What is Hair Transplant Surgery?

Three of the most commonly used hair transplant techniques are explained below: 

• FUE Hair Transplant: FUT is follicular unit transplant. This technique involves surgically creating a thin strip of scalp from the donor area (usually the back or sides of the head). The strip is then dissected carefully into smaller grafts, with each graft containing 1-4 hair follicles. These individual grafts are then transplanted into the recipient area by making tiny incisions. The FUT hair transplant technique allows the surgeon to transplant a large number of grafts in one session. However, it leaves a linear scar at the donor site. 
• FUE Hair Transplant: FUE is follicular unit extraction. This technique involves extracting individual hair follicles from the donor area using a specialized instrument, typically a punch tool. The surgeon makes tiny, circular incisions around each follicular unit, and then the follicles are carefully extracted one by one. After extraction, the follicles are transplanted into the recipient area. FUE does not leave a linear scar and instead creates small, dot-like scars that are less noticeable. This method is preferred by individuals who desire shorter haircuts or have a limited donor hair supply.
• DHI Hair Transplant: DHI or direct hair implantation technique is an advanced form and variation of FUE hair transplant.  The key difference between these two techniques is that instead of using a normal punch tool, DHI involves using a specialized implantation tool called the CHOI Implanter pen. The hair follicles are extracted using a similar process to FUE, but instead of creating tiny incisions at the recipient site, the CHOI pen is used to implant the extracted follicles directly. The pen further allows the surgeon to have precise control over the angle, depth, and direction of hair implantation. 

Each of these hair transplant techniques has its advantages and considerations. The choice of technique depends on various factors, including the patient’s specific needs, the extent of hair loss, the quality and quantity of the donor hair, and the surgeon’s expertise. 

Typically, imaging tests are not required before hair transplant surgery. However, the doctor evaluates the patient’s overall health, including hair health, beforehand to ensure the surgery is safe and can provide the expected results. The key aspects of the diagnostic process include the following:

• Medical History: The first thing evaluated by the doctor is the individual’s medical history to determine if he/she has any underlying conditions or medications that may be contributing to or causing hair loss. This involves assessing the family history and other relevant genetic factors as well. 
• Scalp Evaluation: A detailed exam of the scalp is conducted to assess the hair loss pattern, extent, hair quality, scalp condition, and potential donor areas. This exam helps to determine the feasibility of a hair transplant and the availability of the donor hairs. 
• Hair Evaluation: The doctor will classify the hair loss pattern and stage based on the Norwood-Hamilton scale for men and the Ludwig scale for women. Along with this, the thickness, texture, and color of the hair are also evaluated to determine the suitable technique and whether the results will look natural. 
• Test or Scalp Biopsy: In some cases, the doctor may recommend a blood test, scalp biopsy, or other diagnostic procedures to identify the medical condition, hormonal imbalance, nutritional deficiencies, or other factors that might be responsible for hair loss. 

During the initial consultations, the hair transplant specialist will discuss the patient’s expectations, desired outcomes, and realistic goals. Based on them, the ideal technique and the number of hair grafts required are determined. 

A hair transplant is highly beneficial for men and women who are experiencing hair loss. Some key benefits include the following: 

• Natural-Looking Results: Hair transplant surgery can provide natural-looking results, with transplanted hair blending seamlessly with the existing hair. This helps to achieve a fuller and more youthful head of hair. 
• Permanent Solution: Hair transplant surgery offers a permanent solution to hair loss. The transplanted hair follicles are typically resistant to the hormone dihydrotestosterone (DHT), which is responsible for hair loss in individuals with a genetic predisposition. Therefore, the transplanted hair is less likely to fall out over time.
• Improved Self-Confidence: Hair loss can significantly impact the individual’s self-confidence and self-esteem. Restoring a fuller head of hair through a hair transplant can help boost self-confidence and improve overall well-being.
• Styling Options: With a successful hair transplant, both men and women regain the flexibility to style their hair as desired. They can choose different hairstyles, including shorter cuts, without worrying about visible thinning or bald spots.
• Restored Hairline: Individuals experiencing receding hairline or temple hair loss can benefit from a hair transplant to restore a more youthful and balanced hairline. Transplanted hair follicles can create a natural and symmetrical frame for the face.

It should be noted that the results of the hair transplant will vary for each individual based on the extent of hair loss, the quality of donor hair, and the selected hair transplantation technique.

