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FAQs of Hair Transplant - Answers by Dr Ashish Dutta

 Are you suffering from hair loss and looking for hair transplantation but have lack of knowledge for this. Don't worry! Answers given by Dr Ashish Dutta will clear all your doubts.

1. How does Hair Transplantation work?

Hair transplants generally work when the patient has adequate number of donor grafts and has realistic expectations. It is performed by harvesting DHT (hormone which inhibits scalp hair growth) resistant hair from the back of your own scalp and implanted into the balding areas where each transplanted follicular hair graft grows into a new hair. These implanted hair will grow in the same fashion as one's native hair and stay for a long time, because the hair follicles taken from the back of the head are genetically resistant to baldness, regardless of where they are relocated to.

2. Am I a candidate for hair transplantation surgery?

Hair transplantation candidates should have some noticeable hair loss with healthy hair growth at the back and sides of the head which is mainly DHT (Dihydrotestosterone) resistant, to serve as donor areas from which grafts are taken. Both men and women are suitable for this surgery. The extent of your hair loss can be assessed using either the Norwood-Hamilton Scale (for men) or the Ludwig Scale (for women). Patients are counselled about the benefits and limitations of hair transplant surgery.

3. What is the difference between FUE and FUT method of hair transplantation?

FUT (Follicular Unit Transplantation), also known as strip surgery in which donor hair (follicular units) is taken from back of the scalp (head) in one thin, long strip and then subsequently dissected into individual follicular units using magnification or stereo-microscope, whereas in  FUE (Follicular Unit Excision) method follicular units are harvested one-by-one directly from the scalp. The creation of recipient sites and the placing of follicular unit grafts are same in both FUE and FUT procedures

The FUT method leaves a linear scar in the donor area which can be concealed by normal hair style whereas FUE method leaves tiny round white scars in the donor area which are normally undetectable to the naked eye even when a patient's hair is cropped extremely short.

The FUE technique is less invasive with minimal recovery period as compared to FUT technique of hair transplantation.

4. How long will the transplanted hairs last?

The hair follicles that are transplanted to the balding area is extracted from the safe donor area which is genetically resistant to going bald. At some stage in later life, the hair from the back and sides may start to thin. The transplanted hair will continue to grow for a long time, but will thin when the remaining hair from the donor areas show signs of thinning.

5. What is male pattern baldness (MPB)?

It is also known as Androgenic Alopecia which follows a pattern of receding hairline and hair thinning on the crown, and is caused by hormones and genetic predisposition. A combination of genetic factors and the effect of the male hormone DHT shrink the hair follicles and weakens them inhibiting the growth of new hair. Over time, the remaining hairs start to thin and eventually fall out.

It starts with a receding hairline and spreads from this over the top and towards the back of the head. The remaining hair around the back and sides forms a distinctive ‘horseshoe’ pattern and is used as the donor site for transplantation because this area is DHT resistant. The progression of male pattern baldness is generally classified on the Norwood-Hamilton scale, which ranges from stages 1 to 7. Male pattern baldness is permanent and can be treated by surgery or medical management.

6. How long does hair transplant surgery take?

Hair transplantation is a day case procedure which generally takes as little as 3-5 hours but in some cases it may take as much as ten hours. Some patients require more than one session. It all depends upon the type of procedure and the extent of the hair loss.

7. Can you do a hair transplant using someone else’s hair?

No, this is not possible because your body would reject the hair transplant without the use of immunosuppressive drugs. The problem with immune-suppressants is that they will lower your natural immune response, increasing your susceptibility to infections and even cancer, and you’ll have to take them for the rest of your life. That’s why we use only your hair for your hair transplantation.

8. Will a Hair transplant procedure hurt?

We all have different pain thresholds and your Surgeon takes this into consideration. Usually the sting from anaesthetic injections is the most painful part of the procedure, otherwise the surgery is almost painless as it is done under local anaesthetic.

9. Which is the better Hair Transplant technique FUT or FUE?

FUT (via strip) will give the more volume to the transplanted hair because the follicular grafts are of better quality and better graft selection can be done (as the grafts can all be harvested from the mid-portion of the permanent zone) whereas with the FUE technique, the surgeon needs approximately 5 times the area for follicular units harvesting one by one. Because of this large donor area requirement, some of the hair must be harvested from fringe areas and thus the hair will be less stable genetically.

The main advantage of FUE over FUT is to have the option of wearing your hair very short (but not shaved) as it leaves only tiny white scars.

But with subsequent FUT procedures we remove the first scar, so the patient only has one linear scar while with subsequent FUE sessions we are adding additional scars, so over the long-term the cumulative scarring over large areas can present its own problems of visibility.

As FUE technique is time consuming, it is more expensive than FUT.

10. How many hairs/grafts will I need?

This depends on the degree of baldness, age, family history, hair type and your expectation, e.g., how much coverage and what density you would like to achieve. All this will be discussed with your surgeon, Dr. Ashish Dutta, during your consultation.

