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PLASTIC RECONSTRUCTIVE SURGERY
The process of losing hair is a natural occurrence. We normally lose about 40-200 hairs daily. Our hair starts to thin out when the lost hairs out number the re-growth of the follicles. There are multiple causes of hair loss, the most important is the hereditary (genetic). This means that every hair follicle has its life course predicted from the time we are in the womb. Other causes are hormonal, stress, scarring after scalp trauma, bad nutrition and medications.
Male pattern baldness starts at different ages and areas of our head, most commonly in the crown and/or temples and frontal hair line. A female's hair loss is more of a generalized thinning of the hair affecting the whole scalp. All persons are possible candidates for hair restoration. The one important factor is the donor area, Occipital (back) and temporal areas (sides) of each candidate. The reason why the hair is taken from the occipital or temporal areas of the scalp is that these hairs will not fall in our lifetime. If you see persons in their eighties or nineties, they usually have hair in the occipital and temporal areas. It is very rare to see complete baldness unless there is some type of medication or illness behind it. Transplanted hair is for life. We have been doing hair transplants for over 25 years and have gone through the evolution from large (3-3.5 millimeters) plugs (7-10 hairs per grafts) to the present mini (3-4 hairs) and micro-grafts (1-2 hairs), (1-1.75 millimeters). Presently we place several hundred to over a thousand grafts per session. Our vast experience and the usage of mini and micro-grafts provides each patient with a natural look, which is the most important aspect of this procedure.
Hair transplants are done in our surgical suites as an out-patient procedure with local anesthesia. The session takes an average of 2-4 hours depending on the number of grafts used. The first consultation involves a complete history of the medical and hair condition of the patient. Each patient is evaluated in a unique way. All aspects of his/her hair are evaluated: donor area, recipient area, combing styles, how many grafts and/or sessions are needed to achieve each patient's goals. What is transplanted is the follicle, which is from where the hair grows; this is inside the skin of our scalp. It is the follicle that has the genetic information of not to fall. We could transplant this follicle to any place in the same patient's body and it will grow. The procedure involves harvesting the grafts from the donor area (strip of hair) and placing them where they are needed (frontal hairline, crown area). The donor area is washed, outline and trimmed. Next the local anesthesia is applied and the grafts are harvested. After harvesting, the donor area is sutured. The donor area is invisible since it is covered by your hair; and the suture line is very thin.
The next step is the cleaning and preparing of the mini-micro grafts for insertion into the recipient sites. The recipient area is anesthetized and then the grafts are placed in the normal direction that hair grows.
After the grafts are inserted a bandage is placed over the scalp. This dressing is removed on the morning after the procedure. The dressing is to keep the area clean and all the grafts in place for a few hours.
Hair replacement candidates should have some noticeable hair loss with healthy hair growth at the back and sides of the head to serve as donor areas.
The patient is seen in our center the day after the procedure to remove the dressing and have a shampoo. After combing their hair they are ready to go home or work.
The first 6-7 days after the procedure the patients are asked to restrain from strenuous physical activities (jogging, playing sports), they are not allowed to go to swimming pools or the ocean for 15 days. He/she can start to do all his/her desk work, or light activity the second day. On the 8th post-operative day the sutures are removed. A scab will form over each transplanted graft. All the scabs will fall off by themselves around the 10th postoperative day. Transplanted hair starts to grow around the second month after the procedure at 1 centimeter per month for the rest of the patient's life. Once the hair starts to grow it can be treated as your normal hair; cut, wash, and comb it. This is for life.