Hair Replacement Surgery: A Popular Treatment for Balding

Introduction:

Hair loss is usually an age-related change. Apart from that, many factors cause hair loss, including hereditary factors, stress, medicines, hormonal disturbances, hairstyle treatments, nutritional deficiency, etc., or a combination of these factors. Hair loss has become a common problem due to lifestyle changes. People are searching for options to combat this problem. Hair replacement surgery can achieve good results, restore confidence and self-esteem and prevent social and psychological trauma caused by hair loss.

What Is Hair Replacement Surgery?

Hair replacement surgery is a process where hair is transplanted from thicker areas on the head to the bald or thinner area of the scalp. This transplant of hair is called a graft. The site from where the graft is taken is called the donor site. Dermatologists or plastic surgeons perform this procedure. It is done as an outpatient and sometimes as an inpatient procedure, depending on the amount required for hair replacement.

In What Condition Is the Hair Replacement Surgery Done?

• Hereditary baldness in males and females.

• Alopecia areata is an autoimmune disease with a loss of hair follicles.

• Traumatic injury or burns on the scalp.

Why Is Hair Replacement Surgery Needed?

People opt for hair replacement surgeries for several personal and social reasons like

• Improved appearance.

• It boosts the self-esteem of the patient and increases confidence.

• A permanent solution to baldness.

• Natural hair.

• Negligible maintenance.

Who Is a Potential Candidate for Surgery?

• Any healthy individual without any systemic complications.

• The one with healthy hair growth in other parts of the scalp.

What Are the Medical Issues Associated With Hair Transplant Surgery?

Before undergoing hair transplant surgery, discuss the following medical considerations with a medical practitioner:

• Physical Health: An examination will help determine if the treatment is appropriate.

• Medical History: Pre-existing conditions and previous surgeries may influence decisions, including the type of anesthesia used.

• Hair Evaluation: This includes assessing hair growth patterns, the extent of hair loss, family history of hair loss, and any prior treatments for hair loss.

• Medication: Inform the medical practitioner about any regular or recent medications, including over-the-counter preparations like fish oils and vitamin supplements.

• Past Reactions to Medication: Report any adverse reactions or side effects from medications, including anesthesia.

• Preparation for Surgery: Follow detailed instructions provided by the medical practitioner for home preparation, which may include taking specific medications or adjusting doses of existing ones.

How Is Hair Replacement Surgery Performed?

A hair transplant involves two main steps: harvesting and implantation.

• Harvesting: There are two main techniques for harvesting hair. In follicular unit strip surgery (FUSS), a surgeon removes a strip of hair-covered skin from the lower back of the scalp, where hair is less likely to fall out. Small grafts are then dissected from this strip. In follicular unit extraction (FUE), individual hair grafts are taken directly from the donor site using a tool called a micro punch.

• Implantation: Once enough grafts are harvested, the surgeon makes tiny incisions in the bald or thinning areas of the scalp using a small blade. Each incision receives a graft, planting new hair in the desired areas.

There are four types of hair replacement surgeries. They are,

1. Grafting

• This procedure is performed under local anesthesia.

• The procedure takes place over several hours, and the patient is generally awake and talks to the surgeon while the procedure is going on.

• Grafting is the most common hair replacement surgery.

• In this procedure, the surgeon removes small pieces of skin that contain 10 to 15 hairs. These are called hair plugs or grafts.

• There are two types of grafts. Slit graft contains four to ten hair per graft, and micrograft contains one to two hairs per graft.

• These plugs are carefully transferred onto the bald or thinner areas of the scalp.

• Many other procedures may be required to achieve the desired results.

2. Scalp Reduction:

• This procedure is performed under local anesthesia.

• This procedure is done on areas usually surrounded by hair, such as baldness on the scalp, back, and top.

• In this procedure, a small area of bald skin is removed, and surrounding areas with hair are loosened, pulled over, and stitched onto the bald area.

