What types of hair loss can be treated with a hair transplant?
Baldness can have a variety of causes, sometimes caused by an underlying condition, and it can be temporary (reversible) or permanent. This blog is about treating the main cause of permanent hair loss: androgenetic alopecia, often referred to as male or female pattern hair loss. This is by far the most common reason for patients seeking a hair transplant.
What is androgenic alopecia?
Androgenic alopecia is a genetically determined, hereditary and hormonally controlled process that is triggered by an increased androgen reaction. It affects approximately 50% of men and women (depending on age) and results in gradual scalp hair loss after puberty, with different patterns in both sexes. In men there is pronounced hair loss on the vertex, on the top of the head and in the frontotemporal regions, while in women the front hairline usually remains, but the vertex and the top of the head are diffusely thinned.
Other causes of hair loss
With some limitations, hair transplants can be a solution for patients with permanent hair loss due to trauma, surgery, or burns.
Contraindications
Unfortunately, hair transplants are not always successful for other causes of hair loss and may even be contraindicated in patients with certain diseases.
Alopecia areata
Autoimmune diseases such as alopecia areata, an autoimmune disease that specifically attacks the hair follicles.
Hormonal disorders
Thyroid disorders or other hormonal imbalances.
What is a hair transplant?
A hair transplant is a surgical procedure in which healthy hair follicles are transplanted into areas of the scalp affected by baldness or thinning. This procedure is also known as hair surgery and is often performed by people who have exhausted all non-surgical methods to treat hair loss. The hair transplants – also called micrografts – are taken from the back and sides of the scalp because they are genetically programmed differently than the hair that typically falls out in people with androgenic alopecia.
Variants of hair transplantation
There are different types of hair transplant techniques. The removal is usually carried out using the more modern and popular FUE method.
Follicular Unit Extraction (FUE)
FUE is a minimally invasive technique in which individual follicular units are removed from the donor area using a small punch, resulting in less visible scarring.
Follicular Unit Transplantation (FUT)
FUT, also known as the strip technique, involves surgically removing a strip of scalp tissue from the donor area, which is then broken down into individual hair follicles under a microscope. The donor area is closed with sutures or staples, leaving a linear scar. Because of the scar, this method is rarely used today.
Direct Hair Implantation (DHI)
In this technique, the grafts are removed using a special device called the Choi implant pen and implanted immediately. Although we do not currently offer this type of hair transplant, it may be a viable option for select patients with small area hair loss. The procedure is more expensive and lengthy than FUE surgery, but allows for higher hair density than other techniques. Please read on to discover the individual steps on the way to a full head of hair!
How is a hair transplant performed?
Hairline design and anesthesia
After determining the hairline with the patient, we typically shave both the donor and transplant areas. This is followed by thorough disinfection and the injection of a local anesthetic with a thin needle. Because the injection can be painful, we offer several options to increase comfort. In our practice, you can opt for additional painkillers and sedative/relaxing medications, administered either orally, intravenously, or by inhalation (Entonox®).
Follicle harvesting
After checking that there is sufficient anesthesia, numerous tiny punch cuts are made around the individual follicular grafts under loope magnification. The grafts, which contain 1-4 hairs, are carefully removed using microsurgical instruments and stored in a special preservation solution. We work with a team of highly qualified and experienced harvesting technicians to reduce operation times.
Loupe magnification
Working under magnification and correctly handling the follicles are crucial for optimal results, as both reduce the likelihood of damaging these delicate structures.
Follicle implantation
Next, the receiving channels for the micrografts are created (channeling) using a tiny knife in the intended recipient area of the scalp. The grafts are then carefully inserted into these holes.
Number of grafts
Thousands of hairs can be transplanted in a single treatment session. But even the most experienced teams do not recommend transplanting more than 3,500 to 4,000 grafts in one session, as this increases operation time, increases the risk of complications and lowers the quality of results to unacceptable levels. If you have extensive baldness, we recommend carrying out hair restoration in several sessions. It is important to know that hair taken from the donor area will not grow back. Therefore, the donor area should not be depleted by high graft volume surgeries all at once, as later corrections may be necessary depending on further hair loss over time.
Bandage
At the end of the procedure, the donor area is covered with an antibiotic ointment and a bandage. The recipient site is left as is to avoid damaging the delicate grafts.
Hair density
It is not always possible to achieve the desired hair density, especially if the donor area is not sufficient or the bald area is too large. If hair restoration is performed in multiple sessions, they must be spaced at least six months apart to allow the donor area to recover.
Recovery and result
After a hair transplant, the recovery process is usually quick. All of our hair transplants are performed on an outpatient basis, allowing our patients to return home or to their hotel room the same day. The next day after the procedure, you can remove the bandages and shower. After 3 to 5 days, you often feel well enough to resume light activities and go to work with some precautions.
Sport
After about 2 weeks you can start exercising again, even if certain restrictions apply for a longer period of time.
Result
It is important to know that the results of a hair transplant will only be fully visible after 12 to 18 months and that the transplanted hair will initially fall out in the weeks following the procedure before growing back in a window of approximately 6 months. Throughout the entire recovery process, it is important that you strictly adhere to our post-operative instructions to achieve optimal healing and long-lasting top results. If you would like to know more about the different supportive treatments to achieve the best results from your hair transplant, as well as are curious about non-surgical alternatives, read about medical treatment for hair loss.
Please contact me if you require further information or would like to schedule a consultation. I’m here for you!