Number of Transplant Procedures needed
Any completely bald area can be restored in 2-3 sessions. Placing micro-grafts in the recipient area has the advantage of not damaging any existing hair, as the "slits" are made between the hairs. It is worthwhile for you to have 1 or 2 early transplanting sessions, before your hair loss has reached an advanced stage. The benefits of these early sessions are threefold:
- your remaining hair provides natural camouflage for the initial sessions
- your transplanted hair (once it has grown) will persist, thus providing additional coverage for any later sessions
- your sessions can be spaced further apart, thus spreading your cost over a longer period.
If you wish to have transplants in both the front and crown areas, the size of the bald area can be reduced by an alopecia-reduction (AR) operation in selected patients. In this procedure, a portion of the bald scalp is removed, and the normal laxity of the scalp is used in closing the resulting gap. A hairline scar is all that remains after the procedure, and your scalp will become loose again within a few weeks. AR's result in a denser look once the transplant has been carried out. While this may sound rather frightening or painful, it is a routine procedure, and is no more uncomfortable than a transplant session. Your need and suitability for this is discussed at your consultation.
Transplant sessions may be done as far apart as you wish, although they cannot be repeated in any given area without a wait of 4 months between sessions. The number of grafts transplanted at one session, and the frequency of transplant sessions, depends on the characteristics of your individual case _ this is planned in advance for you.
What to Expect After Each Session
A crust or scab will form over each graft shortly after the procedure. Once the area has healed, these will separate from the scalp and fall off. Although these crusts are visible during the one-week healing period, you can often camouflage them by combing the adjacent hair over the transplanted site. If you wear a hairpiece, it may be used to conceal the crusts after the first week (but it should be worn as little as possible during the second week). The slit grafts will be virtually undetectable within 7 - 10 days.
The hairs in the transplanted grafts are shed between 2 and 8 weeks after the procedure. Many of these hairs will fall out together with the crusts; occasionally they persist for longer. A few of the transplanted follicles may not shed their hair at all, but will continue to grow immediately after the procedure. The grafts are usually bare for a period of 10 - 14 weeks after the operation, during which time the hairs are shed and the follicles recuperate to produce new hair - this is normal. A new generation of hair starts to grow by the 12th week after transplanting, but this may occur slightly earlier, or up to 8 weeks later, in individual patients. These hairs grow at the same rate as they did in their original location.
Please be patient as this is a gradual process.
Some of your own hair may also fall out.
Do not be concerned - it will grow back.
When a large area is transplanted, swelling of the forehead may occur. While this is usually mild, lasting 2 - 4 days, it can occasionally be severe enough to cause a large amount of puffiness round the eyes (approximately 1 out of 50 patients has swelling bad enough to cause black eyes). This swelling generally begins 2 - 3 days after the procedure, and lasts 3 - 5 days. Swelling is most likely after the first session, but with subsequent treatments it usually occurs in a milder form or not at all. For this reason, it is advisable, if possible, to schedule a few days’ leave after your first session. Please be assured that the swelling is always temporary and has no adverse effects on the healing of the grafts, or on you.
It is recommended that patients refrain from heavy exercise for 10-14 days after the surgery.
Patients may wear loose-fitting hats directly after surgery, but hard hats or tight-fitting helmets are not recommended for 2 weeks. After the sutures have been removed, all normal activity can be resumed.
The scalp may be gently shampooed from the third day after the transplantation.
Full written instructions explaining the pre- and postoperative routine are given to all patients prior to surgery.