Hair transplant refers to surgical removal of hair follicles from a hair-bearing donor site and their relocation to a balding or bald area by a grafting procedure, in order to restore normal healthy hair growth at the recipient site over a period of time. The most common application of hair transplant is in treating male and female pattern baldness.
Hair transplant is a minor outpatient surgery carried out under local anesthesia and a single session lasts about 3 to 5 hours, depending upon the number of grafts performed.
The total number of sessions required for full treatment will depend on the (i) the area of the bald patch, (ii) the size and number of grafts used, (iii) the hair density desired by the patient, and (iv) the individual characteristics of the hair, e.g., coarse, fine, curly, etc.
History of Hair Transplant
Hair transplant in its present form has evolved a long way ever since it began in 1952, when Dr. Norman Orentreich performed the first hair transplant for male pattern baldness in New York City. For many years, hair transplants were carried out using more or less the same method. It involved direct removal of 4-mm-diameter circular grafts (called punch grafts or plugs) from the back of the head by punching, giving the donor area a moth-eaten look. Each graft carried 15 to 20 hair follicles. Such large grafts resulted in acorn row or a dollar haircut look, not a fine natural look. This technique is outdated now.
In the 1980s, hair transplant surgery evolved dramatically with the emergence of the method of harvesting mini-grafts (4 to 8 hair) and micro-grafts (1 to 3 hairs) from a strip of donor tissue; a combination of mini and micro-grafts gradually replaced the punch grafts. Mini-grafts were used to create fullness and density, whereas micro-grafts were used to give a soft, feathered natural look to the hairline.
The nineties saw the emergence of a very refined surgical procedure called the follicular unit hair transplant (FUT). This very precise and painstaking procedure involves transplanting hair using 1- to 4-haired follicular units, exactly like how natural hair growth occurs. This procedure gives a fine natural look to the transplanted hair and is now considered a Gold Standard in hair transplant.
Statistics on Hair Transplant
To give you an idea of how prevalent hair transplants have become today, here are some statistical facts and figures according to the International Society of Hair Restoration Surgery (ISHRS) 2005 Practice Census: An estimated number of 168,155 hair transplant procedures were performed worldwide in 2004, of which 87,987 were in US alone. The US market for hair transplant was estimated to be a whopping US $811,684,185!
Hair Transplant Procedure Today
The procedure begins with the removal of a donor strip (usually 1 and 1.5 cm wide) from the back or sides of the scalp under local anesthesia. The opening is then closed with self-absorbable sutures. The donor strip is then dissected into grafts of three different sizes: single-hair micro-graft, 2-hair single follicular unit, and 2 and 4-hair modified follicular unit. This takes about 2 to 3 hours. After the individual hair follicles are isolated from the donor strip and the excess tissue removed, they are immediately inserted into pre-cut micro and mini slits or punctured holes that are strategically placed so as to give a natural and aesthetically appealing look to the hair that will grow in future from the transplanted follicles. An expert surgeon can place up to 50 grafts per square cm. The surgery does leave a scar in the donor area, but that gets covered once the hair grows fully.
A far less invasive method of obtaining hair grafts for transplant is the follicular unit extraction (FUE) method. Here the surgeon examines the donor tissue under a microscope and selects individual follicular units and then plucks them out using a fine needle, eliminating the need to excise the skin from the back of the head. The benefits of the FUE method are faster healing, less trauma, no strip scar, and the surgeon's ability to individually select follicular units. However, this procedure is far more time-intensive than the traditional strip methods and therefore much more expensive.
Since the hair transport involves outpatient surgery, recovery is speedy. You can go to work the very next day itself and carry out all your normal activities within a week. Post-surgery, you would need to take the prescribed antibiotics and vitamin supplements for some days to avoid wound or graft infections and aid healing. The transplanted hair will fall in 2 to 4 weeks time and new hair will start growing in 3 to 4 months time; within 6 to 9 months the hair growth will become normal, allowing you to style your hair as you please.
Since the hair is transplanted from ones own scalp, it is a safe procedure with no major or long-term side-effects. The only important requirement to get good results is to have healthy hair growth at the donor sites. So do not wait to get your hair transplant done until you go completely bald!
Other Areas for Hair Transplant
Other than treating male/female pattern baldness, hair transplant surgery makes it possible to restore hair on other areas of the body too, e.g., eyebrows, eyelashes, chin, moustache, sideburns, chest and pubic area.
According to ISHRS 2005 Practice Census, 95% of the hair transplant surgeries were done for treating baldness (89% for male baldness, with 30% of them being in their 40s). Approximately 3% of hair transplants were performed on eyebrows, about 1% on moustache/beard, 0.35% on eyelashes, 0.34% on the pubic area, and 0.06% on the chest.
In fact, the earliest hair transplant carried out by a Japanese dermatologist Dr. Okuda in 1939 was for restoring hair on the eyebrows and eyelashes of burn patients by using small grafts from the scalp.
Advantages of Hair Transplant
The greatest and most palpable advantage of hair transplant is that you have your own new crop of hair thats there for keeps! Unlike a wig, there is no fear of transplanted hair moving around or changing position, no matter what the activity. And since the transplanted hair is harvested from your own scalp, there is also no fear of tissue rejection or foreign body reaction as in other organ transplants. Also there is no headache of matching color and texture that you face while shopping for a wig.
The transplanted hair can be shampooed and styled just like normal hair, because they are your normal hair. A hair transplant can immediately take away 10 years off your visible age. It makes your looks youthful and boosts your self-esteem.
How Expensive is Hair Transplant?
Though at first glance a hair transplant procedure may appear expensive, in the long run it can turn out to be more economical than buying wigs. Due to the stiff competition in the hair transplant market, the rates have fallen from the earlier US $15 per graft to US $3 per graft. Of course, the number of grafts required will depend on the area of the bald patch, the size of the graft, the required hair density, etc. In general, the total cost of hair transplant can vary from US $4000 to $15,000.
Whatever the case, considering the boost and positive energy it adds to the psyche, a hair transplant is worth every cent. After all, its hair today, not gone tomorrow.
Barry A. S. Lycka is one of North America's foremost authorities on cosmetic, skin cancer and laser surgery of the skin. You can find out more at http://www.barrylyckamd.com and http://www.restoringyouthonline.com. He is founder of the Etical Cosmetic Surgery Association (http://www.ecsaonline.com)