Hair Restoration Frequently asked questions
"Hair transplant describes the process of hair redistribution. During the procedure hair follicles being insensitive to the balding process will be removed from the donor area and placed to the recipient site. The aim is to redistribute hair cleverly and aesthetically to achieve a maximum result with natural hair and undetectable restoration effects. The hair to be relocated, i.e., can be harvested from the donor site which has permanent but limited resources. Every responsible surgeon has to focus on an economically distribution of hair follicles in order to leave enough hair for eventual progression of hair loss."
For more information about the principles of hair restoration please read "What is hair transplant? "
How long will transplanted hair survive?
Follicles units are extracted from the donor area, a remaining horseshoe-shaped fringe from the back to the sides of the human´s head. After a successful extraction the follicles will be relocated to the balding area of the scalp. The donor fringe is insensitive to the balding process and will grow permanently. Any transplanted follicular unit is genetically resistant to the male hormone DHT (Dihydrotestosterone) and programmed to grow for a lifetime.
Will my hair start growing as before? Can I get my full hair status back?
The donor area has a limited amount of DHT insusceptible follicular units which can be harvested. This is the reason why it is very important to redistribute hair economically and aesthetically. With most patients the final outcome will only leave a visible impression of high density but never reaches its former status.
Realistic expectations are very important for personal satisfaction and a restored sense of self-confidence.
What kind of hair loss can be treated?
Hair transplant can be performed both with men and women. However, not every type of hair loss can be treated by hair transplant. Surgical hair restoration can only be performed on patients experiencing inherited balding (androgenic hair loss or "alopecia androgenic").
In most of the cases women do not expect complete baldness. That is why hair transplant often achieves outstanding densities with female patients.
Hair transplant cannot be performed on people suffering from diffuse hair loss, alopecia areata or other patterns of hair loss. Before scheduling a procedure every patient is asked to undergo a thorough investigation by a dermatologist and have a complete physical and laboratory workup. Conventional therapies by medication against hair loss can be useful before planning a hair transplant. Modern medication like Propecia (Finasteride) and Rogaine (Minoxidil) has been proven to regrow hair.
Even in case a hair transplant is a possible option there is no guarantee for a satisfying and aesthetically pleasing result according to different personal predispositions. Not everyone will be a good candidate. Hair transplant is only possible in case there is enough donor hair available.
Please refer to the chapter "Planning your hair transplant " and find more details!
How much density is necessary?
This is one of the most elementary questions with bigger concern on the hairline. Due to its individual and personal matter, an answer to this question cannot be generalized.
The density to achieve depends on various factors such as the natural hair density, hair texture (thick hair, hair styling), the caliber and the individual color of hair.
For understanding the rules of hair loss it is important to realize that at least 50 % of the natural, genuine hair has to fall out before hair loss can visibly be noticed. Specific requirements regarding the number of grafts to be redistributed or the density to be achieved must be discussed during a personal consultation. People experiencing a natural density lower than 100 FU per square centimeter before hair loss definitely need less than 50 % of their former hair status back to achieve an aesthetically convenient outcome.
Since each human being has individual hair it is necessary to plan and discuss the effects of hair restoration including an essential density measurement before planning a hair transplant.
Let me show you two examples for different hair densities on the human scalp:
FU density per square centimeter between + - 50 (in the receding hairline)
Patient of Dr. Jones with 60 FU per square centimeter (entire hairline)
An interesting comparison of two transplanted densities. Left 30 - 35 Grafts per sqcm and right 60 Grafts per sqcm
Is hair transplantation surgery painful?
As local anesthetics are used during the procedure the entire hair transplant is painless. The numbing agent will be injected into the donor area and, after extraction, into the recipient area. After the injection you won´t feel anything and may relax, watch DVD or engage in conversation. Later in the evening/night some patients often experience certain pain, which can usually be limited by medication and will finally disappear until the next morning.
What should be considered prior to a hair transplant?
There is a number of relevant information before starting a hair transplant. Here is short list of things to do:
- Don´t drink any alcohol 4 to 5 days prior to the procedure! Go to bed early the day before the procedure! Avoid coffee the day of your treatment!
- No vitamin B or E to be taken 7 days prior to the surgery!
- Carry some comfortable clothing with you on the day you come to the clinic! Take care you don't have to take off any shirt over your head!
- Any pain medication as well as stimulants or narcotics should be avoided 10 days prior to the procedure!
- Inform the surgeon about preexisting medical conditions!
