What is Hair Transplant Surgery?

Although a hair transplant surgery is classified as any surgical act that involves transferring hair from one part of the body to another, this term is traditionally associated with removing hair from a specific area on the back of the scalp (known as the “donor zone” or the “safe zone”) to the area of the scalp that is balding or where the hair has become noticeably thin. This is a cosmetic surgery with the intent to restore lost hair while improving appearance and self-confidence in the process.

Is There One Type of Hair Transplant Surgery?

No. There are two types of hair transplant surgery:

  • Follicle Unit Strip Surgery (FUSS) – Sometimes referred to as “FUT”, this procedure first physically removes a strip of hair bearing tissue from the donor zone, and then individually removes each follicular unit from the strip using high powered stereoscopic dissecting microscopes. These follicular units are then grafted onto the balding area (otherwise known as the recipient site) so that normal hair may once again grow. The side effect of this procedure is a linear scar across the back and sides of the scalp that has been referenced as a “smiley face” and is considered to be an obvious sign that surgery has been performed. With good healing these donor scars are easily hidden with normal length hair cuts.
  • Follicle Unit Extraction (FUE) – This procedure is much like a FUT, but the main difference is that there is no surgical removal of a donor strip from the back or sides of the scalp. Instead, hair is taken from all areas of the scalp via a small circular punch tool and re-grafted onto the recipient site. The benefit of FUE is that there is no linear scar as a result of the procedure. Instead, there are small dots of scar formation that are increasingly difficult to see with smaller and smaller punches used. Currently the gold standard for punch size is approximately .75mm to .85mm in diameter. This allows for shorter hair cuts than those afforded to patients of FUSS procedures.

What are Complications of Hair Transplant Surgery?

Almost all of the complications from this procedure can be eliminated by selecting a highly competent medical professional, but can include:

  • Skin graft elevation – The skin grafts become dry and raised, and can stop producing healthy hair.
  • Necrosis – Bleeding under the skin tissue that eventually clots and prevents blood flow, killing the scalp’s tissue and causing a decaying state that slowly spreads if untreated.
  • Infection – Incisions that are numerous or excessively deep can leave the exposed tissue vulnerable to infection. This can also result from poor surgical protocols and lack of basic cleanliness and disinfection routines.

What Else Should I Know About Hair Transplant Surgery?

The following factors can determine the likelihood of a successful hair restoration procedure:

  • The amount of viable donor hair a doctor has to work with.
  • The overall surface area of the scalp that needs to be restored.
  • (Specific to FUSS) The donor laxity determines the amount of donor tissue that can be removed. This in turn, along with donor density, determines the final number of grafts available.
  • The target density (increasing the density means more follicular units per graft, which increases the likelihood of traumatizing the scalp and causing further complications.
  • Patient Expectations. If a patient expects too much from a procedure then it can be considered by the patient to be a failure even with 100% successful growth.

Is One Hair Transplant Surgery Enough?

This is impossible to answer across the board for everyone. It is wise to accept that hair loss is progressive and unless something is done to stop hair loss, such as taking hair loss medication, then it can be expected that if one hair transplant surgery is performed then at least one more hair transplant surgery will be needed in the future.

One may also need more hair transplant surgery if there was not enough donor hair available in the first procedure. There are limits to how much hair can be taken in one visit to hair transplant clinic regardless of the method being FUE or FUSS. Subsequent hair transplants may be necessary to address areas that were not addressed in the first visit, to add additional density to areas that were addressed or to areas that have since developed hair loss since the original procedure.

Ultimately, the best way to prevent the need for multiple surgeries is to do everything possible to halt existing hair loss before any hair transplant surgery is undertaken, that way a more solid foundation is created to get the best hair transplant result possible, for now and for the future.

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