To sufferers, hair loss is a serious condition that can deeply affect self-image. The loss or thinning of hair can be the result of a variety of factors.

Recent research suggests that faulty hair-making progenitor cells in the scalp may trigger male pattern baldness. Hair loss can also occur due to hormonal imbalances, stress, illness, heredity, rapid weight loss, nutritional deficiencies, chemotherapy, or the side effects of some medications. Hair thinning or loss can affect people of any age or sex but is often an issue for most people as they grow older.

Hair restoration involves the surgical treatment of hair loss. Non-surgical alternatives include oral medications and topical treatments, which are effective for hair loss prevention, but offer a more limited solution than surgery.

Hair replacement surgery, now called Follicular Unit Transplantation, has made tremendous progress since its introduction more than half a century ago. FUT is the most advanced method of grafting. It is the only permanent hair restoration technique, implanting very small groups of existing healthy hair in a thinning or balding area.

FUT is also known as hair follicle harvesting, surgical hair restoration, hair transplantation, or hair restoration/replacement surgery.

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Reasons for choosing to have
hair replacement surgery

Hair replacement surgery is ideal for anyone who is experiencing thinning or loss of hair.

Evaluation of the patient will help determine the individual cause of hair loss, which may have occurred as a result of scarring from previous surgery, scalp infection, tension due to hair weaves, some hair styling treatments or a burn on the head, as well as all the reasons listed above.

Hair transplant surgery (FUT) is popular because

• It is more successful than non-surgical hair restoration solutions.
• It has a very high success rate.
• The surgical option saves time and money in the long run. Other solutions, such as hairpieces and oral/topical medicine, are not permanent.

Things to consider once you’ve decided to have hair replacement surgery

One of the most important considerations is choosing a surgeon. It is of utmost importance that you choose an experienced surgeon who specialises in hair replacement. A top surgeon will produce results that are successful and natural looking.

There are two types of hair transplant procedure: follicular unit grafting (FUG) and follicular unit extraction (FUE). Essentially, the difference between the two is in the way hair follicles are extracted. In FUG, the follicles are removed from a strip of skin where hair growth is permanent. Usually, 1–4 hairs per graft are extracted and transplanted in exactly the same way they grew. The skin is then stitched back together with very small sutures.

FUE uses a circular punch to extract each follicular unit of hair, which is then individually transplanted. While FUE eliminates the need for a strip of hair to be removed, the technique is challenging, and the incised area is about 8 times larger than the area of the strip. FUE produces small circular scars, which may sometimes be seen on shorter hairstyles.

What to expect

Hair transplant surgery can be lengthy, depending on the method chosen (FUG or FUE), the number of grafts harvested and implanted, and, of course, the doctor’s technique. Based on these factors, a large procedure of 3000-3500 grafts can take 6 to 7 hours of surgery time. The work may, however, be spread over a number of treatments.

Hair transplant surgery is performed under a local anaesthetic, and you are able to go home after the effects have worn off. The procedure itself is painless, and patients are usually comfortable throughout the surgery.

After the follicles have been transplanted, a small scab will develop on the newly planted hairs. Once this crust has fallen off, some hairs will immediately begin to grow. Other hairs temporarily fall out and then regrow 12–16 weeks after surgery. The new hairs will continue to grow at the rate of about 1cm per month.

Before and after surgery

There are several things you can do to prepare for any surgery.

Anyone considering hair replacement surgery needs to undertake some preparation prior to the procedure. Your surgeon will perform a patient evaluation, which will include assessing your family history to gauge whether or not hair loss is hereditary. If your hair loss is the result of stress or medication, you may need to see a dermatologist.

If you are accepted as a hair transplant patient, you will need to wash your hair thoroughly on the morning of the procedure. You can use normal shampoo, but do not apply any gel or styling spray to your hair. Refrain from dying your hair at least a week prior to the procedure date.

There are also things you can do following any type of surgery to speed up healing.

Recovery time varies because people heal differently. Some patients feel fine within a day or two; others report mild soreness for several days after the transplant. Full regrowth of the transplanted hair takes 6-12 months following surgery.

Post-surgery care is simple and easy to follow:

• Patients are usually able to wear a head covering to conceal the signs of the transplant. A bandana, scarf or baseball cap can be worn.
• Your surgeon will encourage you to sleep with your head elevated on pillows for a few nights following surgery.
• You can take light pain medication if needed.
• Your surgeon will ask you to wash your hair gently with a light shampoo daily during the first week after surgery.  You can then shampoo your hair as you normally would.
• When you are in the sun, wear a loose hat to protect your head for at least two weeks following surgery.

Possible risks and complications

As with any surgical procedure, there are risks involved in hair replacement surgery. You should be aware of these before you elect to have the procedure. Please familiarise yourself with the list of complications that can result from any surgery.

Specific complications that may occur after hair transplant surgery include:

• Swelling around the eyes and the forehead. Usually, this subsides after a few days.
• Poor hair growth or density, often due to improper handling of the grafts.
• Loss of existing hair, usually as the result of miniaturised hairs in balding patients.
• Infections can occur, but they are rare.

Additional information

Hair transplant surgery or FUT is a painless and straightforward procedure with permanent success rates reportedly as high as 95%. Transplanted hair will continue to grow, but hair in areas that have not been transplanted may thin or bald over time. If this is the case, a further procedure may be required.

A successful hair transplant is defined by a full head of hair and the patient’s increased confidence and satisfaction.

Rough costs involved

The cost of hair replacement surgery depends on the surgeon, the transplant method, the price per graft, and the number of sessions required. Hair transplant procedures are very time intensive and therefore this comes with a price. You should expect hair transplant surgery to cost between $1000 and $2000 (AUD) per 200 grafts. Usually a procedure will require at least 1,000 grafts for mild baldness at least 4,000 being more typical for more severe baldness and thinning.

This information is correct as of 2019.