A hair transplant is a procedure in which a dermatological surgeon moves hair from a hair-filled section of the head to a bald area of the head. The hair is usually transplanted from the back or the side to the front or on top. Hair transplants are typically performed in a medical office under local anesthesia.
According to the Cleveland Clinic, genetics accounts for 95 percent of alopecia (baldness) cases in the United States (Cleveland Clinic). The other five percent of cases are caused by a variety of factors, including diet, stress, illness, and medications.
A hair transplant can improve the appearance and self-confidence of patients who experience hair loss.
Who Is a Candidate for a Hair Transplant?
Good candidates for a hair transplant include:
- men with male-pattern baldness (the most common type of baldness present in 20 percent of men aged 20, and a large percentage of older men)
- some women with thinning hair
- someone who has lost some but not all hair from a burn or scalp injury
Hair replacement is not recommended for:
- women with a wide-spread pattern of hair loss throughout the scalp
- people who don’t have enough “donor” hair sites from which to remove hair for transplant
- patients who form keloid scars (thick, fibrous scars) after injury or surgery
- patients whose hair loss is due to medication like chemotherapy
What Happens During a Hair Transplant?
After thoroughly cleaning your scalp, a surgeon uses a small needle to numb an area of your head with local anesthesia. Next, a round section of your scalp that is covered with hair is removed with a scalpel. The scalp is sewn closed.
The surgeon then separates the removed portion of scalp into small sections using a magnifying lens and sharp knife. These small sections, when implanted, will help achieve natural-looking hair growth.
There are two types of transplant procedures: slit grafts and micro-grafts. Slit grafts contain between four and ten hairs per graft. Micro-grafts contain one or two hairs per graft, depending on how much coverage is needed.
Tiny holes are made with a blade or needle in the area of your scalp that’s being implanted with hair. Hairs are then gently placed in these holes. During one treatment session, hundreds or even thousands of hairs may be transplanted.
After the graft, your scalp is covered with gauze or bandaged for a few days. A hair transplant session can take four or more hours.
Your stitches will need to be removed about 10 days later. Patients may require up to three or four sessions to achieve the full head of hair they desire. Sessions are spaced several months apart to allow each transplant to fully heal.
Recovery from a Hair Transplant
Your scalp may be sore following hair transplant surgery. You may need to take pain medication for several days. You may also be instructed to take antibiotics to reduce your risk of infection and anti-inflammatory medications to keep swelling down. Most people can return to work several days after surgery.
Two to three weeks after the procedure, the transplanted hair will fall out. This is normal and makes way for new hair growth. Most patients get about 60 percent new hair growth six to nine months after surgery. Many doctors prescribe minoxidil (Rogaine) or propecia (a hair-growth medication) to improve hair re-growth. This medication also helps slow or stop future hair loss.
Side Effects and Risks of a Hair Transplant
Side effects from a hair transplant are usually minor and clear up within a few weeks. They can include:
- swelling of the scalp
- bruising around the eyes
- a crust that forms on the areas of the scalp where hair was removed or implanted
- numbness or lack of sensation on the treated areas of the scalp
- inflammation or infection of the hair follicles (folliculitis)
- sudden loss of the transplanted hair, called shock loss, which is typically temporary
- unnatural-looking tufts of hair
Typically, patients who’ve had a hair transplant will continue to grow hair in the transplanted areas of the scalp permanently. The new hair may appear more or less dense depending on:
- scalp laxity (how loose your scalp skin is)
- density of follicles in the transplanted zone
- hair caliber or quality
- hair curl
Patients need to take medication (propecia or minoxidil) or undergo a low level of laser therapy to stop future hair loss. If they don’t, they may continue to experience hair loss in non-treated areas of their scalp.
It’s important to discuss your expected outcome with your surgeon and to develop realistic expectations.