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Hair Replacement
Overview
Losing your hair
is difficult to accept. Hair is seen as a trait of beauty
and of authority. We are lucky to live in an age where something
permanent can be done for hair loss. Recently, much has been
learned as to why hair loss occurs. While much of it is unknown,
we have found that hormonal changes that affect genetically
programmed hair is probably the cause. The hormone, DHT,
is known to be involved. This hormone acts on the genetically
programmed hairs of the hairline and top of head and causes
them to fall out and the follicles to atrophy. Fortunately,
the hairs on the back of the head do not have the same genetic
predisposition, and they are not affected by DHT.
What this means is that hairs from the
back of the head can be transplanted to balding areas to provide
natural, hair bearing scalp. In the past, hair transplantation
was performed using larger grafts consisting of 8 to 10 hairs. Using grafts that are this large created a pluggy look that was evident to anyone with the conversation distance. With the advancement of hair transplantation surgery, we have
realized the importance of creating a natural appearing hairline. This can only be done by using small grafts like those used
by Dr. Cruise. These grafts are called mini-graphs and micro-graphs. The mini-graphs consist of
3 to 5 hairs and the micro-graphs consist of just 1 or 2 hairs. When these are used the re-created hairline is very natural
appearing.
The transplanted hair grows and acts
just like normal hair because it is. It is your own natural
hair except it thinks it is still growing on the back of your
head. Because it is genetically programmed to not be affected
by DHT it will grow for the rest of your life just like it
would have done, had it never been transplanted.
There are medications available such
as Rogaine and Propecia that help. They help because they
block some of the actions of DHT. The reality is, however,
that they are not likely to provide a significant amount of
regrowth but they are effective in preventing further balding
in most people.
The hair transplants procedure normally
takes about 3 or 4 hours to perform and is done under local
anesthesia in Dr. Cruise's office. During the procedure you
will watch a movie. In fact, you are encouraged to bring
in your own movie or you can select one at Dr. Cruise's office. You can drive yourself to and from the procedure.
Normally, 2 procedures spaced 4 months
apart are necessary to obtain the desired results. After
hair transplantation, it will take at least 3 months for the
transplanted hairs to begin growing. The amount of hair transplanted
will be determined by the area to be covered as well as by
the type of hair that you have. A typical session will involve
transplantation of anywhere from 500 grafts to 1000 grafts. During placement of the grafts it is important to make sure
that the hair is placed such that it grows in a natural fashion.
Another type of hair replacement surgery,
that allows for much quicker results, involves expanding the
hair bearing scalp that you have by placing a tissue expander
underneath it. Then, over the course of 6 weeks, the hair
bearing scalp is expanded by filling the expander with water
2 or 3 times a week. When the hair bearing scalp has been
expanded enough, a procedure is performed where the balding
area is removed and the expanded hair bearing scalp replaces
it. This is a good option for people who have lost almost
all their hair. It, however, requires a 4-week period where
your hair bearing scalp is being expanded. During this period
of time you look strange. There's no other way to describe
it. This is 1 of the tools within Dr. Cruise's armamentarium
for hair replacement.
Dr. Cruise feels quite passionate about
hair transplantation. In fact, he has had it done himself. So when you consult with him you can speak to him as both
a plastic surgeon and as a patient. You can see what is possible
when hair transplantation is done correctly.
 Dr. Cruise's philosophy regarding Hair Replacement
 Hair transplantation is something I approach with great empathy. As mentioned above, I, myself, have had hair transplantation. It is very empowering to know that you do not have to be bald if you do not want to be. Hair transplantation has developed to the point where a very natural hairline and full head of hair can be produced if done correctly. It is important to re-create the hairline as good as possible. This is the key. It must be done with micro-graphs along the hairline and mini-graphs right behind.
Typically, hair transplantation requires 2 sessions to obtain the desired results. When you see me for consultation I will first take digital photographs of you. We will then go over these photographs together so that we both come to an understanding as to what it is you would like. I will tell you what is and what is not possible. What is possible is a full natural hairline. What is not possible is a bushy head of hair like that of a 12-year-old.
Even if the density of a 12-year-old cannot be re-created, you will be more than happy with a natural full hairline that you know will grow forever. During the consultation I will assess the quality and density of your hair. We will come up with a treatment plan that usually requires 2 sessions.
Each session usually takes about 3 or 4 hours during which time you will watch a movie. You can drive to and from the procedure. It takes about 3 months for the transplanted hairs to begin growing. It will take a full year before they are growing completely normally. The second session is done 4 months after the first session so that I can see where the hairs from the first session are.
Hair transplantation gives you the satisfaction to know that there is something that can be done about hair loss. I am a big advocate of proper nutrition as well as medication to help your hair grow as thick as possible. I will discuss this with you at the time of consultation.
Benefits
The benefits of hair transplantation
are numerous.
- It makes you feel better about yourself.
- It makes you feel like you have control
over the situation instead of feeling like there's nothing
that you can do.
- Almost any male that is losing his
hair can be benefited from hair transplantation.
