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Hair Replacement

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Surgical Procedures
Hair Replacement Surgery

There are many reasons for hair loss. Heredity and hormonal factors contribute greatly. The most common cause is androgenic alopecia or "male pattern baldness". Women can also suffer hair loss. This often causes much anxiety and despair for the patient because hair loss is usually associated with premature aging. The pattern of hair loss for each patient is different. It is determined genetically and the pattern of hair loss can be determined by your family's history of hair loss. There are many treatments available including hairpieces, wigs, hair weaving, surgery, and certain medications. Unfortunately, there are many gimmicks involved with hair replacement. Desirable treatment for hair loss is not quick and easy as some may promise.

The goal of hair replacement surgery is to redistribute the existing hair into the areas of baldness. Whereas hair in the frontal, crown and vertex areas may be lost, the hairs on the sides and back of the scalp are usually retained. The object of the surgery is to use the hair in well-endowed areas to cover the balding areas. The earlier the surgical treatment for hair loss is performed the less noticeable the change in your appearance. Procedures for hair replacement include hair transplant, scalp reductions ("baldness reduction") and flap procedures. Just as hair loss patterns differ between patients so does the surgical treatment. During your consultation, a thorough evaluation of your scalp will be performed and what procedure(s) will best suit your individual needs will be discussed. This depends upon your pattern of hair loss, anticipated loss, the extent of your baldness, your life-style, and amount of coverage you desire.

Multi-Stage Hair Transplantation

Before Transplantation Stage One Advanced to Stage 3 Completed Transplantation These drawings represent what may be accomplished in the "typical" case of hair transplantation.

Baldness Reduction

The bald area can be reduced by advancing lateral hairlines towards the center. A further reduction can be done 3 months later When no further movement can be obtained, transplants are used to fill in the remaining area. Proper styling is beneficial in obtaining the best cosmetic result.

Scalp Flap Procedures

The TPO (or long flap) operation includes 2 minor procedures prior to the main flap transfer. All three procedures are performed within a two week period. In the first delay procedure, two parallel incisions are placed in the area of the hair fringe. Staging the operation is necessary to condition the flap for transfer. The second delay procedure completes the conditioning process. The procedures are spaced at one week intervals. Two weeks after the initial delay, the flap is transferred into position. The donor area is closed by stretching the scalp above and below. As early as three (3) months later, a second flap may be taken from the other side of the scalp. Areas balding between flaps can be excised. This is similar to Baldness Reduction (see above) only the area excised is horizontal, not longitudinal.

Some frequently asked questions about hair replacement include:

What can I do to prevent hair loss?
Unfortunately the majority of hair loss is determined by ancestry. Grooming and hair care have little effect on hair loss; however, styling can be beneficial to cover thinner areas much like makeup is used to help cover scars.

How long will it take hair to grow after my surgery?
This depends on the procedure performed. Flap surgery and scalp reduction involve taking hair-bearing scalp and relocating it. Therefore, the bald area is removed immediately and replaced with uniform hair-bearing scalp. Because the circulation of these hair follicles is not interrupted, the hair will not be lost after the surgery. When using punch grafts for surgery the hair of the individual grafts will enter a resting phase (telogen), which lasts approximately four to eight weeks. Approximately four weeks later hair growth will begin to occur and continue at a growth rate of approximately one-half inch per month.

If a transplant is the best way to treat my hair loss, how many sessions will it take and how long will I have to wait between sessions?
The number of hair sessions varies from individual to individual depending on the extent of the hair loss. Some patients may require fewer sessions whereas others may require as many as four sessions. The goal of hair replacement is a personal one based on density desired.

What can I expect after the surgery?
A bandage will be placed over the scalp after the surgery. The bandage will be removed and another will be replaced the following morning. This second dressing will be removed later on in the day and instructions will be given to you regarding the care of the scalp for the next several weeks.

How much discomfort can be expected?
There is usually minimal discomfort from hair replacement surgery. This can usually be treated with oral medication.

When will I be able to return to physical activities?
Most patients can return to their usual workout routines 10 days after surgery. It is best at this time to gradually work back to your routine.

What are the risks?
There are risks associated with any surgical procedure; however, hair transplantation has been performed successfully for over 30 years. Bleeding, infection, scarring, temporary hair loss and asymmetries are rare. These will be discussed during your consultation as well as ways to avoid them.

Dr. Greco's practice is limited solely to
excellence in aesthetic surgery of the face.

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