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Hair Transplants – the Ins and Outs

Hair is almost like a social status and over the years has proven to be a powerful statement of self expression. It is undoubtedly our greatest natural accessory but what would you do if you started to experience thinning hair or perhaps dramatic hair loss? There are a range of effective treatments for hair loss but the most mysterious remains the one that has been around longer than most, that is, hair transplant surgery. It’s come a long way since its cultivation by Japanese dermatologist Dr. Okuda in 1939 and whilst there are still some types of surgery to be wary about, generally you can forget about shiny metal contraptions and old-fashioned doll’s hair look-alikes – after years of development, this procedure has thankfully become a much safer hair loss treatment option.

What is hair transplant surgery?

Hair transplant surgery is a one day procedure that is done under local anesthesia. Hair transplantation involves surgically moving skin containing hair follicles that are genetically resistant to balding from one part of the body (the donor site) to bald or balding parts (the recipient site). It is mainly used to treat male pattern baldness but is also used to restore eye lashes, eye brows, beard hair, and to fill in scars.

Effective non-surgical treatments are available to treat various forms of hair loss. The broad condition affects up to 80 percent of men and roughly 40 percent of women and most will find these options much more appealing than surgery and in many cases, the results can be just as good and the costs can be considerably less.

How does surgical hair restoration work? 

Hair naturally grows in follicles that contain groupings of 1 to 4 hairs. Gone are the dark ages of hair restoration when the old “punch graft” technique left you looking like a newly groomed doll. Today’s advanced transplant techniques transplant the “follicular units” in their natural groupings to achieve a natural appearance by mimicking the way that hair grows naturally so that not even a hair stylist is able to tell the difference. This recent hair transplant procedure is called “Follicular Unit Transplantation.”

The transplanted units generally come from the sides and back of the scalp which largely remain unaffected by male pattern baldness. This type of hair loss is generally confined to the majority of the crown where the hair follicles are genetically predisposed to hair loss and more sensitive to dihydrotestosterone (or DHT) – the hormone that causes hairloss.

A hair transplant procedure requires an experienced and skilled hair transplant surgeon and a very well trained and skilled team of nurses and technicians. The number of procedures required is dependent upon a number of factors. The extent of hair loss, the projected hair loss rate, the amount of donor hair you can spare will all play a part in determining the number of procedures required. Most men can achieve the results their looking for in just one or two transplant sessions but women may need more to achieve proper density.

What makes a suitable candidate?

For the right person, hair restoration surgery can significantly improve your confidence and overall self-esteem. However not everyone is the perfect candidate for the surgery.

Suitable candidates for hair restoration surgery include:

  • Men who have been suffering male pattern hair loss for more than five years and are seeing the classic receding hairline
  • Men who have been balding for years and whose pattern has stabilizsed and are interested in adding hair to achieve a more youthful appearance
  • Those who have lost their hair due to trauma or burns or other cosmetic procedures

However, the single most important thing one must have to be considered as a suitable candidate is realistic expectations. It’s important to understand that hair loss might continue to progress and one must be aware and prepared for this. Medications to stabilise hair loss need to be considered in such cases.

As mentioned previously, hair transplants are used to treat male pattern baldness. There are a range of effective non-surgical, non-invasive hair loss treatments and surgery should always be a last resort after all attempts to stop the progression of hair loss have been trailed. Male pattern baldness is a progressive hair loss condition where the degree of loss is determined genetically and produced hormonally. It can start anywhere from puberty and take anywhere from a few to 40 years to establish the pattern and result in baldness. For this reason, careful planning is essential so that the pattern of baldness can be anticipated.

Is it suitable for women?

Hair transplantation is safe and suitable for women but in general, for a woman to be a candidate for a hair transplant, the type of hair loss needs to be scarring alopecia, traction alopecia, or extreme female hair loss conditions. Because female pattern baldness is distributed evenly over the scalp, there would be no guarantee that the hair would continue to grow in the recipient area due to the fact that this hair seems to be inherently unstable and just as susceptible to DHT. The same exception can be made for men who are experiencing diffuse hair loss.

Should I be worried?

Fake hair photoMost people considering surgical hair restoration are not always aware of the scope and the pitfalls of this medical specialty. It’s one thing to grasp the basic science behind the procedures but the aesthetics and artistry required to perform them well is another thing entirely. Unfortunately, for economic reasons, some physicians are performing outdated and sometimes dangerous hair restoration techniques, some of which are mentioned below.

Hair Flap
This is a major surgical procedure in which a wide strip of hair-bearing scalp is moved from the side of the scalp to the front hairline. It is cut on three sides so as not to separate it from the scalp and ensure it is not severed from its blood supply. The flap of skin and hair is then twisted so the hair bearing side faces outward and covers the surgically removed balding area. There are very real dangers of infection, scarring and necrosis related to this procedure.

Linear or Line Grafts
Possibly a cosmetic surgeon’s worst nightmare, these four millimetre strips of donor hair are grafted into surgically cut “trenches” in the bald area. The strips are not divided into follicular units and as hair grows the result is a completely man made-looking line of hair.

Round or Square Grafts
These are your original, real life doll-hair manufacturers. These five millimeter pluggy looking grafts are made with a hole punch devise and due to the size, do not even remotely resemble the way hair naturally grows from the head. This version has been adapted over the years but even the mini and micro grafts don’t compare to the more natural follicular unit transplant.

Scalp Reduction
A somewhat barbaric and disfiguring procedure, Scalp Reduction cuts away the bald scalp, pulls the edges of hair-bearing scalp closer together and sews them closed. The side effects of such a procedure are extensive and include but are not limited to further hair loss, hemorrhaging, scarring and can affect future hair growth as the direction of growth is altered.

So What Can We Infer?

Hair restoration surgery is considered a safe and practical procedure for suitable candidates. However it’s important to know you’re getting the right treatment for your type of hair loss. There are a number of non-surgical treatments for hair loss that we advise before deciding on surgery. These forms of hair loss treatment may resore the hair to your desired density without the need for surgery. The latest techniques in hair transplantation are however highly effective and resemble natural hair growth but the skills required for such a procedure mean only the most skilled and highly qualified surgeons should be consulted.

By the way… did you know?
Hair can be transplanted between identical twins with the same genetic make up. However, in general hair transplanted from one persons head to another will be rejected unless anti-rejection medications are taken for life. At this stage the risk of taking theses medications far outweigh the benefits of a transplant but scientists are currently researching ways to successfully transplant hairs from one person to another.

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