Is hair restoration surgery painful?
Our priority is to make sure you have a safe and positive experience, and this includes keeping you comfortable. The surgery is performed under local anesthesia, not general anesthesia, which means you will be awake and aware of the procedure but feeling no pain. Our surgeons and techs will check in with you regularly and administer more medication as needed. At the end of the procedure, the overwhelming feedback we get from patients is that they’re amazed just how painless the experience is. After surgery, there might be some discomfort for a few days in the donor area, which can be managed with the prescribed pain medication or over-the-counter alternatives.
Do I qualify for hair restoration surgery?
The most efficient way to find out if you qualify for hair restoration surgery is to schedule an in-person consultation. The one-hour consultation involves discussing your hair loss history, examining your scalp at a microscopic level, taking 360-degree baseline photographs, and discussing potential treatment options, including your surgical choices and the cost associated with each method.
During your consultation, your doctor will rule out any reasons why you can’t have hair restoration surgery. These are called contraindications. Some (but not all) of those reasons include:
- Diffuse Unpatterned Alopecia (DUPA): If you have diagnosed DUPA, unfortunately you are not a suitable candidate for hair restoration surgery. In DUPA, hair loss occurs across the entire scalp, including the sides and back, which are usually the “permanent zone.” Without a source of terminal hairs (hair that are not susceptible to miniaturization over time) to harvest from, a transplantation can’t happen.
- Scarring Alopecia: Cicatricial alopecia, more commonly called scarring alopecia, is a specific form of hair loss characterized by an autoimmune response within the body, where the immune system mistakenly attacks the hair follicles. This immune attack results in the formation of scar tissue, which replaces the hair follicles. Unlike other types of hair loss, where the follicles may be dormant or miniaturized but still present, scarring alopecia leads to irreversible damage to the follicles and hair loss. If healthy hair follicles were transplanted into this affected skin, they would also be subjected to the same autoimmune attack that affects the naturally occurring hairs in the area and couldn’t produce hair. For this reason, patients diagnosed with scarring alopecia are not candidates for hair restoration surgery.
- High Blood Pressure: If you have high blood pressure that’s not well-managed with medication, this can increase the risk of bleeding and other complications during and after surgery. You should work with your primary care doctor or cardiologist to control your blood pressure before considering hair restoration surgery. We will check your vitals on the day of surgery, and if your blood pressure is too high, your surgeon will be forced to cancel your procedure.
- Clotting Disorders: People with clotting disorders are at a higher risk of excessive bleeding during any surgery, including hair restoration. If you have a clotting disorder, it’s vital to discuss this with your surgeon to understand the risks to determine if hair restoration surgery is right for you.
- Uncontrolled Diabetes: Diabetes, particularly when it’s not well-controlled, can impede the healing process after surgery and increase the risk of infection. You should strive to achieve good control of your blood glucose levels before undergoing any surgical procedure.
Beyond the medical contraindications, there are also other factors that act as safety guardrails for our patients and surgeons.
- Age: For frontal hairline restorations, our surgeons require patients to be at least 25 years old. For surgery on the top and toward the back of the head (also known as the crown or vertex), patients must be at least 30 years old. There’s a limit to the amount of hair that can be transplanted over the course of your lifetime, so if you are a patient who may need multiple procedures over time, it’s important to reserve resources making it harder for our surgeons to create a natural-looking result that will stand the test of time.. While it is legal to perform a hair restoration on younger patients, any doctor who agrees to start hair restoration too young is doing a disservice to their patients’ long-term wellbeing.
- Insufficient Donor Hair: Hair restoration surgery depends on transplanting healthy hair follicles from one part of your scalp (the donor area) to the thinning area(s). While hair restoration technically “works” from a medical perspective in these cases, the aesthetic results might not be worth the cost. Our surgeons will be thoughtful but pragmatic with you during your consultation about what’s technically possible versus what’s an aesthetically workable result.
- Expectations: It’s important to have realistic expectations about any cosmetic procedure, including a hair restoration surgery. Hair restoration can improve your appearance and self-confidence, but it’s unlikely to restore the same hair density or hairline you had as a teenager. Our surgeons are more than happy to answer your questions and address any concerns you have during your consultation.
Does the donor hair for a hair restoration surgery have to come from my own head?
Yes, the donor hair for a hair restoration surgery does indeed need to come from your own head.
You cannot have hair from someone else’s head implanted onto your own thanks to your body’s immune system. If your body detects anything foreign, such as bacteria, viruses, or in this case, hair follicles from another person, it initiates an immune response, designed to attack and eliminate the foreign substance. Hair transplants involve transplanting hair follicles, which are living tissues, from one area of your scalp to another. If these follicles came from another person, your immune system would recognize them as foreign and launch an attack. (In fact, even in the case of identical twins, who share the same genetic material, it wouldn’t work, because, while twins are genetically identical, their immune systems are distinct and can still recognize and reject transplanted tissue from the other twin.) To prevent this, doctors could theoretically use immunosuppressive drugs (similar to what’s used during organ transplants), but in actual practice the use of these drugs carries significant health risks and side effects that are not worth it for any non-life-saving procedure.
