Understanding Hair Transplants: How Do They Really Work?

Hair Transplant Surgery: An Overview

Hair transplantation or hair restoration surgery offers a long-lasting, voluminous, yet natural look to thinning crowns and receding hairlines. This elective aesthetic procedure involves moving healthy hair follicles from one part of the scalp to the balding regions. It is performed by certified hair transplant specialists, dermatologists, or plastic surgeons. 

While hair fall is a common concern among young males and females, pattern baldness significantly impacts their self-confidence. Here are the common conditions that getting a hair transplant surgery can solve. 

• Pattern baldness: The condition of having a bald crown with thinned hair on the top of the head and a horse-shoe patch of hair left around is called male pattern baldness or androgenic alopecia in men. Conversely, female pattern hair loss shows up as thin hair diffused across the scalp with minimal or no recession of the hairline.
• Burns: Candidates who experience hair loss due to facial burns, trauma, or accidents can reclaim their confidence through hair restoration surgeries. 

Either condition can compromise an individual's self-esteem and emotional stability. Hair transplant surgeries offer volume to the balding or thinning crowns and also help reclaim the receding hairline. 

Does a Hair Transplant Make You Look Younger?

Research suggests that hair transplantation contributes to a younger and more attractive look in men. Hair fall, particularly receding hairline or a bald crown, can make you look older. It induces a perception of diminished attractiveness and adds dullness to the overall look. Studies were conducted investigating the effectiveness and social perception of men who underwent the procedures. They revealed that the candidates themselves felt more approachable and successful post-hair transplant treatment.^[1] Don’t take our word for it. Check out these hair transplant before and after photographs. 

How Hair Transplant Works?

The hair transplant procedure typically involves the transfer of the patient's healthy hair grafts. Hair grafts or follicular units are small sections of the scalp containing 1-4 hair follicles. During hair transplantation, the doctor harvests the healthy hair grafts from the voluminous donor regions and implants them into the hair-thinning areas. Ideally, areas on the back of the scalp are thick and serve as donor areas. The thin areas on the scalp around the temples, on the crown, and the front hairline are the recipient areas. 

Various types of hair transplant techniques vary with the method of hair graft extraction and implantation. Regardless of the specific technique, the procedure requires the following steps.

• Consultation: The doctor will understand the hair loss pattern and evaluate your candidacy. They will determine the donor and recipient areas and decide the required number of grafts. 
• Marking donor and recipient areas: On the day of the hair transplant procedure, the doctor will clearly distinguish the donor and recipient areas and mark them. 
• Graft harvest: Hair grafts are harvested using special tools like scalpels or micro punches from the donor areas. Some techniques, like the FUT, involve removing a long section of the scalp. Hair transplant specialists extract healthy, viable grafts from the collected section.  
• Graft implantation: The viable grafts are implanted into the donor regions on the scalp. Some techniques adopt an immediate implantation following harvest using special tools. However, a few other techniques involve preparing microchannels to accommodate the transplanted grafts.  
• Recovery: Post-hair transplant recovery is a crucial phase and is followed at home. You will care for the new implants as they acclimate and start a regular growth cycle. Use the prescribed antibiotics, topical applications, shampoos, and conditioners. Adhering to these measures nourishes the new implants while protecting them from the adverse chemicals of routine hair care products. 

Hair transplant procedures share the aim of improving aesthetics in men and women. However, minute differences emerge in terms of diagnosis, donor area considerations, and surgical approach.

How Does Hair Transplant Work for Women?

The hair loss pattern in women is more diffused across the scalp with a widening part. Reclining hairline is quite rare. The motto of hair transplant usually runs around increasing the density and maintaining a uniform density across the scalp. Hair transplant specialists pay equal focus to the donor and recipient areas to ensure uniform density over the entire scalp portion.  

How Does Hair Transplant Work for Men?

The hair loss pattern among men is more confined to the crown portion and receding hairline. Hair transplant specialists should focus on attaining density and maintaining the true hairline. An improperly oriented hairline deviates from the natural look. Special attention should be paid to aligning the new grafts in the natural direction so the masculine look is attained. While some doctors use the patient's previous hairline as a model, some hair transplant specialists use special software to design a true hairline. 

How Many Times Can We Do Hair Transplant?

