Hair Transplant

Overview

What is a hair transplant?

A hair transplant is a surgery that moves hair to bald or thinning areas of the scalp. Also called hair restoration or hair replacement, it’s usually for people who have already tried other hair loss treatments. Dermatologists (healthcare providers specializing in the skin) or plastic surgeons (healthcare providers specializing in reconstructive procedures) perform hair transplants.

How does a hair transplant work?

The healthcare provider takes grafts, or small pieces of skin, from areas of the body that contain healthy hair. Healthcare providers call this area the donor site. It’s usually on your head, at the back of your scalp where hair tends to be thickest. The healthcare provider moves the grafts to hairless parts of the scalp. Once the transplanted skin heals, it should continue to grow hair.

What conditions does hair restoration surgery treat?

There are many reasons you might lose your hair. Sometimes hair loss is temporary, but it can be permanent. Hair implants may help with permanent hair loss caused by:

  • Alopecia areata, an autoimmune disease that attacks hair follicles.
  • Androgenic alopecia, or pattern baldness.
  • Thyroid diseases or hormonal imbalances.
  • Traumatic injuries or burns.

Who is a candidate for hair replacement?

You may be a candidate for hair replacment surgery if you:

  • Are in good health.
  • Have realistic expectations about hair replacement results.
  • Still have areas of thick hair growth on your scalp.

Procedure Details

What are the different types of hair transplant surgery?

There are several different ways to perform hair transplant surgery, including:

  • Grafting.
  • Scalp reduction.
  • Flap surgery.
  • Tissue expansion.

How is grafting performed?

Hair grafting is the most common type of hair transplant surgery. A healthcare provider cuts tiny pieces of the scalp containing healthy hair. Sometimes they use a small, round punch to remove skin that contains about 10 to 15 hairs. People used to call these grafts “hair plugs.” Micro-grafts contain one to two hairs.

The procedure can take several hours. Most people stay awake during the surgery, but they receive medication to numb the scalp. You may need several procedures depending on how much hair your provider needs to move. Your scalp will need to heal for a few months between procedures.

How is scalp reduction performed?

Providers also call scalp reduction alopecia reduction. During this procedure, a surgeon removes a small area of bald skin from the scalp. They loosen nearby skin containing hair and pull it over the bald area. Then, they stitch it in place.

Scalp reduction is ideal for bald areas on the top and back of the head. These sections are usually surrounded by skin with hair. Sometimes providers use scalp reduction and hair implants together to achieve full coverage. Like grafting, scalp reduction usually only requires numbing medication on the scalp. This means you don’t need general anesthesia.

How is flap surgery performed?

Your surgeon may recommend flap surgery if you have large bald areas near the front of your scalp. Flap surgery occurs in several phases over a few weeks. The surgeon makes superficial cuts around three sides of donor site. The fourth side remains attached, maintaining its original blood supply. This technique helps the surgeon cut the flap and lift it over bald areas. Flap surgery requires general anesthesia.

How is tissue expansion performed?

If you have scalp baldness or disfigurement due to burns, your provider may perform tissue expansion surgery. Tissue expansion requires general anesthesia and involves several steps:

  • A reconstructive surgeon inserts an implant under the scalp, where hair still remains. Shaped like a balloon, they call it a tissue expander.
  • Over several weeks, the expander is gradually inflated to stretch the skin.
  • The surgeon performs a second procedure to cover the bald area with the stretched skin.

Risks / Benefits

What are the risks of hair transplant surgery?

As with any surgery, a hair transplant comes with risks. These include:

  • Allergic reaction to anesthesia.
  • Excessive blood loss.
  • Failed grafts or flaps.
  • Infection.
  • Loss of feeling on your scalp.
  • Scarring.

What are the side effects of hair transplant surgery?

Side effects of hair transplant surgery are usually temporary. You may experience the following issues on your scalp, at the donor site or where the new hair is:

  • Crust or scabs.
  • Itching.
  • Loss of feeling.
  • Pain or throbbing.
  • Swelling.
  • Tightness.

What are the benefits of hair restoration?

Potential benefits of hair restoration include:

  • Fuller head of hair with fewer bald areas.
  • Improved self-esteem.
  • Permanent hair loss solution.

Recovery and Outlook

What is the recovery process after hair transplant surgery?

Most hair transplants are outpatient surgeries, which means you can go home the same day as the procedure. Your recovery process will depend on the type of transplant you have. In the days after surgery, you may be able to:

  • Day 1: Remove bandages.
  • Day 2: Wash your hair.
  • Days 3 to 5: Return to work and start light activities.
  • After 10 days: Remove stitches (done by your healthcare provider).
  • After 3 weeks: Return to exercise or sports.

How long do the results of a hair transplant last?

It can take up to a year before you see the full results of any hair transplant. The transplanted hair may fall out as the graft or flap heals. This is normal. The hair should grow back. You may need several “touch-up” hair transplant surgeries to achieve a natural-looking result.

When to Call the Doctor

When should I see my healthcare provider about a hair transplant?

You’ll likely have several follow-up visits with your healthcare provider after surgery. They will make sure your scalp is healing well. But contact your provider right away if you experience any of the following problems:

  • A fever that doesn’t go away.
  • Excessive bleeding from your scalp.
  • Severe redness or pain on your scalp.
  • Signs of infection, such as green or yellow pus oozing from the cuts in your scalp.

A note from Cleveland Clinic

Hair transplant surgery may be an option if other hair growth treatments didn’t work for you. There are many different hair transplant techniques. So, it’s important to work with a healthcare provider to choose the procedure that will best meet your goals. Look for a skilled professional with experience in hair loss and hair restoration. They are the only ones who should perform transplant surgery. You should also consider the practical aspects of hair transplant surgery. Think about the cost and the healing time between treatments.

Last reviewed by a Cleveland Clinic medical professional on 04/30/2021.

References

  • American Academy of Dermatology Association. Accessed 5/3/2021.Hair Transplant. (https://www.aad.org/public/diseases/hair-loss/treatment/transplant)
  • American Society of Plastic Surgeons. Accessed 5/3/2021.Hair Transplant. (https://www.plasticsurgery.org/cosmetic-procedures/hair-transplant)
  • Centers for Disease Control and Prevention. Accessed 5/3/2021.What You Should Know Before Your Surgery. (https://www.cdc.gov/patientsafety/features/before-surgery.html)
  • Sattur SS. Journal of Cutaneous and Aesthetic Surgery. 2011;4(2):89-97.A Review of Surgical Methods (Excluding Hair Transplantation) and Their Role in Hair Loss Management Today. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183735/)

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