Hair Transplantation

The proper term for the most common form of hair loss is Androgenetic Alopecia. “Alopecia” is hair loss. “Andro” means man. “Genetic” refers to chromosomes and genes. Putting the word back together, it looks like the word means “hair loss in men related to genes”. However, this is not quite right. In fact, the “andro” part refers to male hormones (testosterone and its derivatives, collectively referred to as androgens). So the word really means “hair loss related to male hormones and genes”. It relates to hair loss in both sexes, because these hormones are found in both males and females. Androgens are found in high concentrations in males and much lower concentrations in females.

In both sexes, if you have inherited the gene for baldness, androgens will act on the hair follicles and cause them to be lost over time. How much time it takes depends on genetic factors and perhaps environmental factors that are not understood (eg. stress, nutrition). Steroid use in body builders accelerates hair loss by boosting levels of androgens.

In men, the high levels of androgens might result in complete baldness. In contrast, the lower levels of testosterone in women usually result only in thinning. About 40% of women have thinning that is noticeable by the age of 50.

The genetics of hair loss is much more complicated than the simple dominant and recessive genes that determine things such as eye color. The gene can be inherited from either side of the family, and it can result in varying degrees of hair loss.
 

What is hair transplantation?
Hair transplantation is a surgical procedure in which hair is moved from the back of the head to the top or front of the head to replace lost or thinning hair.

How is the procedure done?
Hair transplantation is a minor surgical procedure done in the office under local anesthesia.
A strip of hair about one centimeter wide is removed from the back of the head (donor site). This strip is carefully dissected into individual follicles.
Needle holes are created in the thinning or bald area (recipient site), and the donor follicles are inserted into these needle holes.

What is the difference between micrografts and minigrafts?
Micrografts are single follicles. These individual follicles contain one to three hair shafts.
Minigrafts contain two to four follicles and three to eight hairs.
Microgafts are used along the hairline to give a natural look. The hairline must be gradual, not abrupt, and this can only be achieved with single follicle (micro) grafts. They are inserted into needle holes.
Minigrafts can be used to fill in the crown and back of the head where they cannot be easily recognized. They are inserted into scalpel slits about 2mm long.

What areas can be treated?
The most frequently treated area is the scalp, but hair can also be transplanted to any area of the body, most commonly to the eyebrows when they have been lost, usually through injury. If the transplanted hair is taken from the scalp, it will grow at the same rate as scalp hair, and it will need to be trimmed regularly.

Who is a good candidate for hair transplantation?
Anyone, male or female, with hair loss can be treated as long as donor hair is available (there are medical conditions in which all scalp hair is lost).
About 90% of hair transplants are done on men.

How many hairs are transplanted?
A small procedure is 300 to 500 grafts. A huge procedure is 3000 grafts. At York Vein and Laser Clinic most of our procedures are in the 500 to 1000 range.

How long does the procedure take?
The procedure will take all day, between six and eight hours.

Is a hair transplant permanent?
Yes. Androgenetic baldness occurs because hair follicles in the top and front of the head have receptors that respond to the effects of testosterone. Hair follicles at the back of the head lack these receptors. When these follicles are moved to another area of the scalp, they retain this resistance to the effects of testosterone, and they will last forever.

What will I look like and what about the “doll’s head” appearance?
There is a limited amount of hair that can be transplanted, so there is a limitation to the thickness of hair that can be achieved. A reasonable expectation is that you will be given a natural looking “early baldness” appearance.
In the early days of hair transplantation “plugs” of hair were moved. This resulted in the “doll’s head” appearance in which a circle of hair about 4mm wide and containing about one or two dozen hairs is surrounded by a space with no hair. It looks quite unnatural, especially along the hairline. Modern techniques using single follicle transplants give a very natural appearance.

How long does it take to see results?
The transplanted follicles will be shocked into a dormant state by the procedure. They will go into a resting phase for two or three months. Then hair will begin to grow again. It will be aesthetically appealing by six months.

How much does it hurt?
This is a difficult question to answer, because pain tolerance is highly variable from person to person. Generally, patients are sore enough to need Tylenol #3 for one to three days.

What are the risks of hair transplantation?
The incision at the donor site will leave a scar several centimeters long, but this is hidden under your hair. It would only be visible if you shaved your head.
Numbness along the donor incision is common, but it usually resolves.
The scalp has a lot of blood vessels, so bleeding will occur. Serious blood loss is extremely unlikely.
Bruising can occur, and might be visible on the forehead or even around the eyes (blood can track under the skin and pool here).
Infection is a risk, but you will be given antibiotics for three or four days to prevent this.

What are the alternatives to hair transplantation?
There are several surgical procedures such as scalp reduction and flap rotation, but these have been abandoned by most hair transplant surgeons. The simple reason is that nothing compares favorably to follicular unit transplantation for a natural appearance.

Minoxidil (trade name: Rogaine) is a lotion that has been shown to slow down hair loss. It is not very good at regrowing lost hair. The hair that does regrow is only peach fuzz. Minoxidil is believed to affect blood flow to the follicles. Its hair growth properties were an accidental discovery made during trials of minoxidil as therapy for high blood pressure.

Finasteride (trade name: Propecia) is a drug that interferes with testosterone and therefore slows hair loss. It was originally used as a treatment for the prostate gland where it acts on the same hormone to slow the growth of the prostate.

Neither of these drugs is truly an alternative to hair transplantation. Rather, they are treatments that can be added to help preserve remaining hair.

What is your cancellation policy?
We require a 20% deposit to reserve your appointment time for treatment. We require 48 hours notice for cancellation of your treatment. If sufficient notice is not given, your deposit may be forfeited.