Highlighting hair transplants

OP. DR. YUNUS DOĞAN

All about hair transplants

Hair loss is part of life. Just as seasons change and once-green leaves dry up and fall off, our hair can die out and wither away, leaving us bare in patches like an old wrinkled tree on a gray winter’s day. Unfortunately, our hair won’t come back in the spring on its own. The weather will warm up but your pattern-baldness will reflect that midday sun like a mirror in a tanning chair.

Maybe you have naturally-occurring hairless parts of your body that you would prefer to cover up. Birthmarks or scars that don’t support hair growth on their own might need a little surgical intervention. Regardless of your story, you have empty fields in need of a crop. How best to fill that void? You need a hair transplant!

This article is the eleventh in a series highlighting some of the most popular plastic surgery procedures. In the Highlighting series, we tell you ALL the alternative names of the surgery so you learn the medical terminology as well as develop a little street cred with slang terms. We share a little history of the procedure and describe the general process. We mention possible complications and give you an idea of the typical recovery time.

Also known as/similar or related names are:

Follicular Unit Extraction (FUE,) Follicular Unit Transplantation (FUT,) hair restoration surgery, hair transplant graft, inherited-pattern baldness (androgenetic alopecia,) injury-related baldness (traumatic alopecia,) mop job, no-stress tresses, thatch patch.

First recorded

Picture it: Germany,1822. Professor Dom Unger and his student Dr. Johann Diffenbach wanted to grow their hopes and dreams in the form of hair. After a few years of experimenting on birds and animals, Dr. Diffenbach reportedly took six hairs from his head and attempted to transplant them to his arm. Two rooted and grew for an initial success rate of 33% and a projected optimism that genetic baldness would eventually be cured 100% in the future.

In 1897 Turkish Dr. Menaham Hodara performed one of the first successful hair transplant surgeries to cover up unsightly scars left by a fungal skin infection known as tinea capitis or favus.

In the 1930s, Japanese Dr. Shoji Okuda perfected a “punch graft technique” to restore hair lost to different parts of the body as a result of traumatic alopecia. In this technique, Dr. Okuda removed a hair-bearing section of skin and attached it to a bald section. Then in the 1940s Dr. Hajime Tamura refined Dr. Okuda’s process for increased success. Due to the international conflict of World War II, the rest of the world remained ignorant of these Japanese advancements for decades. Coincidentally, there were states in the US developing similar techniques in 1959, specifically New York’s Dr. Norman Orentreich.

General process

We wait for the Harvest Moon to crest the night sky, then we carefully select the thickest and strongest hair follicles from the donor site. A sacrifice is offered, scalpels are ceremoniously cleaned, and then… . The method of extraction differs based on the procedure you and your dermatologist or surgeon have agreed upon in your consultation. Two of the most popular methods include:

• FUE (Follicular Unit Extraction) - As the name suggests, each hair follicle is individually chosen and removed from the donor site via a punching tool. Complications are higher and success rates tend to be lower with this method due to the difficulty in removing completely intact hair follicles. Your hair transplant specialist must be extremely accurate with the punch tool and instinctively know how your follicles grow.
• FUT (Follicular Unit Transplantation) - Similar to the punch graft, the FUT involves taking an intact section or strip of fertile, hairy skin and transplanting it to a section in need. This method is preferable due to its higher success rates. Patients also do not need to shave their entire head (or donor site) prior to extraction. Shaving is required for the FUE.

After your consultations and pre-procedure testing, you are ready for action. You will lay on your back or stomach depending on the location of your donor site. Local anesthesia will be injected into the donor area and extraction begins when you are comfortably numb. Donor follicles/grafts are cleaned, sorted according to how many hairs are attached - if you’re doing a graft procedure - and placed in a plasma solution for maximum freshness. Your donor bits will be kept in a refrigerator until it’s time to plant those seeds.

If you’re having FUE, your surgeon will use implanter pens to place your transplants. Surgical technicians will pre-load your donor follicles into these pens and then hand them to your trusted surgeon. (Sidebar, do you trust your surgeon? Did you follow our advice to find him/her?) Pew, pew, pew, your follicles are injected and you are the master of your own hairy destiny regarding following aftercare instructions.

What could go wrong?

Complications that may occur include:

• Donor site depletion - your surgeon taketh and he giveth, but if he taketh too much, your donor site might look a little sparse. Just a little off the top, Doc!
• Folliculitis - can happen if hygiene standards are not met consistently but can be treated with daily antibacterial shampoo.
• Keloid scarring - although rare, prominently colored and raised scars can occur if your skin is prone to this type of surgical reaction.

What could go right?

Playfully flip those bangs out of your eyes and think about:

• A thicker, more youthful head of hair.
• More confidence in your daily life at work, on dating apps or when you first get out of the shower and catch your own reflection in the mirror.
• Finally covering up any physical scars you may have been hiding behind.

Recovery time

Hair transplants are an out-patient procedure so you and your new future ‘do are headed home same-day. Specific aftercare instructions will vary based on your surgeon and you should be given detailed direction on how and when to clean your hair transplant site. Your surgeon may also give you recommended hair care products to clean and moisturize your cute little baby hairs.

Hygiene and maintenance aside, there are a few general limitations to keep in mind as you recover from your hair transplant. Don’t wear caps or anything on your head unless directed by your surgeon. Don’t scratch your head for the first month. Don’t exercise for the first week. After that week, you can do light exercise such as walking or light bicycling. Save your heavy lifting and harder workouts for the second week post-transplant. You don’t want to sweat your new hair out.

As with any surgical procedure, your life decisions will determine your surgical outcome. What you ingest can help or hinder your recovery. A healthy, balanced diet is optimal to nourish your body and give it the vitamins and minerals it needs to help you heal.

Hydration is also important and this advice is two-fold: drink plenty of water and also avoid alcohol for at least the first month. Good news for all the social smokers out there: no drinking = no smoking. And if you’re a non-social smoker, you should quit smoking for at least the first month post-op. That’s it.

The last stitch

We don’t know how many trips around the sun we have, so make the most of your time. If it makes you feel sexy, beautiful, powerful, do it. Get the hair transplant and sow the seeds of confidence now.