Hair Transplantation


Hair transplant (or hair restoration, hair implants) is a hair replacement treatment for men and women. The procedure permanently restores hair by transplanting new follicles into balding or thinning areas.  Hair transplants correct male-pattern baldness and other forms of hair loss.

Hair restoration surgery usually takes a full day and is performed under local anesthesia and sedation, although some cases may require general anesthesia. In this surgery, healthy hair follicles are removed from the back and/or sides of the head, and transplanted to areas where hair loss is occurring.

Surgery usually involves transplanting follicular units (the natural bundling of hairs as they grow in the scalp), with each unit containing one to four hairs. The most common technique is “strip harvesting” (sometimes referred to as follicular unit transfer, or FUT), which involves removing a single strip of the scalp where follicles are plentiful (the “donor site”) and then cutting out the follicular units to create grafts for transplanting.
Another increasingly common technique is follicular unit extraction (FUE), in which each follicular unit is removed one at a time–a more time consuming process, but one that avoids the linear scar from the donor site. It can result in tiny dots on the back of the head that can sometimes be visible if the head is shaved. FUE is usually chosen by men, particularly those under 30 who may wish to shave their head, and by African Americans.

The average number of individual grafts needed depends on the patient; anywhere from 1,000 to 3,000 grafts is possible in an average day of surgery.

Your recovery time will depend on the extent of the surgery. Most patients report mild pain, numbness and soreness; this can be controlled with pain medication prescribed by your surgeon. It is common for hairs from the transplanted follicles to fall out in the first month and then regrow. Within 4 to 5 months, they should be growing normally in their new location.

Complications with hair transplant surgery are relatively uncommon. Potential hair restoration side effects may include scarring or uneven hair growth. If the results of the surgery are patchy or if the follicle grafts don’t establish well at the new site, your surgeon may wish to perform a follow-up surgery to correct scarring or to transplant more follicles to fill in thinner areas.

Lots of wonderful results online contradict your bad experience. I personally know a guy that had a transplant, 4250 grafts, and the results are close to miraculous. He’s 53, and women are interested in him for the first time in 20 years. It’s not a wall of hair like a 20 year old, but it’s a huge cosmetic improvement. A lot of us look ugly with shaved heads. We don’t get the Bruce Willis look – we get the Martian look.

The number of hairs that can be harvested and transplanted is limited and dependant on the donor site.  The hair taken from the donor area will continue to grow and not fall out as a result of pattern baldness because this hair is not sensitive to the male hormone DHT.  We can harvest 3,000-4,000 hairs in a single session, (this would still depend on hair density and scalp laxity).  Whether or not you can attain a “full head of hair” depends on how much hair your donor site can offer and this will vary from patient to patient.  The angle, direction and hairline design is equally important as density is in achieving a pleasing result.  On occasion the texture of the hair may change.  This rarely occurs.  The growth mimics the surrounding hairs in terms of texture and growth.

The period after hair transplant surgery

Hair transplantation is not an exact science, but it is a unique process. Putting hair in a new place to grow is exciting. The clinic that you have chosen should be reputable and have results to show.

After surgery, the results take lots of time. An eight-hour surgery takes patients about three weeks to heal. At about eight weeks post-op, the transplanted hair will have fallen from the scalp. The pinkness on the scalp typically lingers for one to three months and then gradually dissipates. The hair might not show up until around six months post-op, so you have to deal with the anxiety of seeing little growth. You might show to be at fifty percent at 6 months post-op but with no certainty. The eight to twelve-month time period will show eighty percent of growth or more. Lastly, new hair will continue to grow in for up to twenty-four months.

There’s no way to tell how one unique case may progress, but hair generally grows in a great variance in hair growth cycles. Patience is the key. Stay healthy, care for your scalp, and one day you may forget about what once didn’t exist.

The Proper Way to Transplant Hair

A lot of improvements in scientific techniques, medical developments and methods of artistic design have been made since hair transplantation was first introduced. Today’s hair transplant techniques can mimic the way hair grows in nature. The most important advancement is the identification of naturally occurring tiny bundles of hair called “follicular units.” This discovery has been fundamental to the major advances in literally all of the surgical hair restoration procedures used today.

These methods not only enable the physician to produce results that mimic nature but provide the hair restoration surgeon with the tools to actually fix the problems of old unsightly grafts and scars. The number of people who will benefit from hair transplant repair techniques will continue to grow over time as more people become aware that the older procedures can actually be corrected.

Hair transplantation has changed dramatically since the first cases were performed. We have now gone beyond the “Wild West” days of the old hair plugs and there is new hope for people who have been harmed by bad hair transplants. Most importantly, with adequate research in finding the proper hair restoration doctor, now there is a much better chance to get it right the first time around.

trichoscopic Hair and Scalp Analysis




Why should you get IV therapy if you are having surgery? Lack of proper nutrition delays wound healing and leaves surgical patients more vulnerable to surgical complications. Studies show that most people have some level of nutrient depletion. For example, one in four Americans are at risk for poor absorption in the gut leading to nutrient deficiencies, meaning that the food you eat does not get digested and absorbed normally. Many more Americans are at risk for reduced nutrient levels because of food choices and the Standard American Diet. Both fast food and processed food (essentially any food that is packaged and has an ingredients list) contain “empty calories” which are nutrient-poor.

