Hair loss factors
Hair loss is mainly caused by a combination of genetics, changes in hormones and the impact of aging. In some cases hair loss can be caused by trauma or accidents.

Realistic expectations
A hair transplant may boost your confidence but it will not change your personality or make people treat you differently. Everyone is individual and surgery will not transform you into someone else. It is critical that you spend time thinking about what you want to achieve from surgery and talk about your hopes with your surgeon.

It is also important to understand that transplant methods use existing hair. The ideal candidates for a transplant have a large amount of healthy hair at the back and sides of their head. From these areas grafts and flaps are taken to treat the bald area. Popular techniques include strip, mini, punch or micro grafts for people who want more modest hair improvement.

Still, there are limits to what can be achieved. A person with very little hair is likely to be advised not to have a transplant. The patient must remember that hair factors such as texture, curls or colour may impact negatively on the result.

What happens during consultation?
The surgeon will discuss your medical history, review your family hair history and lifestyle, examine your hair type and provide you with a realistic overview of what you can expect to achieve from specific treatments.

Getting the most out of your consultancy
Often in cases where clients are unhappy with the results of surgery it is because they did not discuss their expectations thoroughly or were afraid to talk about the outcome or risks. You have to make an informed decision before signing the consent form so ask plenty of questions. You want to feel relaxed, confident and completely understand what will happen during surgery.

You may want to know:

• About the surgeon’s qualifications.
• How many operations of your procedure are carried out each year.
• How you prepare for surgery.
• What realistic results can be expected and when.
• How long the results will last.
• About side-effects and possible complications.
• How long it will take to recover.
• About the extent of scarring and how it will change in time.
• What happens if anything goes wrong.

Preparing for surgery

• Avoid alcohol, aspirin, garlic and food oils a least a week before surgery as they can cause excessive bleeding.
• Do not eat or drink anything six hours before general anaesthetic (if you require this).
• The surgeon and anaesthetist needs to know your medical history and if you are on any medication.
• You will be advised of any health checks or X-rays required before your procedure.
• Prior to surgery you meet your surgeon who will assess and discuss your queries.
• Try and give up smoking a couple of weeks before your procedure as it interferes with healing processes.

Important considerations about surgery
A hair transplant is usually performed using local anaesthetic in addition to a relaxing sedative. In more involved cases requiring significant grafts, general anaesthetic may be used.

Hair transplant surgery involves taking small grafts from hair donor sites and reinstalling them into the required area. Graft sizes range from literally one to two hairs to strips of up to 40.

The grafting process can be long and protracted. Often a series of surgical visits are needed as well as a few months to allow the hair to heal between grafts. As a result it may take up to two years to receive the desired effect.

Often patients are disappointed to discover that their newly grafted hair falls out within weeks of surgery. This is normal. After the hair has fallen out it takes about five to six weeks before growth resumes. It is also highly likely that you will need a follow-up procedure to fill-in areas of the treated hair.

What happens during surgery?
In some cases small grafts of hair are usually removed using a scalpel or punch from the donor areas and installed in the required area.

For other types of graft, small pieces are taken from the hair area, divided into tiny sections and rooted in holes or slits in the hairless scalp. The donor holes are then closed with stitches.

The grafts are normally located about half a centimetre apart from each other. Over a series of sessions the spaces between grafts are filled with new grafts. After surgery the head is cleansed and covered with a surgical dressing.

Flap surgery is another technique used to transplant hair. Here a section of hair-bearing skin is cut from the donor area while still maintaining a ‘hinge’ of attachment. This is then rotated into a pre-prepared area of bald skin and sewn in place.

Finally a process known as scalp reduction removes sections of scalp from the bald skin area (often in an upside down Y shape). The skin that surrounds this cut-out area is then released so sections of hair-bearing scalp can be brought together.

After surgery

• Depending on the extent of your surgery you will be in a recovery room for a few hours or a couple of days being cared for by nursing staff.
• Your surgeon will visit and advise you when you can leave.
• You will also be advised on how to shower and change your dressings.
• You should not drive for two days after anaesthetic.
• Avoid alcohol, aspirin, garlic, food oils and smoking. All of these can interfere with the body’s healing processes.

Road to recovery

• You may be able to carefully wash your hair within two days of surgery.
• If the surgeon recommends that you take medication such as antibiotics, make sure that you complete the course.
• Your treated area is likely to feel sore during the first couple of weeks, so take it easy and get plenty of rest.
• You must contact your surgeon if you suffer from an abnormally high temperature, severe pain that is not treated with Paracetemol or if you experience severe bleeding.
• If you are in doubt about any of the post operative effects speak to your surgeon.

All surgery carries an element of risk
Most people believe that the benefits of a hair transplant outweigh the risk. However before you sign the surgery consent form you should be aware of any possible complications and side effects.

Complications associated with any type of surgery include problems healing, the danger of infection and the potential formation of clots that may be life-threatening. Excessive bleeding or bleeding under the skin, known as a haematoma, may require a return visit to the surgery. Some patients may also have an allergic reaction to anaesthesia.

In some hair transplant procedures there is a risk that grafts may not survive in their new location. This may require repeat surgery. There may also be patchiness if a transplant is next to hair that is continuing to thin out. Again, further surgery may be necessary.

Complications in connection with hair transplants depend on individual circumstances such a person’s health, hair type, genetics and the extent of the procedure. Your surgeon will be able to explain how the risks apply in your circumstances.