The number of hair transplant sessions one requires depends on the intensity of hair loss, donor hair, and the candidate's aesthetic expectations. Typically, hair transplant surgeons suggest the optimal number of grafts, sessions, and the appropriate type during the initial consultation. While most patients can safely undergo 2–4 hair transplant sessions over their lifetime, it’s worth noting that the results of a single, well-performed transplant are designed to last a lifetime.

The number of candidates getting hair transplant surgeries is growing tremendously across the globe, thanks to the amazing benefits of these procedures.

Benefits of Getting Hair Transplant Surgery

Here are the benefits of getting a hair transplantation procedure.

• Enhances aesthetics and imparts a youthful look.
• Improves self-esteem and confidence.
• Offer safe, effective, and long-lasting natural results. 
• Involves low maintenance costs and eliminates the need for additional touch-up procedures. 

Different Types of Hair Restoration Surgery

Hair restoration surgeries differ in their techniques, but the core goal remains the same: transferring healthy hair to areas with thinning or no hair. The choice of hair transplant surgery varies with the candidate's condition, specific needs, and budget. Below are the various types of hair transplant surgery.

Flap Surgery

This procedure will be carried out under general anesthesia. It involves the transfer of the hair-bearing flap of skin to the bald areas. Flap surgery is typically recommended for individuals with a bald crown on the front of the scalp. The surgeon makes superficial cuts around three sides of the hair-bearing areas of the scalp. They transfer this flap, stitch its end on the bald areas, and allow the sutures to heal. Only a qualified dermatologist or dermatosurgeon will perform the flap surgery. This procedure yields mild discomfort and requires time to heal.

Scalp Reduction Surgery

This procedure will be performed under local anesthesia. It involves surgical removal of the bald scalp areas and replacing them with the surrounding thick hair-bearing areas. The dermatosurgeon secures the position with sutures and allows the scalp to heal. The sutures and the scalp-removed areas take longer to heal.

Tissue Expansion 

This method relies on the tissue expansion of the hair-bearing zone on the scalp. The surgeon uses a balloon-like device called the tissue expander for this procedure. They place the device under the thin flap of skin and fill it with saline. Gradually, the hair-bearing skin expands, and the reconstructive surgeon performs a second procedure to cover the bald areas with the expanded skin. This method is ideal for candidates with scars on the scalp due to burns. 

Follicular Unit Transplantation (FUT)

This method of hair transplantation is also called the strip method. It involves the surgical removal of the thin strip of hair-bearing skin from the back of the scalp. The hair transplant specialist will separate the individual hair grafts from the extracted strip. Further, they will make minute channels on the bald areas to implant the extracted grafts. This surgical procedure leaves a long scar on the donor area and also requires a longer healing period.

Follicular Unit Extraction (FUE)

This is a minimally invasive technique that involves individual hair graft harvesting from the donor region, typically on the back of the scalp. Hair transplant surgeons prepare channels to implant the grafts in the bald areas. The FUE recovery is simple and leaves no visible scars on the scalp. However, the success of the treatment relies on the surgeon's expertise. The hair grafts need to be handled with extreme care to maintain their viability. 

Direct Hair Transplantation (DHI)

The DHI method of hair transplantation is minimally invasive and has a short recovery period. The hair transplant doctors extract the individual grafts and implant them immediately. This method eliminates the step of channel-making by using a specialized Choi implant pen. This increases graft viability by reducing the transection time and graft desiccation.  

Stem Cell Hair Transplant

Stem cell hair transplant involves removing a small skin sample from the patient. Next, stem cells are separated from the extracted skin tissue, and new hair follicles are grown in the lab. The lab-grown hair follicles are transplanted to the thin hair areas on the patient's scalp. The best part of stem cell hair transplant is that it eliminates the necessity of removing large tissue pieces or numerous hair grafts.

Are you confused about choosing the right method for you? Sign up with Envoy Health and get your FREE initial virtual consultation. Our best hair transplant specialists will evaluate your candidacy and suggest the right method for your hair. Rely on expert care because your hair deserves the best!

How Do Hair Plugs Work?

The transplanted hair grafts adapt to the implant site and begin a normal growth cycle. They behave like the surrounding hair roots and follow the same aging cycle. Naturally, hair follicles follow four phases of the growth cycle. 

