Top 5 Things to Know About Hair Transplantation

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Hair transplant surgery is more popular today than ever before. It is almost impossible to not hear or read something about hair transplantation in 2019 due to the massive increase in acceptance that the procedure has gained. But is hair transplant surgery as easy and simple as what many social media posts and articles will have you believe? It can be, but the one fact that cannot be overlooked is that hair transplantation is real surgery.


Like with any surgical procedure it makes sense to do your research so that you know your options, what the side effects may be, and if you’re a good candidate to begin with. The International Society of Hair Restoration Surgery (ISHRS) is the leading organization worldwide educating and advancing the state of the art hair transplantation and is an excellent resource for information.


What You Should Know


There are a lot of things to know when considering a hair transplant surgery but we’re going to discuss the top five things you should know before having your own hair transplant.


1. Are your expectations realistic? 


This isn’t usually one of the first things that patients think about. They’re focused on what they’re seeing on websites and dreaming about having results just as good as what they see online. The truth is, there are limits to what can be accomplished with surgical hair restoration and this is usually down to one reason, supply and demand. The concept of supply and demand is quite simple in the context of surgical hair restoration.

Patients have a supply of donor hair that is finite and it’s a non-renewable resource. This means that once it is transplanted to the area of loss on top of the scalp, the hair is not replaced or regrown in the area where it was originally harvested. When we look at the balding scalps of many hair transplant patients, they have lost a number of hairs on top of the scalp that exceeds the number of hairs available and growing in the donor area.


This means that the doctor performing the surgery has to decide how to create the biggest cosmetic improvement with a limited amount of hair. He simply cannot replace each hair that has been lost on a one to one ratio because that amount of donor hair does not exist. This is why when you’re searching through various hair transplant galleries, you won’t see patients that have advanced hair loss regaining full heads of hair with their teenage hairlines.


But what about cases where there is minor hair loss, such as hairline recession? Are there enough grafts to restore a full head of hair in these cases? Yes, there are, but if the patient continues to lose more hair then the hairs that were used to create a low hairline with high density won’t be available for creating coverage in the areas of new loss as the patient ages. This is why doctors with proper training will avoid being too aggressive as there will always be a chance that more work will be needed in the future. If that happens, as a patient, you don’t want to be in a position where no more donor hair is available to give even light coverage on the balding scalp.


2. How long will be before you can return to work?


There is no single answer to this question as it depends on what you do for work and which procedure you have. In general, the minimum amount of time a patient should wait before going back to work is one week if the procedure performed was FUE, and two weeks if it was FUT (strip). FUT can be more physically invasive as a procedure so it may take longer to recover. Because there is wound closure performed during FUT, most clinics also require patients wait up to one to two weeks to have their sutures or surgical staples removed.


However, there are other considerations to keep in mind. With FUT, you generally do not have to shave your entire head. If you have a FUE hair transplant, many clinics will require that your head be shaved, either in part or completely, to properly perform the procedure. The reason for this is that it provides the surgeon a clear field of view of the donor region for efficient and safe follicle harvesting. The recipient area may also be shaved for the same benefits of having a clear field of view. For FUT, usually it is only the immediate area of strip excision that is shaved.


This allows the longer donor hair above the excision to cover the sutures or staples used for wound closure and will help to hide the donor region for the first couple of weeks of healing. If your clinic does not shave the recipient region for graft placement then you might be able to return to work even sooner than one week due to the lack of any visual evidence that you had surgery. But, if your clinic does require the recipient region to be shaved, then this can delay your return to work due to the inevitable hair styling complications that you’ll experience. Whichever procedure you decide to have, ask your doctor about the recovery time and down time that you’ll experience.


3. How many surgeries will I need?


This is question that oftentimes goes unasked as the patient will assume that one surgery is all they need for life, and that they can forget about their hair loss once their dream result grows in. Sadly, this is rarely the case. In reality, hair loss is a progressive issue. This means that once you start losing your hair, you will continue to lose your hair, at varying degrees, throughout your life. This is not referring to your transplanted hair but rather to the native hair that you haven’t lost yet.


There are medical therapies that one can consider but even then, there are no guarantees that your hair loss will completely stop. The probabilities will vary from patient to patient but the general rule of thumb is to always consider your hair transplant to be your first hair transplant and to not be too greedy with your hair restoration ambitions. Remember in tip #1, your donor hair is a finite resource, so conserving some of your donor hair for the future is always the best route to take.


4. Will you meet with the doctor before your procedure?


This is a question rarely asked but it is important to know if you’re going to speak with your doctor or with a consultant. Hair transplant consultants are an important part of any hair restoration practice but they should not be considered the final word when having a hair restoration consultation. Only a licensed physician should present medical advice, much less surgical recommendations.


Consultants should serve only as an educator about the hair transplant procedure you are considering only and are invaluable for answering basic questions that pertain to the specific clinic you are considering. The advantage to having a qualified physician present your surgical recommendations is that the physician has a chance to visualize your case personally and only through their experience and training can a legitimate surgical plan be formulated.


5. Will a doctor or a technician perform your hair transplant?


This is one of the most important questions you should ask. This question has more to do with FUE procedures and not FUT procedures as only physicians can physically remove a donor strip. With FUE, there has been an explosion of new clinics worldwide due to the low financial and resource investment required to get started, and with this difference, more unscrupulous persons have seen the opportunity to cut corners.


The ISHRS strongly urges you to consider the ramifications that can come from having unlicensed medical professionals performing your hair transplant surgery. FUE hair transplant surgery is real surgery and comes with all of the potential downsides presented by any surgery. The question you should be asking yourself is: Would you feel safer with an experienced doctor performing your hair transplant surgery, or an unlicensed technician who may have little medical knowledge and training?

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