Are you a balding male or female and desperate to do something? Hair restoration surgery may be worthy of consideration.

Baldness

• Temporary
• Permanent

Temporary baldness: Hair follicles are vacated temporarily e.g. postnatal alopecia, alopecia areata, telogen effluvium etc. Hair re-generation should occur.

Permanent baldness: Hair follicles cease to regenerate hairs.

This may be due to disease, skin damage, androgenic (hormonal) or genetic (inherited) factors. Rarely is this associated with hat wearing, circulatory or vitamin deficiency. Men and women are affected.

Female pattern loss may begin as a single coin-sized thinning patch in a central position just behind the fringe area. This thinning may extend to inculcate much of the scalp. One in five women will probably experience some degree of hair thinning associated with illness, ageing, hormonal changes after menopause or heredity.

Wigs may be an answer. Topical prescription drugs may help, but rarely is lost hair replaced-naturally. Hair restoration surgery may offer a solution. The best candidates for this procedure is sufferers of scalp damage, Androgenic or Genetic Alopecia. The procedure involves the redistribution of an individual’s hair bearing follicles from safe ‘donor’ sites at the occipital (between the ears) to the balding regions.  A skilled specialist surgeon can produce cosmetically satisfying results.

Techniques used

• Scalp reduction
• Micro-grafts (containing a single hair)
• Mini-grafts (containing two or three hairs)
• Flaps and tissue-expansion

More than one technique may be employed during a procedure. As suitability to each technique    depends on individual circumstances, one to one advice is essential FUE (Follicular Unit Extraction) involves removing single-follicle hair grafts with one mm punches. This avoids lineal scarring and eases more rapid healing. It is time consuming procedure which costs more to perform and produces a lesser number of grafts per session.

The Micro & Mini Grafts Procedure

Only the patient’s hair follicles can be used.  Areas of baldness may extend to exceed 400 sq.cm. Whereas some patients provide an abundance of donor hairs from densely populated donor sites, others less fortunate may provide insufficient numbers with which to establish even modest hair cover.

Whereas subjects with good donor hair will not regain the density of hair coverage possessed before their hair loss this proven surgical technique can re-establish a modest level of hair cover at bald sites and increase the density at thin areas in most individuals. This repositioned hair is expected to thrive in its new location for the remainder of natural life.

Several surgical sessions may be needed to achieve satisfactory fullness. A healing interval of several months are recommended between sessions. It may therefore take some years before the result is achieved.The cosmetic result may be influenced by: hair color texture and levels of waive or curl.

Anesthesia

Usually ‘local’ and you may be given sedation to make you relaxed and comfortable. The procedure should be painless although some sensations (e.g. pressure) may be experienced.  General anesthesia may be used for more complex cases involving tissue expansion or flaps.The ‘donor’ area hair will be trimmed short so that the graft material can be easily reached and removed.

The surgeon/doctor will use a scalpel to remove small sections of hair-bearing scalp, which will be divided into tiny sections and transplanted into tiny slits at the recipient graft area. Your surgeon may periodically inject small amounts of saline solution into the scalp to maintain proper skin strength. The donor site will require stitches leaving a thin straight-line scar.  The surrounding hair wills conceal the stitches and any subsequent minor scaring.

Other Procedures

Tissue Expansion:

Plastic surgeons employ this procedure in reconstructive surgery where burn wounds and other injuries have created significant skin loss. In hair reconstructive surgery a balloon-like device called a tissue expander is inserted beneath hair-bearing scalp adjacent to a bald area. Over a period of weeks the device is gradually inflated with salt water causing the skin to expand. This stretched hirsute skin then replaces the bald scalp.

Flap Grafting

During flap surgery, a section of bald scalp is surgically removed and a flap of hair-bearing skin almost detached but still attached at one end is sewn into its place. Hair usually grows to the very edge of the incision.

Scalp reduction

This procedure involves the removal of a section of bald scalp. The surrounding hairy skin is then made free and stretched to cover the area. The procedure is employed at the top and the back of the head but is not advised at the frontal hairline. Extensive areas may benefit from this method.

After surgery

Sensations include tightness and occasionally discomfort for which pain medication may be necessary.Any swelling or bruising should be reported. Bandaging if used will be removed the following day and the hair /scalp carefully washed. Sutures remain intact for up to ten days. Your surgeon may want to examine you at some time. Please arrange some days off work following the surgery.  Resumption of your normal life may take a few weeks.

Cloning: Hair follicle cloning or more correctly ‘Tissue engineering’ (hair follicle creation from stem-cells) is a focus of great interest. The procedure will be the most significant advancement in the effective treatment of androgen related hair loss. Current tests are encouraging – we await the results with interest.