Surgical Hair Restoration

Surgical hair restoration has come a long way since it was first experimented on in the 1950s. It was then that some of the basic principles that hair restoration is founded on were discovered, including Donor Dominance. Donor Dominance is the idea that hair follicles will live forever and that it is the hair follicle that determines longevity, not where it is located or relocated on the scalp.

In the 60s and 70s, with this concept firmly in place, physicians began to perform the first transplants for cosmetic improvement. Doctors were successful in transplanting hair from the sides and back of an individual's head to the top. However, the results left much to be desired—they were unnatural and obvious.

The procedure obviously needed a lot of work, but continued to develop through the years. In the 80s, minigrafts became the norm, but, though these were an improvement, the minigrafts only served to generate smaller plugs of clumps containing 5-8 hairs. Many procedures today involve the repair and/or camouflage of these plugs or minigrafts. Even though this was a huge improvement over the larger grafts, it still led to a slightly unnatural look.

The current hair restoration technique is called follicle-unit micrografting, and has revolutionized how most people approach hair loss. Micrografting involves many hundreds or thousands of tiny, living grafts containing only 1-4 hairs. These grafts are inserted in closely spaced areas over the entirety of the bald and thinning areas. This procedure has finally developed a way to produce a realistic, aesthetically pleasing appearance because it uses at most 4 hairs, which is the most that naturally grow from each original follicle.

This transplantation procedure works because, as the terms male pattern and female pattern baldness describe, there is a pattern to the baldness. In most cases, at least with men, no matter how much hair they lose at the top of their heads, the sides and backs of their heads retain hair, and sometimes a lot of it. Thus, hair can be taken from these areas, also called donor sites, and transplanted to the balding areas.

Once the hair has been extracted from the donor area, it is transplanted to the balding parts of the scalp, into tiny incisions that the doctor has made. The donated hair, hair follicles, surrounding tissue, and skin are what is referred to as the graft, and each graft contains up to four hair follicles, as mentioned above, with accompanying hair, tissue, and skin.

The ultimate number of procedures needed depends upon a number of factors: the extent of the hair loss, the projected hair loss rate, the amount of donor hair that can be spared, as well as other artistic and medical considerations. Typically, men can gain their desired results with one or two treatments in which thousands of follicles are transplanted. Women, however, often need more sessions to achieve the appropriate density. Each session can last between 5 and 10 hours each, so it will not be a short day.

Essentially, you're a good candidate for hair replacement if you've lost your hair due to an inherited trait, if it lost it because of trauma or burns, and/or you have healthy hair growth at the back and sides of your head. The transplantation works because it does not affect the ability of the transplanted follicle/hair to grow.

There are few side-effects, and when they do occur they are generally mild. You may experience slight pain or discomfort directly following the operation, and swelling or the formation of scabs over the grafts (which take about one week to heal) is also a possibility. Serious problems like bleeding, scarring, and infection are rare. Typically, modern hair transplantation surgery is comfortable, predictable, and the results are pleasing.

It's important to remember that hair loss is a lifelong process, so the aging process continually thins the entire head of hair. Progressive hair loss or the desire for more density may require more transplant procedures. Nevertheless, modern techniques allow hair restoration specialists to transplant a larger number of grafts at one time, which greatly reduces the number of procedures needed to achieve the desired result.

By Liz Smith