Hair Transplant > Hair Transplants Step by Step

Hair Transplants Step by Step

Hair transplants are the most popular and common form of surgical hair restoration.  Unlike some of the more radical surgical options, transplantation is a relatively minor procedure with few complications.  With the advent of follicular unit grafts, most doctors today believe any patient should be able to get a natural looking and satisfactory hair transplant.  Due to increased competition, prices are generally decreasing as well. A transplant is a permanent operation, so you should research your doctor well to assure you get good results and the best price!  Here are some tips for finding the best hair transplant surgeon.

Pre-operative Check List

Your hair transplant surgeon will discuss with you any steps you need to take pre-surgery. In general, the following are usually recommended for two weeks prior to surgery:

• Do not take Aspirin or any other anti-inflammatory medications prior to your procedure
• Do not use Rogaine or take tricyclc antidepressants, blood thinners such as heparin and coumandin, nicacin, accutane, beta blockers, and MAO inhibitors
• Do not take any multivitamins including vitamin B and vitamin E for one week before your procedure as they will increase bleeding
• Stop smoking
• Stop drinking alcoholic beverages
• Complete any lab tests that need to be done and make sure the results are sent to your surgeon
• Fill any prescriptions prescribed by your surgeon.
• Make arrangements for transportation to and from surgery since you may be unable to drive due to anesthetics or medication

The Hair Transplant Surgery, Step by Step

Hair transplants are really a very simple idea and process.  It is simply the removal of hair at the back and sides of the head where hair is very dense and surgically implanting them into the balding area of the scalp.

When you arrive at your doctor's office, the doctor or his staff will go over the procedure with you and what to expect. You will sit in a reclining chair, similar to at a dentist's office. Your doctor may give you some medicaton to help you relax if you are extremely nervous about the procedure. 

The procedure is preceded by a series of anesthetic injections to the scalp to null any pain.  This is actually the most painful part of the operation and depends on the individuals.  Some people have found it pretty painful and said that doctors underplayed this.  After the anesthetic sets in, there is no pain.

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First, a small area of the scalp is selected as the donor area.  The amount of hair you can transplant depends on how thickly this hair grows. The strip of hair wil be trimmed and prepared for the procedure.

In the traditional method, a linear strip of hair containing scalp is removed and the open area is stitched together so that it can heal.  Scarring is generally minimal but depends on how easily you heal from scars and the skill of your surgeon.  The hair near the scars overlaps the scar and therefore hides it.  This flap of scalp containing the hairs to be transplanted is then taken and cut and divided into the hairs or groups of hairs to be transplanted. After surgery, the donor area will probably feel sore, numb or 'tight' as the area heals for up to a few weeks post-surgery.

In the newer Follicular Unit Extraction (FUE) method, the individual follicular units are removed via a punch (there is also now a new automated machine to remove the follicles which removes more follicular units quicker). The holes from FUE are similar to a small scalp biopsy and heal on their own in matter of days with no stitching required. There is no soreness or tightness as in the strip method.

The hairs are then grafted into position by the surgeon. The hair transplant surgeon will cut many small slits with a scalpel where the hairs will be placed. The hairs will then be inserted one by one ino the little slits. These grafts will heal quickly and you may experience some numbness, redness or scabbing, which is expected to heal within one week's time.

This is the most critical part of the operation as far as results are concerned, since the hairs must be placed properly in order for the hair to have a natural appearance.  This is why many doctors stress the need for your surgeon to have an artistic ability when creating hairlines and to see many examples of his work.  A good surgeon can be the difference between a hairline that looks natural and one that makes it obvious you had a transplant.   How you look afterward is obviously a concern.  The above picture demonstrates how grafts often look after hairs have been transplanted before the slits for the graft have healed (source: Dr. Stephen Cotlar).

The whole process will take a few hours, but the healing and regrowth process will take longer.

See: After Hair Transplant Surgery