Like good health and youth, most of us take a thick head of hair for granted. Until, that is, it starts thinning. In most cases hair loss is caused by male pattern baldness or to give it its official name, hereditary Androgenetic Alopecia.
This does not, of course, limit the tendency to men. Nearly half of all cases of thinning hair are attributable to women, although the loss is almost always less severe and therefore less noticeable than in men. Most men start to lose their hair in their 30s or 40s, women in their 50s or 60s.
While there are many and varied causes, including poor general health or a recent illness, the tendency for male and female pattern baldness is largely genetic.
And then the debates begin: Shall I live with it or do something about it? If I do something, will it be subtle or drastic? How much time and money am I prepared to invest in getting my hair back?
For many people, hair transplant procedures can help bring back the appearance of a full – or at least a fuller – head of hair. Offering a permanent and natural solution to hair loss, transplants have been used with great success since the 1950s.
As a patient undergoing a hair transplant, you will be both donor and recipient. There are two principal methods by which donor hair can be harvested, and the choice is made after extensive consultation between you and your surgeon.
One method is termed strip harvesting which involves the removal of a strip of tissue and the subsequent dissection of the individual follicular units using a microscope. The other method is follicular unit extraction in which grafts are harvested individually, obviously a more time consuming method but one which is invaluable in certain cases.
Most hair transplants are performed in the doctor’s office under a local anaesthetic. The surgeon will first clean the scalp, then inject an anaesthetic into it to numb the area. Then either a three- to four-inch strip of scalp will be removed, or individual follicular units will be harvested.
The scalp is then closed surgically, the site being hidden immediately by the hair surrounding it.
Next, if the strip method has been used, the surgeon divides the strip of removed scalp into approximately 500 to 2,000 tiny grafts containing an individual hair or just a few hairs each. The number and type of graft used depends on the hair type, quality and colour as well as the size of the area to which it will be transplanted.
The surgeon then cleans and numbs the area where the hair will be placed, and creates recipient sites in the proper angle, direction and orientation according to the artistic hair transplant plan designed specifically for the patient. Delicately, the surgeon then places each graft in one of the holes.
Depending on the extent of the procedure, the transplant will take four to eight hours. This might be all that’s needed to produce the thick head of hair you once had, or additional sessions may be needed if you continue to lose hair at a later stage, or if you decide you want even thicker hair.
Expectations and recovery
After hair transplant surgery, your scalp may be tender, and pain medication might be needed to help you over the next few days. You will wear a surgical dressing over the scalp for at least a day or two.
Your surgeon may also prescribe antibiotic and anti-inflammatory medication to be taken for several days following surgery. Most people are able to return to work two to five days after surgery. Because the procedure is carried out under local and not general anaesthetic, recovery is localised to the scalp and no side effects are felt by the patient.
Transplanted hair goes through the same cycles of rest and growth as normal hair. Within two to three weeks after surgery, the transplanted hair will fall out, but then something almost magical happens.
The hairs contained within the transplanted grafts will usually start to grow approximately four months after your procedure and will continue to grow over the next 10 months.
Within a few months, you should start to notice new growth in the areas which, previously, had been either bald or covered in very little hair. The majority of people will experience sixty per cent new hair growth after as little as six to nine months.
Some surgeons prescribe medication designed to promote hair growth in the aftermath of transplantation, although the effectiveness of this will depend on several factors and it might not be necessary.
Surgical techniques are now so advanced that it is possible, if performed by a competent surgeon, that the procedure will re-create the look of a person’s original hairline. This ensures a completely natural outcome.
It is little wonder that the procedure enjoys such widespread popularity, offering as it does the potential to dramatically change a person’s look. It is, not surprisingly perhaps, by a long way the most popular male cosmetic procedure in most countries.
Many people who have enjoyed successful hair transplants look years younger than pre-procedure, and continue to benefit from full heads of hair for many years. The advances over the past two decades have been such that the procedure is reported as minimally invasive, producing near-instant results and with very little aftercare needed in the majority of cases.
The reason transplants provide permanent solution is because of the physiological pattern of hair on a person’s head. The horseshoe-shaped area of hair around the back and sides of the head is determined genetically to grow for a lifetime. Therefore, transplanting this hair to other areas of the scalp will result in a head full of the same sort of hair – thick, lustrous and designed to last.
Giant leaps with micro grafts
There are as many as six different ways in which hair can be surgically replaced, the latest technique, micro grafting, being the most commonly specified by surgeons these days because it produces the most natural results.
Micro grafting utilises a combination of larger grafts which create density and a number of smaller grafts which engender a natural effect. Whereas a normal graft will hold about twelve hair roots, a micro graft will hold about three or four hair roots.
A combination of larger and mini-grafts (which are smaller than the older-style plugs) is therefore used to produce a natural, soft hairline, with results that are virtually impossible to detect.