WHO SHOULD GET A HAIR TRANSPLANTATION AND WHY?
Hair transplants are most often performed for patients who are bothered by hair loss and baldness. Mostly male pattern baldness, but it is not uncommon for female patients to come to us with similar problems. Hair transplantation is therefore recommended and can be successful for both men and women!
Hair transplantation can be a solution not only for hereditary baldness but also for “acquired” hair loss. Hair loss can be caused by an injury or scar caused by a disease, or by a previous hair transplant procedure that was not done properly. In such cases, we recommend corrective hair transplants. The surgical procedure is always preceded by a personal examination to make sure that the hair transplant can be performed.
AT WHICH TIME OF YEAR AND AGE IS IT RECOMMENDED TO HAVE HAIR TRANSPLANTATION?
From the point of view of surgery, there is no season that is particularly detrimental to the success of hair transplantation. The procedure can be performed at any time that suits the patient. Experience has shown that late autumn to early summer is the most popular period for hair transplantation, as it is the time to wear a hat and to enjoy a holiday.
But it plays an important role in setting up the surgical plan. It is the implant specialist’s responsibility to assess the extent, and rate of hair loss. These factors all influence the expected outcome. Intervention at too young an age can limit the amount of hair that can be used for transplantation, which could be used up if baldness develops later.
The Norwood chart shows the different degrees of male pattern baldness. Some people may never go beyond the 2-3 stage of hair loss in their lifetime, while others may reach the 6-7 stage in their early twenties. The table shows only the basic forms, but there are many more individual variations.
As the primary aim of the operation is to give a natural look in 20 to 30 years, so the question is not whether hair transplantation is possible, but whether it is worthwhile.
For example: in a young patient aged 22-24 years with a balding stage of N-3-4, where due to family inheritance and already observed hair loss we can expect to reach N-5-6, it is not advisable to place the frontal hairline too low, for several reasons. Firstly, because it will no longer be natural in later life and secondly, because of further hair loss, we prefer to implant grafts towards the top of the head. This will allow us to achieve good coverage in areas that will become prominent in the future.
BY PERFORMING HAIR TRANSPLANTATION AT THE RIGHT TIME EVEN IS CASES OF SEVERE HAIR LOSS, IT IS POSSIBLE TO MAINTAIN THE LEVEL THE DESIRED HAIR APPEARANCE!
WE DO OUR UTMOST TO ACHIEVE THE BEST POSSIBLE RESULTS
During a personal consultation before the procedure, we will discuss the patient’s expectations, assess their general health and take any information about hair loss or baldness. During the consultation, we may already recommend against surgery if the personal data suggests that hair transplantation is unlikely to be successful. This may be due to alopecia areata (patchy hair loss), young age, or the patient’s inadequate hair conditions or unrealistic expectations.
Hair transplantation involves transplanting the patient’s own hairs, so the success of the operation depends largely on the patient’s individual characteristics and hereditary traits. Therefore, during the personal consultation, we always assess the degree of baldness, the patient’s potential and expectations on an individual basis. If we consider that there is too great a discrepancy between the above-mentioned aspects, we do not recommend surgical intervention!
Hair transplantation will be most successful if the quantity and quality of hair that can be transplanted is appropriate. If the hair loss or baldness is more extensive, but the patient is satisfied with partial coverage, we can also guarantee good results with surgical intervention.
For female patients, other factors may influence the expected outcome. These factors may include the haircut required for the procedure, possible hair loss after the surgery, and the significant difference between the donor area and the expected coverage requirement. If the surgery is not expected to meet our patients’ expectations, we do not recommend hair transplantation surgery.
Setting up a surgical plan is of paramount importance in the field of hair transplantation. This is when we design the most optimal hair transplantation protocol for the patient and determine the exact location of the hairline to achieve a lush and natural, but most importantly, a real hair effect in the long term.
Important technical parameters are set at the start of the operation. We also test the elasticity of the scalp, the thickness and hardness of the epithelium, and the degree of tissue adhesion of the grafts. Hair follicle units are studied by micro-camera mapping. These parameters are used to adjust, for example, the thickness of the punch needle to be used.
Adequate care of the grafts during extraction, counting and grouping, as well as during implantation, contributes greatly to achieving the desired result. After harvesting, the grafts should be stored at the right temperature in the right medium to prevent them from drying out. If the hair follicle units are not kept in the right conditions, dehydration will set in, making them unsuitable for transplantation. Transsection, i.e. the cutting of grafts, is to some extent unavoidable during hair transplantation, but these hair follicles are not transplanted. During the treatment, we aim to minimise the number of grafts that are transected. A small technical loss of about 5% is still expected during the surgical procedure, but this does not affect the outcome of the hair transplantation.
The preparation of the intake openings also plays an important role in the intervention. The correct size and depth must be precisely adjusted, as this will influence the density, direction and angle of growth of the hair. Some parts of the head, such as the rotation areas, may require particularly careful adjustments, which require professional experience and precision.
WHEN MIGHT MORE SURGERY BE NEEDED?
Baldness causes the amount of hair to decrease, which in some cases can also affect the donor area (see Norwood table). Before the onset of any type of hair loss or baldness, there is an average of 100,000 hairs on the scalp. If baldness results in the loss of around 30,000 or more hairs, several surgical procedures may be necessary. Hair transplantation must also take into account the regenerative properties of the scalp, as the donor area available for hair transplantation is finite. This is unique to each patient, so some patients are not suitable for multiple operations at all. On average, 10-18,000 hairs can be harvested from the area, but this may be less in the case of weaker, sparse scalps, so the number of operations that can be performed can be determined on an individual basis.
When removing hair from the donor area, care should be taken not to remove excessive amounts of hair, as the hair follicles removed will not grow back, but will continue to grow in the recipient area. If we are aggressive during the procedure, the donor area may become thickened and possibly scarred. The maximum number of grafts is about 2500-3000 grafts, which means 5-7000 hairs. By grafting this amount in an area of about 100-120 cm2 we can achieve an excellent density.
The primary aim is not to completely cover up hairless areas – as this is not always possible – but to give our patients the best possible visual result. This applies to both donor and recipient areas. Thus, in cases of too few transplantable hairs or too much baldness, we do not recommend hair transplant surgery!
THE NUMBER OF GRAFTS IS NOT EVERYTHING
The number of grafts is an important data point in hair transplantation, but it is not the only thing that matters. Since each of our patients has different hair characteristics, these factors also influence the outcome of the hair transplant. These include hair density, thickness and colour. In a patient with a higher quality, darker hair colour, we can understandably achieve a better visual appearance than in a patient with lighter, thinner hair. The expected result is therefore unique for each patient, which we will discuss in more detail during the personal consultation.
WHEN IS HAIR TRANSPLANTATION NOT RECOMMENDED?
- Young age: when there is no significant baldness, hair loss or the balding process is still in progress.
- Excessive hair loss: if the donor area is not dense and wide enough, and if the patient prefers to wear short hair and is not satisfied with partial coverage.
- Female pattern baldness: if the donor area and the hair quality are not sufficient, the surgery will not achieve a positive, spectacular result.