- Be aware that the clinic has to consult or talk to your personal doctor in case you have to take medications against blood clotting (e.g. Marcumar).
- Stop using medication against hair loss containing Minoxidil (e.g. Regaine, Rogaine, Lipoxidil) 7 days before the procedure!
- Products containing Finasteride like Propecia or Proscar can be taken without any risk
Is there anything to care about after the procedure?
There will be some swelling after the insertion of the grafts in the recipient area as well as in the face 2 or 3 days after the procedure. This process is painless and will only cause some disfiguring and uncomfortable appearance, which will disappear after another 2 or 4 days. Any activities as sport, sweating, heavy physical work and working in wet or dusty areas should be avoided for a healthy recovery during the first 2 -3 weeks. Any swimming (in chlorine basin), exposure to the sun (tanning), visit of sauna or wearing of hairpieces should be avoided over a period of 4 weeks after the procedure.
What is to be expected next?
Each patient will expect a number of crusts forming on the scalp during the next 10 days, which will dissolve after 1-2 weeks. To avoid public activities most of the patients are advised to go on vacation for a period of about 2 weeks post transplant. After that period everyone will be able to return to normal social activities without risking a detection of the hair transplant except a little redness around the recipient area which will last about 2 - 3 months based on the individual case. The redness can be covered with concealers or other make-up items.
After a hair transplant via strip surgery the sutures on the linear scar at the back of the scalp can be removed after 14 days (not needed via FUE!). Patients having a long journey to the clinic do not need to come back for post-operative treatment. Everyone is free to consult his personal doctor at home. The removal of the sutures isn't necessarily part of the procedure of the clinic.
Newly implanted hair will fall out within the first 2 or 6 weeks post transplant. The shedding is a usual and mostly unavoidable process due to the fact that follicular units have been out of blood- and oxygen-supply during the procedure. This phase is temporarily and new hair growth will start about 3 to 5 months after the procedure. Every patient will notice a gradual increase in density and thickness.
By transplanting follicular units to an area with preexisting hair many patients can expect some "shockloss". Even residual hair in the recipient area will fall out temporarily. This may affect the individual outcome for a period of about 3 to 5 months after the transplant. Later the hair status will stabilize and the patient may notice an impressive difference since the initial procedure.
New hair growth varies individually from patient to patient. After 6 to 10 months considerable new hair growth will be noticed and hairs will begin to thicken. In some cases new hair growth has not been noticed before 8 to 10 months post transplant. The usual rate will be 10 % per month until the final outcome will be achieved in 12 months.
Sometimes the transition from fine and thinner hair to fuller density will take a longer time and one may actually notice improvement even later than 12 months as hair continues to change in texture and caliber and will reach additional volume.
International blogs have lots of interesting information about hair growth after a transplant. Have look at some of them:
Virtually all implanted hair will start growing for a lifetime and generally can be styled in any manner the patient wishes. There is no need for any further medical treatment as there is no special regimen required to care for the new hair. Standard shampoos and other hair products (gel, wax or spray) can be used the way you want.
When can I return to social activities?
As described earlier there the patient may expect some mild swelling around the transplanted area and the face within the first two weeks, which is mostly painless but uncomfortable.
5 days post transplant the swelling may have disappeared and will no longer be visible to others. As small crusts in the recipient area may dissolve after 10 days a period of two weeks (14 weekdays) after the procedure will be an appropriate time to find your way back to social activities.
How much hair transplants/grafts will I need? What are the rates for hair transplant?
Most of the clinics charge for the number of grafts being implanted. How much grafts anyone will need depends on various factors such as the balding area, the patient´s individual density and his personal expectations and requirements.
The number of grafts to be redistributed actually depends on the extension of the balding zone and the quality of the patient´s donor hair (density, caliber, hair color, individual characteristics as coarseness and fineness of hair etc.).
To estimate the amount of grafts your personally may require feel free to ask for a consultation and send some images of your scalp. Any consultation at HAIRFORLIFE is free and non-committal.
Generally the rates for hair restoration differ from clinic to clinic depending on the extraction method. Ask for further information if you need cost calculation!
- Hair transplant Surgery Training, FUE workshops for Physicans, doctors and hair surgeons in Ankara Turkey
- The PCID - Motorized Fue Extraction Device - Revolutionizing FUE Hair Transplant
- Hairforlife / Andreas Krämer interviewed by DER SPIEGEL
- Hair Transplant Forums and Blogs: Evaluating Clinics and Surgeons on the Web / Recommendations / Misjudgments