• Anagen (growth phase)
• Catagen (transitional phase)
• Telogen (resting phase)
• Exogen (shedding phase)

Each hair follicle behaves independently and completes 10-30 growth cycles before ending into exogen and falling out. While some hair follicles remain in anagen, few enter into catagen, which reverses over time, and the cycle continues.^[2] After a successful hair transplant procedure, the transplanted hair grafts fall out as part of the shedding phase, typically between 2-12 weeks. This is shock loss and is a normal part of healing, indicating the adaption of new grafts to the transplant site. The hair follicles then enter anagen and start a growth cycle, reaching 1-2 inches by 9 months. You will attain full-fledged results by 12 months after hair transplant surgery. A hair transplant after 10 years is more or less the same volume, with normal aging like the surrounding hair. Are you wondering what a good hair transplant looks like? We have covered it in the upcoming section.

What Is a Good Hair Transplant?

A good hair transplant is more than just restoring hair. It is about achieving natural-looking yet long-lasting results with a seamless recovery. Below we listed a few pointers defining a good hair transplant.  

• Uniform density: A good hair transplant ensures uniform hair density across the scalp. The transplanted hair should neither be too dense nor too thin. It should match the existing volume of the surrounding hair on the patient’s scalp. Too much extraction leaves sparse volume on the donor area, leaving an awkward look. So, the extraction and implantation should be meticulously performed for optimal results.
• Youthful look: A good hair transplant should make the candidate look younger and impart an attractive look. Getting fuller hair and a natural hairline with a hair transplant procedure enhances confidence.
• Natural hairline: Achieving a true hairline is another important point for a good hair transplant. Doctors need to consider the candidate’s facial proportions before planning the surgery. They usually draw the hairline using a marker on the scalp before surgery. Some hair transplant specialists use advanced software to design a true hairline. 
• Natural orientation: Proper graft alignment in the right direction offers a natural look. This is more particular in cases of hair transplants for thinning crowns. The harvested grafts should be implanted in the natural direction of the existing hair for a natural look. 

Aren’t you impressed with knowing what a good hair transplant would look like? The following section details the various factors influencing the success of a hair transplant.

Factors Influencing Hair Transplant Success

While a hair transplant results in life-changing transformations, its success depends on a few factors.

• Donor hair quality and quantity: The higher the donor hair quality, the better are the outcomes of hair transplant. Too thin donor hair follicles yield poor aesthetics. Donor hair follicles with optimal thickness offer a fuller appearance. Further, the amount of hair left on the donor areas of the scalp also influences the overall results. While many patients ask us, Does hair transplant work if completely bald?, the answer is a straight No! A completely bald crown cannot yield a successful hair transplant due to the lack of donor hair follicles. Further, too sparse hair left in cases of severe baldness does not guarantee the expected density.  
• Hair transplant type: Methods like FUE and DHI are considered more successful than the conventional FUT. Minimally invasive methods incur a shorter recovery period. Plus, they are associated with fewer complications of graft infection or scar formation. On the other hand, FUT leaves a long scar, with the donor area taking longer to heal. Further, this method also compromises the overall aesthetic look.  
• Hair loss intensity: Severe baldness requires more grafts for optimal outcomes. Mild or moderate baldness typically can attain a natural look. However, severe hair loss conditions with too little donor hair left cannot assure better aesthetic outcomes.  
• Surgeon’s expertise: The naturality of the results relies on the hair transplant surgeon's skill set. Determining the required number of hair grafts (while ensuring a uniform density) and preserving an optimal density is crucial for the overall outcomes. Achieving a natural hairline is indeed the surgeon's skill. Positioning the hair grafts so they align with the direction of surrounding natural hair offers a seamless, natural look.  
• Chosen clinic: Hair transplants utilize advanced technology and specialized tools for successful graft harvesting and implantation. Moreover, hair transplantation techniques need to be carried out in intensely sterile conditions. The chances of graft failure due to infection are high when the procedure is carried out in unhygienic conditions. Clinics should be maintained well, and doctors should rely on the latest technology for assured results. 

Performing a hair transplant for the wrong candidate not only diminishes the chances of success but also increases the risk of unsatisfactory results. Understanding who is not an ideal candidate for this procedure is just as crucial as knowing who is. Now, let’s dive deeper into this.

Who Cannot Be a Candidate for Hair Transplant Surgery?

Hair transplant specialists meticulously examine the candidate, considering various factors before planning hair transplant surgery. Here, we discussed a few conditions that hair transplants do not treat.

