In the last decade the hair transplant has become popular thanks to the speed of the technique, the minimal discomfort for the patient and the excellent end result.
Hair transplantation is a surgical technique that allows you to mobilize healthy hairs from a donor area to another area presenting alopecia, baldness. For this purpose local anesthesia is used and donor areas where alopecia does not have effect, as in the nape of the males are chosen. Follicular units, i.e. hair follicles that may contain one or more hairs are extracted from this area. There is a limit defined in number of follicular extraction, units just to avoid scarring. Each follicular unit is then grafted in another area that has lost hair, always try to keep a certain natural hair density.
In 1936 he started to perform more or less elaborate form capillary graft to get remedy male pattern baldness, but techniques were imprecise and the final result was not expected. During the 20th century, various techniques were perfected, but until the 1990s not they began to use grafts follicular, i.e. the graft of hair follicles that contain healthy hair. At the beginning mini-injertos 4 mm were used with little flattering results (“Doll hair” appearance), but eventually managed to extract individual follicles to make micro-grafts with an optimal result.
In the last decade the hair transplant has become popular thanks to the speed of the technique, the minimal discomfort for the patient and the excellent end result. Currently carried out routinely in countries like the United States or Mexico, and is especially common in countries of the Persian Gulf. Europe also has become popular, especially in countries such as Spain where arrive has make up to 20 weekly hair transplants according to estimates. The price of the technique is variable, must take into account that it is usually a procedure that entails significant costs (an operating room, specific material, trained professionals and a capillary surgeon) for what usually exceed the 5,000 euros.
The experience of the professional who performs capillary graft is one of the keys to success. A good result must be as natural as possible, in such a way that achieves the highest density of hair along with the maximum discretion, so that is can not guess if you have had a hair transplant or not. Complications are rare, the most frequent being the false expectations of the patient because, although grafted hair will not fall, recover the same density youth capillary is impossible and would be unnatural.
The hair transplant increases hair density in an area affected by baldness.
A hair transplant is performed when you want to increase the density of hair in an area affected by baldness. It is an intervention that is appropriate both for men and for women, but the first are who most rely on it. There are many types of alopecia, known up to 100 reasons why hair is lost, so that an initial evaluation by a dermatologist is key to properly indicate a hair transplant. Not in all types of alopecia hair graft, is recommended in some cases would be useless or even counterproductive. The transplant is usually indicated in the following types of alopecia:
- Androgenic alopecia: referred as well to the common baldness. It is the main reason for hair transplant today. The ideal is to do it when baldness has stopped, either with prior medical treatment or because he has reached a age in which sex hormones do not induce her (usually older than 40 years, though the graft capillary from the 20-25 years may be done with treatment).
- Secondary cicatricial alopecia: is due to scars on the scalp causing hair loss. The reasons can be various and are divided into two groups:
- Medical: surgery on the scalp (especially neurosurgery, but also surgeries for tumors of the skin in that location) can cause alopecia. Radiotherapy can also destroy hair follicles radically avoid that grow back.
- Accidents: burns or trauma can damage hair follicles leaving scars very little aesthetic.
- Primary cicatricial alopecia: there are a number of diseases that produce alopecia of the scalp scar, i.e. without the possibility to regenerate hair with medical treatment (medication, infiltrations…). To perform a transplant in this type of alopecia a braking the fall with medical treatment for at least one or two years, make sure to avoid that the implanted hair is also destroyed. Some types of alopecia where the realization of a capillary graft could be useful are Lichen Planus, pillar the Folliculitis Decalvans and frontal Fibrosing alopecia, but still is their long-term outcome.
- Alopecia congenital triangular: it’s a hair loss in lateral regions of the head since birth. You can be a hair transplant when the patient reached the necessary maturity, generally around adolescence.
- Alopecia in other locations: eyebrows can be another body region suffered alopecia. It may happen as the own age or by specific alopecia, as frontal Fibrosing alopecia. Transplantation is an option to fix this hair loss, although to be held with the scalp hair growth of implanted hair will be accelerated and should be trimmed frequently. Permanent eyebrow tattoo also achieves very good results and is another good option to take into account in such cases.
In situations where it is better to not be a hair graft would be the secondary alopecia to nutritional, or metabolic alterations since by correcting the initial cause hair can recover. Not recommended in alopecia difficult to control with drugs, as it may occur in some cases of alopecia areata. In general, any alopecia with bad evolution despite proper treatment with medication may be contraindicated transplantation and therefore the initial evaluation of the dermatologist is the key to properly indicate this intervention.
Recommended not to perform hair transplant while you are pregnant. In principle there would be no risk to the baby, but special hormonal situation of pregnancy can you alter the growth of hair and may not well rating alopecia. Breastfeeding is not an absolute contraindication, but it is preferable to find another more comfortable stage to perform the operation.
To perform a transplant hair first removed hair from the patient, then implanted in the area affected by alopecia.
