Baldness is often blamed on poor circulation to the scalp, vitamin deficiencies, dandruff, and even excessive hat wearing. These are just theories and for the most part have been disproved. Hair loss is primarily caused by a combination of heredity, or family history of baldness, age, and hormonal changes. Generally, the earlier hair loss begins, the more severe the baldness will become. While they are usually viewed as a last resort, hair transplants are the only permanent solutions to male and female hair loss.



It is estimated that one in five women will experience some degree of hair loss due to hormonal changes, aging or illness. Women tend to have subtle thinning all over the scalp rather than losing hair in patches as is common with men. Either way it is important to know that you will never be able to achieve the same coverage you had prior to hair loss, but surgery can camouflage the thin areas and give you more fullness. If you have considered any type of hair restoration, hair transplants are the only permanent method of restoring hair. You may find some comfort to know that board certified plastic surgeons have been successfully performing hair transplants for more than thirty years.

The process of hair transplants begins with an evaluation of the donor area. This area on the back and sides of the head contain healthy follicles, which are genetically programmed not to shed. An individual with very little hair might not be advised to undergo the procedure since a sufficient amount of donor hair is required for successful transplantation. There are limits to what can be accomplished and are dependant on several factors. Hair color, texture, and curl or waviness can affect the results.

There are several hair transplant techniques. Punch grafts, mini grafts, micro grafts slit and strip grafts are usually performed on those who desire a more modest change in the fullness and appearance. Tissue expansion, scalp reduction and flaps are more suited for those who are looking for a more dramatic change. Sometimes more than one type of procedure may be performed to achieve the maximum desired result.

Hair transplantation involves removing small pieces of hair bearing scalp grafts from a donor site and relocating them to a bald or thinning area of the scalp. Since mini grafts are usually the treatment of choice for filling in thin spots, dense hair growth at the back of the head is required. Grafts differ in size and shape. Mini grafts contain only a few hairs, micro grafts only one or two. Slit grafts that are inserted into slits created in the scalp contain about four to ten hairs each whereas strip grafts are long and thin and can contain up to forty hairs. Punch grafts usually contain about fifteen hairs. Before the procedure, the donor area will be trimmed so that the grafts can be easily accessed and removed.

For punch grafts, the practitioner may use a special tube-like instrument made of sharp carbon steel that punches the round graft out of the donor site so it can be replaced in the area to be covered, generally the frontal hairline. For other types of grafts, your doctor will use a scalpel to remove small sections of hair-bearing scalp, which will be divided into tiny sections and transplanted into tiny holes or slits within the scalp. When grafts are taken, your doctor may periodically inject small amounts of saline solution into the scalp to maintain proper skin strength.

In general, several sessions are needed to achieve the fullness desired and the sessions should be spaced several months apart to allow for healing. To maintain healthy circulation in the scalp, the grafts are placed about one-eighth of an inch apart. The number of large plugs transplanted in the first session varies with each individual, but the average is about 50. For mini-grafts or micro-grafts, the number can be up to 700 per session. In later sessions, the spaces between the plugs will be filled in with additional grafts. Great care will be taken in the removal and placement of grafts to ensure that the transplanted hair will grow in a natural direction and so that hair growth at the donor site is not adversely affected.

Hair transplant procedures are generally completed in two to six hours. How soon you resume your normal routine depends on the length, complexity and type of surgery you've had. Some patients find that they can return to normal activities the same day where others require a few days of healing. A local anesthetic is usually used along with sedation to make you feel relaxed and comfortable during the procedure. You may feel some tugging or pulling, but you should not feel any pain or discomfort. In some more complex cases, a general anesthesia will be used and you will sleep through the procedure.

Many patients who have had transplants are dismayed to find that the new hair may fall out up to six weeks following the procedure. This is normal and almost always temporary. The hair should begin to grow after about three months and will continue to grow at the same rate as your natural hair. Normal hair growth equates to about a half inch per month. The transplanted hair does not require any special maintenance and will continue to grow forever.

As with any type of cosmetic procedure there is some risk involved. There is a chance that the grafts wont take, or that the hair will continue to fall out or will result in a patchy appearance. Sometimes the procedure may need to be repeated. While the risk is low, bleeding, infection or scarring may occur. Certain medical conditions such as uncontrolled high blood pressure, blood-clotting problems, or the tendency to form excessive scars could cause problems with the procedure. As always you should discuss your medical history, including medications you may be taking and whether or not you are a smoker with your physician. What to expect as far as the procedure, outcome, preparations and any follow up care should be discussed and fully understood before undergoing hair transplant.