Hair Transplant Guide

If you are looking for information about hair transplantation (methods, costs, etc.) but are confused by the abundance of information available on the internet, PAVICON ACADEMY makes all the information of hair transplantation available here.

Whether you are thinking about or have already decided to get a hair transplantation, with this guide, you will be provided with complete information of hair transplantation for the best decision for your hair loss.

Definition and History

Hair transplantation involves the removal of patient’s hair from a part of the body and implanted them into the balding areas.

Therefore, in hair transplantation, the existing hair is removed and distributed evenly to cover the balding or thing areas, not the implantation of new hair shafts.

Hair transplants were first performed in Japan during the 20th century by two Japanese doctors, Tamura and Okuda. But it was the time of World War 2, so hair transplantation has not received much attention.

Does it give good results? Although hair transplantation was successfully performed, it was easily noticed even from a distance, and therefore natural-looking results were not achieved?

Hair transplantation began to be introduced to the Western world in the 1960s when Dr. Orentrich performed the first hair transplant for a patient in the United States. However, the results are quite unnatural, even though hair transplants have been developed for decades (this method is called Hair Plug).

In 1988, Masumi Inaba, a Japanese doctor, succeeded in revolutionizing the new hair transplant method (“FUE” – which we will cover more on later) which provided very aesthetic and natural results. This paves the way for modern hair transplantation with minimally invasive procedure.

Since then, hair restoration methods have continued to evolve and today’s hair transplantation can produce natural-looking results without any serious side effects.

Recently, more modern technologies have been applied to hair transplantation. For example, the use of hair transplantation robots like ARTAS technology that can automatically extract the grafts from the donor area, thereby reducing fatigue of the hair surgeon during hair transplantation process.H

Types of Hair Loss

Before you start thinking about hair loss treatments, you should do a thorough analysis of your hair loss condition and it is essential to get an accurate diagnosis before treating hair loss.

There are three main types of hair loss:

Androgenetic Alopecia

The most common type of hair loss is androgenetic alopecia or pattern baldness affecting 80% of the male population. This type of hair loss is a result of genetics or heredity and usually occurs between the ages of 20-30 years. In androgenetic alopecia, the hair follicles are highly sensitive to the dihydrotestosterone (DHT), a hormone that makes the hair smaller and easily fall out.

In the early stages, the hairline gradually recedes upward starting at the temples. It may progress into a circular baldness in the center of the head until the entire head is bald with only the hair on the back and sides of the head left.

Hair transplantation is an effective and sustainable treatment for androgenetic alopecia.

Norwood-Hamilton Scale

Symptoms of male androgenetic alopecia range from a slight receding hairline to complete baldness. The larger the balding area, the greater the need for hair transplantation. The degree of male androgenetic alopecia can be measured using the Norwood-Hamilton scale which is divided into 7 stages based on its severity. While Ludwig Scale or Olsen scale is generally used in measuring the degree of female hair loss.

What is Hair Graft?

A graft is a strip or piece of skin tissue containing hair follicles to be used for transplantation. These grafts are usually extracted from the donor area at the back of the head. However, hairs from other parts of the body can also be used. In FUE method, each graft is collected, while in FUT, a strip of skin tissue is removed from the scalp and then dissected. In general, the hair transplant fee is charged according to the number of grafts used.

Alopecia Areata

Alopecia Areata is a form of circular hair loss that results in hairless or thin patches on the patient’s head.

This type of hair loss may be caused by white blood cell disorders. However, it is usually temporary and can be solved by symptomatic treatment in many cases.

People suffering from alopecia areata should consult a doctor as it may be a consequence of comorbidities.

Diffuse Hair Loss

This type of hair loss can be caused by stress, hormonal fluctuations or malnutrition.

In many cases, this type of hair loss can be treated by addressing the underlying cause, such as dietary changes. Hair transplantation is not suitable for diffuse hair loss. Therefore, it is best to consult your doctor for an accurate diagnosis.

Hair Transplantation Costs

People tend to think that hair transplants are expensive. However, the study showed that FUE hair transplant costs an average of 103.04 Baht per graft in the UK and 30 Baht per graft in Thailand. Therefore, hair transplantation cost in the UK is 206,080 Baht for 2,000 grafts, while it costs only 60,000 Baht in Thailand

People tend to think that hair transplants are expensive. However, the study showed that FUE hair transplant costs an average of 103.04 Baht per graft in the UK and 30 Baht per graft in Thailand. Therefore, hair transplantation cost in the UK is 206,080 Baht for 2,000 grafts, while it costs only 60,000 Baht in Thailand

Hair Transplantation Methods

There are many different transplant methods and the most common methods are as follows:

In FUE method, each hair shaft is extracted from the donor area using a hollow needle, trimmed and then inserted into the recipient area. Recently, robot has been used in the extraction step in FUE method (e.g. ARTAS robotic hair transplant). This procedure contributes to high survival rate of grafts and shortened operation time. In the DHI method, a special tool is used to harvest the grafts and then directly implant them into the scalp without making any incisions.

