Hair development begins in the intra-uterine life and continues throughout the life span of the person. Although hairs are thin and light colored in the uterine life, they start thickening and darkening after birth. There are about 100 thousand hair follicles in the scalp of an infant.
Our hair grows for a certain period of time and sheds, but they are replaced by hair follicles. Although there are interpersonal variations, 80 to 120 hair strands may shed every day and it is a result of the ordinary life cycle of body hairs. Each hair strand progresses through growth, resting and shedding phases.
Hair loss is considered, when hair gets thin, more than usual hair sheds while combing and bathing, and when the front hairline recesses.
Numerous factors play a role in hair loss, including but not limited to genetic predisposition, exposure to chemicals, drugs, psychological stress, skin diseases, systemic diseases, hormonal disorders, surgical procedures, improper hair care and insufficient nutrition. One or more than one of these factors may be responsible for the hair loss, although it is possible to fail identifying an underlying cause.
Moreover, hair loss can be reversible or irreversible. For irreversible cases, growth of hair may sustain after the underlying cause (e.g. stress) is eliminated.
The type of hair loss is also important. Male type (androgenetic) hair loss is the most common type of the hair loss in men and women. This type of hair loss is a result of genetic and hormonal factors, while trauma, medications and diseases has no role. This type of hair loss is very rare in women.
Another type of hair loss is the development of patchy bald areas on the scalp. An abnormality of immune system is accused in this disorder, called "alopecia areata" in medical terminology. It may be irreversible, but it is also possible for hair to grow again.
The other type of hair loss is generalized hair loss. This condition is caused by a factor that damages the hair follicles throughout the body (for example, drug, stress, thyroid gland diseases and other hormonal disorders and insufficient nutrition as well as major surgeries).
Why is this procedure done?
Since the underlying factors of the hair loss covers a wide spectrum, there are a number of treatment options, including hair transplantation.
Excluding androgenetic or male type hair loss, the underlying cause must first be investigated. After the underlying cause has been identified and treated or eliminated, your doctor may offer to wait for re-growth of hair. In this period, you can take measures to improve the appearance, such as wearing a bandana or hat, make-up, and wig. If it is considered that the hair loss is reversible, medicines, such as Minoxidil and Finasteride, nutritional supplements and acupuncture, which support and accelerate the growth of the hair, can be tried. In addition, healthy eating, proper hair care, hair care products and avoiding from hair dyes and perm that contribute to the hair loss can alleviate or stop the hair loss. Recently, hair mesotherapy is also giving promising results in the selected patients. Finally, platelet-rich plasma (PRP) is a treatment that re-grows the hair. Blood is drawn from the person, it is subjected to a special process and the resultant solution is injected to the bald area. The aim is the re-growth of hair by nourishing the hair follicles. PRP can be used alone or in combination with mesotherapy.
However, hair transplant is the definitive treatment for androgenetic hair loss and other forms of hair loss caused by factors that lead to irreversible damage of hair follicles, such as chemotherapy, radiotherapy, scalp infections, burns and major surgeries.
However, there are also conditions that hair transplantation does not help. First of all, the donor are should have sufficient number of healthy hair follicles. Moreover, extra pre-transplant procedures may be required or hair transplantation may not be possible in cases, such as burn, as the scalp does not allow hair transplantation.
If there is no condition that contraindicates the hair transplantation, the “natural looking” solution will be provided by hair transplantation.
The preparation phase of hair transplantation rather aims determining whether you are a good candidate of hair transplantation.
Your health history, medications (prescription and over-the-counter) and all vitamins and food supplements are reviewed and blood and urine tests are analyzed to investigate the underlying cause of hair loss.
The time elapsed since the onset of hair loss, thickness of hair, type of the hair loss (androgenetic, generalized, alopecia areata), past history of hair loss and whether hair grew again, if same condition developed in the past, and factors that grow hair and worsen the hair loss are carefully addressed.
If your doctor deems necessary, the scalp is biopsied and the scalp and hair follicles are examined under microscope.
After it is clearly determined that the hair transplant is the best choice for your condition, you should inform your doctor about all your expectations in order to avoid disappointment after the procedure.
If you carefully follow recommendations and instructions of the doctor who will perform the hair transplantation, the risk of complication after hair transplantation is almost zero.
Surgery and early postoperative period
After the final decision of hair transplantation is made, the donor area, where hair follicles are harvested, and the recipient area, where hair follicles are transferred, are drawn and a plan is made, before the procedure is initiated. Local anesthetic agent will be administered to relieve or eliminate discomfort during hair transplantation.
Today, there are two hair transplant techniques, namely FUE and FUT. However, Follicular Unit Extraction (FUE) is the most commonly preferred technique. Follicular Unit Transfer (FUT) is the other method that was more commonly used in the past, but it is not a common method nowadays due to scar formation and requirement of stitching.
The FUE method has two subtypes, Conventional and No Shave FUE, according to whether the area that hair follicles are transferred is shaved or not. The only difference between No Shave FUE and conventional FUE is that the donor and the recipient areas are not shaved or they are cut short. In addition, if deemed appropriate, your doctor may recommended combining FUE technique with PRP and / or hair mesotherapy.
In the FUE method, hair follicles can also be harvested from other parts of the body, if the hair follicles on the scalp are not sufficient for hair transplantation. On the other hand, FUE method produces effective results in the treatment of hair loss in eyebrows, mustache and beard.
In FUE technique, the donor and the recipient areas are cleaned and prepped. After the scalp is drawn to plan the transplantation, photos of the scalp are taken to make comparisons.
Hair follicles are harvested from the nape, where hairs are genetically resistant to hair loss, using very special thin needles measuring ≤1 mm in diameter. FUE technique does not require making incision on the scalp, while hair follicles (graft) are collected, and therefore, no scar tissue forms. The hair follicles are prepped to be transferred. Very tiny holes are drilled at the recipient area using a device called micromotor. These canals or holes are drilled at the direction of the growth of hair and thus, your hair will look natural when they grow after hair transplantation. After hair follicles are transferred in line with the pre-transplant plan and drawings, the scalp is closed with bandage.
Hair transplant procedure takes about several hours. If necessary, the procedure can be completed in the second session in the next day.
You may feel mild redness and discomfort after the procedure. Usually, these conditions do not require treatment, but your doctor will inform you in detail about issues that require your attention and you will also be given an information procedure. You should avoid strenuous activities for 15 days and you should protect the scalp against traumas.
Your doctor will probably ask you to visit the hospital one day after the procedure. The bandage will be removed in this visit.
If you experience warmth and remarkable pain at the donor or the recipient site if you have a fever or any symptoms that you think are due to the hair transplant after you are discharged, contact your doctor immediately.
Hair will grow, but it will shed quickly after the hair transplant. You can see growth of hair by transferred hair follicles approximately two months later. Your hair will normally grow and the baldness will be completely eliminated approximately 6 months to one year later.