Can you implant my body hair into my scalp?
Body hair can, technically, be implanted into the scalp but at the expense of making a tiny scar where each donor follicle is extracted. Also, because body hair doesn’t have the same texture or growth cycle as scalp hair, it doesn’t look natural. We do not transplant body hair onto the scalp at the Anderson Center for Hair.
Can you clone my hair follicles?
In October 2022, scientists in Japan published an article demonstrating how they cloned the first fully-grown hair follicle in medical history – a mouse hair that’s 3mm long. This is a truly remarkable feat, and one worth celebrating! The potential is incredible for this lab-grown hair model to help us better understand how hair grows, test drugs that could promote or inhibit hair growth, and study gray hair in a controlled setting. While we’re closer than ever, don’t expect commercially available cloned hair for cosmetic implantation to be available any time soon.
What are the different types of hair restoration surgeries?
The most common types of hair restoration surgeries are follicular unit transplantation (FUT), also known as “linear” or “strip” surgery, and follicular unit extraction, also call FUE surgery.
How long does hair restoration surgery take?
The length of your procedure depends primarily on the method of surgery, your surgeon, and the number of grafts being transplanted. Smaller FUT cases may take as little as four hours, while very large FUE cases could take eight hours. We can make a closer estimate once we know the details of your case.
While you won’t be under general anesthesia during your procedure, we will administer medicine to help you stay calm and remain still that will prevent you from driving yourself home. We’ll take down a phone number at the beginning of the day and call your ride approximately one hour before you’re ready.
What is the recovery period like after hair restoration surgery?
Following the procedure, minor discomfort is expected but easily managed with the prescribed pain medication or over the counter pain relivers. You’ll also be prescribed an antibiotic and a steroid for several days to prevent infection and minimize inflammation. Most patients report returning to many of their normal (non-exercise) activities two to five days post-surgery. Swelling and discoloration are also common and might extend to the forehead or around the eyes; this usually starts on day two and peaks on days three to five.
You’ll be given specific instructions on how to care for your scalp following surgery, including how to wash your hair. It’s important to follow these instructions closely to ensure the best outcome for your hair restoration.
For example images of the initial recovery process, click here.
When will I start to see the results from hair restoration surgery?
About two to three weeks after surgery, the transplanted hair will begin to fall out. This is a normal part of the process, so don’t be alarmed. The newly implanted follicle sheds its hair and begins to form a new one. New growth should start to be visible within a few months. Most people will see 60% of new hair growth after six to nine months with full results as early as 12 months after surgery and as late as 18 months.
Keep in mind that hair grows slowly – only about one-half inch per month – and each hair follicle starts regrowing hair on its own timetable, so seeing an appreciable difference as the hair trickles in can sometimes be feel disheartening. We take serial 360-degree photographs so that we have an objective view of changes over time. You can call the office at any time during your recovery process and the new growth phase to request a photos appointment and we’ll add the progress to your medical record. Also, while it’s not medically necessary to follow up after surgery, we love seeing our patients’ results and strongly suggest a 12-month post-op appointment.
How long do the results last?
The hairs implanted during a hair restoration surgery are permanent. These hairs will grow thick and strong forever in properly selected candidates thanks to the concept of donor dominance. However, the overall look achieved from your surgery may change over time due to continued miniaturization of the other hairs in the same area.
Imagine a forest where 100 trees are standing tall, but due to some kind of environmental issue, some of the trees are gradually withering away. To restore the forest’s density, you decide to plant 50 new, resilient trees that are immune to the specific issues causing the original trees to wither away.
However, if you don’t address the root environmental issues causing the original trees to wither, you’ll keep losing more of those original trees. This means that despite your efforts of adding 50 new trees, your forest might end up only having 100 trees in total – the same as your starting count – but now you’ve spent the money, time, and energy to plant all those trees only to have the same forest density.
Similarly, when you have a hair restoration surgery, you’re planting resilient new hairs in areas of thinning. These are the hairs from the donor area that are resistant to the factors causing your hair loss. But if you don’t address the root cause of your hair loss, the naturally growing hairs in the recipient area will continue to miniaturize and eventually fall out.
So, even if you’ve added 50 new hairs to an area of your scalp that originally had 100 hairs, if you lose 50 of the original hairs after the surgery, you’re back to the original number of hairs in that area, despite the surgery.
This is why it’s so important to treat the root cause of your hair loss. Even with the permanent hair implanted during surgery, preserving the hair you do still have is crucial. Using hair loss prevention tools and therapies such as finasteride, minoxidil, and low-level laser therapy (LLLT) can help you maintain the density and fullness achieved through hair restoration surgery. This way, you’re not only adding to the forest of hairs on your head but also doing your best to keep the original trees standing strong.
