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Hair Transplant
Hair Transplant

Hair Transplant

Hair transplant (or autotransplant) is a surgery that involves the transfer of small areas of scalp or just hair bulbs from an obviously thick area of hair to a hairless or less thick area of hair.

These are, therefore, live, non-atrophied follicles taken from the same patient (this is why it is called an autotransplant).
Neither a transplant from a donor nor the grafting of synthetic bulbs is possible.

Fortunately, in the majority of people affected by androgenetic alopecia, a "crown" of hair remains in the occipital and temporal region, which is available for transplantation as it is resistant to loss even in old age.

01

Who can do a hair transplant?

Generally speaking, hair transplant is indicated for individuals, both men and women, who suffer from androgenetic alopecia.

Erroneously, we tend to think that it only concerns men (as they are more affected by androgenetic alopecia), but this is not the case.

Hair transplant can also represent a solution for people who have suffered burns involving the scalp.

02

Who can't have a hair transplant?

The operation, however, is contraindicated in case of: Women who complain of general hair loss, all over the scalp.
People who do not have enough donor sites to take hair from.
Individuals with a tendency to form keloid scars after skin lesions or surgical interventions (this peculiarity emerges only after a thorough specialist examination).
Subjects in whom hair loss is due to drugs (e.g. chemotherapy).

Today, hair transplant represents one of the few solutions available in the presence of widespread atrophy of the hair bulbs, typical of those suffering from androgenetic alopecia.

In fact, drugs such as finasteride and minoxidil and the large number of cosmetics and various supplements can produce a certain improvement only in the presence of more or less suffering, but still vital, follicles.

Since the transplanted bulbs retain the typical life cycle of the region of removal (which is genetically resistant to alopecia), hair transplant can be considered a definitive treatment, but not an entirely conclusive one. In fact, it is not able to intervene on the causes that triggered baldness.

It will therefore be the doctor's task to direct each patient towards the treatments and therapies that best suit each individual case.

What is androgenetic alopecia: a quick review Androgenetic alopecia is a common condition that can affect men and women and is characterized by hair loss.

Androgenetic alopecia has a genetic origin and is due to an excessive response to androgens (hence the name), hormones typically associated with the male sex, but which are actually also present in women (although in smaller quantities).

In androgenetic alopecia, hair loss progresses in a very characteristic way in men and women:

In humans, it starts from the temples and the frontal area; after that, it also affects the vertex area.
With time and the progression of hair loss, the areas without hair meet until the only areas of the head covered by hair are the lateral and occipital areas.
In women, however, androgenetic alopecia affects almost exclusively the vertex area, with the temples, occipital area and frontal area remaining mostly unchanged.
For men, it is the Norwood scale that describes the evolution of androgenetic alopecia and represents a point of reference for diagnosis; for women, however, the equivalent is the Ludwig scale.


Transplant Techniques

Modern hair transplant techniques have improved significantly since the mid-1950s, when the first procedures often resulted in conspicuous scars and unnatural-looking results.

The two most widely adopted transplant techniques today are:

FUT (Follicular Unit Transplant)

  • Involves taking a strip of scalp from the occipital area (nape) and sectioning it into small grafts containing 1-4 hair follicles.
  • Provides fairly natural results but can leave scars at the donor site.

    • FUE (Follicular Unit Extraction)

  • Involves individually extracting and transplanting hair follicles using specialized instruments.
  • Includes variations like Micro FUE, which uses smaller instruments for a less invasive procedure without scarring.
  • Allows for implants to be oriented in the natural direction of hair growth, providing extremely natural results with minimal post-operative issues or permanent scarring.

    • Performed by experienced professionals, modern hair transplant techniques are effective, minimally invasive, discreet, and more accessible solutions compared to earlier methods.

    Understanding the Hair Transplant Process

    A hair transplant is a surgical procedure that must be performed by a qualified and experienced cosmetic surgeon. It takes place on an outpatient basis under local anesthesia and sometimes with sedation. The process involves shaving the areas of the scalp from which the hair grafts will be taken.

    The surgery itself is not painful, and modern micrografting techniques often yield satisfactory results with limited side effects. However, precision and meticulousness in execution are crucial for an aesthetically pleasing final result, as the smaller the grafts, the higher the risk of damaging hair follicles.

    The pre-surgical examination is essential to personalize the operation and maximize its effectiveness. Patients should maintain realistic expectations, as hair transplantation is a delicate surgical procedure with inherent limitations.

    The grafting process is the same for both the Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) techniques. After preparing the grafts, the surgeon cleans and anesthetizes the recipient area, then creates small incisions or holes using specialized instruments. The previously prepared grafts are then carefully placed into these incisions.

    The transplant operation involves a team of medical professionals, including the cosmetic surgeon and an anesthesiologist, ensuring a safe and controlled environment throughout the procedure.

    Hair Transplant Duration

    The duration of a hair transplant procedure largely depends on the size of the area being treated. For an average-sized recipient area, the surgery typically takes around 4 hours in a single session. However, more complex cases involving larger areas may require an extended surgical time of 6 to 8 hours.

    In some instances, it may be preferable to perform additional transplant sessions after an interval of a few weeks to several months, depending on the specific surgical technique used. These subsequent sessions allow for further thickening and density enhancement in the treated area.

    The decision to conduct multiple sessions is often made in consultation with the surgeon, taking into account factors such as the patient's desired outcome, the extent of hair loss, and the availability of donor hair. By spreading out the procedure over multiple sessions, the surgeon can ensure a more gradual and natural-looking result while minimizing potential risks or complications.

    Hair Transplant Results

    The aesthetic results of a hair transplant become visible gradually over several months. Initially, the transplanted hair appears very short, around 2 millimeters, and requires time to grow at a rate of approximately 1 centimeter per month.

    The change in appearance occurs progressively as the newly transplanted hair grows in a natural manner, identical to one's existing hair. The care and maintenance routines, such as washing and combing, remain the same as for regular hair.

    With modern hair transplant techniques, the achievable results are:

  • Natural: The implanted hair belongs to the patient, making it a self-transplant procedure.
  • Long-lasting: The follicles are taken from areas of the scalp resistant to the effects of dihydrotestosterone (DHT), the primary cause of follicle miniaturization in androgenetic alopecia.
  • Gradual: The regrowth of the transplanted hair follows the normal and physiological hair growth process, resulting in a constant and progressive increase in density.

    • Post-Transplant Care

    After the hair transplant procedure, patients may experience temporary head pain, which can be managed with prescribed painkillers until it subsides naturally. Anti-inflammatory medication may also be recommended to alleviate potential swelling. In some cases, antibiotics are prescribed to prevent possible infections like folliculitis.

    Most patients can return to work within a few days, once they begin feeling better. Several weeks after the surgery (typically 2 or 3), it is normal for transplanted hair to shed temporarily. This shedding phase should not cause excessive concern, as the new hair will regrow.

    To encourage and enhance the growth of the newly transplanted hair, the surgeon may prescribe medications like minoxidil or finasteride, which can aid in the recovery process.