Is Hair Transplant Permanent?

A hair transplant is a cosmetic procedure done to add more hair over the balding or thinning areas of the scalp. It is generally done by taking the hair from another part of the scalp (donor site). This part of the scalp is not controlled by androgens (the male hormones contributing to hair loss); hence, it does not go bald. Hair from other body parts may also be used.

Pre-procedure preparations:

• The “donor area” needs to be trimmed short for the easy access and removal of the hair that is to be transplanted.
• Your plastic surgeon will inject a numbing agent into the scalp.
• Wounds in the donor site after recovering the harvest grafts will be stitched and closed.

The harvesting and transplant procedure:

• Punch grafts, mini-grafts, micro-grafts, slit grafts, and strip grafts are performed on patients who have small bald areas.
• Flaps, tissue-expansion, and scalp-reduction are procedures that are done for patients who have extensive balding.

The different techniques for hair transplants are as follows:

• Strip harvesting: The surgeon cuts strips of the tissue from the donor areas of the scalp. These strips are punched into the bald parts. The new hair grows in the bald spot from these strips.
• Flap surgery: In this procedure, the surgeon can cover large bald patches. One flap has the ability of around 350 grafts. An area of the bald scalp is cut. A flap of the hair-bearing skin is lifted off another area of the scalp. The other end of this flap is still attached at its original blood supply. The hair-bearing flap is brought into the bald patch and sewn into place. This technique yields better results among other hair transplant techniques.
• Scalp reduction (also known as advancement flap surgery): In this technique, parts of the hair-bearing scalp are pulled forward or “advanced” to fill in a bald crown. The skin surrounding the cut-out area is loosened and pulled so that the hair-bearing scalp can be brought together and closed with stitches.
• Single hair (micro-grafting) and slit grafting: This method is used most often to recreate a frontal hairline. Slits are made in the scalp using a scalpel or needle. Thin strips of the tissue containing the hair follicles are then inserted into the slits.
• Dilation: Dilators are inserted directly into the scalp to push aside the scalp and allow the insertion of micro-grafts or mini-grafts. Holes may be punched into the thinned part where the graft needs to be inserted. The surgeon can also create a site for graft insertion with lasers.
• Follicular unit extraction (FUE): The surgeon takes individual hair follicles out of the scalp. He makes small holes in your scalp and grafts hair follicles into the holes.

Post-procedure protocol:

• The surgeon bandages the transplanted area with sterile gauze and an antiseptic ointment.
• He may inject triamcinolone (steroid) into the scalp to bring down swelling.
• You will need to take antibiotics, painkillers, vitamins, and medicines to promote hair growth.
• No weightlifting, exercises, and sexual activity are permitted for one to three weeks after the procedure.
• You must not wash your hair for two weeks after the procedure.

You can expect the hair growth of half-inch per month.

Results will be seen after three or four months and continue to improve over the year. In three to six weeks, the hair will fall off, and you may seem to have less hair than before. This is normal. That hair will grow back in the next few months. Medicines such as Propecia (finasteride) and Rogaine (minoxidil) may be given to stimulate inactive hair follicles.

In some cases, the grafts die out. Such individuals may need a repeat procedure.

Several surgical sessions may be needed to achieve satisfactory hair growth. An interval of several months is usually recommended between each session. An additional touch-up procedure to fill in the frontal hairline and a better look may be undertaken if needed.