Frequently Asked Questions (FAQs) on hair replacement
We have collected below a number of common questions, and
answers, regarding baldness and hair replacement treatments.
No matter whether you are male or female, please press the
question you need answered and you will be taken directly
to the appropriate answer. Remember, you can book your free
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What causes baldness?
Most male baldness is the result of an inherited characteristic
in certain hair follicles. This leads to the follicles becoming
sensitive to the presence of scalp hormone dihydrotestosterone.
In the years after puberty, these follicles become weaker
and die prematurely. The gene causing this problem may be
inherited from either side of the family, but certain other
factors may retard or speed up the effects of this gene.
Sometimes, scalp diseases may also lead to hair loss.
What can be done about hair loss and baldness?
You need to have your scalp examined by Dr. Shiell to determine
the cause of your hair loss. As mentioned, there are many
scalp diseases which lead to hair loss, some of which have
no cure at present. Fortunately these conditions are rare
and represent only about 1% of the patients we see.
Patients with early male baldness generally respond well
to the oral medication finasteride (Propecia or Proscar).
Other drugs are likely to be approved soon. The topical medication
Minoxidil is also known to be reasonably effective in the
early stages of hair loss for both males and females. More
advanced degrees of hair loss may require surgery.
What exactly is a Modern Hair Transplant?
Healthy hair follicles are removed from the rear or sides of
the scalp, where hair is at its thickest and implanted into
new sites prepared in the bald area. In the case of thinning
hair, these sites are located between the remaining hairs.
In recent years there has been a trend towards the use of
very small grafts containing 1-4 hairs. These are generally
known as micrografts or follicular units. Two thousand of
these units, up to 6000 follicles, may be inserted during
the course of one procedure. This can last up to 8 hours,
however we usually recommended shorter sessions.
The technique of varying the size and density of the grafts
is the reason why your hair line and hair growth will so closely
resemble natural hair growth.
During you consultation, Dr. Shiell will discuss the most
appropriate technique for your condition.
Can all types of baldness be helped by surgery?
Both male and female hereditary baldness can benefit greatly
from modern hair transplant surgery. It is also occasionally
used for treating baldness caused by accidents, burns and certain
skin diseases.
Increasingly over recent years, transplants have also been
used to conceal scarring following facelifts and other scalp
surgery.
How long does it take for the new hair to start growing?
Transplanted hair is usually shed within 3-4 weeks. New hair
growth is then generally seen after about 10 weeks and continues
to grow at about 1 cm per month thereafter. Please note that
some hairs take longer to regrow than others.
The operative process may cause temporary increases in the
natural hair loss, but many of these hairs will generally
regrow over the following 6 months.
Why does hair taken from a donor site continue to grow when
transplanted into a bald scalp?
Every hair on your body has its own distinctive and inherited
life cycle and these characteristics are not altered by transplantation
to new sites. Some hairs are predetermined to fall out prematurely
while in other regions the follicles produce hairs of a more
permanent variety. Hair follicles at the back of the head
are not sensitive to the effects of dihydrotestosterone, which
is why they continue to grow strongly.
Is the new hair permanent?
The new hair will grow strongly for many years, but there will
be some thinning and greying with age, just as there is with
normal healthy hair.
Will the operation damage my remaining hair?
You may notice a slight increase in hair loss in the recipient
area for a few weeks after surgery. Most of these hairs will
regrow within 6-8 months but in some individuals the loss is
permanent and further transplants will be required to replace
these hairs.
Is hair transplantation painful?
The operation is performed comfortably under local anaesthesia
and preliminary mild sedation. Some patients find that the suture
line is tender for a week or two, but most patients find that
the experience is no worse than a routine dental procedure.
How is the new front hairline created?
As this is a very important aspect of hair transplantation,
it will be discussed at your initial consultation and also before
your operation. Factors which influence the placement of the
new hairline are age, head shape, personal preference and the
availability of remaining hair.
What should I do before an operation?
A comprehensive, pre-operative instruction sheet will be sent
to you. In short, you are forbidden to consume alcoholic drinks
for 24 hours prior to your procedure. Similarly, you are not
to take aspirin containing drugs in the seven days before attending
surgery. Herbal preparation Gingko Biloba and Vitamin E tablets
should be also be ceased 1 week beforehand. Any medication your
family doctor may have prescribed for you must be mentioned
to Dr. Shiell as well.
Fasting is not necessary and you are advised to eat normally
and on the morning of your procedure you must shampoo your
hair.
How long does an operation take?
Operations take between one and eight hours, depending on the
number of grafts you are to receive. It is recommended that
you remain a further 30 minutes after the operation, during
which time refreshments will be provided. We further strongly
recommend that you do not drive immediately after your operation.
We suggest that you arrange transport with a friend, or if required,
we can call a taxi for you.
What happens after an operation?
Most patients leave without any bandages. Please note that your
scalp will be a little tender for several days.
A post-operative leaflet will be given to you containing
full instructions.
Will there be any scarring?
As with any skin surgery, faint scars may be detected on very
close inspection. This is generally less of a problem with hair
transplantation, as the new hair growth usually conceals any
residual marks.
In the donor region any faint scar is generally well hidden
by your surrounding hair.
Are there any complications likely from this procedure?
In our experience, post-operative complications have been infrequent
and never serious. The most common condition we have discovered
is some swelling and occasional bruising around the forehead
and eyelids on the third day, which may last for up to a week.
Occasionally, the glands behind the ears become a little
enlarged and tender for a few days, but this settles without
treatment. Parts of your scalp may remain numb for some time
after each operation due to temporary interference with the
nerves in this area. Infection is extremely unusual and responds
rapidly to antibiotics.
Is there any risk of catching HIV (AIDS) or Hepatitis during
the operation?
No. The operation is completely safe. All needles and blades
are discarded after use and instruments are pressure sterilized,
just as they are in a surgery room in a hospital.
Will I need to take time off work?
Many patients are able to resume work the next day and perform
light sporting activities within one week. We do recommend that
vigorous sports such as football, water skiing and weight lifting
should be discontinued for at least two weeks. Should you require
time off work to recuperate, Dr. Shiell will be able to furnish
you with a certificate. You may choose to schedule part of your
holidays to coincide with the procedure.
How many visits will be necessary?
This will depend on the size of the area to be covered and the
type of procedure involved. As a minimum, two visits are generally
required. If extra hair density is desired, further transplantation
sessions can be scheduled at intervals of 14-16 weeks, although
longer periods are preferred.
What are the costs of hair related surgery?
This will depend on which technique Dr. Shiell recommends and
the number and size of procedures required. He will discuss
these in detail with you at the time of your first appointment,
outlining the full facts to help you make your decision.
A deposit is required 3 weeks before surgery and final payment
should be made on the day of your procedure. Part of the cost
of hair transplantation is tax-deductible as a medical expense.
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