FACE

Hair Restoration

Our hair is genetically programmed to fall out at a specific time in life, and this can be affected also by illness and poor nutrition. Typically, the hair in the back and on the sides of the head remains later in life, and it is this "reserve" of hair that is utilized in hair restoration.


Shown here are before (left) and after (right) views of actual patients. Remember, every patient responds differently to surgery, and no one can be certain that he or she will get the results shown. However, these photos will illustrate the changes that are possible with these procedures.

Hair Restoration - Process and Procedure


The Process

A number of treatments for hair loss exist. These may include topical medications such as minoxidil, oral medications like Propecia, both of which limit the amount of hair loss and may stimulate a modest amount of hair regrowth, especially in the area of the crown of the head. However, some patients experience hair loss too severe to be helped by medications; also, many patients lose hair at the frontal hairline. The frontal hairline typically does not respond as well to medications, and recession of hair in this area takes away the normal hair boundary that helps frame the face.


The Procedure

Surgical restoration of the hairline can be done a variety of ways. These include hair transplantation, scalp reduction or scalp flaps. Hair transplantation has made great strides since the days of "doll's hair" or "corn row" results. We transplant hair from the genetically favorable area at the back of the head to areas of baldness as single hairs or units of 2-3 hairs. This results in a natural hair density and pattern. Usually, the transplanted hairs fall out soon after placement, leaving the living root of the hair. Usually, new hair begins to regrow 3 months after transplantation. Several sessions may be necessary to fill in the transplanted area.


Scalp reduction can be performed if the balding is limited to a discrete area, usually at the vertex (top of the head). The bald area is removed, the wound closed and the scar hidden within the hairline. Results are more immediate than with hair transplantation.


Scalp flaps are portions of hair-bearing skin (usually from the sides of the head) that are partially elevated and turned to fit across the frontal forehead. Flaps from both sides meet in the center of the forehead, providing an "instant" frontal hairline. More rigorous hairstyling is necessary to camouflage scars.



What to Expect After Hair Restoration


DIET

If the procedure is done with only local anesthesia, a normal diet can be resumed immediately. If intravenous sedation or general anesthesia is employed, it is best to start with liquids (soup, juices, etc.) immediately after surgery. Once the anesthesia has worn off and your appetite returns, regular food is allowed. Some patients will experience some mild nausea the evening after hair transplantation even if only local anesthesia is used; slow introduction of one's normal diet over a 1- 2 day period is best.


DRESSINGS/SUTURES

A gauze dressing is placed over the head in the operating room. This is removed the day after surgery. The head dressing can be removed on the day after surgery, and a bandana worn over the transplanted area.

Dissolvable sutures are used in the back of the head where the hair was harvested. These typically dissolve in 10- 14 days on their own. Hair grafts are placed in pockets so precise that sutures are not needed.


ACTIVITY AFTER SURGERY

In order to allow your tissues to heal properly, we ask that you refrain from brisk physical activity for two weeks. Walking and non-physical activities are allowed, but it is best not to exercise for the first 2 weeks. After the first 2 weeks, aerobics, running, stair climbing, exercise bicycling and treadmills are permitted, but weight lifting (free weights or machines) should not be done until after the end of the third week after surgery. However, once the effects of the anesthetics have worn off, it is not necessary to remain in bed or at home. You may shower as soon as the bandages have been replaced by the elastic headband. This band should immediately be replaced after each shower.


SWELLING/BRUISING

Forehead and upper eyelid swelling is expected but is usually mild. Sleeping with your head elevated and sitting upright during the day for several days following surgery will help minimize swelling. Most swelling will gradually resolve in 4-5 days. Bruising, too, is normal. The bruises on your forehead may "fall" into your upper eyelids before disappearing. Most bruising will resolve in the first 7 days after surgery and may be concealed with makeup one week after surgery. . Also, homeopathic medications Arnica Montana and Bromelain may limit bruising and swelling. This is best started at least 2 weeks before surgery and continued for 3 weeks; check with your doctor before using these.


BLEEDING

Minimal oozing of blood and tissue fluid along the suture/staple lines can occur for a few days following surgery. Bleeding that is severe or does not stop with 10 minutes of continuous pressure is rare and should be reported to our office.


ITCHING/NUMBNESS

Itching along suture lines and in areas adjacent to the face (scalp, forehead) is common and temporary. A feeling of numbness also occurs. Normal sensation usually returns within a few weeks.


PAIN/DISCOMFORT

Most patients experience little pain afterwards; most describe the discomfort as "soreness" rather than "pain", easily controlled with acetaminophen or acetaminophen with codeine.