The difference between FUT and FUE methods is in the graft extraction step. In FUT method, a tissue strip is removed from the donor area and then dissected into smaller follicular units. This procedure is therefore often referred to as the Strip Method. However, these two methods have similar implantation steps.

What is The Right Age for Hair Transplantation?

Patients are often asked if they should wait until their hair loss problem has become more severe. There is no fixed answer for this question as it depends on each patient at what age the problem started and whether they want to fix it or not. However, analysis of the donor area is necessary because the androgenetic alopecia may progress and become wider, while the number of hairs at the donor area is still the same all the time. If you wait for the problem to stop, it may end at Norwood scale stage 7 where the results of the hair transplantation may not be satisfactory.

Pros and Cons of Hair Transplantation

Pros Cons
• Hair transplant is a sustainable and long-lasting solution to hair loss with a few side effects which usually subside within a few weeks of hair transplantation.
• Hair transplantation is a type of surgical procedure, so there are some risks, such as infection. However, these risks are relatively low. There are also minor side effects such as swelling, stiffness, slight bleeding, and numbness. But in most cases, these symptoms improve in the first week after hair transplantation.
• Although hair transplantation has a relatively high cost, the amount each patient has spent on other hair loss treatments is similar over time. Typically, a 30-year treatment with minoxidil will cost an average of 320,000 Baht.
• The average cost of hair transplant in Thailand is 30 Baht per graft and 103.04 Baht per graft in the UK. Therefore, the hair transplantation cost can be quite high with an average of 2,500 grafts.
• Hair transplants can greatly improve your self-confidence.
• There is a risk of unnatural results, however it is very low if hair transplantation is performed by a highly experienced surgeon.

Hair transplantation is a highly effective hair loss treatment, although there are risks of some complications that everyone should be aware of before undergoing a hair transplantation. It is also important to understand that even after hair transplantation, hair loss medications such as finasteride and minoxidil are often required. Furthermore, hair transplantation is more effective than other methods such as mesotherapy or PRP treatment. There are also risks related to the method and location of hair transplantation, in addition to the general risks associated with these treatments. Some patients may receive scalp micropigmentation after with hair transplantation, especially at the crown region for thicker appurtenance.

Consultation and Pre-Treatment Care

It is very important to consult a hair surgeon before undergoing a hair transplantation as because only a hair surgeon can provide information about the possible results. The degree of hair loss is determined, the future progression is predicted, and possible donor areas are analyzed During the preliminary examination. Consultation not only provides information on possible treatment options, but also allows you to review the detailed information of the hair surgeon and the hair transplant clinic. Therefore, you should be prepared for the consultation and ask questions to get a sense of the surgeon’s competence and the quality of the clinic.

You may have to pay for a consultation. However, as hair transplantation is a cosmetic surgery and is not medically necessary in most cases, it is not covered by health insurance.

Hair Transplantation Procedure

Generally, hair transplantation takes about 6-8 hours depending on different steps in the procedure. The grafts are first extracted from the donor area on the back of the head and then processed and inserted at the donor area. Both FUE and FUT procedures are performed under local anesthesia and the hair on the donor area is usually shaved. Hair from the mustache area may be used if there is not enough hair on the back of the head.

In FUT or Strip method, a strip of skin full of hair with a width up to 1.5 cm is removed from the donor area. The wound is then sutured and the scar is not visible when it is covered by the hair above the wound. This strip of skin is then dissected into the individual grafts or hair follicles under a microscope. The incisions are then made in the recipient area for inserting the hair follicles.

The difference between FUT and FUE methods is in the graft extraction step. In FUT method, each hair follicle is extracted from the donor area using a hollow needle with a diameter of 0.8 – 1.1 mm. The step can be performed by a physician or a robot, such as the ARTAS robot. Wounds in the donor area are not be sutured and can heal naturally. Therefore, in this method, there are many small wounds scattered throughout the donor area, which will heal within 2 weeks.

However, the consultation costs should not be a major factor in preventing you from seeking medical advice. You should take several consultations with different hair surgeons as there can be significant differences in terms of price and quality between hair surgeons. Since hair transplantation is an important procedure, you should pay attention and care and consider it carefully.

