Cosmetic Therapies: Hair Transplants

Cosmetic Therapies Index : Hair Transplants


Hair Transplant Questions and Answers
1. Q. Just what is meant by Hair Transplantation?
A. Hair transplantation is a surgical office procedure for the treatment of hair-loss. It is accomplished by actually transferring grafts or small sections of hair-bearing skin from the back of the scalp to bald areas on the top of the head. Only micro- and mini-grafts are used, which can contain 2 - 7 hairs.

2. Q. In what types of hair-loss is this procedure helpful?
A. This technique is effective in most types of hair-loss, from male and female pattern loss to scarring from injury and complications from disease. It is especially effective in concealing the scars from facial-plastic surgical procedures (face-lifts, brow-lifts, etc.). Even eye-brows can be reconstructed with excellent cosmetic appearance.

3. Q. Does it really work? Has it been proven?
A. Yes. This procedure has been performed for over 40 years. It was originated in the Unites States by a dermatologist, Norman Orentreich, M.D. of New York City, and is well-accepted by the medical and surgical community as an effective treatment for hair-loss.

4. Q. I'm going bald and have some early recession. Should I wait until the hair-loss is advanced before considering transplants?
A. Absolutely not! if you have enough hair with which to cover thinning area, all the better. This will serve as a camouflage during the procedure. We have patients who have had transplants over a period of many years, essentially keeping up with their progressive hair loss. They appear to have the same hairline and coverage which they did years ago, and their friends and family never suspected they were having hair replacement surgery.

5. Q. Will the transplanted hair grow forever, or will it fall out in time?
A. The transplanted hair is taken from the horse-shoe fringe on the back of the head. This fringe usually remains in spite of the most advanced hair-loss. For this reason, it will grow as long as the fringe area grows. The donor area is genetically programmed to remain, despite age, in most individuals

6. Q. How is the procedure perfomed?
A. The donor and recipient areas are treated with a local anesthetic similar to that used by dentists. Slit recipient sites are used in the hairline and bald areas for the most natural look, and may also be used in all areas, replacing punch grafts. The desired number of micro- and mini-grafts are then removed with the Resnik - Lewis CD punch. The donor grafts are then carefully placed into the prepared recipient sites. No sutures are used, and a turban bandage is applied overnight. If appropriate, the donor grafts may be removed using a strip technique. These very thin strips, taken from the same area as the punch grafts, are then cut into small grafts and placed into the scalp in just the same manner. The donor area is closed with special skin staples, which are removed in 1week. This leaves an almost invisible linear scar.

7. Q. Is the procedure painless?
A. Most patients are surprised by how little discomfort they experience. The recipient and donor areas will be numbed before the procedure with medicine similar to dental anesthesia. This is the only discomfort you should expect during the procedure. Some patients experience a temporary burning sensation during the first night after the procedure.

8. Q. Where should the hairline be placed?
A. Although there may be individual preference, we will make suggestions considering the degree of hair-loss, the age of the patient, the shape of the face, and the amount of hair in the donor area available for transplantation. in all cases, our ultimate goal is a natural appearing result, without the "doll's head" appearance.

9. Q. How much time is required for each session?
A. Time required varies with the amount of surgery performed. Establishing the frontal hairline is, of course, more exacting and tedious than general coverage of the top area and therefore takes more time. As a rule, a session of 125 grafts takes two hours

10. Q. How many visits to the doctor will be necessary?
A. This varies with the individual patient, the size of the bald area, and the number of micro- and mini-grafts performed at each visit. The number of transplant sessions can be reasonably well-estimated at the initial consultation. Usually 125-175 mini-grafts are done at each visit. The visits are spaced 2 weeks apart, although longer intervals can be considered.

11. Q. Are there any special preparations necessary for the procedure?
A. Actually, very little preparation is necessary. The hair should be shampooed the evening before or morning of the procedure. The patient is advised not to drink alcoholic beverages or take aspirin for 7 days preceding the surgery. Preliminary blood tests will be ordered two weeks prior to the procedure. Minoxidil solution should be stopped 3 days before surgery

12. Q. Should I have a haircut before the procedure?
A. No! Since the small donor site is trimmed at the time of surgery, it is more easily camouflaged if the surrounding hair is reasonably long.

13. Q. What must the Patient do immediately after the procedure?
A. The patient should resume normal activities, avoiding strenuous physical exertion. Bandages remain in place overnight and are removed the next morning by our staff. The scalp is rinsed in two days and shampooed after three days. Normal exercise can be resumed 1week after surgery.

13. Q. Is a follow-up visit necessary after each transplant session?
A. After the dressing removal, the patient is seen at 2 weeks for follow-up. There is very little crusting, and it is usually gone by the second week. A visit is important at 3 to 4 months in order to evaluate the growth of hair and plan fill-in sessions, if necessary.

14. Q. What happens to the area from which the grafts are taken?
A. These areas are allowed to heal with no intervention. Each small donor area shrinks to a pinhead-sized scar. The donor area is difficult to see one month after surgery. If a strip was taken, the skin staples used to close the opening are removed 7 days after the procedure. The scar is almost undetectable one month after the procedure.

15. Q. When will the transplanted hair begin to grow?
A. With the use of micro- and mini-grafts, the hairs will often continue to grow after being transplanted and never be lost. They will continue to grow at the normal rate of 1/2 inch per month, However, the transplanted hair sometimes goes into "shock" and is shed in 2 weeks. One month may pass before new hair begins to appear.

16. Q. Can the transplanting procedure be done at intervals longer than those suggested?
A Yes, the procedure can be done in stages to suit the patient, Again, this depends on the patient's preferences and the amount of transplantation necessary.

17. Q. What about filling in the spaces between the grafts?
A. Many patients are so enthusiastic about their new hair that they are satisfied with what might be considered a not-quite-finished result. Patients must realize that fill-in grafts, spaced between existing grafts will be necessary for a "totally natural look". Fill-ins are performed after existing grafts have begun to grow.

18. Q. What percentage of transplants "take" or grow?
A. This is an extremely unusual occurrence. In our experience, when a transplant is "lost", it is almost always due to inadvertently combing or injuring the scalp and "uprooting" the transplant before it is completely healed.

19. Q. Will my insurance cover this procedure? Is it tax-deductible?
A. Hair transplantation is considered a cosmetic procedure and not covered by insurance plan or considered a medical expense. However, in certain situations, different standards may apply. It is best that you consult your accountant and insurance company about these matters if they apply to you.

20. Q. Are there any complications about which I should be aware?
A. In our experience, the incidence of complications is extremely low. Occasionally, an area of excessive bleeding may occur, but this is easily controlled by pressure. infection is very rare.

21. Q. Can a hair-piece be worn during the procedure?
A. Yes. This often serves as an excellent cosmetic camouflage if the hair-loss is extensive and no existing hair is available to cover the operative site.

22. Q. What if my hair loss continues after my transplant surgery.?
A. Different patients will lose their hair at different rates. The initial consultation takes into account the possibility of progressive hair loss, and consideration for future needs will be taken into account.

23. Q. Can an unsatisfactory job be repaired?
A. Yes, most definitely! Corrective procedures may be performed under a variety of circumstances. A large percentage of patients are referred to our office specifically for repair measures.

24. Q. Will the application of topical hair growth medications eliminate hair transplant surgery procedures?
A. Topical minoxidil has been shown in scientific studies to slow down hair loss, thicken existing hair and regrow new hair in many individuals. Any resulting growth is most obvious on the crown. Some hair will regrow in the frontal hairline. Minoxidil is not a substitute for hair transplant surgery, but can be used with surgery to reduce hair loss.

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