FAQ on Hair Transplant Surgery

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  +Vaibhav Shah 

                       Frequently Asked Questions on Hair Transplant

*Hair loss in women – can females do hair transplantation?

       The short answer is yes; as long as the women’s hair loss is concentrated in defined areas like in the classic male pattern baldness (i.e. the woman’s hair loss is not too diffuse or thin throughout their entire scalp).

       Consider what Dr. Dow Stough, hair transplant surgeon in Texas writes about women hair loss – “Hair loss in women is culturally unacceptable despite the fact that up to 40% of the female population experiences some hair loss in their lifetime. It is not uncommon, but the stigma attached to female baldness is an extremely stressful and unwelcome event. In fact, androgenic alopecia in women can be psychologically debilitating. There have been several medical studies which have concluded that although alopecia is clearly a distressing experience for both sexes; its effect is much more problematic in women. Most women go to extremes to conceal and treat their hair loss; they use a broad array of creative camouflaging and hair thickening cosmetic techniques in an attempt to mask the condition.

     Women who are experiencing hair loss should undergo a thorough investigation by a dermatologist. The medical workup and testing for women with hair loss is very involved and time consuming. The most difficult cases, are women with diffuse hair loss, i.e. balding which is not concentrated in the frontal regions of the scalp.

     In cases of non-patterned alopecia, a dermatologist will usually recommend laboratory tests, which may include a complete blood count, iron levels and thyroid studies. An extensive medical drug history and family hair loss history must also be obtained, and in some cases testing for a hormonal imbalance is warranted.

      For those women who do not have diffuse alopecia, the diagnosis is simplified and much more direct. These women are classified by the Ludwig classification system. There are three categories; Ludwig I, Ludwig II, and Ludwig III. Those with a Ludwig I pattern are not candidates for any surgical treatment. They are best treated with topical treatments. Patients with more advanced hair loss, those who are classified as Ludwig II or Ludwig III categories, are possible candidates for hair transplantation. They are acceptable candidates if they have an adequate amount of donor density. The donor area is the hair found in the back of the scalp.

    In those women who have complete balding in the central and frontal of the scalp, hair transplants are a viable option. The results from this transplantation can be truly outstanding since many women retain the frontal hairline and it does not need to be recreated.

       Hair transplantation in women with hair loss caused by cosmetic surgery also yields excellent results. By camouflaging the scars resulting from brow lifts or face lifts these patients are able to achieve their expectations”.

*Can I wear a hairpiece until growth of the hair transplant is complete?

      Hair pieces can be worn between surgical visits if you want, as long as proper hygiene and ventilation of the scalp are maintained. For the first 7 to 10 days, post hair transplant, you have to be extra careful not to disturb the transplanted grafts while putting on or off the hair piece.

     After that, in case your hair system requires use of adhesive, we advise you to take care that the adhesive/tape does not rest over the transplanted area.

*Since Finasteride (Propecia/Finpecia) is now available, will hair transplantation be a thing of the past?

     While Propecia (Finasteride) and Rogaine (Minoxidil) have been proven to regrow hair, in a percentage of patients, they will not grow all your hair back. Both products have not been proven to grow any significant hair in the frontal and temple areas, which are the main areas of concern for most people. Their greatest benefit seems to be in slowing down the hair loss process.

*What about “Scalp Expansion and Reductions”?

      Scalp reductions were first introduced in the mid-1970’s as a way of treating an individual with a midline bald spot. Although several design approaches can be used, an elliptical approach is generally the most common. Prior to the excision, a surgical balloon may be inserted below the scalp and filled gradually with liquid to improve the scalp laxity. With this procedure, an ellipse of bald skin is removed centrally in the crown area and the hair-bearing scalp on the sides of the head is stretched toward the middle to obtain closure. Because scalp reductions do not allow for an upward and forward advancement of the entire scalp, they are not effective in treating patients who possess or have the potential for more extensive baldness.

          Due to this inherent surgical limitation, as well as the aesthetic drawbacks, which include an excessive stretching back of the bald area and increased receding at the temples, the scalp reduction procedure is considered outdated for the treatment of moderate to extensive baldness. Newer hair transplantation procedures offer more predictable and better aesthetic results, and often require fewer surgical sessions.

*Does removing hair from the donor area on the back of my head leave a gap?

       The scalp is elastic. When the donor strip of hair is removed, the scalp on both sides is pulled together and sutured. The only evidence of surgery is a suture line hidden under the hair that grows vertically on the back of the head.

*Are there risks involved with hair transplantation?

       Elective surgery to improve physical appearance is universally accepted and is being performed successfully everywhere there are qualified specialists. Hair transplantation procedures differ from general surgery, however, in that they involve only the outer layers of the body. Thus, any risks involved in hair transplant are similar to those with any outpatient surgery. Hair transplant, by itself, has no adverse effect on the brain, eyes, memory etc.

*Is hair transplantation surgery painful?

      The discomfort associated with hair transplantation surgery is usually comparable to that of dental surgery. Pain medication is always offered, though its use is limited generally to the first few days after surgery.

*Will my hair require special care after hair transplantation?

     Your newly restored hair will grow and require the same maintenance as your original head of hair. It’s your hair and can be colored, permanently waved or styled in a variety of ways suitable to your lifestyle. You can even shave them off, they will grow right back.