Hair transplantation is a permanent solution to hair loss. Just as there is hair genetically programmed to fall out there is also hair genetically programmed to stay forever. The area in a horseshoe shape, (click here for diagram) from ear to ear, is the least amount of hair that is guaranteed not to fall out. This hair can be easily removed in a strip without any obvious signs and placed in the areas where you are balding. The strip is closed with a suture, which is removed after 10 – 14 days. The transplanted hair will grow for the rest of your life.

Hair transplants should look perfectly natural, single hairs are used to recreate a natural hairline while follicular units, naturally occurring groups of hair from 1 to 4 haired are used to give density behind the hairline.

Stereoscopic microscopes enable us to identify and dissect follicular groups.

Hair transplantation is an ongoing solution to an ongoing problem. A thinning area may need only one transplant while a bald area may need two treatments to achieve density. As you lose more hair it can be replaced if you require.

As a general rule you can lose 50% of your hair density before you begin to notice any hair loss, it is therefore reasonable to assume that by maintaining 50% of your original hair density to achieve the look of a person who is not losing their hair. However this does depend on the amount of hair you lose. If you lose lots of hair i.e. Norwood classification 5-7, you can only expect to achieve a thinning look.

This is because everyone has a limited amount of donor hair that we can move around; for example, if you are a only ever going to be a Norwood grade 3 hair loss, you have this much hair to transplant into the bald area; (diagram) Whereas if you are a grade 7 Norwood you have more bald scalp but similar amount of donor hair. (diagram) When we are able to clone hair you will have an unlimited amount of donor hair to fill in the bald areas. However this technology is currently still unavailable.

How is density achieved?

Most Doctor will transplant 25 follicular units (fu’s) per square centimetre, some hair clinics can achieve up to 40 fu’s per square centimetre but this would only be on a bald area. Therefore two operations of 25 fu’s per square centimetre could give you the density you require.

Follicular units (fu’s)

Follicular units are naturally occurring groups of hair. They occur in groups of 1 to 4 and in people with very dense hair; groups of 5 or 6 hairs had been noted. They are bound together by collagen and have one sebaceous gland. They cannot be seen with the naked eye; that’s why we use stereoscopic microscopes to identify them and dissect them accurately. This means that the fu’s can be transplanted intact giving every hair the best possible chance to survive and grow.

Micro and mini grafts

Anything bigger than an fu but not a plug graft is a mini or a micro graft. This may contain more than one fu, this doesn’t necessarily mean that they’re bulky or unnatural but they should be used with careful planning and never on the hairline. As they are bigger than fu’s you should expect less per square centimetre.

Plug Grafts

Plug grafts are the things that give hair transplantation a bad name. Up to about 10 years ago they were “state of the art” in this field.

A circular plug of 3-4mm diameter was taken from the back of the head in the area where your hair will always grow, a similar sized plug in the bald area is then removed and the hair bearing plug is then placed in the bald area, angled appropriately and left to grow.

This procedure left a circular scar on the back of the head. Dr’s were always careful to leave enough hair in between, above and below the scar to ensure it remained concealed, this meant that it limited the amount of donor hair available and left the patient with lots of circular scars.

Plugs were great at giving density to a hair transplant but unless you had white hair and white skin they were obvious on the hairline. They worked best when placed behind the hairline but if you then went on to lose your hair around the plug grafts, it would expose the plugs, as they were never meant to be a hairline they look unnatural.

What to do if you’re unhappy with your transplant.

If you have any type of surgery that you are unhappy with, the good news is that you don’t have to live with it. Grafts can be disguised or removed either individually or in a row if necessary, i.e. if they are too low on the hairline and therefore cannot be disguised or in the case of plug grafts if they are just too dense and at the wrong angle. Aesthetically acceptable grafts/follicular units can then be placed around the larger grafts or unacceptable work making the hair transplant look natural /acceptable. Unsightly donor scars can also be removed.

This work requires a high degree of skill, knowledge of surgery, dermatology and the principals of hair transplantation.

The great success of this type of surgery means that you can stop having to cover up those unsightly grafts.