11. Are there any complications or risks with Hair Transplantation surgery?

Yes, as with all surgery, there are risks and potential complications. Among the known risks are post-operative bruising, scarring and more commonly bleeding and forehead and facial swelling. All of these risks are treatable, considered minor, and do not affect the final results of the procedure. In some cases complication may include poor/slow hair growth, changes in the pigmentation of the skin, hair loss in the scar area or infection.

12. Is there any scarring from Hair Transplantation? Is  FUE really a scarless surgery?

This depends upon the choice of procedure. The FUT method leaves linear scar in the donor area which can be concealed easily by normal hair style but it precludes someone from wearing their hair very short while the FUE method leaves tiny round white scars in the donor area which are normally undetectable to the naked eye even when a patient's hair is cropped extremely short. Thus FUE method generally results in less visible scarring compared to FUT.

13. Will my transplanted hairs look completely natural?

Yes, if the surgery is done correctly. It's important to choose the right procedure and clinic to assure that you will get completely natural results.  Results will vary from one person to another. The patient’s transplanted hair will continue to grow naturally as their other native hair.  It is extremely difficult to distinguish between your ordinary hair and your transplanted hair as the difference is usually undetectable.

 14. When and how will my newly transplanted hairs start to grow?

In both FUE and FUT techniques, the restored hair will grow in the same fashion as one's native hair. Within 2-3 weeks some or most of the transplanted hair will fall out from the transplanted hair follicle (generally contain 1-4 hairs). This is perfectly normal and you will start to notice new growth within a few months. Most patients attain 60% new hair growth six to nine months after surgery but in some cases it may take up to twelve to fifteen months for the hair follicles to grow. The transplanted hair grows very thin initially and gradually grows thicker and fuller over time. After one year a patient’s transplanted hair will be fully mature and will continue to grow for a long time as other hairs.

15. What is the guarantee that the implemented hair will grow? Why don’t they too fall under the effect of hormones like other hair?

There is no full guarantees as we are all different, but it works for most of us because the hair follicle to be transplanted is taken from the back of your own scalp (the donor area of your head) which is not affected by DHT (hormone which inhibits head’s hair growth), a by-product of testosterone. That’s why transplanted hairs don't fall under the effect of DHT hormone as they also become genetically resistant to going bald.

 16. What is the downtime and recovery/healing time?

It is often possible to go back to work within the next few days after FUE hair transplant.  FUE patients tend to recover much quicker, often experiencing minimal pain whereas FUT patients may experience numbness and irritation for days, weeks or months after treatment.

Generally patient should relax for 3 days after surgery to ensure a quick recovery with minimal discomfort or swelling. Swimming or other water submersion activities and all sports activities should be avoided for 3-4 weeks after surgery. Patient should not wash the hair for 2 days and the normal gentle showering to the scalp can be resumed on the 3rd day after surgery.

The small hole left behind after the follicle is extracted by FUE method heals over the next few days ends up with tiny white scars These tiny wound contracts as it heals resulting smaller and less noticeable round scars. These donor wounds, approximately 0.7-0.9mm in size, completely heal over the course of seven to ten days. An exposed strip of skin on your head after strip removal by FUT method stitches together which heals over time (2-3 weeks) leaving a linear scar.

17. Can it be done for eyebrows, eyelashes, beard, moustache or other body areas?

Yes. Hair can be transplanted to any area of the face or body.

18. What precautions should I take before & after Hair Transplantation Surgery?

For FUT, it is advised to massage the scalp (the donor area) twice daily at least 6 weeks prior to surgery as this helps to increase elasticity of the scalp. It is important to inform your surgeon of any change in your medical condition and/or medication. Alcohol should be completely avoided 2 weeks before your procedure and smoking cessation is always recommended. Your surgeon should have discussed your suitability and advised you on these issues well in advance.

19. What is the reason for hair loss?

Hair loss is caused by a number of reasons which include:

  • Male pattern baldness (Androgenetic Alopecia) is usually caused by genetic predisposition and by imbalance male hormone testosterone.

  • Stress: extreme physical or mental stress can affect the hair growth cycle and cause hair to fall out.

  • Damage caused by over styling or hair products: overuse of hair products such as gels, mousses or sprays can damage hair follicles resulting into hair fall

  • Side effects of certain medications.

  • Medical conditions: certain conditions such as thyroid disorders can result in hair loss.

  • Poor diet: a lack of essential nutrients can weaken hair follicles and lead to even hair loss.

20. What is a ‘Follicular Unit?’

A follicular unit is a naturally occurring cluster of hair follicles in the scalp. A follicular unit consists of 1-4 hairs and rarely even 5 or 6 hairs.

21. When receiving a quote, what is the difference between charge by per graft and charge by per hair?

Charging by the hair or the graft can be confusing and misleading to some patients who may not differentiate the number but instead may feel it is the same. This is because the number of grafts to be transplanted does not correlate to the number of hairs you will get. A graft is sometimes called a follicular unit prior to extraction. Hairs grow as follicular units and generally a single follicular unit (hair graft) contains 1-4 hairs.

For example: £2000 for 1000 hairs may mean you are getting only 500 grafts.

22. What is the cost of hair transplantation?

This depends on the number of grafts proposed and method of extraction. Generally, it starts from £2000 for FUE,  £1700 for FUT and £2800 for BioFibre Hair Replacement.