- Who should have this operation?
- How is the operation done?
- What sort of anaesthesia is used for this operation?
- How long does the operation take?
- Is the operation very painful?
- How long will I have to remain in hospital?
- Will I be very bruised and swollen?
- What about exercise after the operation?
- Are there any complications associated with this operation?
- How long will the operation last?
Micrograft hair transplantation: This operation is one of the great success stories of the past 15 years.
Hair transplantation has been performed for the last thirty to thirty- five years but, until the development of the Micrograft, was not very successful. Not because the transplanted hair didn't grow in the past, but because the appearance of the large punch grafts used was unaesthetic and artificial.
By making the grafts much smaller, to include on average only 1- 4 hairs, far more grafts were required and the operation involved much more work and time, but the results were far more natural looking than they had been in the past.
Who should have this operation?
For obvious reasons, the vast majority of candidates for this operation are men with typical male pattern baldness and the ages of the patients may vary from the early twenties to the sixties.
Occasionally, women with localised areas of female pattern baldness or loss from such causes as trichotilomania may also benefit from hair transplantation.
How is the operation done?
A strip of hairbearing skin, from 6-14 cm in length by 1.0cm wide is removed from the side or back of the patient's scalp in the area where balding does not occur.
The length of the donor graft (strip) depends on the area requiring treatment and an average of 400-800 grafts is obtained. The donor site is then closed with carefully placed sutures leaving a hairline scar.
As many very small incisions as grafts are made in the recipient area, carefully planned and oriented to recreate a natural appearance in the grafted area, and the micrografts are then transplanted, one graft to each recipient incision. Single hair grafts are used to recreate the hairline, with larger grafts being used further back to provide density.
What sort of anaesthesia is used?
This operation is routinely performed under local anaesthesia. While having injections in one's scalp is certainly not pleasant, the discomfort does not last longer than six or seven minutes and thereafter the scalp is numb and there is no more pain.
In the unlikely event that a patient is particularly apprehensive, sedation is used for this part of the procedure.
How long will the operation take?
This depends on the extent of the area being treated but can be anything from 2 ½ to 5 hours and rarely up to 7 hours if very large areas are treated at one sitting.
Is the operation very painful?
The anaesthesia has been discussed above. In order to delay the onset of postoperative pain, long lasting anaesthetic known as Macaine is used at the end of the operation to ensure a pain free period of four to six hours after the op.
To ensure minimal postoperative pain, the patients start to use a combination anti-inflammatory and analgesic preparation as soon after surgery as possible.
The vast majority of patients experience very little discomfort at the recipient site, having most discomfort or pain at the site of the donor strip. This seldom lasts longer than two days.
How long will I remain in hospital?
This operation is performed under local anaesthesia in an outpatient clinic and you will be able to go home straight away. It is advisable but not essential that someone else drive you home after the procedure.
Will I be very bruised or swollen after the operation?
Bruising is unheard of after this procedure.
A certain number of patients experience swelling of the forehead and around the eyes when the operation has been done primarily just behind the hairline. This is uncomfortable and unsightly for a few days but soon settles.
How soon can I return to exercise?
It is recommended that patients avoid strenuous exercise for 7 - 10 days after this operation. The grafts are very small and might be easily dislodged by bleeding which could be induced by a rise in blood pressure caused by strenuous exercise before the grafts are firmly fixed in place by about the seventh day.
Are there any complications associated with this operation?
This is a very straightforward and uncomplicated operation. Probably the most significant potential complication is the swelling, which has been dealt with above.
Bleeding of any significance is extremely rare after this operation.
Infection is even rarer as the blood supply to the scalp is very rich. For this reason prophylactic antibiotics are only ever used in diabetics who have a greater than normal propensity to develop infections.
I have never had occasion to prescribe an antibiotic to one of my patients after this operation.
How long will the result of this operation last?
Male pattern baldness is the result of a cessation of hair production in the central area of the scalp. This process is genetically determined and is brought about, in men with the propensity for losing their hair, after puberty by exposure of the affected hair follicles to testosterone.
The follicles at the side of the head are not susceptible to this effect and, therefore, once transplanted to the bald area, they start to grow immediately and continue to do so for about 10-14 days. In most patients, all of this new growth then falls out and after a lag phase lasting approximately 8-10 weeks when there is no growth, the hair once again starts to grow and will then continue to do so indefinitely.
Please Note: In order to achieve maximum density, it is almost always necessary to have at least two procedures in any one area at least six months apart.