Hair Fall/Loss - Reasons, Procedure, Cost, Risks, Recovery

What is a Hair Transplant?

A hair transplant is a surgical procedure where the surgeon fills the area of your scalp having thin or no hair at all. The surgery is primarily done to treat male-pattern baldness, where the surgeon takes hair follicles from the thicker parts of the scalp or other parts of the body. The hair follicles are then grafted or implanted in the head with a bald or thin scalp. The procedure is done under local anesthesia to numb the scalp area for the procedure.

Hair loss is considered one of the most common conditions that affect a large portion of the population, including 85% of males and 40% of females. Every year, the incidence of hair fall keeps increasing with age for both sexes. The condition can either be permanent or temporary, affecting your scalp or the entire body. Hair loss can be a result of heredity, hormonal change, medical condition, or aging. Hair loss is more common in men. There are a variety of factors that progress hair loss, such as:

• Diet
• Stress
• Illness
• Medications
• Hormonal imbalance

Who can undergo a Hair Transplant?

Hair Transplant Techniques

• Follicular Unit Strip Surgery (FUSS)

• Follicular Unit Extraction (FUE)

• Direct Hair Implantation (DHI)

Who needs Hair Transplant?

• Hair thinning

• Alopecia Areata

• Minor scalp injury

• Male pattern baldness

Diagnosis for Hair Transplant

Test:

• Blood Test – This helps uncover medical conditions that can be responsible for hair loss.
• Pull Test – The surgeon will gently pull some hair to check the frequency of hair loss. This can help determine the stage of the shedding process.
• Scalp biopsy – This test involves scraping samples from the skin or hairs plucked from the scalp. The surgeon examines the hair roots under a microscope to rule out the cause of hair loss due to an infection.

Diagnosis by the Doctor:

Hair Transplant - Risks & Complications

During the Surgery:

Hair transplant is a safe procedure that ensures hair growth. It is an ever-evolving procedure, and thus, with the introduction of new technology and change in techniques, the effectiveness of hair transplants also changes. However, there may be some complications that can occur during the surgery –

• Tachycardia – It occurs when a tumescent fluid containing adrenaline is given. This may pose a risk for patients with cardiac diseases. Therefore, doctors advise all patients above 40 years of age to undergo an electrocardiogram and physician assessment to avoid such complications.
• Syncope – This complication usually occurs in long surgeries. The patient may feel abnormal pain, postural hypotension, poor hydration, etc.
• Adverse reactions to anesthesia – Some patients may have a history of allergic reactions to local anesthetics. This can cause severe complications including termination of surgery. Therefore, it is important to share the family history of allergic reactions to anesthesia.
• Pain – Mild pain is common during and after the hair transplant surgery. Several factors can contribute to pain, including bleeding, wound tension, and inadequate anesthesia.

After the Surgery:

Hair transplant is a safe surgery promising great results for a natural hair look. It is important to choose a well-experienced surgeon with a demonstrated history of successful hair transplant procedures. However, just like any other surgery, a hair transplant procedure also involves certain risks and complications. The probability of any complication usually depends on the condition of the patient and the experience of the surgeon. These complications can either be short-term or long-term. Some of these complications are –

1.  Bleeding

Minor post-surgery bleeding is quite normal that usually goes away within a day or two. However, at times, the bleeding tends to persist for a few days. Contact a medical care professional in case of abnormal bleeding after the surgery.

2. Infection

It is important to understand that scalp remains very sensitive and prone to infections after the surgery. Therefore, you must prevent exposure to heat, sweat, or any form of dust and dirt. In case of any infection, your doctor may prescribe you antibiotics.

3. Cysts formation 

The hair follicles implanted during the hair transplant surgery can sometimes cause damage to the skin, leading to the formation of small size cysts (not cancerous always) on the scalp. Complications of such nature usually occur due to the inexperience of the surgeon. Therefore, it is crucial to choose a surgeon with great experience and understanding of handling the procedure successful.

4. Hair curl

This is one of the long-term side-effects of the surgery where the transplanted hair follicles get curled under the scalp. This may give an unnatural appearance to the patients and, in some cases, may also cause infection.

