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As explained in previous sections Dehydro-Testosterone is the main cause for hair loss, as it is responsible for the destruction of hair follicles in the frontal, mid scalp and crown areas. Hair follicles at the back and sides of the head
are not affected by Dehydro-Testosterone. In hair transplant procedures, hair follicles are
taken form these DHT resistant areas called
donor areas,
and then placed in the balding parts of the scalp. These hair follicles remain unharmed by the Dehydro-Testosterone in their new locations and
continue to function regularly. It is important to understand that since hair follicles are
transferred from one area of the scalp to another, hair transplant is a process of
redistribution
of hair, and therefore the density achieved can't resemble the one prior to the
balding process.
Strip Excision and Follicular Unit Extraction
There are a number of hair transplant techniques being used today. In most of them the strip excision
method is applied: a strip of skin is removed from a donor area at the back of the head,
and groups of hair follicles taken from it are then implanted in the balding areas. The sutured
cut at the back of the head leaves a very thin scar that usually can't be seen as it is
covered by the remaining hair in that area. In one of newest hair transplant techniques called FUE
(Follicular Unit Extraction) hair follicles are removed directly from the donor area, without
having to remove the small strip of skin as done in all other procedures.
The smaller the implanted groups of hair follicles are, the better
The hair follicles are transplanted in small groups, and in general the fewer the number of
hair follicles in such group is, the more natural the hair is likely to appear after the procedure.
In older hair transplant techniques that are not used anymore, pieces of skin from the donor areas were
transplanted as they were, resulting in a very unnatural appearance often referred to as
"doll hair". In slightly more advanced hair transplant techniques that are hardly in use today either,
hair follicles are transplanted in groups of 10 or more units. While results achieved in these
cases are not as bad as the "doll hair", they too are pretty poor.
Natural distribution equals natural appearance
It is known today that hair follicles are naturally distributed in groups of three or four units
across the scalp. In the most advanced hair transplant techniques in use, the hair follicles are transplanted in
very such groups, simulating their natural distribution. Towards the front of the scalp,
where hair is naturally more diffused, smaller groups are transplanted. These Groups
consist of two or three units per group, and even individual hair follicles at the very front.
It is also crucial to have the groups of hair follicles transplanted in an irregular pattern,
otherwise is it unlikely the appearance of the hair will look natural, no matter how small
the groups of transplanted hair follicles are.
Procedures implementing these principles can result in a head of hair that looks very
natural, and makes the transplant virtually undetectable.
Choosing the right Surgeon
Hair transplant is a surgical procedure that requires a high degree of skill. The
surgeon has to plan the procedure according to the patient's unique characteristics,
taking into account the nature of his hair loss, the size and density of the hair follicles and the
shape of his head and face. According to all these characteristics he then has to make
various decisions, such as the exact placement of the hair follicles and the angle at which
they are inserted. Choosing a bad or inexperienced surgeon will have a direct influence
on how good results will be.
Up to 3000 grafts in a single session
In one session it is possible to transplant up to 3000 hair follicles. Some people will need a single
session, while others may require two or more. Further hair loss in the transplanted areas
(of hair growing from the original hair follicles, not the transplanted ones) may result in a necessity of additional
hair transplant sessions later on.
The procedure is done under local anesthesia and is not painful. While in older
hair transplant techniques full recuperation took as long as two weeks, today it only takes a day or two.
As in all surgical procedures there are some risks involved. Common hair transplant complications, if
occur, are inflammation and bleeding. There is also a very slight chance of transplanted
hair follicles not assimilating well in their new locations, although success rates are nearly
100%.
What if there is not enough hair in the donor area?
Rarely the donor areas can't provide the number of hair follicles needed for a hair transplant. In
such cases a round piece of skin is removed from the top of the head. The opposite ends
of the wide open area in the scalp are then pulled towards one another and sutured. This
is possible due to the elasticity of the scalp tissue. This way the horseshoe shaped strap
of hair (at the back and sides of the head) which is also stretched as a direct result,
occupies a larger area of the scalp. The balding area left is much smaller and requires a
smaller number of hair follicles, a number that the donor area can provide.
Taking a glance into the future
Two new exciting and revolutionary hair transplant techniques being introduced these days are on the
verge of taking hair transplants a giant leap forward. These hair transplant techniques,
Follicular multiplication
and
Hair multiplication
will be discussed later on in the Future treatments
section.
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