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Hair Transplants
Hair grafting is known to have been done in the 19th century, when relatively large areas of tissue from elsewhere on the scalp were removed along with their blood supply and grafted to the bald areas. Hair grafting using small transplants began in Japan in the 1930s, where doctors replaced eyebrows and eyelashes but didn’t treat baldness. World War II supervened so that their techniques were not known in the U.S. until the 1950s.
Hair roots
Hair grows from roots called follicles which are in the skin’s second layer down, the dermis. In this layer also are sweat glands, blood vessels, oil glands, nerves, and a matrix which supports the skin and is made of collagen and elastin, two proteins found throughout the body. The follicles at the sides and back of the male scalp are often genetically resistant to baldness, while those on the top and front of the scalp weaken with age and stop producing hairs.
The general transplant method
Areas of hair from the sides and back are grafted to the top and front of the head. The back and sides are then known as donor areas. At first doctors thought it wouldn’t work, thinking that once transplanted to the bald areas, the hairs would die. But in New York in the 1950s, a dermatologist showed that the grafts were “donor dominant”, meaning that it’s the follicles themselves which determine hair growth, not the area of scalp where the follicles are living.
Follicular Unit Transplantation
At first, relatively large areas of hair were grafted, which is why the early hair transplants looked artificial. Hair doesn’t grow in large areas. It grows in tiny groups of one to four hairs, from one follicle. In hair transplantation each follicle transplanted is known as a follicular unit. By grafting hair one follicle at a time, the cosmetic surgeon is mimicking the way hair grows naturally. This makes it look natural when the procedure is finished.
The Procedure
Hair transplantation is an outpatient procedure. In an initial visit, your cosmetic surgeon will first analyze the scalp to plan treatment, and will discuss options and expectations. For a few days before your procedure, you will be asked to avoid alcohol and certain medications which might increase bleeding or interfere with the graft settling into its new location. Antibiotics are usually prescribed ahead of time, to prevent infection.
· A mild sedative is available along with local anesthetic
· The procedure will last about four hours
· The head is shampooed and treated with an antibacterial substance
· A narrow strip of skin is taken from an area that has good hair growth. It is usually about a half-inch wide by six or seven inches long
· That site is sealed off
· Surgical assistants wearing binocular microscopes gently separate follicular units and remove excess tissue
· The surgeon uses a fine needle to create sites for each unit, making them angled in a natural-looking hair pattern.
· Each follicular unit is inserted and semi-permeable dressings are applied to the finished area
Be sure and choose a fully qualified cosmetic surgeon for your hair transplantation, as this is a permanent procedure, and you would want to have it done right the first time.
Recovery
The first seven to ten days are the most important for an excellent outcome. You will have a print-out of post-op self-care instructions, and you should follow them exactly. The dressings should be changed at least daily and you will need to stay out of the sun. Shampooing can and should be resumed about two days after surgery. It will help prevent tiny scabs from forming which could interfere with hair growth.
Don’t be concerned if many, even all, the hairs fall out. They will regrow within two to three months after the follicles have settled down in their new homes. Your hair will thicken for six to nine months, giving you a full head of hair again and a newly youthful appearance.
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Be sure and choose a fully qualified cosmetic surgeon for your hair transplantation, as this is a permanent procedure, and you would want to have it done right the first time.
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