Simply stated, a hair transplant involves the removal of hair follicles from one area on the scalp and transplanting them onto another area. We remove follicles from the back of the head and transplant these healthy hairs in the areas where baldness or thinning has occurred. These transplanted hairs take root and grow continuously throughout the patient's lifetime.
The trend in hair restoration is to do a transplant in the early stages of hair loss. This proactive approach has several benefits: there's no drastic change for others to notice; hair is replaced by permanent hair as it is lost; the remaining hair provides natural coverage for the temporary crusting that occurs after the procedure; your own naturally existing hair serves as a guide in the shaping and positioning of the transplanted hairs; the procedures are smaller and therefore less costly.
We have performed successful transplants on men in their early twenties and on men in their late seventies. Because most men experience some degree of hair loss by age fifty, surgery in the mid-life years is the most common. Some men simply choose to start early and stay ahead of their hair loss while others wait to see what happens before deciding a transplant is for them.
Follicular units are small bundles of hair spaced approximately 1 millimeter apart, viewable under the microscope. Each unit contains 1, 2, 3 or sometimes 4 hairs. Follicular unit transplantation involves separating 1,000 to 3,000 follicular units from the donor strip at the back of the scalp and inserting these units into the recipient site where hair loss is occurring. Using a microscope, we carefully dissect the donor strip into slivers 1-3 follicular units wide, carefully remove each graft and implant it into the recipient area, one at a time. Tiny openings no larger than a pinprick are made in the recipient area to receive each unit.
Follicular unit transplantation achieves astonishing results. For that reason, FUT is our method of choice with most patients. The results create a fuller, natural-looking head of hair and a more youthful appearance.
The body's immune system recognizes another person's hair as foreign and destroys it. For that reason, a transplant done with donated hair is ineffective. Be assured, however, that even the most advanced cases of baldness have some fringe hair usable for transplantation. Dr. Nusbaum advises each patient on the degree of coverage to expect from hair restoration surgery.
The hairs in the transplanted grafts are shed between the 2nd and 8th week following the procedure. In some cases these hairs fall out along with the pinpoint crusts that form in the grafted area; occasionally they persist longer. The grafts are usually bare for 10-14 weeks after the procedure while the follicles recuperate to produce new, permanent, growing hair. In rare instances, the transplanted follicles do not shed their hair, but continue to grow in the days and weeks immediately following the procedure.
A new generation of hair is usually visible at the surface of the scalp by week 12 following the transplant. In some patients this new growth may occur slightly sooner or up to 8 weeks later than the usual 12 weeks. In general, results are visible at 6 months. The new hairs grow at the same rate they grew in their original location, which is typically 1/2 inch per month.
The procedure takes 3 to 6 hours, depending on the size of the area being transplanted. Following a brief rest period, you are ready to leave the office. Due to the mild sedative used during the procedure, please make arrangements for someone to bring you home. If the baldness is extensive, the front half is transplanted first and a second procedure for the back half (or crown) is performed 10 weeks later.
Hair replacement candidates must have healthy hair growth in the donor area at the back of the head, but other factors such as hair color, texture, and the degree of curliness or waviness can also impact your results. We will discuss these factors with you during your initial consultation.
Plan to spend the night of the procedure in Miami. There are several fine hotels in the vicinity of our office. You'll need to return to our office for a 20-30 minute visit the next morning. We'll check the results and give you a proper shampoo before sending you on your way.
We recommend you not take aspirin or other anti-inflammatory medications, prescribed or over-the-counter, for 7-14 days prior to your procedure. They could affect blood flow and interfere with healing. If at all possible, avoid products such as Advil, Aleve, Alka Seltzer, Bufferin, Excedrin, Nuprin or Motrin.
The procedure takes 3 to 6 hours, depending on the size of the area being transplanted. Following a brief rest period, you are ready to leave the office. Due to the mild sedative used during the procedure, please make arrangements for someone to bring you home. If the baldness is extensive, the front half is transplanted first and a second procedure for the back half (or crown) is performed 8 months later.
You will experience minimal, if any pain during the procedure. A technician will massage your scalp prior to administering local anesthesia. The massaging creates a vibration in the skin that works in combination with the anesthesia to reduce any discomfort. We give you a mild sedative at the beginning of the session to minimize anxiety, and send you home with a medication to minimize any discomfort during the 12-18 hours following the procedure.
You will leave our office without bandages. The only sign of the procedure will be pinpoint crusts that form in the grafted area and remain for 7-14 days. Many patients are able to camouflage these crusts by combing the adjacent hair over the transplanted site, or by wearing a hat. Topical solutions may be applied after the procedure to accelerate the separation of the crusts. If you wear a hairpiece, it may be used to conceal the crusts after the first week, but should be worn as little as possible during the second week.
You can resume office work, shopping and the normal routines of daily life the following day. Avoid strenuous physical activity for 48 hours. We advise patients to postpone all sport and exercise activity, including jogging, tennis and weight training, for one week. Please avoid contact sports for two weeks.
Because we specialize in artistic, state-of-the-art techniques, you will acquire a completely natural looking head of hair, including a hairline that can be brushed back or cut very short. We achieve this naturalness by designing a hairline in harmony with your facial proportions and reflective of your growth patterns at a younger age. We also use the right combination of different sized follicular grafts transplanted at the proper angle.
Like men, women who have dense hair growth in the donor area at the back of the head are the best candidates for follicular unit transplantation. Surgery camouflages thinning areas on a woman's scalp and helps to create fullness, giving you more styling options and a greater sense of ease about your hair.
In the technique called follicular unit extraction, follicular units are removed from the donor area in a scattered pattern rather than in a solid strip, which is the case in follicular unit transplantation. FUE produces tiny "dot-like" scars in the donor area instead of the line scar produced by strip removal. Because FUE is more time consuming than FUT, the cost is considerably greater (3-4 times). If you are concerned about your line scar after the surgery, we can use FUE to fill in the donor area.
If we haven't answered your questions, please give us a call or send us an email.
Phone: 305.448.9100
Toll-Free: 800.309.2449
email: drnusbaum@miamihair.com
