+ Is it safe?
The procedure is extremely safe. In our practice there has never been a serious complication, either during the operation or following the operation.
+What hair loss conditions can be treated with hair transplantation?
The most commonly treated conditions are male and female patterned hair loss. However, hair transplantation can be used to treat other hair loss conditions, such as scarring hair loss, provided that patients have a suitable donor region.
+Do I need to be bald to have a hair transplant?
No. Our preference is to operate earlier, before individuals are profoundly unhappy with their hair loss, and at a time when the procedure can be easily camouflaged. It is possible to add hair to thinning regions of the scalp, without harming existing hair, if grafts are placed carefully at the same angle and direction of existing hair.
+Do I have to be a certain age in order to undergo hair transplantation?
No. Individuals should consider a transplant at any age if they are bothered by their appearance. Younger individuals often have a milder degree of thinning, but the impact of hair loss, although significant at any age, is potentially more emotionally taxing, and thus the need for treatment is proportionally more important. Although younger patients often want aggressive treatment with high density graft placement, paradoxically they need a more conservative surgical plan. Just as there is no minimum age for undergoing the procedure, there is also no maximum age limit. If you're bothered by balding, the problem can be corrected.
+Can women have hair transplantation?
Yes. A large percentage of women suffer from hair loss, and frequently they are excellent candidates for hair restoration surgery.
+Do you guarantee a certain number of grafts?
No. We can provide an estimate of how many grafts we expect to harvest, but surgical variables influence the final number of grafts that are harvested. Adhering to a precise number runs the risk that physicians alter their surgical plan based on an abstract number, rather than conditions on the day of surgery.
+How many grafts are transplanted during surgery?
In a single session, we typically transplant between 2000-2500 follicular unit grafts in males and 1000-1500 in females. This number of grafts produces a notable cosmetic improvement, while off-setting certain risks. Larger, so-called megasessions, permit treatment of an expanded area of hair loss in a single session, but increase the risk of potential complications in both the donor and recipient area.
In the donor area, harvesting a larger number of grafts is associated with different potential complications, depending on the harvesting technique. Using unified donor harvesting (UDH), physicians tend to excise wide sections of tissue in order to obtain a larger number of grafts. This increases the closing tension of wounds, thus increasing the likelihood of wide scarring or the wound reopening. In contrast, with follicular unit extraction (FUE), physicians tend to stray outside of the safe donor zone in order to obtain the required number of grafts, thus potentially transplanting impermanent hair.
In the recipient zone, larger sessions are similarly associated with a higher risk of complications. First, the cumulative incisional area of larger sessions can result in poorer graft survival. As an example, if 3000 FU are transplanted into a 1 mm long recipient-site incision, then the total recipient incisional area is 3 meters. In our experience, this large an incisional area results in poorer graft survival. Moreover, patients are at greater risk of developing the serious, but rare, complication of recipient area necrosis, wherein no grafts grow, or of severe hair shedding after the operation.
+How dense are grafts placed?
Grafts are usually transplanted at a density of 30-35 follicular units/cm2. This strikes a balance between providing cosmetic density, while preventing the use of excessive numbers of grafts in a finite region. Mathematically, it is impossible to restore full density to thinning scalp without compromising on the size of the treated area. In other words, there is no such thing as a free lunch. While older individuals with small areas of thinning are candidates for higher density planting, this should be avoided in younger individuals given the uncertainty surrounding the eventual size of their recipient and donor areas with the passage of time.
+Will I need to shave my head for the procedure?
No. While a longer hair length increases the time that it takes to perform the procedure, at the same time it makes it easier to follow existing hair patterns, and in that way helps produce a more natural result. Equally important, it provides camouflage for the procedure so that there is considerably less visibility in the post-operative period.
+Are transplanted grafts visible?
Hairs are implanted the same way they were removed, as individual follicular units, and thus the results always look natural. This is in contrast to older techniques, whereby larger grafts could be observed as unnatural clumps of hair.
+How many operations do I need?
Over a lifetime, most individuals require multiple sessions, but it depends on patient goals, the size of the initial surface area that needs to be treated, and the size of the progression of thinning over time. We often conceptualize the scalp as being composed of a "frontal" area extending from the hairline to a line drawn between the ears, a "midscalp" area extending from the frontal area to the point where the scalp changes from being parallel to the ground to sloping perpendicular to the ground, and a "vertex" area that extends from the midscalp to the hair fringe at the back of the head. Most individuals need treatments to the frontal and midscalp regions at minimum. In this way, they look as though they have a full head of hair from the front and the sides. However, if they want the crown treated as well, then additional transplantation is needed.