• Sometimes this procedure may be combined with grafting to achieve a more natural look.

3. Flap Surgery:

• This surgery is performed under general anesthesia.

• This procedure is done in case of large areas of baldness.

• In this procedure, a flap is raised with superficial cuts on three sides, and one side is intact to maintain the blood supply to tissues.

• This procedure is done in several phases according to how much hair coverage is needed.

4. Tissue Expansion:

• This procedure is done in case of baldness due to burns.

• This procedure will be performed under general anesthesia.

• In this procedure, an implant called a tissue expander is inserted under the scalp where hair is intact.

• This expander is inflated to stretch the skin. This procedure is performed for a few weeks.

• Then the surgeon performs another procedure where the bald area is covered with the stretched skin and sutured.

What Are the Complications of Surgery?

• Infection at donor and graft areas.

• Allergic reaction to local anesthesia.

• Clotting.

• Failed grafts.

• Numbness on the scalp.

• Permanent scars that may be significant, elevated, red, and itchy.

• Tissue necrosis around the wound.

• Fake-looking hair.

• Bruising around the eyes.

What Happens to the Donor Area?

At the site where a graft is removed, the patient may experience the following symptoms. However, these symptoms are temporary and usually heal once the hair grows back.

These include,

• Burning or itching.

• Swelling.

• Loss of sensation.

• Pain.

• Tightness.

• Scabs.

What Are the Alternatives to Hair Transplant Surgery?

Non-surgical options for addressing hair loss include:

• Using prescription creams and medications.

• Wearing wigs, hairpieces, or hair extensions.

• Embracing hair loss as a natural part of aging. Speaking with a counselor or psychologist can help in addressing concerns about appearance and may lead to greater self-acceptance.

What Are Self-Care Instructions for Patients?

Once the surgery is completed, the patient is advised to follow certain instructions to avoid graft failure and achieve a successful look.

Don'ts:

• Smoking after the surgery.

• Touching the grafted area.

• Heavy workouts.

• Coloring or oiling hair.

• Sleeping face down or on the sides.

• Forceful removal of scabs.

Do’s:

• Spraying saline solution on the graft every half an hour.

• Use medications as suggested.

• Use the antibiotic cream for three days.

• On day four, the doctor suggests gentle washing with a mild shampoo.

• After one week, a scrubbing motion can be used to wash the hair.

• The patient can go swimming after one month.

What Is the Recovery Process After Surgery?

Recovery depends on the type of surgery undergone by the patient. In most outpatient surgeries, the patients can go home on the same day.

• After three to four days, the patient can resume routine work.

• After ten days, stitches are removed.

• After three to four weeks, the patient can start exercising.

How Long Does the Result Last?

Hair replacement surgery will take at least one year to show the full results. In the meantime, as the graft heals, the hair may fall out. It is a natural process, and new hair grows back. The patient may require other procedures to achieve long-lasting permanent results.

When Should a Revisit Be Done?

The surgeon will schedule follow-up appointments to monitor the healing of grafts and hair growth. One should not neglect to contact the surgeon if the following symptoms persist.

• A long-lasting fever.

• Pus or yellow discharge from the graft areas.

• Severe pain in the graft area.

• Bleeding from the site.

When to Contact a Doctor?

Reach out to a doctor promptly if any of the following symptoms occur:

• Significant bleeding.

• Rash, skin bumps, or cysts (indicating possible infection).

• Opening of the wound incision.

• Skin discoloration with a dusky appearance and crusting.

• Facial swelling, potentially accompanied by hives and trouble breathing (signs of anaphylaxis).

Conclusion

Hair replacement surgery should be considered only after other common hair regrowth treatments fail. Always talk to the doctor, explain the expectations and allow the doctor to suggest the best suitable treatment. Choose a plastic surgeon with good experience and knowledge in hair replacement procedures. But no single treatment can guarantee the results. Patients may undergo multiple procedures and surgery to attain healthy-looking natural hair.