There are several ways to perform hair transplant surgery. Depending on your condition, your surgeon will choose the best procedure for you.
Hair transplant graft:
The surgery generally includes:
- For easy handling, the hair on the 'donor' area of the scalp is trimmed short.
- The surgeon applies anaesthesia to this area of the head where the thick hair grows.
- They take small sections of the hair-bearing scalp and transplant them to the desired site (generally, the front of the scalp above the forehead).
- They may use various equipment to harvest the donor skin. For example, a scalpel or a round tube (punch) may be used. Depending on the size of the tube, a single punch graft may harvest two to 15 hair. The slit graft may contain four to 10 hair strands, while the strip graft may contain 40 hair.
Flap surgery:
The procedure involves:
- The surgeon implants a balloon-like tool (called tissue expanders) under the skin of a donor section of the scalp. The expanders are filled with increasing amounts of saline over a period of a week. This stimulates the growth of skin cells.
- It takes about two months for the scalp to grow enough extra skin for transplantation.
- The bald section of the scalp is cut and removed. The newly grown and developed area of hair-bearing skin is partially cut away, transferred to its new location and stitched into this position. Since the flap is never entirely separated from the scalp, it should retain a good blood supply.
Scalp reduction surgery:
During the procedure:
- Strips of bald skin are cut out in a U or Y shape by the surgeon.
- The surgeon loosens the scalp, and the incisions are brought together and stitched.
What to Expect Before Surgery?
You can expect the following:
- You might be given local or general anaesthesia, depending upon the type of surgery.
- The surgery can be completed in two to eight hours.
- Insurance does not cover this surgery because it is cosmetic surgery.
Tests needed to be done before the surgery:
In order to determine if you are a good candidate for a hair transplant, your doctor will examine some factors, such as:
- Whether you have enough healthy hair on your scalp that can be transplanted to the area that needs hair.
- Whether you have the ability to grow hair on the thinning area of your scalp.
- Blood test: A blood test is needed to diagnose the cause of your hair loss. The surgeon will use it to check for problems occurring in your body that contribute to hair loss.
- Scalp biopsy: A biopsy is a diagnostic test where a small tissue sample from your scalp is taken to study it in detail.
- Physical health: With a physical examination, your doctor can determine whether the treatment is right for you.
- Hair evaluation: It evaluates your hair growth pattern, the extent of your hair loss, your family history, and any previous surgical or medical treatment for hair loss you may have had.
What to Expect on the day of Surgery?
You can expect the following:
- Medical history: Some pre-existing conditions and previous surgeries may influence the anaesthesia used during this surgery. Therefore, your doctor will take your medical history before the procedure.
- Risks and possible complications: Understanding the risks and complications is essential to decide whether it is right for you to have a hair transplant.
- Medicines: Inform your surgeon if you are taking any medicines, including over-the-counter preparations such as vitamin supplements and fish oils.
- Preparations for the surgery: Your surgeon will provide detailed instructions about how you should prepare for surgery at home. For example, a doctor may advise you to take a specific medication or change the dose of another medicine you already take. Be sure to follow all instructions.
What to Expect During Surgery?
Anaesthesia: The type of anaesthesia given depends on the type of procedure:
Hair transplant graft:
- Local anaesthesia is generally used for hair transplant grafts. Treatment sessions can last from two to eight hours, depending on the number of hairs transplanted. A local anaesthetic will be given to numb the area so that you don’t feel any pain. However, you will not be asleep during the surgery.
- Transplanting 1,000 to 2,000 hair follicles in one session is common, but larger areas of hair loss can require up to 4,000 follicles per session. Sessions can last several hours, and many people choose to schedule two or three separate sessions.
Flap surgery:
Flap surgery is used if the hair transplantation is extensive (for example, it requires large tissue flaps instead of small grafts). For this type of hair loss surgery, you may be required to stay in the hospital under general anaesthesia. If you're given general anaesthesia, you will be asleep during the surgery and won't feel any pain.
Scalp reduction surgery:
- A scalp reduction is best suited for treating bald spots on the top and back of the scalp, not on the front. Local anaesthesia is administered to the scalp.
- You will be placed in a supine position for all the procedures, lying horizontally with the face and torso facing up. The head of the operating table will be lifted upwards for easy handling of the scalp.
- After all the hair have been transplanted, your scalp will be bandaged, and you will receive instructions for aftercare.