Follicular Unit Hair Transplant

There are many reasons for hair loss, but 95% of all cases in men are due to a condition called “androgenetic alopecia.” This is commonly referred to as “male pattern baldness.”

Most cases of hair loss in women are due to inherited female pattern balding, but medical conditions such as low thyroid levels, hormonal imbalances (elevated testosterone), binge dieting, and pregnancy can contribute to the condition.
You may loose 10 to 100 strands of hair per day. The hair goes through a generation, growth and fall cycle which continues again with generation of new hair. You do not become bald because you are loosing more hair, you will become bald when the lost hair is not replaced with new hair.

A hair transplant involves transferring hair from the back and side of the head (the “donor area”) to those areas undergoing hair loss or thinning. The hair from the donor area are genetically programmed to be permanent.

Once transplanted, these hair will continue to grow for a lifetime, they can be groomed, shampooed and require haircuts like normal hair.

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Anybody below age of 23 years or not having hair loss beyond Grade III is not considered for hair transplant surgery.

Patients with grade 3 hair loss respond with medicines alone; unless the patient desires to change the hairline or bring forward the temporal receding on either sides. Patients with grade 4 hair loss and more require medicines and surgery to achieve a desirable result. Most men in good general health are candidates for hair transplantation. if:

  • You’ve lost hair due to an inherited trait
  • You’ve lost hair due to trauma or burns
  • You have healthy hair growth at the back and side of your head

In women, the Ludwig classification is used to determine and grade the hair loss.There is hair loss on the front and top of the scalp with relative preservation of the frontal hairline. The back and sides may or may not be involved. Regardless of the extent of hair loss, only women with stable hair on the back and sides of the scalp are candidates for hair transplantation.

The procedure is performed as a day care procedure under local anaesthesia. A mild sedative may be administered to make you feel more relaxed and comfortable.

Consultation & Preparation
During your consultation, to develop a plan for your Hair Restoration ,we will determine:

  • Grade of hair loss (Grade I – VII)
  • Density of donor hair
  • Color of hair
  • Texture of hair
  • Future hair loss projections
  • Scalp laxity
  • Number of grafts required to meet your expectations.

We usually recommend the pre-treatment/pre-conditioning of hair with our medicinal treatment protocol which stops hair fall, induces new hair growth and strengthens the hair roots in the recipient area prior to the transplant. This protocol of medication uses medicines once in 3 days, reduces cost of medication and guarantees no side effects. It stops hair loss in 2 months, and thinning of hair in men and women will get corrected by 60 – 70% with cyclical medicines within 4 months. Moreover, pre conditioning the hair roots ensures a predictable and guaranteed result following the hair transplant.

Follicular Unit Grafting is a state of the art procedure yielding the natural results. It is considered to be the gold standard in Hair Restoration.

A follicular unit is the naturally occurring grouping of hairs containing from 1 – 3, occasionally 4 hairs. As many as 2500 grafts can be transplanted in a single procedure lasting 6 – 10 hours.

A narrow single strip of scalp (1-1.5cms wide & 15 – 20 cms long) is harvested from the back of the scalp. The donor area is closed primarily leaving no residual bald area.

The follicular units are cut from the donor tissue under total microscopic control into single hair, micrografts (2-3hair) & minigrafts(4-5hair). The grafts can be inserted into tiny needle-sized sites in the recipient area.

A combination of these different sized grafts is used in the Hair Restoration, with the one- hair grafts in an irregular pattern along the hairline, and the two-, three- and four-hair grafts placed further behind to create more density. By transplanting follicular units, the way hair grows naturally, the results of the hair transplantation are virtually undetectable. The front and top of your head will receive transplanted hair first, because these are the areas that frame your face & make the most impact on your appearance. The crown is usually the last area to receive hair (in later procedures), unless it’s your only balding area.

Antibiotics & mild pain pills to reduce the chance of pain & swelling are taken the first three days after the procedure. You can shampoo your hair with a mild shampoo on day 3 following surgery and can return to work and most regular activities. You will have to return to the clinic on Day 10 to remove the sutures from the donor area at the back of your head. If you are from out of town you can get it removed from a qualified practitioner close to your place.Weight-lifting, heavy exercise, and swimming can be resumed after one week, once the stitches used to close the donor site have been removed.

To help accelerate the growth of the transplants, the medicinal treatment protocol is started again, following the removal of the sutures as it reverses or halts the miniaturization process in many individuals and is thus the logical way to decrease the risk of shedding following a transplant. Find that their “new” hair falls out within 2 – 3 months after surgery. This condition is normal and almost always temporary. After hair falls out, it will take another 5-6 weeks before hair growth resumes. You can expect about a 1 – 1.5 cm of growth per month, after 5- 6 months following the operation. You may need a “touch-up” procedure to create more natural-looking results or to increase the density if required, after your incisions have healed. This is carried out approx. 4-6 months following the first surgery.The results of hair replacement surgery can enhance your appearance, self-confidence and change your persona.

As with any surgical procedure, you will likely experience some discomfort, swelling, and bruising in the upper portion of your face and around your eyes, which can be alleviated with cold compresses and pain medication.

Keeping your head elevated as you recover, will help to reduce bruising and swelling as well. Any stitches or sutures may remain in place for approximately 4 – 7 days. While you will feel well enough to return to work in approximately a week, the swelling and bruising make take a few weeks to completely subside.

It is important that you avoid strenuous activity such as heavy lifting or exercise for at least 2-3 weeks following the procedure to allow your body sufficient time to heal

Sameer Karkhanis, MD

Board-Certified Mumbai Plastic Surgeon

Chief Plastic Surgeon & the Director at CCRS is a qualified Aesthetic Plastic and Reconstructive Surgeon. He is Board Certified, with the qualification of DNB Plastic Surgery (Diplomate of National Board). He is an active member of the International Society of Aesthetic Plastic Surgery.


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