Hair transplant

During a hair transplant, hairs are moved from an area of thick growth to bald areas.

Most hair transplants are done in a doctor's office. The procedure is performed as follows:

• You receive local anesthesia to numb the scalp. You may also receive medicine to relax you.
• Your scalp is thoroughly cleaned.
• A strip of your hairy scalp is removed using a scalpel (surgical knife) and set aside. This area of your scalp is called the donor area. The scalp is closed using tiny stitches.
• Small groups of hairs, or individual hairs, are carefully separated out from the removed scalp, often done under magnification or microscope.
• In some cases, smaller areas of the scalp and groups of hairs are removed with other equipment or robotic assistance.
• The bald areas that will receive these healthy hairs are cleaned. These areas of your scalp are called the recipient areas.
• Tiny cuts are made in the bald area.
• Healthy hairs are carefully placed in the cuts. During a single treatment session, hundreds or even thousands of hairs may be transplanted.

A hair transplant can improve the appearance and self-confidence in people who are balding. This procedure cannot create new hair. It can only move the hair you already have to the areas that are bald.

Most people who have a hair transplant have male or female pattern baldness. Hair loss is on the front or top of the scalp. You must still have thick hair on the back or sides of the scalp to have enough hair follicles to move.

In some cases, people with hair loss from lupus, injuries, or other medical problems are treated with a hair transplant.

Risks of surgery in general include:

• Bleeding
• Infection

Other risks that can occur with this procedure:

• Scarring
• Unnatural-looking tufts of new hair growth

It is possible that the transplanted hair will not look as good as you had desired.

If you plan to have a hair transplant, you should be in good health. This is because surgery is less likely to be safe and successful if your health is poor. Discuss your risks and options with your doctor before undergoing this procedure.

Follow the doctor's instructions about caring for your scalp and any other self-care measures. This is especially important to ensure healing.

For a day or two after the procedure, you may have a large surgical dressing or a smaller dressing that can be protected by a baseball cap.

During the recovery period after surgery, your scalp may be very tender. You may need to take pain medicines. The hair grafts may appear to fall out, but they will regrow.

You may also need to take antibiotics or anti-inflammatory medicines after surgery.

Most hair transplants result in excellent hair growth within several months after the procedure. More than one treatment session may be needed to create best results.

The replaced hairs are mostly permanent. No long-term care is necessary.

Hair restoration; Hair replacement; Hair plugs; Follicular unit extraction (FUE)

Avram MR, Keene SA, Stough DB, Rogers NE, Cole JP. Hair restoration. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 157.

Fisher J. Hair restoration. In: Rubin JP, Neligan PC, eds. Plastic Surgery, Volume 2: Aesthetic surgery. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 21.

Updated by: Tang Ho, MD, Associate Professor, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.