Hair transplantation

Hair transplantation is a surgical procedure used to treat baldness orhair loss. Typically, tiny patches of scalp are removed from the back and sides of the head and implanted in the bald spots in the front and top of the head.

Hair transplantation is a cosmetic procedure performed on men (and occasionally on women) who have significant hair loss, thinning hair, or bald spots where hair no longer grows. In men, hair loss and baldness are most commonly dueto genetic factors (a tendency passed on in families) and age. Male patternbaldness, in which the hairline gradually recedes to expose more and more ofthe forehead, is the most common form. Men may also experience a gradual thinning of hair at the crown or very top of the skull. For women, hair loss is more commonly due to hormonal changes and is more likely to be a thinning of hair from the entire head. Transplants can also be done to replace hair lost due to burns, injury, or diseases of the scalp.

Although hair transplantation is a fairly simple procedure, some risks are associated with any surgery. It is important to inform the physician about anymedications currently being used and about previous allergic reactions to drugs or anesthetic agents. Patients with blood clotting disorders also need toinform their physician before the procedure is performed.

The surgery is performed by a physician in an office, clinic, or hospital setting. Each surgery lasts 2-3 hours, during which approximately 250 grafts will be transplanted. A moderately balding man may require up to 1,000 grafts toget good coverage of a bald area, so a series of surgeries scheduled 3-4 months apart is usually required. The patient may be completely awake during theprocedure with just a local anesthetic applied to numb the areas of the scalp. Some patients may be given a drug to help them relax or to put them to sleep.

The most common transplant procedure uses a thin strip of hair and scalp fromthe back of the head. This strip is cut into smaller clumps of five or six hairs. Tiny cuts are made in the balding area of the scalp and a clump is implanted into each slit. The doctor performing the surgery will attempt to recreate a natural looking hairline along the forehead. Minigrafts, micrografts, or implants of single hair follicles can be used to fill in between larger implant sites and can provide a more natural-looking hairline. The implants willalso be arranged so that thick and thin hairs are interspersed and the hairwill grow in the same direction.

Another type of hair replacement surgery is called scalp reduction. This involves removing some of the skin from the hairless area and "stretching" some of the nearby hair-covered scalp over the cut-away area.

Health insurance will not pay for hair transplants that are done for cosmeticreasons. Insurance may pay for hair replacement surgery to correct hair lossdue to accident, burn, or disease.

It is important to be realistic about what a hair transplant will finally look like. This procedure does not create new hair, it simply redistributes thehair that the patient already has. Some research has been conducted where chest hair has been transplanted to the balding scalp, but this procedure is notwidely practiced.

It is important to find a respected, well-established, experienced surgeon and discuss the expected results prior to the surgery. The patient may need blood tests to check for bleeding or clotting problems and may be asked not to take Aspirin-type products before the surgery. The type of anesthesia used will depend on how extensive the surgery will be and where it will be performed.

The area may need to be bandaged overnight. The patient can return to normalactivities; however, strenuous activities should be avoided in the first fewdays after the surgery. On rare occasions, the implants can be "ejected" fromthe scalp during vigorous exercise. There may be some swelling, bruising, headache, and discomfort around the graft areas and around the eyes. These symptoms can usually be controlled with a mild pain reliever like Aspirin. Scabs may form at the graft sites and should not be scraped off. There may be some numbness at the sites, but it will diminish within 2-3 months.

The transplanted hair will fall out within a few weeks, however, new hair will start to grow in the graft sites within about 3 months. A normal rate of hair growth is about 0.25-0.5 in (6-13 mm) per month.

Although there are rare cases of infection or scarring, the major risk is probably that the grafted area does not look the way the patient expected it tolook.

Major complications as a result of hair transplantation are extremely rare. Occasionally, a patient may have problems with delayed healing, infection, scarring, or rejection of the graft; but this is uncommon.

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