Other associated terms: Hair Restoration, Follicular Unit Graft, Micrograft, Minigraft, Slit-graft, Follicular Unit Transplantation.
Overview
In the past, there were limited options available for those who had experience hair loss. Toupées that were either extremely expensive or of the cheaper, highly noticeable variety were available – but these were rarely desirable. Beyond that, there were countless over-the-counter remedies 
that were less than completely effective and required constant re-purchasing, making them considerably more expensive.
An effective permanent solution eventually came about, in the form of modern day hair transplants. Earlier transplants (dating back to the 19th century) were extremely expensive, painful and didn’t always create a “natural look”. This has changed in recent times. Hair transplant costs (while still considerable) have lowered, are less painful and provide an undetectable natural appearance.
Benefits
The benefits of hair restoration can be related to self-esteem, self-confidence and other factors that pertain to emotional and social issues. The elimination of self-consciousness due to hair loss can have a tremendous effect on social and professional interactions.
Hair restoration has always been an option for those who have experienced hair loss. Topical, oral medications and hair pieces are not new. However, with the advent of hair transplants, there is a permanent, cost effective means of addressing this issue. Hair transplantation provides an actual re-growth of your own hair. The improvement of your appearance will give a confidence boost that will have a ripple effect in just about all your day-to-day activities.
Three Main Types of Hair Transplants
Follicular Unit Strip Surgery (FUSS) is a procedure in which a donor site strip of hair is surgically placed in a region where the hair is thinning/balding. The donating area is then sutured closed. Several days are allowed for the site to heal. This technique is considered the best approach for balding that is average to extreme. The reason for this revolves around the fact that several grafts can be placed in each session.
Follicular Unit Extraction (FUE) is a procedure that has gained popularity over the FUSS technique. This procedure involves transplanting hair strands from locations in the sides or back of the head (in groups of 1-4 strands). Results from this technique provide a more natural look, since it imitates natural hair formation. Another reason for the popularity of this technique is that it doesn’t utilize deep incisions so there will be a shorter recovery time with less possibility of scarring.
Scalp Reduction is a relatively rare procedure. With this technique, the balding area is actually removed surgically and the area of the scalp, with hair, is stretched in order to cover the area that has been removed. This is a more expensive procedure that can have the negative effect to scalp tightening – which could, in and of itself, lead to more hair thinning.
Patient Characteristics
The ideal candidate for a hair transplant is a person who is self-conscious concerning their appearance but has a realistic expectation of the final results. For purposes of the transplant, they should have healthy hair growing on the sides and back of the head which can serve as donor sites. They should also have a good understanding of the procedure and the time and financial investment involved.
Procedure
The most common procedure for hair transplants involves using your own hair (in the form of “plugs”) to fill out the thinning/balding areas.
The surgery is performed as an out-patient procedure and will require only a local anesthetic. There is little, if any, discomfort during the surgery – which actually surprises many patients. Patients often watch TV or take a nap during the transplant.
At the start of the hair transplant procedure, anesthetic is applied and the donor hairs are trimmed – then the hair follicles are removed for transplanting. These are usually taken from an area that is resistant (genetically) to thinning. In most cases, this will be the back of the head. This has the added advantage of the removed hair being undetectable – even with almost half of the hair being taken from this area.
The most common methods for removing hair, to be transplanted, involve; removing the hair in small areas (plugs) with each plug consisting of 8-12 hairs each. Another method is removing the hair in strips at the lower portion of the hairline or at the sides. This can have the advantage of giving the surgeon more hair to mold into various sized grafts with thousands of grafts made from just one hair strip.
Following this, the surgeon will make small incisions in the balding area to accommodate the plugs or strips. These can be made either with a scalpel, needle or a laser. The patches of hair to be transplanted are trimmed into small pieces and placed into the incisions (about 1/8 of an inch apart). The hair in these grafts will continue their normal growth and will be supplied by normal blood flow.
The donor sites are stitched (sutured) closed. Sutures are applied to close the area where the grafts or plugs were taken and the skin stretches naturally to cover the wider area. The plugs or grafts, themselves, will not need sutures since they will be bonded to the transplanted area by natural fluids from the body. In order to complete the surgical series, several visits may be necessary.
Recovery
Typical things that the patient will be instructed to do after hair transplant procedures include; wearing a loose cap (which should be brought to the surgery) right after the procedure is performed in order to avoid damage to the site and infection possibilities. The doctor will also give prescription medications. Take them on schedule! These medications are given to address pain, infection and swelling.
For the next two days, you should avoid touching the surgery area. This means no hair washing. For the next two weeks after that, you will be washing your hair with warm water (in a cup) and shampoo that is lightly applied (by patting – no scrubbing). No towel or blow dryer is to be used – let your hair dry naturally.
During those two weeks, you will also be avoiding direct sunlight by keeping indoors and wearing a loose cap when you need to go outdoors, in the daytime. Strenuous activity should also be avoided. Your doctor may also provide you with a surgery cap to wear at night in order to avoid contact with your pillow – but you should try to sleep in an upright position (which also helps with swelling).
A good practice would be to use several pillows placed underneath your neck to prevent the surgery site from rubbing against any surface.
Above all – don’t pick at or rub the scabs on the surgery site! Scabbing is normal and is an indication of proper healing. The scabs, themselves, should begin to go away within one to two weeks. Some small hairs that fall out with the scabs is a normal occurrence, as well.
A follow up visit will be made around 10 days after the procedure. At this time, sutures will be removed by your doctor. Usually the total healing time will extend over several months with final results of all procedures taking up to two years to be fully evident.
Risks Associated With Hair Transplants
Any surgical procedure will always carry some form of risk- such as infection (which can be treated with an antibiotic).With hair transplants, the risks are usually minor and correctible. Most complications can also be avoided by following the instructions of your doctor prior to and following the procedure.
However, some issues that do exist include; scarring at the site of the graft, some grafts that don’t work or a skin plug that dies (necessitating another procedure). With scarring, the scars are usually small and the growing hair will eventually cover them.
Hair loss after the procedure can also still occur, creating bald spots. These can be addressed with additional procedures. Disappointment with the procedure is another factor to consider. Hair transplant recipients should understand that the original hair coverage prior to hair loss will never be fully restored. Hair transplants are designed to give more fullness and provide additional coverage for thinning areas.
Procedure Costs
Since the total cost of getting a hair transplant is dependent upon the number of grafts that are needed, the price can vary greatly. This means that each situation is unique and you should discuss this with your doctor during the consultation. With this in mind, an average cost for hair transplants range between $6,000 and $15,000.
Individual grafts can average $5 to $6. Although this can represent a considerable investment, the advantage is that it is a permanent solution as opposed to the many temporary solutions available (making them more expensive, in the long run). You may also wish to inquire about financing options.
Things to Discuss with Your Surgeon During Your Consultation
During the consultation, with your doctor, you may wish to ask questions regarding the procedure, costs and reasonable expectations of hair transplants. These may include questions such as; how does the procedure actually work and how much pain is involved? Other related procedural questions might be; how long does the procedure last and where will it be performed? What is involved in the recovery and how long is the recovery time?
You will also be curious about how “natural” the transplant will look. Will the transplant be noticeable? When will the transplanted hair start growing on its own? A discussion of the costs will also be included and you may wish to inquire about financing.