During the consultations, the surgeon is likely to give you a set of instructions that needs to be followed before the hair transplant procedure. These may include, but are not restricted to the following:

• Do not consume alcohol in the three days before the hair transplant surgery. 
• Stop smoking 24 hours before the surgery. Nicotine can affect healing abilities and recovery after a hair transplant.
• Do not cut or trim hair before hair transplantation surgery. It is important for the donor area to grow enough to facilitate the transplant.
• Start massaging the scalp a month or two weeks before the surgery. The best results can be attained by doing this for 15-20 minutes per day.
• Just before the surgery, wash hair with shampoo and conditioner as normal. Do not use any hair products such as hair gel, hair cream, hair wax, etc. 
• Wear loose-fitting clothes to ensure no damage to the incision spot while changing after the procedure.

Though hair transplant surgery is generally considered safe and effective, like any other procedure, there can be potential side effects and complications. 

The common hair transplant side effects include the following:

• Swelling in the recipient and donor site which may take several weeks to subside completely. 
• Redness and bruising in the scalp due to skin trauma. 
• Pain and discomfort during the initial healing period. 
• Shock loss or temporary shedding of transplanted hair, which is normal. 
• Temporary numbness or sensitivity in the scalp due to nerve damage. 

These side effects are short-term and often resolve as the scalp heals over time. Besides these, some serious complications may also occur after surgery that may require prompt medical attention. These hair transplant complications include the following:

• Infection: Though infection is rare, it can still occur if the patient fails to maintain proper hygiene or follow post-op care. This will result in persistent redness, swelling, and pain and may also cause discharge from the scalp. 
• Bleeding: Excessive bleeding may occur during or after the hair transplant surgery. To prevent this, doctors usually suggest that patients avoid blood-thinning medications and supplements, but they can still occur in some people. If the bleeding persists and increases over time, the patient will need immediate help. 
• Folliculitis: In some patients, the implanted hair follicles may become inflamed due to infection caused by bacteria on the scalp. It causes small pimple-like pockets around the follicles, which may or may not go away on their own. 
• Scarring: Typically, scarring is significant only in the case of a FUT hair transplant, as it results in a linear scar at the donor site. Over time, the scars heal and become invisible. However, in some people, the scar may heal abnormally and may become raised. 
• Uneven Hair Growth: Though it is not a serious complication, uneven hair growth will require additional treatment to correct the unevenness and unnatural-looking hair growth. 

If any complications arise, the patient should contact the surgeon right away and seek proper help.

After getting a hair transplant, the individual needs to be very patient to get the desired results. Typically, the results and hair growth timeline vary for each patient depending on the extent of the treatment. The general timeline and intermediate results are as below:

• Immediate Post-Transplant Phase: After the hair transplant surgery, the transplanted hair follicles may initially shed within the first few weeks. This is a normal part of the process, and it is known as shock loss.
• Initial Hair Growth: After the shedding phase, new hair growth typically begins within 3 to 4 months. Initially, the new hair may be fine, thin, and shorter in length. This is normal, and the hair will gradually thicken and become more noticeable over time.
• Continued Hair Growth: Hair growth continues to improve and becomes more significant between 6 to 12 months after the procedure. During this period, the hair follicles undergo a natural growth cycle, transitioning from a resting phase to an active growth phase.

It can take up to a year or more to see the full results of a hair transplant. By this time, most of the transplanted hair should have grown and matured, providing improved density and coverage in the recipient area. However, individual experiences may vary, and some individuals may continue to see improvements after a year. 

The complete recovery after hair transplant surgery is likely to take around 9 to 12 months. In the first month, the patient will recover from the surgery itself, but the hair growth will take longer to become apparent. Throughout the recovery period, the patient will have to take extensive precautions for hair care to get the desired results. 

Here are some common hair transplant aftercare tips that the patient needs to follow:

