HAIR TRANSPLANTATION
- Hair transplantation takes hair from the back of the head where "permanent" hair grows, and transplants it to the balding front. This "donor hair" will stay and grow, just like it would have in the back.
- The methods for doing this have improved vastly in recent years, with much better results, less patient discomfort and less recovery time.
- There are currently no good alternatives for hair transplantation except hairpieces, which have many disadvantages.
- The modern procedure is done under local anesthetic, occasionally with some sedation, and takes three to eight hours.
- After the first l0 days, not much is seen in the transplanted area. Usually new hair growth takes four months.

Hair transplantation has been practiced for decades, and the results have been mixed. But recent innovations are revolutionary. The old pluggy, toothbrushy look is gone. When skillfully done, today's transplants are virtually indistinguishable from a normal hair pattern. The doctors who have changed with the times are seeing superb results, while those who still use the old methods are getting compromised or mediocre results.

How It’s Done
Hair transplantation involves removing some of the hair-bearing scalp from the back of the head and planting it in the front of the head in tiny seedlings or grafts. The hair continues to grow in the front just as it was doing in the back (the permanent hair from the back of the head normally grows for life). The area from which the hair is removed at the back of the head is called the "donor site." This is closed with stitches or staples, heals quickly, and the scar is concealed with the remaining hair.
In the last few years doctors have used smaller and smaller graft sizes. In the past, large plugs- groups of up to 25 hair roots- were transplanted together, but now the tiny grafts contain just one to six hairs. We've learned that fewer hairs per graft produce a more natural result, and the problem of handling large numbers of grafts has also been solved. The techniques for "harvesting" hair from the back of the head have improved too. These new techniques result in less damage to the hair, less healing time, less discomfort, and a better look.

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.