- It is best to begin early in the balding
process so that people do not even know you are balding
in the first place.
- Men that are almost completely bald
must understand that it is unrealistic to expect a full
head of hair. However, it is possible to create a dense
natural appearing hairline that can be styled.
- It will make you look younger and
more attractive.
With women, the situation is a little
different. While quite often they are candidate for hair
transplantation, sometimes they are not. It depends on the
type of hair loss that you have. If you are losing hair from
all over, even from the back of the head then hair transplantation
may not be as effective. It is necessary to consult with
Dr. Cruise to see what the options are.
Possible complications
The most common complication is inadequate hair density. This can usually be corrected by performing another session of hair transplantation. It is important to understand that the balding process will continue and that even though you're having hairs transplanted hair density may not increase because of progress of balding. This just means that more hair transplantation may be necessary. Other complications include bruising and swelling, infection and wound healing problems, and possible graft loss.
Are
you a good candidate?
As mentioned above, almost all men that
are losing their hair are candidates for hair transplantation. It is best to begin early in the balding process so that hair
transplantation can be done over time so that it does not
appear as if you are significantly balding.
If you have lost all your hair it is
not reasonable to transplanted your entire head. In this
case you have the option of developing a hairline so that
you can have hair to management style. Another option is
tissue expansion of the hair that you do have to replace the
balding area. As mentioned above, however, this is more involved
and you should discuss this with Dr. Cruise.
Women who have lost isolated areas of
hair are the best candidates for hair transplantation as the
results are quite good. If, however, you are losing hair
from your entire head, hair transplantation becomes more difficult.
Prior to surgery
While there are not many things that
are do’s and don’ts for hair transplantation there
are a few important things to understand.
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Medications. Certain medications thin your blood and should not be
taken within 3 weeks of surgery. The most notable is
aspirin and aspirin containing products. Vitamin E and
many herbal products also thin the blood and should not
be used within 3 weeks of surgery. Dr. Cruise will go
over this more thoroughly prior to the procedure.
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Sleep. It is important to get a good night's rest prior to the
procedure. If you think this may be a problem, please,
do not hesitate to ask Dr. Cruise for something to help
to sleep.
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Eating. Do not eat within 2 hours of a hair transplantation.
Please discuss all medications with Dr. Cruise.
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Washing. It is a good idea to wash your hair the morning of hair
transplantation and comb it straight back. Do not apply
hair spray or any gels to your hair.
- State of mind. Remember,
this should be a happy and exciting time. A certain amount
of nervousness is normal but you must not be overly concerned. Put your trust and Dr. Cruise and ICRS as they are well
trained and experienced. Excessive worrying can actually
be detrimental and you should discuss this with Dr. Cruise
prior to surgery so that something can be prescribed to
make sure you remain calm.
Anesthesia
ICRS uses only board certified anesthesiologists
to make sure you have the best anesthesia possible. The anesthesiologist
will discuss with you what type of anesthesia is best for
you. He/she will take into consideration your medical history,
the procedure, and your personal wishes.
Hair transplantation is done under local
anesthesia. If you would like something to relax, discuss
this with Dr. Cruise prior to the procedure.
After
the procedure
The procedure itself will take about
3 to 4 hours.
Immediately. Right
after the procedure you will get up and walk around. The
local anesthesia will still be effective so you will be able
to drive home comfortably without pain medication. Dr. Cruise
is a strong advocate of a good pain relief so you will be
given as much pain medication as necessary to last for the
next 4 to 5 days. Of course, there will be swelling and bruising
but there is surprisingly little pain. You will have a head
dressing on as well as ice packs to help keep the swelling
down. You must sit up for the first week so that your head
and face do not swell.
That evening. It is recommended that you take it easy. You can walk around,
eat, but not too much more. You must sit and lay with your
head up on at least 3 pillows. You should take as much pain
medication as necessary and try to go to sleep early. Apply
ice packs every 2 hours for the first 24 hours. You will
be given medication to help keep the swelling down as well
as to prevent infection.
First
48 hours. It is important to leave the head dressing
on until the 3rd day or 2 days after the procedure. This
is when you will see Dr. Cruise. He will take down the dressing
and make sure everything is going OK. He will reapply another
light dressing. You should then go home and take a bath. At the end of the bath submerge your entire head under water
and gently let the water soak the transplanted area. Dry
and repeat this the next day. Comb your hair gently.
First
week. Four days after the procedure you can begin
to let shower water gently trickle over the transplanted area. It is not necessary to apply anything to the area. From here
on out it becomes easier as you can begin to style your hair
gently.
Beyond. At about 10 days after the procedure the scabs will fall off. Resist the urge to help them come off. I know it can feel itchy. Some of the transplanted hairs will
be visible but most will not. Many of the transplanted hair
will fall out over the next 4-5 weeks but will regrow in about
3 months. It will take 6 months for the results to begin
to show. It will take 1 year for all the hairs to be growing
normally.
Recovery
time
Most people return to work in 3 days. At this time there will be some scabs and swelling but this
is not usually a problem.
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