Definition and Overview

Hair transplantation is a surgical technique that involves removing healthy hair growth from certain parts of the body and transferring them to sections of the head where they are thinning out. The process is one of the effective methods of treating male-pattern baldness.

Also known as hair implantation, a hair transplant can be done using two different techniques: follicular unit extraction or the removal and transplantation of a follicular unit one by one, or follicular unit strip surgery (FUSS), where a strip of scalp is removed and divided into several micrografts that contain small pieces of hair.

Who Should Undergo and Expected Results

Hair transplant is a procedure that can be carried out on both men and women who suffer from a certain degree of hair loss, although men tend to develop it more often and earlier than women. Male-pattern baldness or androgenetic alopecia, for example, most occurs among men starting at age 35. Some cases have reported the condition on males as young as 20 years old.

Hair transplantation can be recommended to anyone whose permanent or temporary hair loss is caused by any of the following:

  • Genetics – Male-pattern baldness is generally associated with genetics, particularly a person’s sensitivity to the by-product of testosterone called dihydrotestosterone (DHT), which can interfere in the way the hair follicles shrink and allow the hair to grow.

  • Underlying conditions – Some patients suffer from certain types of autoimmune diseases, such as lupus, where the body’s own immune system treats the growth of hair in the follicles as a threat, thereby preventing it from growing or making it susceptible to fall off quickly.

  • Medications – Certain drugs, such as those that are used in chemotherapy, can cause hair loss since they are designed to eliminate all types of cells, especially those that divide at an increasingly rapid rate.

  • Certain activities – People who rub or pull their hair vigorously such as when drying it with a towel may also experience hair loss.

  • Trauma – Burns victims, for example, may lose their hair as part of their injury.
    Although hair transplants can work for both men and women, it’s not meant for everyone. One of the essential criteria is the presence of significant hair from the donor site particularly the back and side of the head. Also, while the results can be permanent, the process does not treat any underlying disease that causes hair loss.

How Does the Procedure Work?

The hair transplant specialist first assesses the degree of hair loss and determines the best possible donor site. It’s important that the surrounding hair of the donor site are enough to hide possible scars, which is one of the common side effects of the procedure.

Once the assessment is complete, the surgeon proceeds to the transplantation. The patient is administered with sedative and local anaesthesia, although in some cases, general anesthesia is provided. The donor site is then thoroughly cleaned and applied with antiseptic.

If FUE technique is to be used, the surgeon and his team will remove the follicular unit one by one, leaving behind the appearance of tiny dots. If it’s FUSS, the surgeon removes a strip of the scalp using a scalpel and sews the scalp shut, allowing the nearby hair to cover it. The surgeon’s team then begins to separate the scalp into several micrografts composed of 5 hairs on the average.

With the hair ready for transplant, the surgeon applies antiseptic to the recipient site and makes holes or incisions where the follicles are transferred one by one.

Depending on the amount of hair to be harvested and transplanted, the surgery, which is performed on an outpatient basis, may take at least four to eight hours.

Possible Risks and Complications

The main risks associated with the procedure are permanent scarring and discomfort or pain in both the donor and recipient sites following the procedure. Other side effects such as bleeding, infection, uneven hair growth, and hair loss recurrence do happen but are very rare.

References:

  • Avram MR, Keene SA, Stough DB, Rogers NE. Hair restoration. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 157.

  • Fisher J. Hair restoration. In: Neligan PC, ed. Plastic Surgery. 3rd ed. Philadelphia, PA: Elsevier; 2013:chap 23.

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