What is Surgical Management of Hair Loss?
Surgical management of hair loss involves performing cosmetic surgery to transfer your own hair from areas on your scalp that have good growth to areas where growth is scanty or absent. The main options for surgical management of hair loss include hair transplants, scalp reduction surgery, and scalp flap surgery. Hair transplant surgery is a popular choice as it offers a permanent solution, while also being the least invasive type of hair loss surgery.
Ideal Candidates for Surgical Management of Hair Loss
You may be an ideal candidate for hair loss surgery if you:
- Have hairline recession, thinning hair, and bald spots on some parts of your head with healthy hair growth on the back or sides of your head
- Are seeking a permanent solution to your hair loss problem
- Have realistic expectations of the surgery
- Have overall good health
Contraindications for Surgical Management of Hair Loss
You may not be a candidate for surgical management of hair loss if you:
- Are prone to develop keloid scars
- Do not have suitable donor hair sites
Preparations of Hair Loss Surgery
Specific instructions will be provided by your surgeon. In general, you should:
- Get a health checkup to clear you for the procedure.
- Inform your surgeon regarding any health conditions, allergies, and medications.
- Avoid smoking as it can slow down the healing process.
- Use a shampoo and conditioner to wash the hair before surgery, but do not use any additional hair products.
What to Expect from the Hair Loss Surgery Procedure?
Hair Transplant Surgery: This surgery can be performed under local anaesthesia. The two main techniques of hair transplant surgery are:
- Follicular Transplant Technique (FUT): During this procedure, a surgical scalpel is used to cut a thin strip of scalp skin from the donor site. The hair follicles are carefully removed from the harvested skin using a surgical knife under magnification. These hair follicles are then implanted into the bald regions to achieve normal-appearing hair growth.
- Follicular Unit Extraction (FUE): During this procedure, tiny punch incisions are made to extract the hair follicles directly from the donor areas at the back or sides of the head. A needle or blade is used to make tiny holes in the recipient area into which the hair follicles are gently placed.
The surgery can take 1 to 4 hours. A gauze or bandage will be used to cover the scalp for a few days. Several surgical sessions may be needed to achieve satisfactory hair fullness.
Scalp Reduction Surgery: This surgery is performed under local anaesthesia. A mild sedative may also be given to help you relax. The skin over the section of the scalp to be treated is surgically removed. A balloon-like tissue expander is placed under the scalp skin adjacent to the area of hair loss. The expander is then gradually injected with a saline solution over a few weeks at follow-up appointments, causing the skin covering the expander to stretch and grow. Alternatively, a surgical device with elastic bands is placed under the skin and the tension in the bands is increased over time to stretch the hair-bearing skin. Once the ideal skin size is achieved, it is distributed over the section of the scalp that does not have hair.
Scalp Flap Surgery: This surgery can be performed under general or local anaesthesia. Over multiple surgical sessions, a strip of the scalp from the donor site is removed and attached to the recipient site. This surgery is usually combined with a scalp expansion procedure to obtain a large enough area of hair-bearing scalp.
Recovery after Hair Loss Surgery
You can return home after the effects of sedation have worn off. A bandage will be placed over the head that should be maintained for a day or two. There may be some swelling and discomfort for which medications may be prescribed. Antibiotics may also be prescribed which should be taken as directed to avoid the risk of infection. You may have to sleep in a semi-upright position for 2-3 days to avoid putting pressure on the treated areas. A follow-up may be scheduled in 7-12 days for suture removal.
Risks Associated with Surgical Management of Hair Loss
Hair loss surgery is performed using minimally invasive techniques to minimise the risk of complications. However, as with any surgical procedure, there are associated risks that include:
- Bleeding
- Pain and discomfort
- Swelling
- Infection
- Scarring
- Failure to achieve hair growth