Individuals Facing Temporary Hair Loss

Hair loss can result from various factors, including genetics, malnutrition, stress, hormonal changes, and medication. Are you wondering how does hair loss genetics work? Genetics indeed plays a significant role in causing pattern baldness. Note that the genetically caused pattern hair loss cannot be reversed. The genetics behind baldness is poorly understood. Studies suggest the cause to be a pleiotropic phenomenon, where a single gene influences multiple characters. ^[3] Genes, along with the other causative factors, often cause pattern hair loss. Conditions such as stress, hormonal imbalances, pregnancy, or the side effects of certain medications typically lead to reversible hair loss. Opting for a hair transplant in these cases is unlikely to yield successful results, as the underlying causes are not permanent.

Candidates With Birth Problems or Autoimmune Conditions

Hair transplant treatment offers stunning transformation for androgenic alopecia. However, it's not recommended for congenital alopecia or alopecia aereata. Congenital alopecia is a condition where an individual is born without scalp, hair, or eyebrows. On the other hand, alopecia areata is an autoimmune condition where an individual's immune system attacks the hair follicles. Hair transplant surgery utilizes the candidate's hair follicles, which grow normally and, hence, is not a solution for either of the conditions.  

Young Candidates Aged Less Than 18 Years

Although individuals aged between 18 and 25 experience hair loss, it often follows a diffused pattern. Doctors usually recommend non-surgical treatment for this age group. Even if a hair transplant is performed, hair loss is likely to continue with age, potentially causing an uneven, unnatural appearance.

Patients with Poor Scalp Health

Poor scalp health cannot contribute to viable and successful hair grafts. An unhealthy scalp with poor healing ability or scarred tissues with non-viable grafts can indeed cause complications. Candidates suffering from problems like Lupus, psoriasis, and eczema are likely to have scalp inflammation. Increased sensitivity, irritation, and poor healing ability can deteriorate the scalp condition with a hair transplant. Further, in some patients, it can generate an itching sensation in the transplanted areas, causing the new grafts to fall off. 

Candidates With Unrealistic Expectations

Hair transplants should be performed for individuals with a proper understanding of the procedure and its results. Unrealistic expectations can hold them far from reality. Even a technically well-performed procedure can seem an aesthetic failure in such cases. The result would be severe dissatisfaction, which could negatively impact mental health.  

Individuals Experiencing Psychological Illness

The success of hair transplants relies on effective aftercare. Patients with sound mental health and those who can adhere to post-surgical care are good candidates. Suffering from anxiety, depression, or OCD does not interfere with the healthy growth of the hair grafts. However, these conditions indeed interfere with certain aspects of lifestyle, impacting post-treatment care and, eventually, the success of hair transplants.    

Curious if you're the right candidate for a hair transplant? At Envoy Health, we believe informed decisions are key to peace of mind and successful treatment. Connect with top hair transplant specialists and get a professional evaluation effortlessly—sign up with Envoy Health today!

Hair Transplantation Surgery: Aftercare

The new hair grafts need to acclimate to the recipient area and begin a normal hair growth cycle. They should be cared for well for successful results. The post-treatment care starts a day after the hair transplant surgery with a first hair wash. It should be as gentle and delicate as possible. The goal of this hair wash is to remove the blood stains on the donor and recipient areas. You may return home, but the new grafts should be handled with extreme care.

• Use the prescribed antibiotics and wear the therapeutic headband around the scalp. 
• Do not expose the scalp to direct sunlight, and avoid strenuous physical activities.
• Expect facial swelling around the eyes and forehead during the first few days. 
• Sleep with your head elevated using pillows.
• Slight tissue discharge on the scalp is a part of normal healing.
• Avoid touching the scalp for at least a week. 
• Use mild shampoos or conditioners while avoiding harsh styling products.
• Rely on a nutritious diet rich in vitamins, proteins, and nutrients. 
• Do not skip follow-up appointments, as they are crucial for the early detection and management of complications.   

Is Hair Transplant Permanent?

When performed by skilled professionals on suitable candidates, hair transplant results can last a lifetime. Within 12 months, you can expect natural, fully developed results. The transplanted hair integrates into the natural hair cycle, aging and turning grey just like your existing hair. However, the permanence of the results depends heavily on the expertise of the hair transplant specialist.

