HAIR TRANSPLANT

General Information

DEFINITION--Relocating hair-bearing skin, usually from the back of the head to the front. Multiple procedures are necessary with intervals in between, so the total time involved may be 18 months or more.

BODY PARTS INVOLVED--Hair and scalp.

REASONS FOR SURGERY--To correct markedly receding hairlines or large bald spots caused by pattern baldness (see in Illness section), an inherited trait.

SURGICAL RISK INCREASES WITH

• Smoking.
• Chronic illness or poor health.
• Poor quality hair on the back and sides of the head.
• Hair transplants that are performed before hair loss has come to a standstill.

What To Expect

WHO OPERATES--Plastic surgeon; other doctor with special training (sometimes).

WHERE PERFORMED--Doctor's office, outpatient surgical facility, special hair-transplant clinic or hospital (for more complex procedures).

DIAGNOSTIC TESTS

• Before surgery: Physical examination.
• After surgery: None required.

ANESTHESIA--Local anesthetic injected into both the donor and recipient sites. In complex procedures more sedation may be necessary.

DESCRIPTION OF OPERATION--

Several procedures are available. You and your doctor will decide the most appropriate one depending on the degree and location of your baldness:

• Punch grafts (plugs): A round graft is punched out of a donor site and fitted into a hole in the bald area. Each punch contains about 15 hairs plus skin and fatty tissue. > Mini-plugs: About half the size of punch grafts and used to fill in spaces between larger grafts. > Micro-plugs: Made by splitting one large plug into 4 to fill in spaces. Adds a more irregular natural look to hairline. > Strip grafts: Similar to punch grafts except the graft is long and thin. May be used to finish hairline once plugs have filled in bald spot. > Flaps: A flap of hair on the back or side is cut out and swiveled onto the bald spot. The cut edges of the donor site are brought together and stitched closed. > Scalp reduction: An area of bald skin (2 inches by six inches) is cut out and the two sides are brought together and stitched. A series of these scalp reductions can be done over several months, reducing large bald spots. > Tissue expansion: A balloon is inserted under hair-bearing scalp and gradually (weekly, for a 2 month period) inflated with saltwater solution. When the skin has stretched enough, the adjacent bald area is removed and the expanded tissue is brought over to cover it.

POSSIBLE COMPLICATIONS

• Scarring and decreased circulation.
• Excessive bleeding.
• Surgical-wound infection.
• Failure of the transplant.

AVERAGE HOSPITAL STAY--0 to 1 day.

PROBABLE OUTCOME--It will take several months to be sure the procedure worked. The results of hair replacement surgery are permanent and can be remarkable.

Postoperative Care

GENERAL MEASURES

• Ask your doctor about guidelines for shampooing or getting the hair wet.
• Bandages can usually be removed in 2 to 5 days; stitches will be removed in about 10 days.

† You may use non--prescription drugs, such as acetaminophen, for minor pain. Avoid aspirin.

ACTIVITY

• Resume your normal schedule and activities once the bandages are removed, except swimming.
• Avoid exercise for 2 to 3 weeks. Exercise stimulates blood flow to the scalp and may lead to bleeding around the transplants.

DIET---No special diet.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.