By providing optimal vitamin supplementation before and after surgery we can positively influence how well you heal. This is especially true in an obese or overweight patient. The risk of death from other medical conditions increases significantly as weight increases. Patients who are poorly nourished, obese, and diabetic are particularly prone to surgery-related complications, including wound infection and poor healing (bad scarring).
Most Americans consume diets too high in calories and low in essential nutrients. We are known as a malnourished and overfed population. More than 70 percent of American adults do not get even two thirds of the RDA for one or more nutrients—consumption of fruits and vegetables is very poor. American meals, loaded with packaged, processed, nutrient-poor foods, contribute to marginal deficiencies that result in a shortage of vitamins and antioxidants that are particularly important to surgery patients undergoing anesthesia, trauma, and wound healing.
Deficits in micronutrients (vitamins and minerals) such as zinc, selenium, and vitamin B6 have a negative influence on the immune response. Replacing these nutrients before surgery can have a significant and measurable effect on results by favorably reducing free radicals caused by surgery and anesthesia, increasing the immune system, reducing bruising and swelling, and promoting better wound healing. The importance of optimal nutrition is so that your systems work at their peak efficiency. If you are undergoing surgery, you want peak immune function to prevent infection, peak clotting function to reduce bleeding and bruising, peak protein synthesis for collagen formation and repair for better and minimal scarring.

Deficiencies of even a single nutrient result in altered immune responses even when the deficiency is mild. Obesity, diabetes and other chronic diseases of metabolic and nutrition imbalance can have a significant negative impact on surgical outcomes and complications. Vitamins and minerals, such as carotenoids (orange in carrots), vitamins A and C, and selenium act as antioxidants. This is important, as during surgery it has been documented that the blood and tissue levels of nutrients decrease while the body’s requirement for them increases.

What do they tell us to do before surgery? First we are told to fast, so we are already depleted. Then they also have us stop all vitamins and supplements two weeks before surgery. We are severely depleted before we start. There are some nutrients you do not want to take since they can increase bleeding risks, but others are essential to healing. Undergoing surgery with reduced nutrition increases your risk. Surgical patients with malnutrition are two to three times more likely to have both minor and major surgical complications such as decreased wound strength (where the wound can open back up), increased rates of infection, delayed wound healing, increased inflammation, increased bruising, and increased risk of death. The length of hospitalization can be extended by 90 percent compared with the length of stay of well-nourished patients.

Major surgery itself increases the risk of malnutrition because of the stress and resulting increase in metabolism using up nutrients to rebuild. This is made much worse if the surgery is on your digestive tract because digestion and absorption are further reduced. This is especially true for obese and overweight patients who are having bariatric (stomach bypass) surgery, because studies show the presence of nutritional deficiency (due to unhealthy diet) before surgery, which is made worse by bypass surgery. Plastic surgery outcomes are also profoundly affected by pre and post operative nutritional status. The number of patients with pre-existing nutritional deficiencies and health problems who are seeking cosmetic surgical procedures is growing.

Pre and post operative IV nutrients supply your cells with the nutrients, co-factors, vitamins and minerals necessary for their peak functioning, so that your risk of complications is diminished and your healing is optimal. It generally consists of one nutritional IV before the surgery and one after, as well as supplementation by mouth. The specific components and possibly the number of nutritional IVs will vary depending on pre-operative health, nutritional status and other considerations.

Some nutrients required for proper healing include vitamin A, vitamin C, B vitamins, zinc, selenium, magnesium and copper. All but copper is included in fairly high doses in the IV so the body has all of these essential nutrients for repair. If a patient has an emergency surgery they can still benefit from IV therapy after surgery to improve the healing process.

There are numerous reports that show significant improvement in surgical outcome with pre and post operative nutritional IVs. In one study, 30 surgical patients who received nutritional support had an 85 percent reduction in infections compared to 30 surgical patients given placebo. Because these patients were randomized, there was no pre-operative distinction in their nutritional status. In another study, wound healing in nutritionally deficient patients given nutritional IVs was better than wound healing in healthy surgical patients that did not get IVs. These results alone have profound implications for all patients undergoing surgery.

IV pre and post operative nutrition can decrease bruising, swelling, inflammation, pain, scarring, and infection rates. It will also improve wound healing and recovery time, especially for that person choosing to have elective cosmetic surgery—you want the best outcome with the least scarring.

What prescriptions are needed before or after hair transplant surgery?

You will not need any special prescriptions BEFORE the procedure except the Vitamin C 1000 mg three times a day to promote healing as we discussed.

The written instructions outline all the directions for the three prescriptions needed AFTER the hair restoration procedure.

The first is an antibiotic (typically Keflex or the generic name of cephalexin). This is to prevent infection. You will start this when you arrive home after your hair transplant procedure and then one tab at bedtime. Then follow package directions.
The second prescription is for discomfort (typically Vicodin or the generic name of hydrocodone or Percocet (oxycodone). As a rule, discomfort is very well managed following hair transplantation. A dull headache or ache at the donor site for two or three days is not uncommon. Please remember that alcohol should be avoided when taking pain medication, as should operating heavy equipment.

The third is to prevent swelling and is called medrol dosepack or methyleprednisolone. This comes in a little plastic box. Take three when you arrive home and three at bedtime. Then follow package directions to complete the package.