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Restore growing hair with natural results

Hair Restoration Hair Replacement Surgery

Alabama Hair Transplants, Hair Replacement Surgery

Restore Growing Hair to Balding or Thinning Scalp with Hair Transplants

Baldness is often blamed on poor circulation to the scalp, vitamin deficiencies, dandruff and even excessive hat-wearing. All of these theories have been disproven. It is also untrue that hair loss can be determined by looking at your maternal grandfather or that 40-year-old men who have not lost their hair will never lose it.

Hair loss is primarily caused by a combination of aging, a change in hormones and a family history of baldness. As a rule, the earlier hair loss begins, the more severe the baldness will become. Hair loss can also be caused by burns or trauma, in which case hair replacement surgery is considered reconstructive and may be covered by insurance.

Though an unpleasant and annoying reality for many men and women, people with pattern baldness no longer have to accept hair loss as a permanent condition. A Hair Transplant at Hedden Plastic Surgery is a precise procedure where individual follicular units (bundles of one to four hair follicles) are transplanted from donor areas to balding or thinning areas.

Using their surgical skills along with an artistic touch, these follicular units are placed by our Alabama hair transplant surgeons to provide very natural results. Dr. William J. Hedden is a member of the International Society of Hair Restoration Surgery.

Hair Replacement Surgery Candidates

Male hair replacement candidate
Hair Replacement candidates should have healthy growth at the back and sides of the head for donor areas

Hair replacement candidates should have some noticeable hair loss along with healthy hair growth at the back and sides of the head to serve as donor areas. Other factors, such as hair color, texture and waviness or curliness, may also affect the result.

A number of techniques are used in hair replacement surgery. Hair transplantation techniques are generally performed on patients who desire a more modest change in hair fullness. Flaps, tissue expansion and scalp reduction are usually more appropriate for patients who desire a more dramatic change. Two or more techniques are sometimes used to achieve the best results.

Hair Loss in Women

Some doctors estimate that one in five women will experience some degree of hair loss. Women tend to experience a subtle thinning all over the scalp rather than losing hair in patches, as is common in men. Hair replacement surgery may be the answer for women who are uncomfortable with wigs, hair extensions or topical drugs.

Because mini-grafts are usually the surgical treatment of choice for filling in thinning areas, good candidates for this procedure should have dense hair growth at the back of the head. Mini-grafts are harvested from this dense area and replanted in thinning areas to create a fuller look. Flap and tissue expansion procedures may be used if the individual is judged to be a good candidate.

Though you will never have the coverage you had prior to your hair loss, surgery may camouflage the thin areas and give you more fullness.


Your Hair Replacement Surgery Consultation

By choosing a member of the American Society of Plastic Surgeons (ASPS) for your hair replacement procedure, you can be assured that you are choosing a highly-trained, board-certified plastic surgeon. ASPS Member Surgeons must meet rigorous standards for training, ethics, physician practice and research in plastic surgery.

At your initial consultation, your hair restoration surgeon will:

  • Evaluate your hair growth and loss.
  • Review your family history of hair loss.
  • Find out if you have had any previous hair replacement surgery.
  • Ask you about your lifestyle.
  • Discuss your expectations and goals for surgery.

Medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood-clotting problems or the tendency to form excessive scars, should also be checked by your doctor. Be sure to tell your surgeon if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting.

Your surgeon will explain anesthesia, where the surgery will be performed and the risks and costs involved. Don't hesitate to ask your doctor any questions.

Think carefully about your expectations and discuss them with your surgeon. Make sure you understand the hair replacement procedures that will be used and how long they will take. Ask your doctor to give you an idea of what you will look like after the procedure or after each stage of treatment in the case of grafts.


Hair Replacement Surgery Risks and Safety Information

Hair replacement surgery is normally safe when performed by a qualified, experienced surgeon. However, people vary greatly in their physical reactions and healing abilities. The outcome is never completely predictable.

As with any surgical procedure, infection may occur. Excessive bleeding and/or wide scars, sometimes called "stretch-back" scars caused by tension, may result from some scalp reduction procedures.

There is a risk that some of the grafts will not "take" following hair transplant procedures. Although it is normal for hair contained within plugs to fall out before establishing regrowth in its new location, the skin plug sometimes dies and surgery must be repeated. At times, patients with plug grafts will notice small bumps on the scalp that form at the transplant sites. These areas can usually be camouflaged with surrounding hair.

Progression of hair loss after surgery may result in an unnatural, "patchy"look, especially if the newly-placed hair lies next to patches of hair that continue to thin. If this happens, additional surgery may be required.


Preparing for Hair Replacement Surgery

Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking and certain vitamins and medications to take and avoid. Carefully following these instructions will help your surgery go more smoothly. If you smoke, it is especially important to stop at least a week or two before surgery. Smoking inhibits blood flow to the skin and can interfere with healing.

You should arrange for someone to drive you home after your surgery. Plan to take it easy for a day or two after the procedure and arrange for assistance if you think you will need it.

