HAIR TRANSPLANT
Baldness for some men is a very serious matter to the point of affecting their self-esteem. But what causes hair loss? Excessive use of hats, dandruff, poor circulation in the scalp, or vitamin deficiencies? All these claims have been debunked. It is also not true that 40-year-old men who have never had hair loss will not be bald. What is known today is that baldness is caused by a combination of some factors such as aging, genetics, and hormonal change. And, of course, it can be caused by burns or trauma.
WHAT IT IS AND HOW IT IS DONE
Today, we have several surgical techniques for Hair Transplant and the choice of the best one depends on each case. The procedure is performed in a hospital and, generally, we opt for local anesthesia with sedation so that the patient is relaxed and feels comfortable. General anesthesia is for more complex cases that involve tissue expansion or flaps. Likewise, the surgery time varies for each case.
The most used technique today is FUE (Follicular Unit Extraction). We shave the hair from the donor area and remove the follicular units, one by one, using a punch (tube-shaped instrument). This process is done with a micro-incision of minimal depth around the follicle. The advantage of this technique is that the hair is transplanted not by cuts, but by minimal incisions – in the donor and recipient areas – and can result in a natural presentation. There are 800 follicular units transplanted, on average, each session, and a single stitch can close each donating hole.
Another Hair Transplant technique, also after shaving the hair from the donor area, is the round-shaped grafts done using a scalpel. Usually, each graft contains about 10-15 hairs, mini-grafts 2 to 4 hairs, and the micro-grafts 1 or 2 hairs. The amount of transplanted hair can reach 700 per session, and the holes in the donor site can be closed with stitches forming small linear scars that are hidden by the surrounding hair. In subsequent sessions, the spaces between the grafts are filled with additional grafts.
The flap surgery techniques, scalp reduction, and tissue expansion are procedures indicated for patients who need a more drastic approach. The flap technique replaces an area equivalent to 350 punch grafts, when a section of the bald scalp is cut and a flap is sewn in its place.
In the scalp reduction technique, sections of the scalp are pulled forward to fill in the area you want hair. It works well on the top and back of the head. The tissue expansion technique – commonly used in reconstructive surgery for skin expansion – has shown excellent results on the scalp near the bald area. When the skin with the hair has been stretched sufficiently, it covers the bald area. Combining these three techniques can result in better coverage of the crown and frontal area, providing a more natural hairline.
When the hair loss has been caused by burns or trauma, the application of the tissue expansion technique can show good results in Hair Transplant surgery in a relatively short period of time.
At the end of the surgery, the scalp is cleaned and covered with gauze. If necessary, a compression bandage is placed for a day or so.
INDICATION
If you feel uncomfortable with your hair loss, if it causes a problem with your self-confidence or if you want to improve your appearance, you can talk to your plastic surgeon about performing a Hair Transplant. It is worth remembering that the best candidates must have healthy hair growth on the back and sides of the head, as these are the donor areas.
Men and also women can undergo the procedure. In the case of women, the hair loss is relatively small and is usually caused by aging, some diseases, or hormonal changes after menopause. Medications tend to work well, stopping the abnormal hair loss. If surgery is indicated, most women resort to hair grafts.
PREOPERATIVE
It is very important that you check the SCHEDULED THE SURGERY? page, which has a series of questions for us to talk about during the consultations, to help you with your doubts, and where you will find recommendations for the day of the procedure.
In the consultation and through complementary exams, if necessary, we evaluate your hair growth and hair loss, we talk about your family history in relation to hair loss (and tendency to keloid) and even if you have already undergone a Hair Transplant procedure.
If the surgery is indicated for your case, we plan together about the anesthesia, the surgical technique and how many sessions are necessary.
POSTOPERATIVE
The procedure rarely requires hospitalization. After the surgery, the patient is released. We prescribe medication if the pain and throbbing bothers you. When you have stitches, we remove them between one week and 10 days. It is important not to remove those little healing peels.
Sleep with your head tilted the first few nights. The time it will take you to return to your normal routine depends on the extent, complexity and type of surgery you have had. Avoid exercise and contact sports for at least three weeks.
We will release more intense physical activities after evaluation. If you go out, wear a cap and use sunscreen from the second day after surgery, at least during the post-operative period. Avoid as much as possible the incidence of sun on your head.
You will be instructed about the first washing of the hair or we will do it in our office. At home, prefer warm water when washing your head. Hot water stimulates the appearance of dandruff and seborrheic dermatitis or excess oiliness, which is not good for healing and for the scalp. We advise about which shampoo and soap to use.
Generally, several surgical sessions may be necessary to obtain the planned result, with an average interval of three months between them, which is the time required for healing.
It is important to keep in mind that it is very common for newly implanted hair to fall out around six weeks after surgery. After five or six weeks the hair will grow back. The result of the whole procedure can take from 1 to 2 years, depending on your case.