Medical hair restoration is a field of cosmetic surgery that has seen great advances since the 1980s. The best candidates for surgical hair restoration are men who have good hair growth on the sides and back of their head and who do not have rapidly progressive male pattern baldness. Essentially, this is an issue of not waiting too long. If you have only a fringe of hair left, there is little that can be done for you.
Surgical Hair Restoration
Permanent hair transplant via surgical methods can be accomplished in a number of ways, either by harvesting follicles and relocating them to balding areas of the scalp or by removing the balding areas and stretching adjacent hair bearing tissue in to place to cover the gap created.
Hair Transplant Surgery
Hair restoration surgery or hair follicle transplantation takes approximately four hours and is conducted under a mild sedative in conjunction with a topical, local anesthetic. First the patient is shampooed and then the scalp is treated with anti-bacterial medication. The surgeon selects an area at the back of the scalp to harvest a graft with good hair growth. Usually the piece removed will measure 2 x 10 centimeters.
Individual units are then dissected from the strip under a microscope. Excess fibrous and fatty tissues are carefully removed to gain access to the individual follicles. The surgeon then uses a fine needle and painstakingly punctures the balding spot with a predetermined pattern of density. By paying careful attention to angle, the surgeon duplicates a natural growth pattern. The follicles that have been extracted are then inserted into the punctures.
After the surgery the patient will wear semi-permeable bandages that allow for drainage. These bandages will be changed daily and there can be no exposure to the sun and no shampooing for at least a week. The patient should not be concerned when all of the transplanted hairs fall out in the first week to ten days. New hairs will be produced by the transplanted follicles in two to three months. This hair will grow normally and thicken for six to nine months.
Subsequent hair loss can occur in untreated areas and some transplant patients take medications to retard further balding. Others assume they will require additional transplantation in the future. For the most part this is a procedure that is reasonably affordable. Hair transplant surgery normally costs in the neighborhood of $4,000.
Alopecia Reduction Surgery
Another form of hair loss restoration is alopecia reduction surgery; a procedure in which bald scalp is actually removed and the hair-bearing tissue is pulled forward. This may be done as a single treatment, as part of a hair transplant, or occasionally in conjunction with a facial cosmetic procedure like a brow or forehead lift.
A very similar procedure is scalp expansion surgery in which a device resembling a balloon is placed under the skin. Over a period of time (usually two weeks) this device expands the balding scalp. The device is then deflated and removed, the excess scalp is cut away, and hair bearing scalp is brought forward to cover the area.
In scalp flap surgery, a flap of scalp and underlying tissue are moved from one area of the head to another. The flaps are either “pedicle” or “free.” Pedicle flaps are removed and relocated with the artery-vein blood supply intact. This is the kind of flap most often used in cosmetic hair surgeries and the presence of the consistent blood supply greatly enhances the survival rate of the flap. A free flap does not have the artery-vein attachment and a reattachment of the blood supply via microsurgery must occur at the new site. This type of flap is most often used in reconstructive surgery to repair a trauma or correct a congenital defect.
Since the 1980s scalp flaps have been used only rarely for cosmetic surgery with frontal hair transplants and scalp reduction or expansion being the preferred methods. After any of these procedures the patient will wear dressings that must be changed on a daily basis and will be given explicit instructions for wound care and cleansing of both the surgical site and the surrounding hair.
There are potential complications with medical hair restoration, mainly with the procedures in which the scalp is stretched. Essentially the tissue can attempt to stretch back toward its original location. There is also a danger of excess scarring at the point of the required incisions. While these conditions are rare, they can occur and should be thoroughly discussed with your surgeon.
The only real potential complications in a hair transplant procedure are infection at the site from which the graft material was removed or a failure of the transplanted follicles to survive in their new location. Both of these events are extremely rare.
There will be temporary numbness and swelling following each of the surgical procedures. Recovery time varies with the extent of the work performed and with the individual patient but normally within two to three weeks normal activities can be resumed with full recovery in six weeks to two months.