What is hair transplantation?
Hair transplantation is not growing new hair; it is simple transferring and implanting the hair roots from one region of the scalp to the other region. Hair must be of their own and invariably harvested from the back of the scalp. In specific cases, beard and body hair can also be used to implant on the scalp.
How does hair transplantation help to grow hair on the bald area?
Removing hair roots from the hair baring area and implanting these follicles in the deep layers of the bald scalp will accept like graft and grow with the features mimicking the native hair is the basic philosophy behind hair transplantation surgery.
Normal hair density is around 50-70 roots per square cm. when we harvest the roots and spread them at a density of 25-40 roots per sq cm it appears satisfactory and covers the scalp skin as there is an adequate hair.
When we take roots from 30 sq cm area one can cover/transplant about 100 sq cm areas satisfactorily: this is the principle behind follicular unit transplantation.
The scalp color, angulations and density we implant should be ideal to cover as much scalp as possible.
What is the donor area?
A donor area is nothing but the area from which follicles/ roots/hair is harvested for transplantation. In the scalp the permanent donor area is occipital scalp i.e. back of the scalp, because hair is dense in that area and hair loss is invariably absent in that area.
What are follicular units (FU)?
Hair exits from the surface of the scalp as un- divided follicles constituting single, double or triple structures. Present day hair transplantation principle is based on the isolation of these follicles under microscope/magnification and implanting them in the hair less area as densely as possible.
How do we harvest these follicles?
• Strip method:
In this method a full thickness hair strip is harvested, from which individual hair follicles are dissected for implantation. This is done under Binocular stereo microscopes to avoid injury to the roots and to prevent the wastage.
• FUE method:
In this method follicles are extracted directly with the help of a follicular extractor punch, it is practically a blind method and there is a risk of injury to the roots while extracting with the help of a punch.
What happen to the area where the roots are removed?
In FUE method, roots are harvested randomly without making any cut. So, FUE method would not leave any visible scar
In strip harvest method; after removing 1-2cm strip of skin bearing hair roots the skin margins can be closed safely by producing a fine scar which is barely visible.
Which is the better method? Either strip harvest or Follicular unit extraction
• In the FUE method more than 1000 follicle transplantation is also possible in one session and scar is not going to be linear but it leaves a multiple scar spots which want leave any visible scar; I suggest FUE method; for all my client; strip is recommended for selective individuals.
• In the strip method large area coverage is possible in view of ability to harvest large number of follicles so mega and Giga sessions are done in single session.
• When we transplant more than 2500 follicles it is called as mega session. If the follicle number is more than 5000 we call the session as Giga session.
• Mega and Giga sessions are possible only with strip method of follicular harvest.
• But the disadvantage with the strip method is a linear scar on the back which is usually not visible but it is visible when the head is shaved completely. This disadvantage is minimized by Trichiphytic closure method; here we advance the skin margin by trimming the cut follicle skin so that some follicles will grow and hair exits even on the scar.
What is micro-dissection?
• Micro-dissection is dissecting slivers in to follicular units under magnification of the microscope.
• This will facilitate better quality graft and avoid damage to the roots; micro –dissection will yield more grafts and better outcome after hair transplantation.
What type of anaesthesia is used for hair transplantation?
• Hair transplantation is done under local anaesthesia, you will be completely alert and sitting on a reclined and ergonomic chair comfortably throughout the procedure.
• Local anaesthesia injections will be given a two points, one on the back of the scalp and the second one on the front of the scalp; which will make the whole scalp skin numb and painless.
• These injections help throughout the procedure. After the procedure the slight pain will be controlled by oral pain killers for 3-5 days.
What is the procedure and preparation required before hair transplantation?
During the consultation causes for your hair loss will be assessed, classification of type of hair loss and density of the donor site will be assessed. You will be asked about your concern, expectations and requirements.
• You will be shown the previous operated client's pictures depicting the procedure, short term and long term results
• Once you are prepared to get the procedure done you need to get basic surgical profile, these are the battery of blood tests required to undergo before performing any surgical procedure.
• We will tell you about the number of grafts /roots probably implanted for satisfactory result and duration of the procedure and cost estimate for the whole procedure
• Another visit before surgery:
In this visit you will come with your test reports and you can ask further questions arise after some understanding of the procedure.
• We will clarify your questions and inform you about the preparation required on the day before and on the day of the procedure
• Preparation before surgery:
Do not shave your head completely; better maintain the around 20 days old hair length after head shaves i.e. around 1-2 cm.
• Scrub your scalp thoroughly a day before with any regular shampoo
• On the day of surgery have light breakfast 2hrs before starting the procedure
How does the scalp look after finishing the procedure? What is the bandage process?
After completing the procedure you will be able to walk home comfortably.
· After Hair transplant, we don't do any bandage on the scalp.
· Just cover the scalp with a cap.
· You can shower your scalp after 3 days.
What are the post procedure precautions and long term medication and follow up?
• Avoid hot and spicy food for few weeks which will produce sweating of the scalp
• Do not cover the scalp with a cap/hat constantly, let the scalp ventilated well.
• Eat balanced diet and have timely sleep, try to reduce mental stress at work environment
• We advice vitamins containing Biotin and Pantothin predominantly for 3 months
• I advice Minoxidil 2% topical application for 6 months
• Daily scalp mild shampoo scrub to be continued
• No special precautions and special medication required
• No worry when you lose implanted hair; it is as good as drying of a leaf after transplantation of plant from one place to other. The root will definitely germinate new hair.
Does hair transplantation entails any stitches?
FUE method won't need any stitches.
· Strip method will have stitches, which are usually absorbable.
How long will it take for the complete growth of the implanted hair?
Growth will start after 3 months, growth will go on and the entire roots will grow into thick hair by the end of one year, so one has to wait to reach the peak result. But it looks satisfactory in the appearance after 4 months
How does it differ from wigs, bonding and other artificial methods?
In hair transplantation your own hair is transplanted by microsurgery, it grows with the similar characteristics of your native hair normally, and it can be washed trimmed. You will not lose transplanted hair along with your progressing baldness. Others hair cannot be transplanted. Transplanted hair will not require any extra care for the rest of the life. No supervision and medication is required.