Different Types of Hair Transplant Methods: Procedure & Risks

Having thick, healthy, and soft hair is a dream to many as it can boost their confidence and improve their overall look. However, some people lose part of their hair due to various reasons such as cancer, trauma, heredity, hormonal change, a very stressful life, etc.

Fortunately, having dense and bushy hair is no longer a dream; anyone can restore their hair by getting hair transplant surgery. In this essay, we introduce different methods of hair transplantation and discuss the procedure, risks, and long-term outlook of this surgery.

What Is Hair Transplant?

There are various methods to stop hair loss or treat baldness, such as taking medication, using minoxidil lotions, avoiding hairstyle products, and having a healthy lifestyle. However, these methods won't work on everyone; some have to get surgical treatment for their hair loss.

Hair transplant, also known as hair restoration surgery and hair transplantation, is a minimally invasive procedure through which a plastic surgeon or a dermatologist moves hair from a part of the scalp to a bald or thin area. This surgery is usually done under local anesthesia, in the doctor's office, or in a dermatology clinic.

Good Candidates for Hair Transplant 

Getting hair transplant surgery can improve everyone's appearance and self-esteem, but you should have the following features to be an ideal candidate for a hair transplant:

• Be physically and mentally healthy;
• Have realistic expectations about the results of the surgery;
• Be a non-smoker;
• Be between the age of 18 to 65;
• Have enough donor sites; 
• Not have a history of blood clot formation or development of keloid scars;
• Not have certain diseases such as lupus and cancer.

On the other hand, people with widespread hair loss (diffuse un-patterned alopecia), unstable hair loss, and mental disorders such as body dysmorphia and trichotillomania are considered poor candidates for hair transplantation.

How to Prepare for Hair Transplant?

Before getting a hair transplantation, consider the following points:

• Prepare a detailed medical history consisting of the medications you take daily or have recently taken, your food and drug allergies, and the history of your previous hair loss treatments.
• Massage your scalp 14 days before the surgery. You should rub your head in oval movements for 10 to 15 minutes a day to increase the blood flow in the scalp, trigger the follicles to grow, and increase the elasticity of the scalp's skin. 
• Avoid sun exposure and pollution. You should wear a hat or umbrella for a month before getting a hair transplant to protect your scalp from sunburn and dust.
• Avoid smoking and drinking alcohol. Avoid smoking for three days and alcohol for seven days before the surgery, as they can prolong the healing process and cause infection.
• Take your prescribed medications. Your doctor probably asks you to take specific medications to stimulate the follicles and antibiotics to prevent the infection.
• Avoid taking supplements and multivitamins. Some supplements may interfere with your hair treatment medications, so it is advised not to take OTC supplements and multivitamins for at least two weeks before the operation. 
• Avoid NSAIDs and herbal teas. Blood thinner medications such as Tylenol, aspirin, and herbal teas may thin your blood and cause severe bleeding during the operation. Therefore, you should avoid them 14 days before the procedure.
• Take the necessary medical tests. If you are above 45 or have a history of life-threatening diseases, your doctor probably asks you to take an electrocardiogram (ECG) test to check your heart's rhythm or a blood test to check for your blood pressure and sugar. 
• Don't get a haircut from a month before the surgery, so there will be enough donor area for the operation. Also, long hair can cover your scars and stitches after the surgery.

Hair Transplant Types and Procedures

Today, various methods of hair transplant surgery are practiced, two of which are more popular and common; FUT and FUE. In the following, different types of hair transplant surgery are introduced.

Follicular unit transplantation (FUT)

Follicular unit transplantation, commonly referred to as FUT and strip method, is a highly-practiced hair restoration surgery through which the surgeon removes a long and thin strip of tissue from the back of the scalp and removes follicular units from the tissue by stereo-microscopic dissection. Then, the tissue is divided into small parts using a magnifier and a surgical knife. Each tiny piece of tissue is then implanted into the bald spots to give a natural look to the hair. Notably, the FUT method requires stitching, so the surgeon will stitch the back of your head where the graft has been obtained. 

This surgery is minimally invasive and is done under local anesthesia. Still, it takes 4 to 12 hours, depending on the size of the treating area and the number of grafts that need to be transplanted. The recovery period of FUT also takes up to 14 days, but you can return to work within a few days after the operation.

Follicular unit extraction (FUE)

Follicular unit extraction, or follicular transfer method, is a minimally invasive and suture-less procedure under local anesthesia. In this method, the surgeon first cleans the scalp and numbs its skin with small needles. Then, they retrieve hair follicles from the donor area one by one by making hundreds of tiny incisions. After that, the doctor makes small holes -with a blade or needle- in the receiving area and implants the follicles in the holes. When the surgery is over, your whole scalp is covered with bandages and gauze you can get back home on the same day.

FUE is usually done in several 2 to 4-hour sessions, and its recovery takes two to three weeks. However, you can return to your daily routine almost 4 to 7 days after the surgery.