Types of Anesthesia

No matter what technique is used, hair replacement surgery is usually performed using local anesthesia with sedation to make you relaxed and comfortable. You may be aware of some tugging or pressure, but your scalp will be insensitive to pain. General anesthesia may be used for more complex cases involving tissue expansion or flaps. If general anesthesia is used, you will sleep through the procedure.


Hair Replacement Surgery Procedure

Hair Transplants

Our Birmingham, Alabama hair transplant surgeons perform Follicular Unit Transplantation to restore growing hair to balding or thinning areas of the scalp with results that are virutally undetectable. Using this very precise procedure, small groups of hair follicles, or "follicular units," are taken from donor sites and transplanted into recipient sites to treat balding or thinning.

During the hair transplant procedure, hair follicles are taken from the donor area in small strips or as follicular units consisting of one to four hair follicles. If strip excision is used for harvesting, the strips are placed under a special microscope and separated into individual follicular units. Scarring in the donor region is concealed with surrounding hair.

Tiny incisions are created in the recipient sites, which are distributed to achieve a natural appearance. The follicular units are carefully placed into these incisions so that the transplanted hair will grow in the proper direction.

Tissue Expansion

Tissue Expansion is commonly used in reconstructive surgery to repair burn wounds and injuries with significant skin loss. Tissue expansion has yielded dramatic results in hair replacement surgery by creating significant coverage in a relatively short amount of time.

Using this technique, a balloon-like device called a tissue expander is inserted beneath hair-bearing scalp adjacent to a balding area. The tissue expandeer is gradually inflated with salt water over a period of weeks, causing the skin to expand and grow new skin cells. This causes a bulge to form beneath the hair-bearing scalp.

When the skin has stretched enough (usually about 2 months after the first operation), another procedure is performed to bring the expanded skin over to cover the adjacent balding area.

Flap Surgery

Flap surgery on the scalp is capable of quickly covering large areas of baldness. The size of the flap and its placement are largely dependent upon the patient's goals and needs.

A section of bald scalp is cut out and a flap of hair-bearing skin is lifted from the surface while still attached at one end. The flap is brought into its new position and sewn into place while remaining tethered to its original blood supply. As you heal, you will notice that the scar is camouflaged or at least obscured by relocated hair, which grows to the very edge of the incision.

In recent years, plastic surgeons have made significant advances in flap techniques, combining flap surgery and scalp reduction for better coverage of the crown, or with tissue expansion to provide better frontal coverage and a more natural hairline.

Scalp Reduction

Scalp reduction is used for coverage of bald areas at the top and back of the head. It is sometimes referred to as "advancement flap surgery" because sections of hair-bearing scalp are pulled forward, or "advanced," to fill in a bald crown.

After the scalp is injected with a local anesthetic, a segment of bald scalp is removed. The pattern of the section of removed scalp varies widely depending on the patient's goals. A segment of scalp in an inverted Y-shape is commonly removed if a large amount of coverage is needed. Excisions may also be shaped like a U or a pointed oval.

The skin surrounding the cut-out area is loosened and pulled so that the sections of hair-bearing scalp can be brought together and closed with stitches. It is likely that you will feel a strong tugging at this point and occasional pain.


Hair Replacement Surgery Recovery and Follow-up

How you feel after surgery depends on the extent and complexity of the procedure. Any aching, excessive tightness or throbbing can be controlled with pain medication. If bandages are used, they will usually be removed a day later. You may gently wash your hair within 2 days following surgery. Any stitches will be removed in a week to 10 days. Be sure to discuss the possibility of swelling, bruising and drainage with your surgeon.

Because strenuous activity increases blood flow to the scalp and may cause your transplants or incisions to bleed, you may be instructed to avoid vigorous exercise and contact sports for at least 3 weeks after surgery. You may be asked to avoid sexual activity for at least 10 days.

Male hair replacement candidate
Hair Replacement surgery results can enhance your appearance and self-confidence

To make sure that your incisions are healing properly, your doctor will probably want to see you several times during the first month after surgery. It is important that you carefully follow any advice you receive at these follow-up visits.

Getting Back to Normal

How soon you resume your normal routine depends on the length, complexity and type of surgery. You may feel well enough to go back to work and resume normal, light activity after several days.

Many patients are dismayed to find that their "new" hair falls out within 6 weeks after hair replacement surgery. This is normal and almost always temporary. After the hair falls out, it will take another 5 to 6 weeks before growth resumes. You can expect about a half-inch of growth per month.

Follow-up Procedures

You may need a surgical touch-up procedure to create more natural-looking results after your incisions have healed. This sometimes involves blending, a filling-in of the hairline.

If you have had a flap procedure, a small bump called a "dog ear" may remain visible on the scalp. Your doctor can surgically remove this after complete healing has occurred.


Procedure Information © American Society of Plastic Surgeons

If you would like to find out more about Alabama Hair Transplants at Hedden Plastic Surgery, please contact our cosmetic surgeons in Birmingham today.