Do hair transplants really work? And is an undetectable hair transplant possible?
Yes, modern techniques of surgical hair transplantation can restore lost hair and replace or re-shape your hairline with your own natural, growing hair, which needs no more care than the ordinary washing, styling, and trimming you have always done. Transplantation can be done today so well that often a barber or stylist cannot even tell that grafts have been placed.
The medical process for hair restoration simply involves the transplanting of hairs and follicles from one area of the head to another. In the case of "male pattern baldness", the hairs on the back and sides of the head, from what we call the "donor area" -that are resistant to the hormone dihydrotestosterone (DHT) -are artfully moved to the thinning areas at the top and front of the head. It is important to remember that the hair follicle itself is resistant to DHT, so even when moved to the top and front of the head, the follicle retains this resistance, and the transplanted hair thrives where the genetically sensitive hair failed.
Then, using magnification, the tissue is dissected into follicular unit grafts (containing 1–4 hairs). These small grafts are then meticulously planted into the bald or thinning area of the scalp (recipient area) so as not to injure any follicles already existing in the area and at the same exact angle as the other hairs present. The creation of very small follicular unit grafts has enabled the hair surgeon to create very natural, feathered hairlines, which do not have the abrupt, “pluggy look” that was commonly seen in hair transplants of years past. Depending on the degree of balding in the frontal, mid-scalp, and vertex (crown) areas, usually 2–3 procedures are performed, with the number of grafts used varying tremendously, based on the area of potential alopecia, the patient’s “safe” donor supply, the textural characteristics of the patient’s hair. Hair transplant surgery today is remarkably well tolerated. Within 24 hours small crusts will form on each graft that is then shed in approximately 4–14 days. The grafted hairs will often start to grow by 10–16 weeks after the procedure and will continue to grow for most, if not all, of one’s life. (As men and women age, in many there is a slight loss of hair density all over the head, which would naturally also affect the transplanted hairs).
What happens during a hair transplant procedure?
Hair transplantation surgery is considered to be “minor out-patient surgery.” Hair transplant procedures can take from 3–8 hours and are usually performed using local anesthesia on an out-patient basis, often with some supplemental oral medication for sedation. Patients are often awake, but feel very relaxed because of the effect of the sedative. There is typically little discomfort during the surgical procedure. The donor areas, where the grafts have been harvested, are usually closed with sutures. These are usually removed in 5-7 days. Dissolvable sutures may occasionally be used in order to eliminate the need for you to return for suture removal. The recipient sites, where the grafts are placed on top, are essentially small, superficial needle holes or slits in the skin of the scalp. The surgeon should be willing to discuss with you the pros and cons of the various methods of both donor harvesting and transplanting the grafts. At the end of the procedure, either a very light dressing is applied, or, in many cases, the doctor will have you stay for brief observation and then allow you to leave with no dressing whatsoever. At the conclusion of the procedure the surgeon usually checks the final placement of the grafts, and the doctor or an assistant then explains the postoperative instructions, which are usually supplied in written form as well.
What happens after hair transplant surgery?
Hair transplantation is a very safe, relatively minor surgical procedure. Significant complications are extremely rare. There is usually little or no discomfort in the grafted area. Most patients feel some “tightness” in the donor area for 1–2 days and are prescribed a mild analgesic to help cope with this. Patients may be asked to wear an elastic headband and to sleep in a semi-upright position for 2–3 days following the procedure to minimize swelling and bruising. Small crusts may form on each graft, and these can usually be camouflaged by any existing hair that can be combed over the recipient area, or with camouflage products such as Toppik. These crusts will flake-off by 5–14 days after the surgery. The transplanted hair seen growing out of the scalp may initially be shed; however, the roots remain and will be dormant for 10–14 weeks, at which time the new hairs will all begin to grow. Numbness that may occur in the donor or recipient area usually disappears within 2–8 months following surgery. As stated above, complications are rare. Minor inflammation can occasionally occur around a newly transplanted hair
follicle, similar to an infected ingrown hair or pimple, and usually responds to simple warm compresses. The scar that occurs in the donor scalp as a result of the removal of donor skin is usually quite narrow and can be easily hidden by the surrounding hair. The graft sites in the recipient frontal area heal with almost no visible scarring and are covered by the transplanted hair. A minority of patients may experience mild swelling in the forehead area for a few days following surgery. It typically appears around the 3rd post-op day and goes away after 3–4 days. Infection in either the donor or recipient area is extremely rare. Many patients experience a small area of numbness above the donor scar and in the rear central scalp that gradually disappears after a few months.
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