What is a Hair Transplant?
source: ishrs.org
A hair transplant is an operation, which takes hair from the back of the head and moves it to the area of hair loss. The fringe (back and sides) of hair on a balding scalp is known as donor dominant hair which is the hair that will continue to grow throughout the life of most men. The transplantation of this hair to a bald area does not change its ability to grow. Donor dominance is the scientific basis for the success of hair transplantation. Dr. Okuda of Japan first described the use of transplanted hair to repair scarred eyelashes and eyebrows. Unfortunately, the outbreak of World War II prevented his valuable discovery from reaching the rest of the world for two decades. Dr. Norman Orentreich published the first widely read report on hair transplantation surgery in 1959 and the field of HRS was born.
Candidates for a hair transplant are those individuals with hair loss that have sufficient donor hair from the fringe of the scalp to transplant to the balding area. In the past, many bald patients were not suitable candidates for a hair transplant, but modern techniques have advanced the art of hair restoration surgery so that many more men are candidates.
Hair transplant surgery has improved in leaps and bounds over the past decade. The days of the "plugs and corn rows" are gone and the age of single hair-, micro-, and mini- grafting has arrived. Through the use of the these variable sized hair grafts along with new and improved instrumentation, the accomplished hair transplant surgeons can create a natural hair appearance that is appropriate for each individual patient. Single hair-grafts have the finest and softest appearance. Although they do not provide much density, they do provide the critical soft hairline that is the transition to thicker hair. Reconstructing a new hairline is a skill requiring surgical as well as artistic skill. It is critically important to get it right the first time and thus requires considerable forethought and planning. Getting it Right. Examining the hairline of a nonbalding person will show the presence of numerous single hairs in the very frontal hairline. Micrografts are small grafts containing 2-3 hairs that are placed behind the hairline to provide a gradually increasing hair density. Lastly, minigrafts contain 4 or more hairs are placed well behind the hairline so that the single hair and micrografts can blend naturally into the density provided by these larger grafts.
There is different terminology and techniques used by many ISHRS surgeons. This is because ISHRS surgeons are innovators and are on the cutting edge of hair restoration surgery. New techniques naturally give rise to new terms. Although there are variations in the techniques of individual surgeons, the combination use of these grafting techniques provide the most natural and pleasing results.
The side-effects of hair transplant surgery are relatively minor consisting of mild pain and discomfort after the operation, swelling which may move down to the eyes, and the formation of scabs over the grafts which take approximately one week to resolve. Serious problems of bleeding, scarring, and infection are rare. Modern hair transplantation surgery is comfortable, predictable, and the results are pleasing to most patients.
Hair loss, however, is a life long process, most men will develop male pattern baldness (due to male hormones) until approximately 40-45 years of age. After that, the aging process thins the entire head of hair. Progressive hair loss or the desire for more density, will require more transplant procedures. Modern techniques, however, allow hair restoration specialists of transplant larger number of grafts, greatly reducing the number of procedures needed to complete the result.
Understanding transplant
Provided by The Bald Truth
As in the case of any other medical procedure, the more you know, the better off you'll be. Gone are the days when people willingly remained in the dark about heir own bodies, their treatments and conditions. An educated and informed person now become an active partner in his/her own health care, which not only leads to better health but also is of great advantage to the doctors because nobody knows his/her body better than they do.
The following questions and answers will prepare you to understand the procedure and methods:
Whose hair will be transplanted onto my head? Does this work like organ transplants where there's a donor and a recipient?
Unlike the case of organ transplants, in a hair transplant you are your own donor. If you received hair, follicle, and tissue from someone else (other than an identical twin), your body would reject them without immune-suppressant drugs. You donate your hair from what are called your donor sites.
Where are my donor sites?
Male pattern baldness and female pattern baldness are terms that include the word pattern. That's because there is a pattern to the baldness. You've probably noticed, especially in men, that no matter how much hair they lost in the front, top, and crown areas of their heads, the sides and backs of their heads retain hair and sometimes a great deal of it. The sides and back are far less affected by the action of DHT upon their hair follicles. These areas are the donor sites from which the hair you donate to yourself is removed, along with the follicles and some surrounding tissue.
Where does the surgeon put my donor hair during the transplantation?
Once it's been extracted, it is transplanted to the balding parts of your scalp, into tiny slits that the doctor has created with his or her surgical tools. The donated hair, hair follicles, surrounding tissue, and skin are called grafts, and each graft contains one or more hair follicles (ideally no more than four), with accompanying hair, tissue, and skin. No two heads are alike, and you will see that the art of hair transplantation is just as important as its science or medical aspects.
Some people have naturally thick hair, and some don't. How does this factor into your ability to have a successful hair transplant?
Hair density is the number of hair follicles you have per square centimeter of scalp. Scalp laxity is the flexibility and looseness of your scalp. More grafts of hair can be transplanted when your density is high and the scalp laxity is high.
How does the direction in which your hair naturally grows affect your hair transplant?
Coarse hair is bulkier and can therefore be transplanted using fewer hairs per graft since it gives more coverage of the scalp. Fine hair has less bulb and can give a very natural look but less coverage than coarser hair. Wavy and curly hair lends itself to good visual results in transplantation because a single wavy or curly hair curls on itself and can therefore cover more scalp area than can a straight hair. Curly hair also rises from the scalp and holds its shape, and these factors also give the appearance of greater coverage.
Does hair color or skin color play a role in hair transplantation?
The closer your hair color is to your skin color, the better the appearance of the hair's coverage. African hair is dark and very curly and therefore provides the least contrast against various shades of dark skin, giving the best visual hair transplant results. From a visual point of view, people with dark, straight hair and alight complexion pose the most artistic challenges in hair transplantation because they have the most contrast between their hair and skin shades.
What are some of the other visual considerations?
When designing your procedure, your doctor must keep in mind your future hair loss pattern and the rate of that potential hair loss. The design of your restored hairline is crucial. Natural front hairlines vary in shape and density from person to person. Your doctor will choose the recipient sites for the transplanted hair based upon an overall design that may take more than on hair transplant session to achieve. These sessions typically take place months or even years apart, depending upon the progression of your hair loss.
How do doctors decide which part of my head will receive the transplanted hair?
The front and top of your head will receive transplanted hair first needed because these are the areas that frame your face and make the most impact on your appearance. The crown is usually the last area to receive hair (in later procedures), unless it's your only balding area.
How many procedures will I need?
The number of procedures depends upon the extent of your hair loss, the projected hair loss rate, the amount of donor hair you can spare, and other artistic and medical considerations. Men can often have the results they're looking for in just one or two hair transplant sessions in which thousands of hairs are transplanted in follicular units of one to four hairs each. Women need more sessions to achieve proper density. These sessions can last between five and ten hours each. Future sessions can follow if necessary.
What should I expect during my first meeting with a hair transplant surgeon?
During your first consultation, the doctor should examine your head thoroughly and take a detailed medical history. The examination of your head should include the use of an instrument called the Hair Densitometer.™ This measures your hair density and allows your doctor to properly evaluate the number of hairs in each of your naturally occurring follicular units and the hair loss pattern you may experience over time if it is applicable to your type of hair loss. This instrument compares fine hair to thick ones, measuring the degree of miniaturization of your hair strands caused by shrinking hair follicles, the progressive diminishing of each hair's diameter and length. You doctor should put into writing your hair transplant design and an estimated timeline for any procedures that may be necessary. The doctor should also explain the entire hair transplant procedure, including any associated risks, and tell you what you can expect in the months following the procedure.
