HAIR TRANSPLANTATION PROCEDURES

Hair loss is an aesthetic and health issue worldwide. It affects both men and women. Over 60% of men notice some signs of hair loss before they reach the age of 40. Later in life, the percentage goes as high as 85%. With that many potential patients, no wonder the hair loss market erupts with countless ineffective supplements, shampoos, and medications.

Supplements may make the existing hair healthier, and some medications can stop or slow down early hair loss. But, nothing except hair transplant surgery can restore hair to bald areas of the scalp.

Overview

There is no cure for baldness. Hair transplant surgery can restore hair in hairless areas, but it cannot stop new hair loss in any part of the scalp. That’s why it is best to combine hair transplantation with other available therapies. The exact treatment method will, of course, depend on the cause of hair loss.

The good news is that hair transplantation can conceal bald areas regardless of the cause. Physical appearance enhancements can also improve some psychological issues which may exist as a result of hair loss. These include depression, anxiety, low self-esteem, etc.

What to expect from a hair transplantation procedure?

Many people dislike surgeries due to their invasive nature, the long recovery process, and relatively high cost. Although, these three categories differ from one surgical procedure to the other. For example, hair transplant surgery is not particularly invasive, and the recovery time is not very long.  But, the cost is usually high.

All of this also depends on the transplantation technique and the time necessary to achieve the desired result. Here are some things to keep in mind if you are considering hair transplant surgery:

• Talk in detail about the procedure with your doctor so you can form realistic expectations. If your remaining hair is already dense, the transplantation area will also blend in more easily. On the other hand, if you do not have much hair at all, transplantation may not provide you with satisfying results. Remember, it’s not cheap.
• Thick hair that is grey or light in color guarantees better procedure outcomes than thin and dark hair.
• Patience is essential. Your hair did not fall off overnight, so it will not come back that fast either. Hair transplants may take up to nine months to take root and provide visible aesthetic improvement.

How is hair transplantation done?

Hair transplant surgery takes place in a doctor's office. Preparation for surgery depends on the technique you choose. The two available ones are Follicular Unit Extraction (FUE) and Follicular Unit Strip Surgery (FUSS).

FUE procedure requires trimming or shaving of the donor area, but it is less invasive. The FUSS method involves removing a small skin strip, usually from the back of the head.

The surgeon will use instruments, such as scalpels and needles to prepare the skin grafts and donor follicles, implant them to a new position, and numb the scalp. Both procedures use local anesthesia.

Usually, there is no need for a hospital stay. Some swelling and discomfort in the scalp are normal, and downtime lasts two to five days.

Types of Hair Transplant Surgery

We’ve already mentioned the two popular types of hair transplant surgery – the FUE and FUSS. The latter one is also known as Follicular Unit Transplantation or FUT.

These are not the only hair loss surgical techniques. However, they are the only ones that use hair transplantation to improve signs of pattern baldness.

So, let's explain them in more detail.

Follicular Unit Extraction (FUE)

Follicular Unit Extraction is a hair transplantation technique that transfers entire healthy hair follicles from the donor area to another part of the scalp. It is a newer treatment, suitable for patients looking to improve smaller areas of low hair density.

The procedure uses miniature harvest tools to extract whole hair follicles and transplant them elsewhere. Also, everything happens under local anesthesia. That makes the technique far less invasive. The donor area is much less likely to become sore and cause discomfort. It also shortens the recovery period for patients.

It is necessary to shave or trim the donor area and often the entire scalp. So, the follicles become more manageable.

FUE does not involve scalpel incisions, skin removal, or scars.

Compared to Follicular Unit Strip Surgery, FUE is much more labor-intensive. Therefore, the procedure lasts significantly longer and also costs more. One session is rarely enough. Although, it can last several hours. So, patients usually opt for two or three treatments.

Follicular Unit Strip Surgery

The FUSS technique requires taking a strip of skin from the donor site (usually the back of the head). The size of the skin strip varies, but it rarely exceeds 15mm in width.

Doctors use the skin strip to create smaller grafts containing one or several hair follicles. Then, using a scalpel or a needle, they create micro insertion sites in the hairless area of the scalp. The graft positioning follows a natural hair growth pattern.

The FUSS procedure takes place under local anesthesia. It is more invasive but shorter-lasting than FUE. The wound at the donor site requires suturing, and poses a greater risk of infections, bleeding, and pain during recovery.

The new hair will likely die. However, the follicles remain active and begin growing new hair six to nine months after surgery.

Potential Side Effects and Complications

Some common side effects of hair transplant surgery include:

• Bruising
• Swelling
• “tight scalp” feeling
• Numbness
• Pain and discomfort
• Scab formation

Serious complications are uncommon. They may include the death of skin grafts and additional issues that may arise from other types of surgery. These include:

• Infections
• Allergic reaction
• Bleeding
• Tissue death
• Nerve damage (loss of sensation)

The Bottom Line

It's never too early to act when you notice the signs of hair loss. The first thing you should do is talk to a doctor. Getting medical advice promptly is likely to save you a significant amount of time and money. So, don't go buying over-the-counter products on your own. What seems like a cheaper solution could end up being a costlier one, and not only in a financial sense.

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References:

• Zito PM, Raggio BS. Hair Transplantation. 2021 Jul 25. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 31613520.
• Jiménez-Acosta F, Ponce-Rodríguez I. Follicular Unit Extraction for Hair Transplantation: An Update. Actas Dermosifiliogr. 2017 Jul-Aug;108(6):532-537. English, Spanish. doi: 10.1016/j.ad.2017.02.015. Epub 2017 May 5. PMID: 28483047.
• Kerure AS, Patwardhan N. Complications in Hair Transplantation. J Cutan Aesthet Surg. 2018 Oct-Dec;11(4):182-189. doi: 10.4103/JCAS.JCAS_125_18. PMID: 30886471; PMCID: PMC6371733.
• Farjo B, Farjo N, Williams G. Hair transplantation in burn scar alopecia. Scars Burn Heal. 2015 Oct 1;1:2059513115607764. doi: 10.1177/2059513115607764. PMID: 29799573; PMCID: PMC5965333.

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