Hair transplantation has changed dramatically over the past decade. What used to be complex surgery is basically now a day or half day event in a chair. About four years ago my practice merged with the Washington medical hair clinics. It’s been a wonderful marriage. All of the physicians involved in your care are Board Certified plastic surgeons.
How is it done?Today hair isn’t placed in lumps or clumps. Hair can be harvested in three different ways which are discussed below. Hair is taken from areas of the scalp that are not prone to hair loss and placed in areas that are lost or thinning. For appropriate candidates the surgery can help both men and women. The individual hairs called microfollicular grafts are individually planted into the scalp giving the most natural hairline possible. Local anesthetic is used and patients spend the day with us listening to music or watching movies as the procedure is performed.
How is the hair harvested?Three basic ways:
2) Automated follicular unit extraction : Automated follicular unit harvests one hair or small groups with a small coring needle (called “follicular unit extraction”). This too is done under a local anesthesia. It is not “scar less”, but it leave small holes in the back of the head where the hair follicle was removed. These small holes heal in almost imperceptibly. The benefit is that its less invasive and recovery is a little more comfortable than a strip. The down side is that it can take longer and give less yield. It also requires that the head be shaved in the donor site and it will take some time for the hair to grow back. Large areas may require multiple sessions. It may not be a good option for patients with curly hair as there can be a higher rate of hair root injury.
1) Strip graft: In Strip graft a strip of hair bearing skin is removed from the back of the scalp. It is performed under a local anesthesia. The benefit of a strip graft is that it gives the highest yield of transplantable hair, so it is a good choice for patients looking to restore a larger area and there is no shaving of the back of the head. The down side is that it leaves a scar in the back if the head so it’s not a great option for patients who wear their hair very short. In patients with longer hair the scar can be hard to find. Neograft (see below) scares people with pictures of ugly scars. Generally, as a plastic surgeon our scars are well hidden and accepted. Many hair transplant surgeons are not plastic surgeons, in fact some are not surgeons at all.
3) ARTAS Robot: The ARTAS Robot is the newest kid on the block. It is basically the same idea as the follicular unit extraction, with the same pro’s and cons, but harvesting with the robot is automated. This makes it faster, and it can do more in a day. Same idea as automated follicular unit extraction, different tool, but faster, more precise and unfortunately more expensive.