Aftercare

In FUT method, the stitches can be removed from the donor area 2 weeks after the operation. The transplanted hair may fall out after the procedure due to the temporary lack of oxygen supply to the grafts during the operation. Shock loss may occur, which is the loss of hair around the donor area after hair transplantation, especially in FUT method. Patients can wash their hair 2 days after the operation, but they must wash their hair carefully and use a mild shampoo. After about 12 weeks, hair begins to grow out of the hair roots. The first few centimeters of new hair may look more curled than the rest of the hair on the head. But when the hair is about 5 cm long, it grows in the similar shape, structure and color as in the donor area.

After a hair transplant, you should avoid certain activities and hair products for a period of time. You should not dye or use chemicals for 2 months after hair transplantation and should avoid heavy work or sports during the first week to the first month. In addition, sunbathe and sauna should be avoided in the first month.

How long does it take to achieve the final result?

In most cases, you will begin to see results 6-9 weeks after the hair transplantation and the final results will be visible after 1 year. The transplanted hair will fall out in the first few months. This phenomenon is referred to as “Shock Loss”, but new hair will grow back within 5-6 months.

Can One Hair Transplant Give Full Coverage?

The number of hair grafts required for each patient depends on the degree of his/her hair loss. A larger number of grafts is required to cover the larger baling area. The hair surgeon will assess the affected area together with the amount of hair can be extracted from the donor area for hair transplantation, by taking into account the size of the balding area and the density required. The surgeon then discusses with the patient about the possible methods to cover the entire or part of the affected area.

Conclusions

With the advancement in technology, the hair transplantation procedure and recovery are no longer difficult. This guide provided you with complete information about hair transplantation. However, this guide is not a substitute for medical consultation as you should have a preliminary examination for proper diagnosis and better decision on the right treatment. It is not recommended to undergo hair transplantation without a preliminary examination.

Hair transplant is one of the hair loss solutions that provides permanent and lasting results with relatively few side effects. It has therefore become a popular hair loss treatment among celebrities such as Wayne Rooney or Elon Musk. In 2019, about 182,025 and 106,949 hair transplant procedures were performed in the USA/Canada and the UK, respectively. The number of hair transplant procedures performed in the USS/Canada and Europe increased by 75% and 231%, respectively from 2008.

FAQ

How much does a hair transplant cost?

The hair transplantation cost depends mainly on the degree of hair loss and the number of hairs in the donor area that can be extracted for hair transplantation. Some clinics may offer the packages that are independent of the number of grafts used.

What is the success rate of hair transplantation?

In general, hair transplantation has a higher success rate than conventional hair loss treatment products. However, other factors such as the skill and experience of the hair surgeon as well as the problems of each patient and the number of hairs must be also considered.

How long will the results of hair transplantation last?

The grafts are usually extracted from the back of the head, where the hair usually doesn’t become smaller and fall out from the scalp as it is resistant to DHT, a hormone responsible for hair loss. These grafts are able to grow naturally when transplanted in another area, so hair transplantation is a permanent solution to hair loss.

Is hair transplantation painful?

Hair transplantation is performed under local anesthesia, the patient therefore will feel pain only during anesthetic injection and no pain should be felt during the operation. The patients may experience swelling and stiffness on the top of the head after the hair transplantation. However, these symptoms usually disappear within the first week.

How long does it take to achieve the final result?

In most cases, you will begin to see results 6-9 weeks after the hair transplantation and the final results will be visible after 1 year. The transplanted hair will fall out in the first few months. This phenomenon is referred to as “Shock Loss”, but new hair will grow back within 5-6 months.

Do you have to shave your head before getting a hair transplant?

FUT method does not require shaving the head. However, it is often recommended to shave the head during FUE hair transplantation for better extraction. Nowadays, we can perform FUE hair transplantation without shaving the hair with Long-Hair method. However, if a large number of grafts is required, it is recommended to shave the hair around the donor area.

Dr. Suthida Arayametee

– Doctor of Medicine, Chiang Mai University

– Grad.Dip.Clin.Sci.(Radiology), Chiang Mai University

– Diploma in Practical Dermatology, Cardiff University, UK

  • Certificate of completion: Fundamental of Platelet Rich Plasma (PRP) Therapy Training Course
  • Certificate of attendance: Implanter Workshop for Hair Transplantation, Faculty of Medicine Siriraj Hospital
  • Certificate of Completion: Medical Weight Management Specialist, School of Antiaging and Regenerative Medicine, Mae Fah Luang University
  • Certificate of attendance RELIFE Master Network Module 3 Advance Workshop for Thread Lifting (Definisse Free Floating)
  • Certificate of attendance Mid-Face Correction & Enhancement using thread, botulinum toxin, filler Workshop by No 1 Trainer
  • Certificate of attendance: RELIFE Master Network Module 2 Advance Workshop for thread Lifting (Definisse Double thread technique with 23-cm-thread)
  • Certificate of attendance: 9th ITCAM Hands-on Cadaveric Dissection of Toxin and Filler Injections and Thread Lift
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