Many candidates for hair transplantation remember a time when hair plugs were the state of the art. These tended to blend poorly with the patient’s existing hair, and over time each large graft tended to thin out and become immediately recognizable for what it was. Fortunately, hair transplantation has come a long way since then.
These days, hair is transplanted not in large chunks but in tiny batches of a few hairs at a time. This allows surgeons to more carefully match transplanted hair with existing hair, resulting in a far more natural look than previously possible.
A normal hair-transplant surgery takes four to eight hours and is performed under local anaesthesia. Some patients, especially those prone to anxiety, may be offered a mild sedative: the results are worth it, but eight hours is quite a long time to stay perfectly still.
To begin, the surgeon identifies a group of hairs to serve as donors. These hairs may be selected individually, which takes quite a bit of time, or in thin strips, which saves a bit of time at the expense of potential scarring. When strips of hairs are selected, they are then divided to allow small groups of follicles to be transplanted: entire strips are never moved whole cloth.
After follicles have been harvested, they must be prepared for re-insertion, usually by an experienced technician. While this takes place, the surgeon prepares the area of the scalp onto which the follicles will be transferred.
Transplantation itself may be performed by a group of surgeons. In any case, it follows a strict pattern mapped out before the surgery, identifying which hairs move to which precise locations, all in an effort to provide the most natural-looking results.
Once the surgery is complete, the scalp is bandaged and the patient returns home to begin the after-care routine. This often includes topical or oral medication intended to treat or prevent further hair loss.
Hair transplantation may seem like a one-stop cure for thinning or absent hair, but patients can wait up to a year to see full results. This is largely because transplanted hair naturally falls out within two months of transplant surgery. After this initial fallout, the first generation of truly transplanted hair begins to emerge, though it may appear thinner than expected. This, too, is normal. It takes a few cycles of hair growth, shedding, and regrowth for the true results of a hair transplant to reveal themselves.
Hair transplants are recommended for patients with sufficient healthy hair, and those able to grow at least some hair in thinning areas. The first condition is obvious: transplanted hair needs to come from somewhere. The second has to do with the underlying conditions of hair loss. If a patient’s hair has begun to thin for the most common reasons related to age and genetics, hair transplantation is usually viable.
But if a patient’s hair loss is due to unhealthy conditions in the scalp, even healthy transplants may not receive the blood supply and nutrients needed for long-term growth. Dermatologists are able to evaluate hair-transplant candidates and advise on their suitability. In some cases, an initial consultation toward hair transplantation leads to blood tests or even biopsy, and the identification of a theretofore unknown underlying condition.
While hair-transplantation techniques have advanced considerably in the last 20-30 years, much still depends on the skill and experience of the team performing the operation. Some surgeons specialize in hair transplantation, but such specialists can be hard to find outside of large cities. Dermatologists are trained to diagnose and treat conditions of the hair and hair follicles, and many perform hair transplants as well.
Because hair transplantation relies so heavily on the staff supporting the lead surgeon, it is wise to ask not only about the dermatologist’s experience and training but about those of the entire staff.
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