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Hair Transplants

Hair transplants are used where hair loss has occurred due to aging, a family history of baldness or a change in hormones. Hair loss may also be caused by trauma or burns. In such cases hair replacement surgery could be considered to be a medically necessary reconstructive treatment, and might be covered by health insurance. Generally speaking, men undergo the procedure more often than women. Also, the younger one is when hair loss begins, the more severe the baldness will become.

Hair Transplant Techniques
There are several techniques available for hair transplant surgery such as mini-grafts, micro-grafts, slit grafts, and strip grafts. Punch grafts were more widely used many years ago for transplants involving hair plugs but are not generally used today. In fact, some medical practices specialize in punch graft correction. These techniques are usually performed to accomplish a slight change in hair fullness. Flaps, tissue-expansion and scalp-reduction surgeries are usually done in cases where patients want a more drastic change in appearance. Sometimes the best results can be achieved by using more than one technique.

The most common and most recognizable hair transplant techniques involve grafts. Hair is transplanted from donor areas of the scalp (typically from the back of the head) into the areas of the scalp where hair loss or thinning has occurred. With modern "Follicular Unit Transplantation" the grafts are made from naturally occurring groups of 1-4 hairs. In previous years, grafts were made from "plugs" of hair. The results from hair transplant plugs were not as natural looking as the newer techniques using smaller grafts.

Scalp Reductions, Tissue Expansions and Flaps

More extensive surgeries may require scalp reductions, tissue expanders or flaps. A "flap" is a section of scalp containing hair that is to be moved from one part of the scalp to another. The flap surgery would usually be done in combination with some kind of "scalp reduction" where skin is removed from bald areas of the scalp and the area sewn closed to reduce the bald area. Tissue expansion involves the use of a balloon-like device that is placed beneath the skin and inflated, causing the scalp to expand. The expanded scalp with hair can be moved to cover adjacent bald areas which are removed during a scalp reduction surgery.

Hair Transplant Procedure

The surgeon performs an initial consultation with the patient, where he examines the patient's scalp and discusses his or her goals and expectations. The surgeon will usually evaluate the patient's hair growth and hair loss and may consider any family history of hair loss. The surgeon will take into consideration any previous hair transplant surgery and will provide advice on the best approach and expected results. Some of the topics discussed would typically be about the patient's lifestyle, any medical conditions which may cause problems or otherwise affect the results. High blood pressure, blood-clotting problems, or the tendency to form excessive scars are among the medical conditions that may cause problems during or after surgery. The surgeon will need to know if the patient smokes or has been prescribed any medications or drugs (even aspirin). Smoking will affect circulation (and healing) and aspirin can thin the blood and inhibit clotting. During this initial consultation, the surgeon will plan the surgery and whether the procedures are to be done in multiple sessions vs. a single session.

Hair Transplant Surgery

Hair transplant surgery will typically last about four hours usually under mild sedation with local anesthesia. It is performed on an outpatient basis. Surgical assistants will trim and shampoo the scalp then treat it with an antibacterial chemical just before it is excised from the donor area. The surgeon will typically harvest a strip of skin in an area of good hair growth from the back of the scalp. Then while the surgeon closes the wound, special assistants will dissect individual follicular unit grafts from the harvested strip of scalp. Working under a binocular stereo microscope, they will carefully sort and prepare the grafts consisting of only a very small number of hairs each. The surgeon will use small micro blades or fine needles to puncture the skin in the areas where the grafts are to be transplanted, then graft them in a natural manner paying close attention to density, angle of growth and arrangement.

After procedure, the scalp may be covered with gauze dressings, depending on the extent of the surgery, although sometimes the scalp is left uncovered. The patient is instructed when he or she can resume shampooing. Stitches are usually removed after 7 to 10 days.

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