How do I know if I am a candidate for hair transplant surgery?
Compartir
And other frequently asked questions from those who want to improve their hair surgically
Hair transplantation is a booming surgery. Both for patients with advanced alopecia and for those with small defects who wish to perfect their appearance. Transplantation is the only treatment capable of growing hair in areas where it will no longer grow naturally. But it is not as simple as plucking hair with tweezers and placing it in another area. If you want to know how hair transplantation works, I recommend our blog post on hair transplantation
In these paragraphs, I have summarized the questions that I am most frequently asked by patients, acquaintances, or that I see on social media. I hope they are useful to you too! And if you have any more questions, leave them in the comments!!!
1. How do I know if I am a candidate for a hair transplant?
Hair transplantation is a minimally invasive surgical technique with very few contraindications. What most limits its performance is whether or not the patient is a good candidate. It can be performed on both men and women with 2 main conditions
1. The clinical diagnosis must be androgenetic alopecia, traction alopecia, or traumatic alopecia. Inflammatory or cicatricial alopecias will only be eligible for transplantation if they are stabilized.
2. The patient must have hair in other areas to be used as donor hair for the transplant. This is the most limiting point, since if the alopecia is very advanced, it will be difficult to cover the entire alopecic area with the remaining hair (although there are design tricks to improve the patient's appearance with less hair).
If these two maxims are taken into account, most patients with androgenetic alopecia will be candidates for hair transplantation. Their results will depend on the patient's hair type, the area to be covered, and the amount of hair they have to use as a donor. Therefore, to assess whether it is worth it, you should always talk to your doctor to find out these details about your hair.
2. Why can hair be transplanted?
Hair is created by a mini-organ called the hair follicle. The hair follicle is an accumulation of very active cells that generate hair throughout life. As an "independent organ," each hair follicle responds to hormones and other bodily mediators differently. Specifically, in androgenetic alopecia, it was observed that hair from the posterior region of the scalp did not respond to androgens in the same way as that from the superior region of the scalp. This led surgeons to take the entire hair follicle (the hair plus the cells) and transplant it, observing how it grew and also maintained the same characteristics it had in the other area from which it was taken. This is why transplanted hair will not be affected by androgenetic alopecia. If you want to know more about hair, don't miss the post 7 concepts about hair!!!
3. Can hair be transplanted from another person? And synthetic hair?
You cannot use another person's hair for transplantation, because our body would recognize it as foreign and attack it to eliminate it. Therefore, for it to be effective, treatment would have to be used to suppress (inhibit) our defenses, but these have many adverse effects. Immunosuppressive treatments used in organ transplants have risks and adverse effects that are acceptable in cases of absolute necessity (almost life or death) but not in a medical condition for aesthetic improvement such as hair transplantation.
Synthetic hair transplantation is still a pending issue, but it is in process. There are already studies showing that after several years the body does not react to this "foreign body." However, there are others in which the opposite is observed, that the body does not tolerate it well. The problem also lies in the poor naturalness of this hair (it neither grows nor can its appearance be modified). However, in certain situations, it can be useful. We hope that with scientific evolution this technique can be improved to have more eligible patients.
4. The transplant is the definitive cure for alopecia, right?
NOOO!!!!! The transplant is an effective treatment for those areas where medical treatment, for whatever reason, fails to regrow hair. It will allow hair to be seen in that area, and the transplanted hair will not fall out. However, the hair surrounding the transplanted hair will continue its normal evolution if it is not treated to prevent it. Therefore, generally when we perform a hair transplant, we recommend medical follow-up with personalized treatment to prevent the worsening of the results.
5. Does the surgery hurt?
Hair transplantation is performed under anesthesia, so discomfort is minimal. It is a prolonged surgery, so for patients who undergo transplantation with local anesthesia, it can be more uncomfortable or tiring than painful. If possible, it is recommended to perform the intervention with sedation, as this makes the experience more pleasant for the patient, as they will be drowsy throughout the surgery. If a patient does not want sedation, it is done with local anesthesia and oral sedatives that leave the patient relaxed. The only uncomfortable moments are those when the anesthesia is infiltrated, but once the skin is numb, there are no more complications.
6. How long does it take to see results?
As we have mentioned, in hair transplantation, the important thing is the transplantation of the hair follicle, and not the hair itself. This implies that we are transplanting the cells capable of generating hair. That is why results do not begin to be seen until these cells establish themselves in their new location and begin to generate hair. This takes between 6-12 months. First, approximately one month after surgery, the small hairs contained in the hair follicle at the time of transplantation will fall out. There is no need to worry, as the cells responsible for generating hair have remained in the scalp to generate the new hair shaft. Then they generate it, but for a while, it is not visible because the hair follicle is about 4mm under the skin.
7. How many transplants can I have?
Hair transplant surgery can be performed several times throughout life. The use of multiple transplants occurs especially in two situations:
1. When the patient does not want or cannot take medical treatment, as in that case, we will combat the progression of alopecia with new transplants.
2. When the intention is to perform a very large transplant or one with high density. In some cases, it is recommended to do it in two sessions depending on the risk of the hair growing incorrectly or being damaged if placed too close.
What will ultimately dictate how many surgeries can be performed will be the patient's own hair. The patient's available donor hair will limit these transplants; hair can only be removed up to a limit beyond which alopecia would begin to be visible in the donor area if more were removed. Sometimes other locations such as the beard or body can then be sought as donors, but for specific cases and depending on the patient's skin and hair type, as not everyone is a candidate for this type of transplant.
As you can see, hair transplantation is a minimally invasive surgical technique that requires correct diagnosis and execution. If you have doubts about your case, whether you are a candidate or not, or if you have alopecia, do not hesitate to contact me for an assessment.
Rose PT. Advances in Hair Restoration. Dermatol Clin. 2018;36(1):57–62. doi:10.1016/j.det.2017.09.008
Rogers NE. Hair transplantation update. Semin Cutan Med Surg. 2015;34(2):89–94. doi:10.12788/j.sder.2015.0131
Lam SM. Hair transplant and local anesthetics. Clin Plast Surg. 2013;40(4):615–625. doi:10.1016/j.cps.2013.08.006
Rose PT, Nusbaum B. Robotic hair restoration. Dermatol Clin. 2014;32(1):97–107. doi:10.1016/j.det.2013.09.008
Bicknell LM, Kash N, Kavouspour C, Rashid RM. Follicular unit extraction hair transplant harvest: a review of current recommendations and future considerations. Dermatol Online J. 2014;20(3):doj_21754. Published 2014 Mar 17.