Hair Transplant Surgery

It is estimated that nearly 66% of men over age 35 and about 50% of women over age 50 experience moderate to severe pattern hair loss. Since the hair is often associated with youth, vitality, and health, hair loss can feel deeply personal, negatively impacting confidence and self-image. For many individuals, it can be one of the most emotionally challenging experiences of their lives.

Hair restoration procedures help patients feel “whole again” with most reporting significant improvements in both their professional and personal lives after treatment. Many patients find that hair restoration can be profoundly healing. While the procedure delivers clear aesthetic benefits, it is, at its core, a reconstructive treatment designed to restore not just appearance, but self-assurance and well-being.

What is hair transplant surgery?

Hair transplant surgery is a permanent hair restoration technique that uses hair from full areas to fill in areas of the scalp, eyebrows, sideburns, goatee, or beard that exhibit balding or moderate to severe hair thinning. The procedure involves the relocation of healthy hair follicles from fuller areas of the scalp (i.e., the donor area) to regions experiencing thinning or balding (i.e., the recipient area).

How is hair transplant surgery performed?

The first step of the procedure involves the physician developing a clear understanding of the patient’s goals, then designing a hairline to reframe their face. The surgical plan includes careful thought about recipient site density patterns required for the individual to achieve aesthetic density and coverage.

The procedure is performed with local anesthesia so that the patient is awake and comfortable for the entirety of the procedure.

At Westlake Dermatology, we perform advanced hair restoration techniques including Follicular Unit Transplantation (FUT), Follicular Unit Extraction (FUE), or a combination of both harvesting techniques to restore natural-looking density and confidence. Each harvesting technique is highly effective for achieving lasting, natural results, and your surgeon will recommend the best method for you based on your hair type, amount of hair loss, and treatment goals.

• FUT (Follicular Unit Transplantation), also known as strip harvesting, involves the removal of a narrow strip of hair-bearing scalp from the back of the head. Individual follicular units are then microscopically dissected by an experienced hair technician. The surgeon measures the area of the donor zone required to achieve the necessary number of follicles for the procedure, which is typically in the 20 cm x 1.4 cm range.  Donor harvesting and closure in the FUT procedure typically takes about 30 minutes to perform.
• FUE (Follicular Unit Extraction) involves the extraction of individual follicular units directly from the donor area using specialized micro-punches that are less than 1 mm diameter. The small punch size minimizes scarring and stitches are not required. The extraction process generally requires about 3 to 5 hours. Complete donor healing is achieved within 3 to 4 days of a procedure. Small FUE procedures can utilize the “long hair” technique which immediately camouflages post procedure noticeability. Large FUE procedures require very short hairstyles to perform but, typically, within 1 week, there is no evidence that a procedure has been performed.

Combination procedures of both FUT and FUE donor harvesting techniques can be performed in a single setting for patients that require large procedures. Combo procedures are elegant, heal exceptionally well, do not overwhelm the patient’s donor zone, allow for the transplant of a very large number of follicles, and are performed with long hair so there is little to no noticeability post procedure.

Once the hair follicles have been harvested, the surgeon creates the recipient sites and the density patterns required for the new placements. Recipient site density patterns typically range from 20 to 50 sites per square cm, but these can vary based on individual patient characteristics such as color contrast of hair and scalp, hair caliber, or straight versus curly hair. The follicles are placed one per recipient site created until the procedure is complete.

Patients utilizing the FUT technique return for suture removal approximately 2 weeks after the procedure. The FUE technique does not require follow-up for suture removal since none are used in the procedure.

Who is the ideal candidate for hair transplant surgery?

The ideal candidate is ultimately determined by the patient’s goals and expectations. Patient goals can range from re-establishing a frontal hairline and light coverage, to much more extensive coverage due to massive hair loss. In addition to the scalp, hair restoration can also address thinning of the eyebrows, sideburns, or beard.

Hair transplant patients range in age from young children to adults age 80 and up. Healthwise, generally if a patient does not have restrictions going to the dentist, they will be fine proceeding with a hair restoration procedure.

How long does the procedure take?

Patients should expect to stay the entire day, typically 8 to 12 hours, to allow for the appropriate time necessary to obtain quality follicles and to allow for a procedure of the highest possible standard.

What should I expect after hair transplant surgery?

It is rare for patients to report any significant post-procedure discomfort. Non-narcotic analgesics in conjunction with a cool pack can be utilized for two or three days to help with any minor discomfort.

Normal light activities can be resumed immediately post-procedure, with unrestricted physical activity resumed within 7 to 10 days.

Patients are asked to wear a light dressing for the first night following the procedure. No additional dressings are required after that. The recipient scalp will have light crusting (scabs) for a few days after the procedure. The transplanted scalp will also exhibit redness (erythema) for 2 to 4 weeks post-procedure. Scalp infection is rare but is occasionally reported.

Typically, the hair in the transplanted follicles shed within a week or two of the procedure. The follicles remain dormant for 6 to 8 weeks before beginning to grow new hair.

Pre-procedure, many patients worry that people are going to know that they had a hair transplant. The reality is that results develop so gradually that nobody knows that the patient has undergone the procedure. In fact, most patients report in hindsight that having the procedure was surprisingly easy. They report that the most difficult part of the procedure is waiting for the result which develops gradually over the course of one year.

Does hair transplant surgery leave scars?

The FUT technique leaves a fine linear scar in the donor area, typically only 1 to 2 mm diameter. Scarring is minimized by utilizing the trichophytic closure technique which encourages surrounding hair to grow through the closed incision which helps to mask its presence. Scarring is typically only noticeable with very short hairstyles.

The FUE technique results in tiny circular marks that are virtually invisible once healed, offering a scar-minimal option for patients who wear closely cropped hair.

Is hair transplant surgery permanent?

Generally, the results provided by either FUT or FUE hair transplant surgery are permanent. However, in some cases patients may require touch-up sessions to maintain thick and full hair in treated areas. Patients with a genetic predisposition to losing hair may continue to lose native hair, so Minoxidil and Finasteride are recommended to help manage ongoing hair loss.

Are multiple hair transplant sessions necessary?

The need for multiple treatment sessions varies by patient, depending on degree of hair loss and desired result. Many patients accomplish their goal with a single treatment session; while others may choose to have a second procedure at some point in the future to add density and/or gain coverage in an area of scalp that has not been previously transplanted.

Who will perform my hair transplant surgery at Westlake Dermatology?

Our hair transplant team includes Dr. Robert Reese, who has decades of hair restoration experience, and his team of hair technicians. Dr. Reese and his team work cohesively to serve you and will do their level best to provide you with an outstanding experience and a result that is second to none.

Dr. Reese likes to tell his patients to, “Celebrate today, because today is the day that you are going to get your hair back.” You just might find that you are actually having some fun spending the day with us.