The first preliminary step in preparing to perform a hair graft is washing your hair with a special shampoo the day before the transplant to disinfect well the hair and scalp. Then you will have to keep fasting at least six hours before the procedure, if it is the morning following simply dine light and no breakfast. It is not necessary to take any prior medication at home. You must tell your doctor all the medicines taken regularly and will decide which suspend or maintain. You should not take drugs that hinder blood coagulation (such as aspirin or ibuprofen) days must notify also the doctor.
You should keep in mind that the intervention lasts approximately 5-6 hours. You should probably book a morning or an entire afternoon so they can make it to you. Despite its long duration is a simple technique, but processing of the follicular units often require quite some time. The hair transplant does not require income. He is performed on an outpatient basis, so you enter and go by your own foot and on the same day clinic. It is only necessary to make you a blood analysis a few days before the transplant to check that you don’t have major diseases.
A companion is recommended. For transplantation is used local anesthesia and an oral anxiolytic to keep you comfortable throughout the procedure. However, it is normal that you can then find you slightly dazed and prefer not to drive or just arriving home. Usually the doctor who performed the transplant will have all the documentation with it. This documentation must include your medical history, your type of alopecia, the evolution of it and if you have used a previous treatment. Before you undergo the intervention you will sign the informed consent with which you agree to make yourself the technique and you will know the potential risks.
When you arrive at the clinic they ask you to change your clothes for a comfortable robe that is suitable for operating room. Before the intervention, you will take a dose of antibiotic and an anti-anxiety to be relaxed during all the transplant. You will enter to the operating room walking and you will be placed in a comfortable position to begin intervention.
The hair transplant procedure: techniques to remove the hair
The first part will consist of extract the hair of a respected by alopecia area, usually the neck by what placed you slightly face down. It will select the ideal area to extract follicles and pare with an electric machine leaving a minimum length of 1 mm. Once you anestesiarán the back of the neck with a fine needle, you can notice a slight stinging sensation for a few seconds.
After the anesthesia, there are two ways to extract follicles:
- Technique of strip or FUSS (follicular Unit Strip Surgery): consists of a strip of skin from the scalp with all your hair, take. With this technique hundreds of hair follicles get slammed and no shave zone is then left. The scar is not visible, except if you decide to shave head in the future. After removing the Strip a team of professionals divide follicles one at a time and divided them according to the number of hairs that contain (1, 2, 3, etc).
- Technical was (follicular Unit Extraction): consists of extracting hair follicles in the nape of the neck one by one with a very precise millimeter instrument. The technique is more laborious than the Strip and leaves no scars if respecting the maximum of follicles that can be removed. It leaves a more or less wide area shaved in the neck which will take a few days to grow back.
- Robotic technique: consists of one technique was assisted by a robot that allows the extraction of the follicular units in a faster way.
Once extracted follicles and divided according to the number of hairs that contain will proceed to implement them in the area of alopecia. Follicles with more hairs, 3 or 4, will be placed on the area desired more capillary density, the follicles with 2 setae on the transition zone and with a single hair follicles are placed on-line home of hair (the line of implementation).
To implement them a tumescent anesthesia will be used, this involves injecting a volume of liquid under the scalp and thus make millimeter incisions that are distended and give the way to the follicles which are placed gently using a millimeter to one. The work is very laborious and occupies the greater part of the procedure.
Six months of intervention are already observed the first results, but the definitive are checked between 10 and 12 months after transplantation.
After carrying out the hair transplant process, at the end of the implants to check that no bloody point there is. You be cleaned gently and you put you foot. You will not need to take any kind of bandage or dressing, you will take the head into the air without problem. When you get home you will have to get cold dry local, with ice covered by a cloth, to reduce inflammation. Every three hours you have to moisturize the area with saline.
If they have the technique of Strip will have to fold the points in 10-12 days, if on the contrary you have done you the technique was not need extra care. Appear scabs in the implanted area and you can wash your hair the next day gently with shampoo to remove them slowly.
The hair transplant results
The implanted hair will fall, but the follicle persists so it will grow like normal hair to see initial results at six months. The new hair will be fine, but will gradually acquiring thickness until 10-12 months later (in the year of the transplant) can see the final results.
Requires no special treatment, new hair comes from a donor area that would not suffer alopecia so it will never fall. However, is highly recommended a follow-up by a dermatologist with experience in hair care if alopecia progresses the aesthetic result can be very bad.
For a complete natural result the hair transplant should be continued continued medical treatment. There are also complementary therapies that intensify the hair growth: platelet infiltration, infiltration of anti-androgens, etc.
Possible complications of a hair transplant
In the hair transplant complications are very rare and tend to be mild. Some of which may occur once are:
- Local pain: you can take over-the-counter pain medication to relieve pain. Local cold also calms it.
- Swelling and bruising in the area of implementation: local cold prevents further inflammation.
- Mild or superficial infection: sometimes it is required to take antibiotic a few days more to eradicate germs that produce local infection.
- Effluvium telogenic: consists of the sudden fall of around healthy hair that is in its final phase of the growth cycle. It happens in many contexts (pregnancy, illness, stress, etc.) and the hair transplant is one of them.