Hair Loss and Hair Transplants

Reviewed by Mitchel Goldman, MD

With half the men in the United States suffering from hair loss by age 50, it is no surprise that hair loss treatments using transplants have become the number one cosmetic procedure for men in the United States; however, hair loss is not exclusive to men. Many women also suffer from thinning hair or patterns of baldness. Each year there are more than 20,000 consultations and five million transplant procedures.

Although hair loss treatment doesn't work for everyone, hair transplants do offer permanent hair restoration for most patients. The goal is to give you the natural-looking appearance of healthy hair.

The Best Candidate

People typically seek hair transplantation to correct hair loss that has resulted from genetics, aging, a traumatic injury, or certain medical conditions. The ideal hair-transplantation candidate must have healthy existing hair on the back or sides of the head. The candidate must also be prepared to undergo treatment in multiple sessions that can take several hours.

Consult a Qualified Doctor

Hair transplantation is not well regulated and many types of doctors may perform one or more types of the procedure. Dermatologists developed the hair transplantation procedure, and dermatologists are the specialists most likely to have extensive experience. The training for the procedure is required in all dermatology residency programs. Some plastic surgeons and family practice doctors may also have the needed expertise. But only a handful of doctors have refined their expertise, incorporating all of the advances and the lessons learned over the years in hair transplantation. Very few plastic surgeons do this procedure and almost none are taught this in their residency training programs. Family practice doctors can be trained in this procedure by taking courses. Here are some tips to consider when seeking the procedure:

• Review the doctor's credentials, education, training, type of certification held, and number of times that the treatment has been performed in the practice.
• Ask about your specific hair-transplantation procedure and its risks and possible complications. There are a variety of procedures available for hair transplantation, each of which has advantages and disadvantages.
• View before-and-after photos of patients with similar conditions who received hair transplants.
• Ask for a list of pre-op and post-op instructions.
• Remember that results vary among providers and patients.

The Hair Transplant Procedure

The location of the procedure is an outpatient surgery center, doctor's office, or hospital. The procedure can require several hours and multiple treatment sessions over the course of up to two years. Anesthesia options should be discussed with your surgeon and the anesthesiologist. The procedure is often performed under local anesthesia, though general anesthesia may be used for more extensive surgery.

During the transplant, segments of the scalp, or grafts, which contain hair from the donor area, are removed and then attached to the targeted balding or thinning area. There are several types of grafts that vary in size and shape. Mini-grafts contain up to four hairs. Slit grafts that are inserted into slits in the scalp have up to ten hairs. Round-shaped punch grafts have up to ten hairs. Strip grafts contain up to 40 hairs. Ask your doctor about which graft treatment is best for you.

Several hair transplant sessions are usually needed in order to achieve optimum results.

The Recipient Site: The Right Fit

In any hair transplant procedure, the right fit of each graft or follicle is extremely important. Care must be given to ensure the strongest contact with existing tissue. The goal of the right fit is to offer the highest probability for speedy oxidation between existing tissue and the new graft. The wound size depends upon the specific graft treatment used by your doctor.

Aftercare

The doctor will supply a complete instruction list that must be followed to reduce the risk of complications. Normal activity may not be resumed for several days. The doctor may prescribe oral and topical medications to manage minimal discomfort, bruising, and swelling. The transplanted hair will often fall out within six weeks, but re-growth is expected to occur within three months.

Complications and Risks

There are risks associated with every medical procedure. Possible complications include infection and scarring. There may be numbness in the donor and recipient sites, which may subside within three months. There may also be skin discoloration in the affected areas as well as an uneven appearance or dimpling of the skin. Depending upon the strength of the fit, oxidation may or may not occur which can limit blood flow and re-growth of hair in the treated areas. The doctor may be able to intervene and remedy the complications.

The Cost

Each case is highly individualized, which makes it difficult to estimate costs for hair transplants. The procedure usually comprises three costs: local or general anesthesia fees, facility fees, and physician fees. You can expect the average cost of total fees to range from $3,000 to $5,000 per procedure. You may need three or more procedures.

Payment plans are fairly common. For financing options and tips, continue reading about Patient Financing.

About the Reviewer of This Article

[page updated June 2008]