Thursday, February 28, 2008

Hair Transplant FAQs

Why have a hair transplant?
The reason why men get hair transplants is to achieve a more or less “permanent” correction of hair loss in order to improve self-esteem and restore a more youthful self-image.

Who can get a transplant?
Any person with noticeable hair loss that includes thinning hair and bald areas, and whose remaining hair is capable of growing in a transplanted location (called a donor-dominant condition), is a candidate for hair transplantation. A donor-dominant condition is one in which transplanted hairs are able to survive at a new location and will live and produce hairs as long as they would have in their previous location. The most common condition seen is so-called male- and female-pattern androgenic alopecia (hereditary hair loss). However, other conditions such as scarring disorders resulting from injury, diseases, or previous surgery of the scalp, can also be treated with hair transplantation.

When should a hair transplant be done?
A hair transplant can be done any time after there is enough hair loss in a particular area, such as the front, middle, or top of the scalp so that noticeable thinning is present on casual examination of the affected area. Hair loss actually begins long before it is noticeable and approximately 50 percent of the hairs in a given area are lost before noticeable thinning becomes apparent.

How is a hair transplant done?
A variable sized section of living scalp containing live hair follicles is removed from the back of the head (donor area) and subsequently microdissected into small so-called follicular unit grafts that are implanted into small surgically produced recipient sites in the balding area (recipient area). The surgical sites are well-healed in 7 to 14 days, and after a delay of 8 to 12 weeks, the transplanted hairs begin to produce new hair shafts.

Where is a hair transplant done?
Hair transplants are done in an outpatient setting. Patients walk in and walk out the same day. Patients are given oral, or in some cases inhalant/intravenous sedation, followed by local anesthesia to the donor and recipient sites.

What are the main difficulties experienced by a patient before, during, and after a hair transplant?
The main problems encountered by patients before hair transplantation are usually concern about the cosmetic down time in the postoperative period, and varying degrees of anxiety about potential discomfort during and after the procedure. During the procedure, the patients often become restless due to the prolonged time required to achieve the results and because of this, sometimes have difficulty refraining from talking and moving, which makes the procedure more difficult for the surgeon and the assistants. Finally, after the procedure, the patients experience variable degrees of discomfort at the donor site and variable degrees of swelling of the forehead that resolve in a few days. Also, there are variable degrees of self-consciousness caused by the tiny scabs that are present in the recipient sites. However, most patients will say that the difficulties experienced in the postoperative period in no way equal the level of anxiety experienced during the preoperative period. The subconscious fear of detection by casual observers is not realized in the vast majority of patients during the postoperative period.

Which regions of the scalp are best suited for hair transplantation?
The frontal scalp and the midscalp are the areas best suited for microsurgical hair restoration. The so-called bald spot (vertex) can also be corrected, but is somewhat less desirable.

Can a completely bald head be completely restored by hair transplant surgery?
The answer is no, but this is a trick question. Obviously, a completely bald head cannot be transplanted because it has no donor hair to transplant! However, even a very bald scalp cannot be completely transplanted since the size of the donor area and the number of hairs present are smaller than the potentially bald area on the top of the head. However, if the potential donor site is sufficiently large and reasonably dense, a surprisingly large number of hair follicles are available for transplantation to the top of the head, and fairly large areas of balding scalp can be covered adequately with hair that is both natural and reasonably dense in appearance.