What are the risks and complications of hair restoration surgery?
As with any surgical procedure, hair restoration surgery comes with potential risks. However, these risks are minimized when an experienced surgeon performs your procedure at a properly staffed and resourced facility. Some, but not all, of the risks include:
- Infection: Although rare, there is a small risk of developing an infection after hair restoration surgery. Our team takes precautions to minimize this risk by maintaining clean conditions during surgery. Until your wounds are completely healed, it’s important that you (or anyone helping you) wash your hands before touching your hair or scalp. Scalp infections are not subtle. If you experience significant pain, burning, swelling, or oozing during the healing process, call the office to speak with your doctor.
- Bleeding: Some degree of bleeding is common during and immediately after the surgery. Your surgeon will take measures to control bleeding during the procedure, and you will be closely monitored afterward to ensure any bleeding is under control before you leave the office.
What are the side effects from a hair restoration procedure?
Side effects of hair restoration are minimal and well tolerated by the vast majority of our patients. Some, but not all, of the side effects include:
- Pain and discomfort: It’s normal to experience some degree of pain, soreness, or discomfort after the surgery. Your surgeon will provide you with instructions on how to manage this with the prescribed pain medications or over-the-counter pain relievers, plus an inflatable neck pillow.
- Swelling: Swelling of the scalp, forehead, or around the eyes is common following hair restoration surgery. This is a temporary side effect that usually starts on day 2 and peaks between days 3-5. Check out this recovery photo series for a day-by-day walkthrough of what you might expect.
- Numbness or tingling: It’s common to experience temporary numbness or tingling in the scalp after the surgery. This is usually due to the disruption of nerve endings during the procedure and should subside over time.
- Scarring: Hair restoration surgery involves making small incisions in the donor and recipient areas of the scalp. While efforts are made to minimize scarring, it’s important to note that some scarring is inevitable. If you have long hair, you’ll never see the scar under your hair. However, if you like to wear your hair military-grade short, meaning it’s short enough that you can see your scalp between the hairs in the donor area, a scar would be visible. If this sounds like you, a hair restoration procedure using the follicular unit extraction (FUE) method might be a good fit for you. This method leaves tiny, circular scars that are less noticeable compared to a linear scar from the FUT method.
How much does hair restoration surgery cost?
Every cosmetic surgery is a unique case and hair restoration is no exception. We tailor your surgery to your needs, which means there’s no cookie-cutter price chart. Cost depends on many factors including, but not limited to the method of surgery used, your surgeon, and the amount of hair that needs to be moved. To get an estimate of the cost of a hair restoration, schedule a consultation with one of our surgeons.
Why don’t you charge by the graft?
In the realm of hair restoration, it is essential to understand that the practice of charging patients by the graft is not a concept devised by physicians but rather a creation of the business sector. Think about how this would play out if you used the same method to decide on a rhinoplasty, also referred to as a “nose job.”
The general public is aware that nasal surgery is a complex undertaking with permanent results. Your nose is an integral part of what makes you look like you. When selecting a rhinoplasty surgeon, patients often take into account factors such as the surgeon’s training, experience, and frequency of performing the procedure. After choosing a surgeon and engaging in a consultation to discuss their desires, the surgeon assesses the complexity of the proposed nasal surgery. Following this evaluation, the patient usually receives a comprehensive breakdown of the “surgery fees” and “anesthesia/facility fees.” A plastic surgeon specializing in rhinoplasty does not charge based on the length of the nose, but rather on the complexity of the surgical procedure. You won’t come across billboards advertising “Season Special: $1,000 per nostril rhinoplasty, minimum 2 nostrils, at Nose Jobs R Us.” It is simply not realistic to expect satisfactory results from nasal surgery by responding to a billboard advertisement.
Hair restoration is just like other permanent facial plastic surgical procedures, such as rhinoplasty or facelifts. Like rhinoplasty, hair restoration is a challenging procedure that requires expertise, and its results are permanent. There are plenty of surgeons that can deliver a medically successful outcome that is an aesthetics failure. Your nose could heal just fine from a rhinoplasty but be much too small for your face, or too rounded, or maybe too pointy, simply because the doctor doesn’t have the artistic eye to get it just right. The same thing is true for hair restoration. Restoring a natural pattern that doesn’t look like you’ve had your hair “done” depends directly on the surgeon’s skill, training, and experience. It also depends on the expertise and talent of the technicians working with your hair follicles. At the Anderson Center for Hair, we also employ an experienced team of full-time surgical technicians.
Hair restoration is not a simple, one-size-fits-all solution that produces identical results regardless of where it is performed, as long as the number of grafts is still the same. Just like every automobile in the world is not identical just because they have four tires. In hair restoration, there are numerous subtle factors and individual nuances that vary from person to person. This procedure brings immense happiness to our patients by restoring their confidence, youthfulness, and overall well-being. It cannot be reduced to a pricing model based solely on the number of grafts.