Hair and Scalp Procedures
Many people experience great anxiety and loss of self-esteem when faced with natural hereditary hair loss and baldness. Virtually all men, as they age, will experience some degree of hair loss. The extent and pattern of loss depends on the genetic predisposition. Many approaches to hair replenishment are available including hair weaves, wigs, hair pieces, surgery, Minoxadil, Propecia, and others.

Hair transplant surgery has gained wide popularity amongst the 60 to 70 percent of men and small percentage of women who experience alopecia, the medical term for baldness. Beginning hair transplantation before one is completely bald is an excellent idea, allowing some existing hair to be combed over the new grafts while the patient awaits growth of newly transplanted hair. 

The procedure for treating baldness is termed hair relocation, removing hair follicles from one area of well endowed hair-bearing scalp to areas of hair loss. This may be performed with mini and micrografts or with flap surgery. 

Patients with male pattern baldness, baldness from accidents, operations, burns, radiation treatment, infection, or even those who have lost their eyebrows are good candidates for this procedure. In some cases, insurance carriers may cover the cost. Patients must realize that the full head of thick hair present before the balding process will not reappear as a result of the procedure. They should also realize that transplanted hair frequently falls out initially, and grows back in two to four months. With proper hairstyle and grooming, a patient can achieve an appearance close to that of full hair growth. 

The best approach should be conservative, with the goal being a natural appearing adult hairline. Hair transplantation should be approached with the patient's present and future hairline and overall appearance in mind. 

Surgery
The patient should allow their hair to grow before undergoing the procedure. Longer hair allows the best camouflage after the surgery and while the transplants are ingrowing. It may be necessary to trim a small amount of hair prior to surgery, however, this area will be relatively inconspicuous. 

The surgery is done under "twilight" anesthesia in a comfortable position. Complications, such as bleeding and infection are possible, but exceedingly rare. With proper sedation and anesthesia, today's transplant procedure is virtually pain-free. 

The transplantation process utilizes the basic and reliable technique successful since the 1950's. Current techniques have improved upon this by using smaller minigrafts, micrografts, and slitgrafts. By placing the smaller three- to four-hair grafts and individual hair micrografts, the newly created hairline is more natural appearing and refined. The grafts or plugs are taken from the hair-bearing area on the back of the scalp. A portion of the bald scalp is removed and discarded to make room for the transplanted growing hair. The donor hairs are then meticulously prepared and carefully placed into the recipient sites. 

These grafts are placed far enough apart to allow adequate nourishment to ensure survival of the transplanted plug. If all transplants were placed at one time, the blood supply would be compromised and all the grafts would not survive. Once some growth is available for camouflage, further grafting of micro- and mini-grafts are placed in subsequent surgeries to provide optimal results. 

How Many Surgeries Are Necessary? 
Depending on the patient's degree of baldness, three to six surgeries may be necessary for optimal results. The number of surgeries and length of time to complete them will be discussed during your personal consultation. 

The Healing Process
The normal healing process results in a fine scar at the donor site, unnoticeable except under close observation. New growth will cover any scars. Between surgeries, the surgeon and patient are able to monitor the new growth and determine the success of the procedure. 

Any patient who has worn a hairpiece may continue to wear it following the procedure until new hair growth occurs. Remember, transplanted hair may fall out initially and begin to grow at two to four months at a rate of approximately one-half inch per month. Therefore, transplant patients will wait approximately six months after surgery to comb the transplanted hair over the newly transplanted areas. 

Careful hairstyling and grooming are critical to achieve optimal results. An experienced stylist and the use of a blow dryer enhance the effect of the transplantation procedure. The results of this procedure should last a lifetime, since the transplants maintain the growth pattern of their original location. 

Scalp Reduction 
Other procedures exist which are staged and used in conjunction with hair transplantation. During the scalp reduction procedure, a serial excision of the scalp is made, which brings the hair-bearing scalp together and removes the bald scalp. This is an excellent adjunct to hair transplantation because it allows the surgeon to decrease the area requiring transplants and allows concentration on the frontal hairline. 

The procedure can be done three to five times spaced months apart. After each reduction, the scalp stretches allowing more bald scalp to be removed. Finally, the hair is brought close enough together to allow grooming to cover the midline scar on the top of the head. 

Flap Replacement 
This exciting technique allows the surgeon to transfer a long flap of thick hair from the side and back of the scalp directly to bald areas producing an immediate thick and new hairline. It is performed over six weeks rather than several months to two years of transplantation. This allows massive transfer of genetically determined permanent hair to the cosmetically deficient areas. This is best for frontal baldness resulting from hereditary factors or injury. 

The procedure requires careful thought in planning the hairline so that it will appear natural. The ultimate result of the flap replacement procedure is a thicker, denser amount of hair at the frontal hairline compared to that of hair transplants. 

Whatever treatment plan is recommended and chosen, hair replacement is a lengthy process. The candidate must adopt a mature attitude and commit to a process which is designed for a lifetime of permanent improvement.