At Envoy Health, we believe that knowing the positive and negative aspects of any choice is crucial for making an informed decision. Below, we elaborate on the potential drawbacks of opting for hair transplantation. 

Addressing Concerns Related to Hair Transplant Surgery

Expensive price tags and the hair transplant side effects like scarring, pain, bleeding, and discomfort are the main concerns that bother patients. Below, we elaborated on them in detail. 

• Cost: Hair transplant costs are quite expensive when compared to the non-surgical hair loss treatment measures. The high costs are mainly because the procedures are intensive and carried out by highly trained, qualified professionals. They are performed in aseptic conditions using extensive software and specialized tools. Furthermore, hair transplant costs typically vary with the geographical location and the graft number. While this variability may confuse patients, opting for suspiciously low prices can increase the risk of being treated by unqualified or fraudulent professionals.
• Bleeding: Hair transplants can sometimes lead to scalp bleeding. While slight temporary bleeding is normal, excessive bleeding can be a point of concern and can also cause infection.     
• Discomfort: While the procedure is carried out under local anesthesia, you will feel slight pain and discomfort as the anesthesia wears off. The scalp feels tight early after a hair transplant, followed by tissue fluids oozing out and scabs falling off. Further, dealing with post-operative inflammation, swelling, and soreness requires more attention.  
• Scar-formation: Methods like FUT yield a long visible scar, while the minimally invasive FUE or DHI leaves minute white dot heads. Although the scars are minimal theoretically, the practical results depend on the graft harvest and implantation. Improper handling can lead to an awkward white dotted appearance on the scalp.  

Every medical procedure comes with its own set of pros and cons. As a patient, you need to thoroughly understand these aspects and weigh them carefully to make an informed decision. In this regard, we present you with non-surgical hair loss treatment methods.

A Brief on Alternatives to Hair Transplant Surgery

Hair transplant surgery offers long-lasting results. However, some doctors suggest non-surgical treatment methods as an early intervention. While the choice of treatment is entirely dependent on the case, knowing various options can help make an informed decision.

• Medication: Medicines like finasteride and minoxidil are widely used for treating pattern hair loss in men and women. Finasteride blocks the 5-alpha reductase action, which accelerates the conversion of testosterone to DHT (which is a potent contributor to hair loss). Minoxidil, on the other hand, reverses the miniaturization of hair follicles and shifts their resting phase to a growth phase. Although medications are prescribed during the early phases of hair fall, the success rate varies with the patient. 
• Platelet-rich plasma (PRP): Plasma extracted from the patient's blood is injected in a minimally invasive method to stimulate hair growth. While the PRP method for hair loss treatment is relatively effective, one requires multiple sessions for effective results.
• Low-level laser treatment: This method uses low-level lasers to stimulate the cellular activity of hair follicles and push them into the growth phase. Laser treatment for hair loss offers thickness. However, it requires combination therapy using topical applications for effective results.
• Scalp micropigmentation: It involves the creation of hair-like tattoos to create the illusion of fuller hair. While this method deposits tiny pigments into the scalp, it does not address the underlying cause of hair loss.   

Every choice in nature has its pros and cons. The choice of the right hair loss treatment methods is entirely personal. It depends on the hair loss cause, intensity, budget, and expectations of outcomes. While non-surgical treatments are popular, hair transplants have equal demand across the globe.

Is Hair Transplant Effective?

Hair transplant procedures offer successful outcomes when carried out by skilled and qualified hair transplant surgeons on the right candidates at well-maintained clinics. Studies conducted to understand the effectiveness of hair transplants showed good results in 80% of subjects.^[4] Note that success depends on candidate selection, choice of method, clinic hygiene standards, and use of advanced tools. All these factors, when ensured meticulously, offer effective results that last for a lifetime. 

Are you wondering where to begin for a hair transplant that works well to reclaim your receding hairline? Don’t let confusion stand in the way of restoring your confidence. Our expert team is here to guide you through the way. Sign up with Envoy Health, and let us hold you hand in hand as you move closer to achieving your dream look.   

References

1. Perception of Hair Transplant for Androgenetic Alopecia
2. Integrative and Mechanistic Approach to the Hair Growth Cycle and Hair Loss
3. Dissection Of Genetic Variation And Evidence For Pleiotropy In Male Pattern Baldness
4. Longevity of Hair Follicles after Follicular Unit Transplant Surgery