5. Laxity of the scalp may be affected.

Hair transplant is a major surgery that can leave a long-term impact on your scalp and affect the laxity of the scalp. It is usually more common in Follicular Unit Transplantation (FUT) hair transplant than the Follicular Unit Extraction (FUE) procedure.

Hair Fall prevention

Here are some tips to prevent hair fall in men and women –

• Diet- It is important to maintain a balanced protein-rich diet. Our hair is made up of a protein called keratin and so consuming a keratin-rich diet can ensure healthy hair growth. Several other dietary components include Vitamin A, green salads, basil, and fresh herbs.
• Supplements- Some supplements such as multivitamins, vitamin D, biotin, etc., can encourage hair growth and increase hair quality.
• Hair Care- It is essential to regularly wash your hair to keep the scalp moist and clean from pollutants. Several essential oils such as coconut oil, olive oil, etc. can prevent hair loss and promote hair growth.

When to consult a Hair Transplant doctor ?

You can consult the doctor if  –

• You feel constantly distressed due to your persistent hair loss or hair loss of your kin and wish to pursue treatment.
• Women who are constantly experiencing a receding hairline and want to undergo early treatment to avoid significant permanent baldness.
• People who notice patchy hair loss or lose hair more than usual while combing or washing the scalp. Sudden hair loss can signify a medical condition that may require immediate medical attention.

Questions to ask your Hair Transplant Doctor

Hair Transplant Treatment options & cost

Non-Surgical

Surgeons often recommend certain techniques which can prove to be effective alternatives to hair transplant surgery. Non-surgical methods can prove to be effective but can also cause severe side effects. Therefore, it is generally advised to seek consultation from a renowned cosmetic surgeon before proceeding with the alternate treatment. Non-surgical methods for hair transplant are –

• Hair Platelet Rich Plasma

Hair Platelet Rich Plasma or PRP is a non-surgical procedure that aims to treat hair loss with the patient’s plasma. It is a three-fold procedure where the doctor will first collect the blood sample from the patient. The blood is then put into a machine called a centrifuge that spins at high accelerations. The rapid spinning separates the platelet-rich plasma from the red blood cells. The plasma is then injected back into the bald area. PRP stimulates the growth of new cells and progresses hair growth by strengthening existing hair follicles.

• Medications

Medication is considered the most widely used non-surgical method. Doctors often prescribe certain medications for hair loss that are approved by the United States Food and Drug Administration (USFDA). Common medications prescribed by the surgeon include –

• Minoxidil- This medicine was conventionally used to treat ulcers, but it can also treat enlarged prostate. The androgen, such as Dihydrotestosterone, attaches to the hair follicles to trigger inflammation. This inflammatory response makes it difficult for blood vessels to supply blood to the hair follicles. This can also result in tissue death. The tissue death can progress alopecia that in turn leads to baldness. Minoxidil dilates the blood vessels allowing more blood to reach the follicles and prevent damage.
• Finasteride- Finasteride prevents androgen from sticking to the hair follicles. However, this medication can also have some side effects that can cause lower sex drive, erectile dysfunction. This is why some people may not opt for this medication.
• Microneedling: Microneedling is a minimally invasive procedure that can trigger hair growth. The surgeon uses several small needles on the scalp that stimulate new cell growth and promote collagen production. Microneedling is a safe procedure where the patient may experience mild irritation and redness during the recovery.

• Hair Replacement

Hair replacement involves stitching the base with hair follicles that acts as a tight membrane. The surgeon chooses the appropriate skin base from the range of various types such as skin, lace, polymer, and monofilament. Then, the hair follicles to be implanted on the base are opted in terms of texture, length, and color. Finally, the surgeon chooses the ventilation options in the forms of knotting, injection, and looping.

• Low-level laser therapy

It is a non-surgical procedure where the doctor uses a probe that emits photons on the bald area. The weak hair follicles absorb these photons to promote hair growth. This procedure has several advantages with almost no side effects.

• Scalp Tension Reduction Device

Scalp tension is considered the primary cause of hair loss. Hence, surgeons aim to reduce this tension to reduce hair fall via scalp tension reduction device. The device causes the scalp to reduce the tension via constant inflation and deflation.

