If you are losing your hair, there are surgical options to restore the hair that heredity has taken away. The procedure used should be tailored to the patient and result in a natural looking outcome.
Hair replacement surgery consists of taking strips of hairy scalp from the back and sides of the head, converting the strips into grafts, and then transplanting these hair-containing skin grafts into the bald areas. Since the transplanted hair is your own, chances of rejection are minimal. The transplantation of this hair, referred to as donor hair, does not change the hair's ability to grow or its color.
The best candidates are men who are bald over a relatively small proportion of their scalp and who have a large area of donor hairs. Hair color, texture, and waviness or curliness may also affect the outcome of the surgery.
Doctors can achieve natural results by transplanting small grafts called micrografts of hair into the bald area in groups of 1-3 hair follicles. The grafts are placed close together, and the result is denser hair growth that is more natural looking.
Aside from grafting, there are other procedures used in hair restoration. For example, scalp reduction is a surgical method that can effectively reduce a man's bald appearance. According to the International Society of Hair Restoration Surgery (ISHRS), it is often done prior to hair replacement surgery. In this procedure, those with a good amount of dense hair on the sides and back of their scalp have their scalp stretched upward to cover as much of their bald area as possible, leaving less area in which grafts of hair follicles need be inserted. However, the ISHRS cautions that there can be complications with this procedure, including scarring, stretching back of the bald area, and the creation of an unnatural appearance called a slot deformity.
Scalp flap is another procedure, which involves moving entire segments of hair bearing scalp into a bald area. Patients with frontal baldness are ideal candidates since this procedure provides immediate hairline reconstruction. A different type of scalp flap, called a scalp lift, is used for treating hair loss in the crown of the scalp. This procedure involves moving the fringe hair on the sides and the back upward towards the center of the bald area in a U-shaped pattern. It is used in combination with hair transplantation and can achieve good results.
After the procedure, the hair grafts and the donor sites will form small scabs. If you have enough surrounding hair, the scabs can be camouflaged with careful hair combing, and the scabs will usually come off in about a week. Typically the grafted hair will shed in 6 weeks before new hair grows at a rate of about ½ an inch per month.
If you are considering hair replacement surgery, understand that doctors can only work with the amount of donor hair a patient has. Select a doctor based on their certifications in dermatology or cosmetic surgery, number of years of experience, and references from those who have had the procedure and hair stylists. If you are a good candidate, you may be able to regain a full head of hair.
American Society of Plastic Surgeons
http://www.plasticsurgery.org
International Society of Hair Restoration Surgery
http://www.ishrs.org
The Canadian Society for Aesthetic Plastic Surgery
https://csaps.ca
The Canadian Society of Plastic Surgeons
http://www.plasticsurgery.ca
Alopecia reduction. International Society of Hair Restoration Surgery website. Available at:
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Published August 27, 2012. Accessed July 5, 2017.
Androgenic alopecia in men. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116740/Androgenetic-alopecia-in-men. Updated November 22, 2016. Accessed July 5, 2017.
Finding a hair restoration doctor that's right for you. International Society of Hair Restoration Surgery website. Available at:
...(Click grey area to select URL)
Accessed July 5, 2017.
Hair replacement surgical hair transplants. American Society of Plastic Surgeons website. Available at:
...(Click grey area to select URL)
Accessed July 5, 2017.
Skin flap surgery. International Society of Hair Restoration Surgery website. Available at:
...(Click grey area to select URL)
Published October 3, 2014. Accessed July 5, 2017.
Last reviewed July 2017 by EBSCO Medical Review BoardMichael Woods, MD, FAAP