Who are our hair transplant Patients?

In my experience working with hair transplant patients, it's clear that some men are critically affected by their hair loss. Hair is vital to some individuals' self-esteem, and this message has been expressed to us in literature and advertising for centuries.

Most hair transplant patients are men between the ages of 30 and 50, but in some cases, men as young as 25 will come in for consultations if their hair loss has already begun. Hair transplants in younger men are problematic, however, because the hair loss pattern hasn't completely declared itself. Physicians need to allow for the natural elevation of the hairline that will continue to occur in the years to come.

You may be surprised to learn that women also suffer from hair loss. Over 200,000 people had hair transplants in 1994 (more than four times the 1990 rate), and of those, about 13,000 were women.

On the Day of Your Procedure

When you arrive at the office or surgical center, your doctor will mark the outline of your new hairline. As you get older, and your hairline continues to recede, you'll want the new one to be appropriate for your age. If it's placed too low, similar to where it was when you were 20 years old, it will look strange and quite inappropriate when you are over 50.

After this, you'll generally be given a relaxation medicine, and the process will begin. Many of our patients sleep for 20 to 40 minutes and miss the start of the procedure. They don't feel a thing. The doctor will closely examine the back of the head, or the donor area, and may estimate hair density, sometimes with a magnifying instrument. Based on the number of the grafts to be planted, he will decide how big an area needs to be removed.

Next, the area is numbed, and the donor hair is removed. You may feel a little pressure during this process, but little or no pain. This donor site on the back of the head heals with a scar that is usually only visible to your hairdresser, unless you razor cut your hair extremely short. Rarely, patients may get spread or thickened scars in the back.

Once this process is complete, the patient sleeps or watches television while the technicians divide the donor hair into tiny segments, sometimes as small as a quarter of a grain of rice. The smallest segments contain only one or two hairs. These are the grafts, and they're being prepared to "plant" into tiny openings on the head. Each one becomes part of the new scalp and will grow in naturally. They're cut into just the right size so that a "toothbrush" look does not occur when the hair starts to grow. There are usually from one to four hairs in each graft.

While the technicians are working, the doctor numbs the scalp and makes tiny openings where the grafts are to be inserted. It's a lot like transplanting seedlings in a garden. The openings are made at the proper angle so that the hair grows correctly. In the front of the head the hair grows forward and somewhat to the sides, and in the back of the head it grows backward. Sometimes the doctor will even reproduce the irregular pattern or "whorl" that occurs in the crown. There is usually no significant discomfort during the procedure (the local anesthetic is in place). You can be awake and chatting with the doctor and technicians, or possibly a little sleepy from the relaxation medicine.

A typical modern hair transplant session involves 750 to 1,500 grafts, and sometimes more. It's a long, slow process, inserting the grafts one at a time with small forceps. One thousand is a good number for both our technicians and patients — no one gets too tired, and patients are usually impressed with the quantity of hair they ultimately get. Some doctors do more grafts per session, but there is controversy about graft survival with the higher numbers. The grafts fit snugly into the openings, and the skin simply seals together. Because these hairs were taken from the back of the head where the permanent hair grows, the newly transplanted hair will remain intact as long as the hair at the donor site does, which is usually for the life of the patient.

When you schedule your hair transplant, plan on spending anywhere from three to eight hours in the doctor's office or surgical center. A proper modern hair transplant is a labor-intensive process, and implanting tiny grafts into over a thousand points on the scalp takes time. Depending on the medicines you received, it may not be necessary to have anyone else drive you home after the procedure. You may be able to recover in a couple of hours and be able to drive yourself home safely. With the new-style tiny grafts, you can resume relatively normal activities the next day with few problems. It is best to avoid heavy exercise for several days. You might not need to take much time off from work or from your routine social activities. With the older style hair plugs, you had to be careful to avoid any activity for fear of losing the grafts, which were four millimeters (about one fifth of an inch) in diameter. Now, you'll just have some redness of your scalp, and usually some scabbing, which will last for 10 days or so.