Cosmetic Procedures
Hair Restoration

Cosmetic procedures that can be used to restore hair and give patients a more youthful appearance are:

• Hair transplantation – Skin on the scalp that has good hair growth is removed and transplanted to an area(s) of the scalp that needs hair.

• Scalp reduction – Bald scalp is surgically removed and hair-bearing scalp is brought closer together to reduce balding.

• Scalp expansion – Devices are inserted under the scalp for about 3 to 4 weeks to stretch the skin. This procedure may be performed before a scalp reduction to make the scalp more lax or simply to stretch hair-bearing areas, which reduces balding.

• Scalp flaps – A hair-bearing section of the scalp is moved to an area where hair is needed.

The hair transplant is probably the best known and most widely used hair-restoration procedure. While many have heard of a hair transplant, it seems that people often do not know that this procedure has come a long way since the days of the hair plug.

With improved techniques such as the single-hair graft, micro-graft, and mini-graft, it is possible for dermatologists to create a hairline and hair density that look completely natural. Many patients who underwent a hair transplant in the 1990s have such natural-looking results that even a hair stylist cannot tell the procedure was performed.

Signs of Aging Treated
Hair transplantation is used to treat:

• Hereditary hair loss (also called androgenetic alopecia) in men and women
   

• Hair loss due to aging (also called senescent alopecia) in women

Hair transplantation also may be used to treat other causes of hair loss, including a burn. Regardless of the reason for the hair loss, this procedure is usually not performed until the person is at least 25 years of age.

Scalp reduction, scalp expansion, and scalp flaps tend to be limited to treating men who have balding on the scalp.

When See Results from Hair Transplant
Hair re-growth occurs 6 to 8 months after the treatment is complete. It can take up to 18 months to see full growth.

Effectiveness of Hair Transplant
Most patients can achieve natural coverage with 1 to 3 treatment sessions. The goal of current research is to achieve a natural look in 1 treatment session.

Possible Side Effects
When performed by a physician who routinely performs hair transplantation, complications are relatively rare. Some patients experience nausea and vomiting after the procedure due to the medications used. Less than 5% have bleeding after the procedure. Infection, swelling, temporary headache, temporary numbness on the scalp, scarring, and hair loss can occur.

How Long Hair Transplant Lasts
The goal of this procedure is to give the person functional hair growth for the person’s lifetime. Sometimes a hair transplant may have to be repeated later in life. Inherited hair loss often causes progressive hair loss. This possibility should be discussed with your dermatologist.

What to Avoid Before a Hair Transplant
Before the surgery is scheduled be sure to tell your dermatologist about all medications, vitamin supplements, and herbal preparations that you are taking. Some can interfere with the procedure or medication used during the procedure. A few medications can cause excessive bleeding, so be sure to tell your doctor if you taking a blood thinner such as warfarin, a non-steroidal anti-inflammatory drug (NSAID), or aspirin.

Alcohol should not be consumed for at least 1 week before the procedure.

Related Links
10 Questions to Ask Before a Cosmetic Procedure
Age-related Skin Concerns: Hair Loss
Hair Loss (overview)
What Causes Hair Loss?

References:
Sadick N. “Hair Transplantation.” In: Sadick N, Lawrence N, Moy R et al. Concise Manual of Cosmetic Dermatologic Surgery, China, McGraw-Hill Companies; 2008. p. 73-9.

Stough DB, Whitworth JM, Seager DJ. “Hair Restoration.” In: Bolognia JL, Jorizzo JL, Rapini RP et al, editors. Dermatology. Spain, Mosby Elsevier; 2008. p. 2355-68.

Unger WP. “Hair Transplantation.” In: Kaminer MS, Dover JS, Arndt KA, editors. Atlas of Cosmetic Surgery. United States of America, W. B. Saunders Company; 2002. p. 231-63.