Hair transplantation
Hair transplantation is a surgical procedure aimed at restoring hair loss, primarily due to conditions like androgenetic alopecia, which affects both men and women. This condition typically begins in adolescence or early adulthood, leading to the gradual shrinking of hair follicles and eventual hair loss, often observed in patterns like frontal recession or vertex thinning. The surgery uses the patient's own hair from donor sites, typically located on the back and sides of the head, ensuring a natural look.
Performed by board-certified physicians, the procedure involves administering anesthesia and extracting micrografts or microfollicles of hair, which are then inserted into bald areas of the scalp. Modern advancements, such as the NeoGraft technique, utilize semi-automatic devices to enhance the precision of hair follicle extraction and implantation. While many patients undergo this as an outpatient procedure, some cases may require multiple sessions over several months.
However, candidates for hair transplantation should be aware of the surgery's limitations, as success is not guaranteed, and they are advised to consult healthcare professionals to assess their suitability for the procedure.
Hair transplantation
Anatomy or system affected: Hair, head, skin
Definition: The surgical relocation of healthy hair follicles to a part of the scalp where shrunken follicles are producing short, thin hair, or no hair
Indications and Procedures
Several types of balding may cause a patient to seek out hairtransplantation. Perhaps the most common is androgenetic alopecia (common baldness), a condition that can affect both men and women who are genetically predisposed to it. Usually beginning in late adolescence or early adulthood, androgenetic hormones cause hair follicles gradually to grow smaller and eventually yield hair that can be detected only by a microscope or no hair at all.
Different patterns of balding have been observed. Frontal recession is a gradual process during which the frontal hairline retreats from the forehead. In vertex thinning, the hair on the crown of the head gradually disappears, exposing the scalp; the denuded area grows slowly in a concentric pattern. With complete balding, progressive frontal recession combines with vertex balding to create a condition in which hair is present only in a rim at the sides and back of the scalp.
Hair replacement via hair transplantation involves surgery, which should be performed by a board-certified physician skilled in this procedure. Hair transplantation has a distinct advantage over all other procedures for hair restoration because the candidate’s own hair is used. Candidates for surgical hair transplantation must have healthy hair growth on the back and sides of the head to serve as donor hair. The choice of location for donor hair will also be influenced by factors such as hair color, hair texture, and growth direction.
All hair transplantation procedures involve the application of anesthesia. It may be administered as local anesthesia applied topically to the donor and recipient areas of the scalp or as general anesthesia if more extensive transplants are undertaken or if the hair transplantation process is more complex.
Following the introduction of anesthesia, the surgeon removes small micrografts of hair, typically containing several follicles. They are inserted in narrow slits in the bald areas of the scalp or are simply inserted as very small microplugs. Earlier procedures that have largely been discontinued excised plugs containing several dozen hair follicles, which were then inserted into areas of the bald scalp, but this left visible and unsightly bumps or plugs from which hair grew in clumps. Some individuals who underwent this earlier plug procedure have since had all or part of their hair restored with modern micrograft or microfollicle procedures.
For many patients, hair transplantation can be accomplished as an outpatient procedure requiring no more than a single day. More extensive and more complicated hair transplantation cases will require additional sessions that may extend over several months. Following the transplant session, the scalp is cleaned, washed, and covered with gauze.
In the twenty-first century, the technology surrounding hair transplants continued to progress. A procedure called NeoGraft became widely used by dermatologists and plastic surgeons. In this semi-automatic procedure, a pneumonic device is used to precisely select hair follicles from areas of the scalp and implant them into an area of the scalp needing hair regrowth.
Uses and Complications
All hair restoration procedures require surgery, which may not be suitable for everyone, and patients seeking hair transplantation are cautioned to consult a physician and perhaps a psychiatrist as well to determine whether their mental and physical health are optimal for the surgical procedure.
Patients desiring hair transplantation must be cautioned that despite the claims of proponents, there is no certainty that the procedure will be successful. Problems with unsuccessful hair transplantation have led doctors to require patients to sign a form that specifically indicates that the procedure is not guaranteed.
Bibliography
A.D.A.M. Medical Encyclopedia. "Hair Loss." MedlinePlus, May 13, 2011.
A.D.A.M. Medical Encyclopedia. "Hair Transplant." MedlinePlus, February 8, 2011.
American Society for Dermatologic Surgery. "Hair Transplants." American Society for Dermatologic Surgery, 2013.
Hannapel, Coriene E. “Hair Transplant Advances Add Up to Better Results.” Dermatology Times 21, no. 6 (June, 2000): 35.
Perkins, Sara, and Ryan Raman. “NeoGraft Hair Transplant: Benefits, Side Effects, How it Works.” Healthline, 13 Aug. 2020, www.healthline.com/health/neograft-hair-transplant. Accessed 22 July 2023.
Sams, W. Mitchell, Jr., and Peter J. Lynch, eds. Principles and Practice of Dermatology. 2d ed. New York: Churchill Livingstone, 1996.
Scott, Susan Craig, and Karen W. Pressler. The Hair Bible. New York: Simon & Schuster, 2003.
Segell, Michael. “The Bald Truth About Hair.” Esquire 121, no. 5 (May 1, 1994): 111–17.
Thompson, Wendy, and Jerry Shapiro. Alopecia Areata: Understanding and Coping with Hair Loss. Rev. ed. Baltimore: Johns Hopkins University Press, 2000.