Hair transplant surgery is a very safe, minor surgical procedure that involves removing a strip of permanent hair-bearing tissue or extracting one follicular unit at a time using (FUE or follicular unit extraction) from the back or sides of the scalp (Donor Area). Most patients opt for strip excision.
Once the donor tissue is removed it is then carefully dissected into follicular units containing from 1 to 3 hairs. Each follicular unit contains an average of 2.3 hairs. The donor area is then carefully sutured and hidden by the surrounding hair. To minimize scarring Dr. Goertz emphasizes that the donor area is stitched with a monofilament suture using proper depth and tension. This avoids any unnecessary damage to the surrounding follicles and also allows for a more comfortable post operative recovery, in contrast to donor areas that are closed with staples.
The grafted hairs will often start to grow within 6-12 weeks of the procedure and will continue to grow for a lifetime.
The ultra refined follicular unit grafts are meticulously created and placed into the bald or thinning area of the scalp (Recipient Area). This creation of very small single hair grafts has allowed for very natural, feathered hairlines to be created, avoiding the abrupt “pluggy look” that was typical many years ago.
Within 24 hours of the procedure small crusts or scabs will form on each graft. These scabs will shed approximately 7-10 days after the surgery and in most cases the transplanted hairs will also begin to shed. This is called the resting phase. Occasionally, these newly transplanted hairs will continue to grow right away and not go into a resting phase, but that only happens less than 10% of the time. The grafted hairs will often start to grow within 6-12 weeks of the procedure and will continue to grow for a lifetime.
After the surgery, patients are provided with a mild analgesic to relieve discomfort felt the night following the procedure. Patients will be asked to spray the newly grafted area, ice the forehead and stitches and to sleep in a semi-upright position for 2-3 days following the procedure. This is to minimize swelling and to allow the grafts to heal in their recipient sites. The small crusts that initially form on each graft may be camouflaged by any existing hair that can be combed over the recipient area.
The Frontal Hairline
A natural frontal hairline is the most important attribute of hair transplantation surgery and cannot be over-emphasized. This one area of the transplant will be the overriding factor, above all others, by which you judge the quality of your hair transplant result. Dr. Goertz carefully designs your frontal hairline. This is where art must mimic nature. The height and contour are carefully designed to conform and enhance your natural features. He also variegates the hairline contour to imitate nature as closely as possible.
A natural hairline is not a “line” at all, but an erratic arrangement of hairs that are spaced more sparsely at the front edge. In the hairline, the hairs become denser as you progress through the first centimeter of hair. We mimic this by blending in 1-hair follicular unit grafts at the very front and increasing the density as we move back from the hairline.
Pitting and Hair Angle
Grafts must be placed at an angle to mimic the natural angle found. This is more manageable to groom and also avoids the continual “surprised” appearance that results from hair placed perpendicularly to the skin. We take special care to follow proper angles throughout the process to give you back your natural appearance.
“Pitting” of grafts occurs when the tiny amount of skin that surrounds the hairs of the graft is placed deeper than the surrounding scalp skin. When the area heals there will be a “pitted” appearance to the exit site of the transplanted hair, giving an unnatural appearance to the transplanted hairs. This is particularly noticeable at the frontal hairline. Great care is taken to be sure that each ultra refined follicular unit grafts is placed at the perfect depth to avoid pitting and ensure absolutely natural re-growth.
With a larger procedure, your desire for density can often be achieved in one session, however sometimes more than one surgical procedure is required to provide the desired density and coverage.
Density is also a function of hair caliber, color and characteristics. Dark hair on a light scalp will always appear thinner than blonde or white hair on a light scalp. Curly hair gives more coverage than straight hair. We achieve density not by the number of grafts but by the number of hairs that are transplanted. We ensure quality by the appropriate mix of grafts from single hair follicular units to grafts containing at times, up to four hairs.
The amount of available donor hair is fixed. We will help you maintain realistic expectations in terms of desired hair density and areas of coverage.
Did it hurt, ‘NO!’ I enjoyed my day…the Results of a comfortable Pleasant afternoon filled with anticipation of my new real hair. MY HAIR. Would I do it again? Absolutely!Larry Nelson