Hair Replacement Surgery

Because of significant surgical advances with improved results, interest in hair replacement surgery has markedly increased during the past decade. The old “plug” look of yesteryear is fortunately gone now replaced with more refined techniques resulting in seamlessly natural results even upon close inspection.

Understanding the Surgery

In the past the only method for hair replacement surgery required taking a strip of hair-bearing scalp from the back of the head, known as follicular unit transplantation (FUT). If the incision is closed well, the scar should be barely detectable. The strip is then divided into several hundred to several thousand smaller grafts. These grafts are then inserted into tiny slits in the scalp and must be placed in the appropriate direction to mimic how hair naturally grows on the scalp. While some of the grafts may contain up to three or four hairs, it is necessary to use a number of grafts containing only one or two hairs to create a natural appearance, e.g., along the hairline.  

Today, another method is also offered known as FUE, which stands for Follicular Unit Excision.  FUE involves removing individual hair follicles from the back of the head rather than using a strip method. Follicular-Unit Grafts of one or two hair follicles are used along the hairline to give it a soft, natural look. There are pros and cons of both methods, which your surgeon will discuss with you during your consultation.

What to Expect After the Surgery

After surgery, your surgeon may choose to apply a dressing for a day or two. If stitches are used, they are usually removed within 1 to 2 weeks. The second or third day after surgery, you will probably be allowed to shampoo. Your head and scalp may have some mild discomfort, but this can be controlled by medication. It is crucial that you follow the instructions for post-operative visits and care that your surgeon provides you. Swelling in the area treated is likely but should not last for more than a few days to a week at most. Cold compresses may be recommended by the surgeon. Scabbing in the transplanted area is also very common and may be visible during the first week after surgery.  The newly transplanted hair often falls out in the six weeks following the procedure. This, however, is absolutely normal. New hair growth will take about 4 to 6 months to start appearing but will require up to 18 to 24 months for the remaining full growth to occur.

Your facial plastic surgeon is the best source of information on what may be required for you as an individual and for your specific surgery. Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging. By changing how you look, cosmetic surgery can help improve how you feel about yourself.

Insurance does not generally cover surgery that is done purely for cosmetic reasons. Surgery to correct hair loss from accidents, burns, disease, or trauma may be reimbursable in whole or in part by insurance but not always.

Medical content written by the AAFPRS Multimedia Committee. Medical content reviewed/approved by Dr. Samuel M. Lam and Dr. Albert J. Fox