Surgical

Types of Hair Transplant Surgery

Follicular Unit Transplantation (FUT) 

• In FUT, the anesthetist first numbs the back of the head with local anesthesia during the procedure. The surgeon then sterilizes the site from where the hair will be taken.
• Medical equipment called a scalpel removes a section of your scalp from the back of your head, which are then closed using surgical sutures.
• The scalp is then split into as many as 2,000 tiny pieces using a scalpel known as grafts.
• The surgeon makes small holes in the rest of the scalp where the hair is to be transplanted via needles.
• The surgeon inserts small grafts into the holes via a procedure called grafting and closes the surgical sites with the help of the bandages.

Follicular Unit Extraction (FUE)

• In Follicular Unit Extraction or FUE, the surgeon cut out hair follicles directly from the back of the head through tiny punch incisions.
• The surgeon will first shave the back of your head, and local anesthesia will be administered that will numb the back of the head.
• The surgeon will proceed with the extraction where the individual hair follicles are removed from the shaved part of your scalp.
• Finally, small holes are made in the rest of the scalp, and hair follicles are precisely grafted. The surgeon will cover the surgical site with a bandage.

Direct Hair Implantation (DHI)

• In DHI, the surgeon will shave the donor area and the back of the head.
• The patient is administered with local anesthesia to numb the scalp.
• Medical equipment shaped like a pen called, DHI implanter is used to remove hair follicles from the donor area without touching other hair.
• These hair follicles are sent to laboratories to be processed into grafts. These processed follicles are then again implanted back in the received area.
• The surgeon makes sure the hair follicles are implanted in a way so that the direction of the hair follicles can also be decided.

Hair Transplant Surgery Preparation

The surgeon or hospital generally provides a set of instructions for the patients before surgery. This may include dietary restrictions, medications, and pre-surgery tips. The doctor generally instructs on when you can have your last drink or food before the surgery. Since anesthesia has to be done on an empty stomach, many doctors recommend skipping dinner or not eating after midnight before your procedure. Here are some tips that may help you before your surgery –

• Inform your doctor about any prior medications and allergies. Some medications like vitamin B and vitamin E tablets can increase the bleeding from your wound site and make it difficult to heal.
• If you smoke, then quit smoking. Smoking will make it difficult for the body to heal after an incision. This may also increase the chances of leaving scars on the site of the incision. Moreover, nicotine can also increase the risk of infection.
• Just before the surgery, wash your hair with shampoo and conditioner as normal. Do not use any hair products such as hair gel, hair cream, hair wax, etc.
• Wear loose-fitting clothes to ensure no damage to the incision spot while changing after the procedure.

During Hair Transplant Surgery

• The doctor will explain to you the course of procedure one last time to make sure the goals and expectations are met. Then, the surgeon will discuss the best way to utilize the donor’s hair and begin the procedure.
• The anesthetist will administer local anesthesia that will numb the site of treatment. The surgeon will then remove donor hair from the back of your head or other body part and place it in the required area.
• Once the surgeon has completed the hair restoration procedure, you may wear a cap if you wish and go back home.

After Hair Transplant Surgery

Hair transplant is considered a major surgery to restore hair growth for natural-looking hair. It is always advisable to undergo the procedure by experienced cosmetic surgeons for zero post-surgery complications. However, even with all the precautions, some patients may experience mild side effects after the hair transplant procedure. You may expect the following after the surgery –

• Itching
• Bleeding
• Swelling of the scalp
• Swelling around the eyes
• Sudden loss of the transplanted hair
• Lack of sensation in the transplanted area
• Formation of crusts in the transplanted or donor area
• Infection or inflammation of the hair follicles- folliculitis

Hair Transplant Insurance

Hair Transplant Recovery Timeline

The recovery rate of a hair transplant procedure depends on the type of treatment you are undergoing. Since direct hair implantation does not involve any cuts or incisions, recovery is swift compared to other surgical procedures.

• The recovery time for FUT is around 2-3 weeks, depending on how strictly the patients follow the post-surgery regime.
• The recovery time for FUE is around 5 days if the patient follows all the recovery tips given by the doctor.

While most patients usually see the results of hair transplantation after 6-7 months, it may take 8-10 months or even 10-12 months for complete recovery. The recovery rate depends mostly on the quality of your hair and how strictly you follow recovery tips.