Hair transplantation is a process of transplanting or moving healthy hair follicles from one area (a donor site) to another area (a recipient site) by surgery. It has been widely practiced for decades as a solution to male pattern baldness. It can work well for men since hair loss is not diffuse, not usually spread out over large areas, and donor sites with stable, healthy follicles are available. In women, however, this is usually not so. When women experience hair loss, the hair generally becomes thinner across the entire scalp, so there are no good donor areas. All areas of the scalp have hair follicles that are unstable as they are affected by follicle-damaging DHT. So it makes no sense to move unstable hair follicles to transplant in another area that has similar unstable hair follicles. The result would not generally yield any improvement.
The target area for hair transplantation in males is generally the areas of the scalp prone to lose hair as a result of male pattern baldness which is the receding front hairline area and/or the vertex, or “crown” of the scalp. Surgeons take individual hair follicles from other areas of the scalp where hair is actively growing and transplant them to the balding areas.
A Routine Procedure Worldwide
Hair transplants have been an accepted and growing practice for decades. This procedure is routinely done on an outpatient basis using local anesthesia. In 2010, it is estimated that more than 100,000 surgical hair restoration procedures were performed in the United States, and more than 279,000 were performed worldwide, according to statistical data published annually by the International Society of Hair Restoration Surgery (ISHRS).
Methods of Transplantation
Two different methods are primarily used for harvesting, or obtaining, healthy hair follicles for transplantation. The first procedure is called “microfollicular transplantation”. With this method, thin strips of scalp from the area where healthy hair is growing (donor area) are extracted. The hair bearing strip is separated to single follicular units under magnification. Each follicular unit contains more than 1 follicle. On an average each graft or follicular unit contain 2 to 3 hair follicles or hair. The surgeon makes micro slits in the area of the transplant. This step is the most important step since the surgeon decides the density of the transplant and the direction of the transplanted hair. The next step is implantation of the grafts into these pre formed slits.
The other method is to remove tiny individual hair follicles one-by-one from the donor area via small surgical incisions and transplant them to recipient areas. Think of digging up individual plants from a nursery area and planting them individually in the desired spots in a garden. Each small section of scalp is from 0.6 to 1.25 mm in diameter. This method is termed “Follicular Unit Extraction” (FUE Harvesting), and leaves only tiny scars compared to the strip harvesting method. The donor wounds, approximately 1-mm in size, completely heal over the course of seven to ten days, leaving tiny white scars buried in the hair in the back and sides of the scalp. However, this process requires significantly more time and is therefore more expensive.
Following the procedure, the hair in the transplanted hair follicles usually falls out days after the surgery, due to the trauma of the process, but begins to grow back in the weeks and months that follow. Full recovery of natural growing hair takes four to six months.
Advances In Technology and Medical Science
Medical, scientific and technical advances have greatly benefited hair transplantation. New transplantation techniques and microsurgical instruments have enabled a safer procedure and more natural looking results. In the 80’s hair restoration surgery evolved dramatically, as the large punch grafts used since the 50’s, were gradually replaced with a more refined combination of mini and micrografts. Now, patients are usually pleased with the look and aesthetics of transplantation as their “new” hair has the same color, and texture as their existing hair.
The price of hair restoration surgery varies, but is typically priced at $5 – $6 per graft, and usually involves hundreds of grafts or even 1,000 to 2,000 grafts in a longer surgical session. Therefore, a session involving 400 to 500 grafts can cost $2,000 to $3,000; while a longer session with 1,500 grafts might cost $6,000 to $7,500. The price per graft often is dropped down as the size of the overall session increases beyond 1,000 to 1,500 grafts, for a volume discount effect. Hair restoration clinics typically provide free no-obligation consultations.
Pros of Hair Transplantation
1. Only option for real hair. In bald scalp areas where the hair follicles have ceased to produce any hair, hair transplantation is the only means of introducing growing hair.
2. A long term solution. The transplanted hair will grow for as long as it would have grown in the site it came from.
3. It is your hair. Transplanted hair has the same characteristics of the patient’s natural hair: the same color, rate of growth and texture. It will blend well with existing hair and look good.
4. Results are more natural looking than ever. Due to many advances in technology and surgical art over the past 10-15 years, hair transplantation results in natural looking hair .
5. Minimally invasive process. Patients can undergo hair transplantation as an outpatient procedure that does not have a major impact on their lives. Patients can be more or less back to normal in a few days after the procedure.
Cons of Hair Transplantation
1. Expense. A moderate hair transplantation procedure could cost $2,000 to $3,000; while a session with 1,500 or so grafts might cost $6,000 to $7,500. A longer session involving 3,000 grafts might cost $12,000.
2. Some pain and discomfort. Patients experience some pain and discomfort following the procedure as their scalp heals. Healing process takes longer for the strip harvesting method.
3. Recuperation period. Following the procedure, it will be a few months before a patient’s hair grows back in fully.
4. Scarring. With the strip harvesting method, patients are left with a scar in the donor area. This may be concealed by hair and may not be a concern.