procedure. WE work together to help you attain your
goal. Our experience of having preformed literally thousands
of hair transplantation procedures over the past twenty-five years
speaks for itself. We have always taken great pride in our
results.
In competent hands, hair
transplantation is one of the safest cosmetic surgery procedures,
and medically it is the surgical procedure of choice for most
patients with a hair loss problem.