Tissue expansion

This surgery is usually performed by plastic surgeons -not dermatologists- and is used to treat large-extent skin/hair loss due to injury or burn. In the tissue expansion method, first, a tissue expander is gently inserted beneath the skin of the hairy part of the scalp. Then, the device is gradually filled with saline solution over a few weeks. By doing so, the scalp's skin expands and grows new tissue that can be used in other parts of the scalp where the skin or hair follicles are lost.

Flap surgery

Flap surgery is another hair restoration procedure used to cover large balding areas. During this operation, the surgeon removes a part of the bald scalp and replaces it with a hair-bearing flap. In some cases, the surgeon combines flap surgery with other methods, such as tissue expansion or scalp reduction, to cover the bald area better and restore the lost skin and tissues. Although this technique is highly invasive and outdated, its results are immediately apparent. 

Scalp reduction surgery

If the balding area is located on top or back of the hair, scalp reduction surgery is performed. During this operation, also known as alopecia reduction surgery, the surgeon removes the bald section of the scalp and stretches the hair-bearing part of the scalp to the balding area. Usually, this method is combined with the tissue expansion method.

What to Expect after Hair Restoration Surgery? 

Immediately after hair restoration surgery, your scalp is red, itchy, swollen, tight, and painful. You can take pain medications and be prescribed anti-inflammatory drugs to minimize the soreness and swelling. Most people can return to work two days after the hair transplant surgery but take a week off if they need more time to recover.

Usually, the transplanted hair falls two or three weeks after the surgery, but you can expect about a half-inch of growth per month after the sixth month. Remember that it takes 6 to 12 months for new hair to grow, so you must be patient. Meanwhile, you should take your prescribed hair growth medications to help your hairs regrow. 

Hair Transplant Recovery 

Hair transplant recovery time depends on the extent of the surgery, how well you have been prepared for it, and how well you take care of your head after the operation. After hair transplant surgery, consider the following tips to speed up healing and obtain better results.

• Feeling pain and pressure in the scalp after hair restoration surgery is normal and can be controlled by regular painkillers;
• The bandages and gauze will be removed one or two days after the surgery. Do not change or remove the bandages without your doctor's permission;
• Avoid washing your head for 48 hours after the surgery, and after this period, wash your head with shampoos suggested by your doctor;
• If your operation involved stitches, they would be removed 7 to 10 days following the surgery;
• Avoid strenuous activities and contact sports for four weeks as they can cause bleeding as well as more swelling and bruising;
• Do not bend, lean, or lift heavy objects for seven days;
• It is recommended to avoid sexual activity for ten days because it will increase the blood flow in your scalp and cause the incisions to bleed;
• Keep your scalp away from dirt, dust, sweat, sun exposure, and bacteria;
• Avoid scrubbing the scalp when bathing;
• Take your prescribed medications, such as antibiotics, anti-inflammatory medicines, and hair-growth drugs, as you have been instructed;
• Arrange follow-up visits to check for hair and tissue regrowth. 

Hair Transplant Risks and Side effects

Since hair transplant is a minimally invasive procedure, it has limited risks and side effects that usually go away a couple of weeks after the surgery. In the following some of the complications of hair transplant surgery are mentioned:

• Mild bleeding;
• Swelling of the scalp;
• Infection;
• Scarring;
• Redness of the scalp;
• Bruising around the incisions and under the eyes;
• Formation of crust on the donor and treated site;
• Change in the sensation of the scalp;
• Folliculitis (bacterial or fungal infection of the follicles);
• Temporary loss of transplanted hair;
• Pus drainage from the incisions;
• Allergic reaction to the anesthetics;
• Damage to nerves and blood vessels in the scalp;
• Death of skin graft;
• Itching.

In some rare cases, the patient may also face keloid and atrophic scars, pimples on the scalp, thinning of hair in the donor site, bleeding, and excessive crust and crust cyst formation on the scalp.

Bottom Line

Having numerous knowledgeable and competent surgeons, Iran is one of the top ten countries in hair transplant surgery. You can get hair transplantation in one of the high-standard clinics in Tehran, Shiraz, Mashhad, Isfahan, and Yazd and benefit from their quality, affordable healthcare services. As far as price is concerned, Iran is the cheapest country to get hair transplant surgery. In fact, the average cost of this procedure is 1.500 USD, including doctor’s fees, clinic charges, and medications.

Hair Transplant in Iran

FAQs about Hair Transplant Surgery

1) Is a hair transplant painful?

During the hair transplant surgery, the scalp skin gets numb with local anesthetics so that you won't feel any pain during the operation. However, you probably experience mild to moderate soreness in your head for a week after the surgery.

2) Will I have dense hair after hair transplant surgery?

The density of the transplanted hair depends on the number of follicles implanted, the type of hair (curly or straight), hair quality, and scalp skin's elasticity.  

3) Is the result of a hair transplant permanent?

A hair transplant is a long-lasting operation, and its results will last over 20 years.

4) How much is a hair transplant?

The price of hair transplant surgery depends on the number of grafts, the extent of the balding area, the quality of the hair follicles, the hospital charge, and the surgeon's fee. In general, hair restoration surgeries are considered costly procedures.