A Beginner’s Guide To Hair Transplants & How It Works

Hair loss.

It is a problem that both men and women inevitably face as they grow older – and can dramatically alter one’s self-esteem, especially in social situations.

Thankfully, there are plenty of solutions today that work to slow down hair loss and encourage the growth of healthy hair – including minoxidil, finasteride, low-level light therapy, and hair transplants.

Other than conventional first-line therapy treatments such as finasteride and minoxidil which serve mostly to stem further progressive hair loss, hair transplants have become a more “permanent” and acceptable option for many patients to restore existing areas of hair loss.

But in order to fully understand how hair transplants work – it is imperative to know why hair loss happens in the first place.

Why Hair Loss Occurs: the Role of DHT

Hair loss is a problem that affects 70% of men and 40% of women at some point in their life.

Unfortunately, hair loss can happen at any time, and can be a result of a multitude of factors, including:

• Genetics
• Iron or vitamin deficiency
• Hormonal abnormalities
• Illness (e.g. thyroid disease)
• Fungal and bacterial infections
• Stress

Globally, the most common cause of hair loss is due to genetics – which makes some of us more susceptible to the hormone dihydrotestosterone (DHT). When hair follicles are exposed to DHT – they become thinner and shorter (a.k.a miniaturization) with every hair growth cycle until they eventually stop growing.

Fortunately, there is an area on the scalp that is resistant to DHT and its effects called the “safe donor zone” – which plays a huge part in why hair transplants work.

Male & Female Androgenetic Alopecia

A progressive condition which constitutes over 98% of hair loss – the key underlying cause behind AGA is the over-production of DHT that causes the hair follicles to shrink and become dormant overtime.

In women, androgenetic alopecia presents itself as dispersed hair thinning that occurs mainly on the top of the scalp, while men typically see more dramatic hair loss at the front and/or top of the scalp instead.

Another common form of hair loss is alopecia areata – an autoimmune reaction which leads to the unpredictable loss of hair that results in random bald patches.

Regardless, one of the most successful hair restoration procedures to treat both male and female androgenetic alopecia is to undergo a hair transplant.

What is a Hair Transplant?

Hair transplants are not completely new – they have actually been around since the 1950s. Techniques have however evolved over the decades to become much more refined, giving patients today a much more natural result. It involves an intricate surgery to extract hair follicles from one part of the scalp (donor site) and transplanting it to the areas that are experiencing hair loss (recipient site).

Hair transplants work on the basis of “donor dominance” – the fundamental principle that transplanted hair will grow on the recipient site only as efficiently as it was in the donor site. This is why doctors typically retrieve hair follicles from the “safe donor zone” in order to prevent continued hair loss at the recipient site.

While the older hair transplants resulted in an unnatural and undesirable “pluggy” appearance – it has led to the more refined hair transplants that we see today.

There are two prominent hair transplant techniques available today: the Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE).

FUT VS FUE Hair Transplant

The FUT hair transplant is an older technique that harvests an entire strip of skin from the safe donor zone at the back of the head for transplantation. Using stereo-microscopes, the harvested hair grafts are then carefully cleaned and dissected to obtain individual hair grafts that are later then inserted into place via tiny incisions made in the bald or thinning areas.

However, due to the fact that an entire strip of hair is removed, this often results in a thin linear scar that can be harder to cover with shorter hairstyles. Patients also report more pain and slower healing times with this procedure, as stitches are required in order to close up the wound.

On the other hand, an FUE hair transplant obtains hair grafts directly from pre-determined sites using micro punches. It is later transplanted in a similar manner as the FUT technique; inserting individual hair grafts via tiny incisions made at the recipient site.

Since FUE involves a tedious and manual extraction process – the procedure is often much more time consuming than the FUT hair transplant, depending on the amount of hair grafts you require.

Scars from an FUE hair transplant are also much less visible, and look like tiny dots that can be easily hidden with shorter hairstyles. Since Asians are more prone to scarring – this has led to the popularity of FUE hair transplants in Singapore.

Both the FUT and FUE hair transplants require local anesthesia in order to maximize the comfort of the surgery, and are considered to be minimally-invasive techniques that are favorable for those who are afraid of going under an extensive procedure under the knife.

The Risks

As with any surgery, there is always a risk. This means bleeding, inflammation, swelling, and soreness that can occur during the initial healing period.

More adverse side effects include infections, continued hair thinning at other areas of the scalp, and overall unsatisfactory results.

Key Factors of a Successful Hair Transplant

The key to any successful hair transplant is the proper extraction, storage and handling of the hair follicles to ensure high quality grafts with the highest survival rate.

The best way to guarantee this is working with a doctor that has the right skillsets, knowledge and experience in both techniques.

While there have been studies showing that FUT hair grafts lead to a higher ratio of successfully transplanted follicles as compare to FUE – choosing the right doctor and team of technicians can lead to high quality hair grafts that are just as comparable to those seen in FUT.

The Ideal Candidate

While hair transplants don’t work for everyone – they work best for men and women who are currently experiencing androgenetic alopecia, or have lost hair due to an injury.

With the FUT hair transplant, it is often recommended for patients who have a more flexible scalp and don’t mind wearing a longer hairstyle in order to cover up the fine linear scar.

On the other hand, FUE hair transplants are often favored due to the fast healing times and minimal scarring that the majority of patients living a highly active lifestyle prefer.

Since hair transplants involve extracting existing hair grafts from your scalp, this means that people who are facing significant balding or are completely bald may not be suitable. It is also not advised to undergo a hair transplant under the age of 25, as the pattern of hair loss has not been fully stabilized.

Managing Expectations

While hair transplants can help to restore your hairline and give it a fuller look; it is not wise to expect the same volume that you once enjoyed in your younger days.

In terms of hair transplant cost, this depends on your chosen technique, as well as how many grafts you require. Most average hair transplants range from between 1,000 to 1,500 follicular units, which may yield a total of between 2,300 to 4,000 hair follicles.

Often, patients notice hair falling out during the first 10 days due to “shock loss” – where the transplanted hairs are traumatized by their relocation and thus fall out. However, this is completely normal and temporary, and your hair will typically grow back within the next two to three months. In the following months, the hair continues to thicken – and majority of people will achieve 60% of hair growth by nine months after surgery.

Hair Transplants at AYD

The main objective of any hair transplant is to give an illusion of a thicker and fuller head of hair.

Just as important as the execution of the hair transplant surgery in terms of achieving results is the commitment towards your post-op care – this can come in the form of complementary treatments such as topical and oral medications, as well as laser treatments to prevent further thinning and promote regeneration.

At Angeline Yong Dermatology, we always consider the likelihood of future hair loss and work with our patients to plan ahead. Dr. Angeline Yong is a doctor and dermatologist whose clinical interest is in hair and nail disorders, and she was previously the founding consultant and lead of the hair transplant service at the National Skin Centre prior to opening her private practice.

An MOH-accredited specialist in managing disorders of the skin, hair and nails, she also offers a wide range of cosmetic, surgical and medical solutions to treat a variety of problems; harnessing the most innovative and progressive solutions to put your needs and goals at the forefront.

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A Beginner’s Guide To Hair Transplants & How It Works