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Hair Replacement Surgery
What causes hair loss?
Hair loss is believed to be primarily caused by a combination of the following:
What is hair replacement surgery?
The interest in hair replacement has significantly increased over the past 10 years. By the age of 50, about 85% of men have significant thinning of hair. Women may also suffer from hair loss. For men, the main cause of a diminishing hairline is heredity. Hormonal changes such as menopause can cause both thinning and hair loss in women.
There are a number of hair replacement techniques that are available, although hair replacement surgery cannot help those who are totally bald. Candidates for hair replacement must have a healthy growth of hair at the back and sides of the head. The hair on the back and sides of the head will serve as hair donor areas where grafts and flaps will be taken.
There are 4 primary different types of hair replacement methods, including the following:
Hair transplantation. During hair transplantation, the surgeon removes small pieces of hair-bearing scalp grafts from the back or sides of the head. These grafts are then relocated to a bald or thinning area.
Tissue expansion. In this procedure, a device called a tissue expander is placed underneath a hair-bearing area that is located next to a bald area. After several weeks, the tissue expander causes the skin to grow new skin cells. Another operation is then required to place the newly expanded skin over the adjacent bald spot.
Flap surgery. Flap surgery is ideal for covering large balding areas. During this procedure a portion of the bald area is removed and a flap of the hair-bearing skin is placed on to the bald area while still attached at one end to its original blood supply.
Scalp reduction. Scalp reduction is done to cover the bald areas at the top and back of the head. This technique involves the removal of the bald scalp with sections of the hair-bearing scalp pulled together filling in the bald area.
Possible complications associated with hair transplantation procedures
Possible complications associated with hair transplant procedures may include:
Patchy hair growth. Sometimes, the growth of newly placed hair has a patchy look, especially if it is placed next to a thinning area. This can often be corrected by additional surgery.
Bleeding or wide scars. Tension on the scalp from some of the scalp reduction techniques can result in wide scars or bleeding.
Grafts not taking. Occasionally, there is a chance that the graft may not "take." If this is the case, surgery must be repeated.
Infection. As with any surgical procedure, there is the risk of infection.
About the procedure
Although each procedure varies, generally, hair replacement surgeries follow this process:
Location options may include:
Anesthetic options may include:
Average length of procedure:
Several surgical sessions are usually needed to achieve satisfactory fullness, with a healing interval of several months recommended between each session. It may take up to 2 years before seeing the final result with a full transplant series.
Plugged or grafted hair falls out within a 1 to 2 months after surgery, which is normal and almost always temporary. After hair falls out, it generally takes another month or more before hair growth resumes. A surgical touch-up procedure may be needed to create more natural-looking results after the initial incisions have healed. This may involve blending, a filling-in of the hairline using a combination of mini-grafts, micro-grafts, or slit grafts.
Online Medical Reviewer:
Lickstein, David, MD
Date Last Reviewed:
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