• Take the prescribed medications as directed by the doctor to ensure proper healing and prevent the risk of complications after the surgery. 
• The doctor will provide specific instructions regarding hair care, including how to wash hair after the procedure. The patient will be suggested to use a mild, non-abrasive shampoo to wash hair and gently rinse the transplanted area without damaging the transplanted follicles. 
• The patient needs to be careful with the scalp in the first week and avoid rubbing or scrubbing the scalp vigorously. 
• Protect the transplanted area from any trauma or excessive friction during the initial healing phase. It’s important to avoid any activity that may dislodge or damage the grafts. This includes rubbing the scalp, wearing tight hats, or participating in contact sports. 
• Try to avoid direct sun exposure to the treated area until it has healed completely. Wear a loose hat or use sunscreen to prevent sunburn and damaging the skin. Even mild sun exposure can cause discoloration on the skin and worsen the scarring. 
• Engage in only light activities after the procedure for the first 2-3 weeks. Avoid intense physical exertion or exercises. Strenuous activities can increase blood flow to the scalp, which will affect the healing process. Resume such activities only after consulting the hair specialist. 
• Be patient during the healing process, as the transplanted hair will fall out first due to shock loss, and then the new hair growth will begin. Hair growth is a gradual process, and it can take several months to a year to see the final results of the hair transplant surgery. 
• Throughout the recovery period, the patient needs to make certain changes in his/her dietary habits. It’s important to increase the intake of foods that provides ample nutrition for the hair follicles to grow. Include foods that are rich in proteins, vitamins, iron, and zinc. 
• Avoid consuming certain foods that can interfere with the healing process. Such foods include spicy and hot foods, fatty and processed foods, caffeine, and alcohol. 
• Stop smoking entirely or smoking less to ensure that the body’s healing process is not affected significantly. Smoking can halt the growth of the implanted hair follicles, thereby compromising the results of a hair transplant. 
• Attend follow-up consultations with the hair transplant surgeon as scheduled. These visits will allow the surgeon to monitor the progress, assess the growth of the transplanted hair, and address any concerns that may arise. 

The recovery duration and experience of each patient will be different. The doctor will provide appropriate guidance and support throughout the recovery phase to address any concerns and optimize the results of hair transplant treatment. 

In India, the cost of a hair transplantcan range from approximately Rs. 40,000 to Rs. 80,000 or more. The exact cost is calculated based on a variety of factors, including:

• The technique used for hair transplant, i.e., FUT, FUE, or DHI. 
• The number of grafts required to provide desired results and quality of hair follicles. 
• The clinic’s reputation, location, and services. 
• The fees charged by the surgeon for consultation and operation. 
• Overall facilities, technology, and equipment available at the clinic or hospital. 
• Additional treatment chosen by the patient or recommended by the doctor. 
• Post-operative care, medications, and follow-up consultations.

All these factors will impact the cost of treatment significantly. However, cost alone shouldn’t be the determining factor when getting hair transplant treatment. It’s important to consider the quality of care at the hospital/clinic and the experience and expertise of the hair transplant surgeon and prioritize these factors while making the decision. 

Though hair transplant surgery is the most effective option for hair restoration, there are other non-surgical hair transplant alternatives that can address hair loss and thinning problems to a certain extent. These methods include:

Medications

FDA has approved several medications, such as minoxidil (Rogaine) and finasteride (Propecia), for hair fall treatment. Minoxidil is a topical medicine that is applied directly to the scalp, and it helps to prolong the life cycle of each hair strand. Unlike this, finasteride is an oral medicine that reduces the production of DHT (the hormone responsible for hair loss). Both these medicines provide effective results but require regular use under medical supervision. Taking these medicines over-the-counter (without a doctor’s prescription) is not recommended. 

Low-level Laser Therapy (LLLT)

It is a non-invasive treatment that uses red light emitted by a laser machine to stimulate hair growth. The light increases the blood flow to the hair follicles and promotes cellular activity. It can be done at home or in a clinical setting using more advanced devices. Similarly to medicines, laser therapy requires regular and consistent use to address hair loss. 

Hair PRP (Platelet-rich Plasma) Therapy

PRP therapy has become a very commonly used non-surgical method to treat hair fall problems. It involves extracting a sample of the patient’s blood, processing it to produce platelet-rich plasma, and injecting the plasma into the scalp. The plasma solution contains growth factors that promote hair growth and improve hair quality, density, and thickness. It requires multiple sessions to provide visible results. 

GFC (Growth Factor Concentrate) Therapy

This method is an advanced form of PRP therapy suitable for people whose hair fall is triggered due to hormonal imbalance. It involves extracting the blood similarly to PRP, activating the platelets, and separating the growth factors individually. Then the growth factors are injected into the scalp superficially using microinjections. 

Scalp Micropigmentation(SMP)

This technique involves using specialized pigments to create a camouflage of short and buzzed hairs. It is more like a visual enhancement technique that only gives the impression of a fuller head of hair. 

Hair Fibers and Concealers

Hair fibers or concealers are cosmetic products that can temporarily camouflage thinning hair by attaching to existing hair strands and creating the illusion of fuller hair. These products are available in various shades and can be applied directly to the scalp.

These non-surgical hair transplant alternatives are effective only to a certain extent and likely require repetition to maintain the results.