Author Bio: Dr. Sanusi Umar MD is the author of this article.
Surgical hair restoration is a major undertaking that will last over a year. It involves personal research, choosing the right doctor, getting your body ready weeks before the surgery, the actual operation, downtime, and waiting up to 18 months for the final results. Knowing what to expect from the hair transplant process ahead of time will help you prepare mentally and emotionally for your experience.
A hair transplant will require a significant investment in terms of time, energy and finances to achieve a more youthful coverage and a greatly improved appearance. Quality results will make a huge difference in how you see yourself. Yet your desired outcome will come into fruition over an extended period of time.
At the onset, having a clear big picture overview will help you plan and adjust more smoothly to the different stages involved in the procedure of transplanting hair.
Choosing the Best Procedure for Hair Transplant Surgery in Los Angeles
The first step to take in the hair transplant process is to spend time doing your own research. This will help you choose the right type of hair transplant surgery that best meets your needs. Different doctors will specialize in different treatment types, such as Follicular Unit Extraction (FUE) or follicular unit strip surgery (FUSS). Knowing which surgery to choose will largely depend on what goals you’d like to achieve.
To clarify your objectives, think about what factors that are most important to you. Some examples might include: achieving ample coverage, greater density or a flattering and natural looking hairline. Also, the type of surgery you choose would affect your options for hairstyles.
How to Transplant Hair – The Basics
A hair restoration surgery involves removing hair follicle grafts from one region of the scalp or body, (known as the donor area) and transplanting them to a new area called the recipient region. Donor grafts must be derived from the same individual, not a different person.
The Best Hair Transplant Treatment – FUE Versus Strip Surgery
Follicular Unit Extraction or FUE, uses tiny punches to remove individual follicular unit grafts. Therefore, this method does not leave a linear scar. In the end, you are then free to choose short, conservative styles.
Follicular Unit Strip Surgery also called FUSS is performed with a scalpel to excise a narrow section of scalp tissue from the back of the head. This strip is then dissected to extract hair transplant grafts. Naturally, this will leave a linear scar. Many patients choose to keep this concealed by wearing longer hair lengths. Those who later decide that they want to sport shorter styles can opt for FUE procedures to insert hair into the scar tissue.
Advanced Follicular Unit Extraction
As you gather information to make the best decisions for your hair transplant process, you may need to research more specialized forms of surgery. This would apply in the following cases:
- Severe hair loss restoration
- Repair of poor cosmetic results from prior hair surgeries
- If you are of African American
- If you are of Asian descent.
Specific issues associated with these various challenges need to be addressed with advanced FUE extraction tools and surgical skills. For example, severe baldness and repair cases are both instances where there are fewer donor follicles on the scalp to work with. However, it is possible for additional grafts to be harvested from body regions such as the beard or torso. In order to qualify for this type of procedure, the right type of hair would need to grow in these regions.
Hair outside the scalp grows at extremely sharp angles. The process needed to transplant body hair requires a different approach. These follicles are more susceptible to damage with basic FUE tools. Advanced FUE instruments like the Dr.UPunch Rotor ™ are designed to perform incisions that are not as deep. Special (non-vacuum) mechanisms gently pull the follicle from its surroundings. Watch this video to learn more.
Dr. Umar has been able to create successful, life-changing hair restoration results for many types of patient cases. If you are interested in considering surgery to reverse the signs of hair loss, schedule a free consultation.
The Hair Transplant Process for Ethnic Patients
The hair transplant surgery for different ethnic groups requires the expertise to overcome specific types of issues such as hair follicle shape and hair caliber.
Patients with Afro-textured hair have unique, curved shape hair follicles. These structures are more likely to be severed by conventional, cylindrical shaped FUE rotary punches. Therefore, advanced tools like Dr.UPunch Curl, developed by Dr. Umar at his Los Angeles clinic, with its double-pronged design offers a much safer way to remove these hair follicle shapes.
Asian patients have very thick hair. When restoring hairlines, the outer edge requires very thin hairs in order to render the most natural outcome possible. The nape is an excellent source of grafts for this type of hairline detail. The special engineering of the Dr.UPunch Rotor device is ideal allows these follicles to be harvested safely while enabling better cosmetic wound healing results in the nape, allowing the skin to appear virtually untouched.
While hair transplant technique is a major consideration, it’s also essential to choose a highly experienced surgeon. The best form of evidence for their skills is real-life examples (e.g. before and after photos and/or videos) of the outcomes they have achieved on past patients.
What To Expect Before Your Procedure For Hair Transplant Surgery
Before your hair transplant procedure, your doctor will want to conduct blood test screenings for pre-existing or emerging conditions that may cause complications with your procedure. Two common examples include hepatitis B and human immunodeficiency antibodies.
In the weeks and days leading up to your surgery, you will also need to follow special instructions from your doctor so that your body can be in the best possible condition to undergo your operation. Here is what you need to know about preparing for these preliminary stages of the hair transplant process shortly before the day of your operation.
About two weeks before your hair transplant surgery, you will need to avoid taking the following types of drugs:
- Anti-inflammatory medications like Ibuprofen, aspirin, or Nurofen which will facilitate bleeding
- Blood-thinning medications like MAO inhibitors and tricyclic antidepressants
- Supplements that have the effect of increased bleeding, including herbal products like Gingko, vitamin E and vitamin B
One week prior to surgery, you will be asked to stop using Rogaine/Minoxidil as well as consuming alcoholic beverages as both would make you bleed more during surgery
Twenty four hours before your operation, abstain from smoking. This is intended to prevent adverse effects on your body’s ability to heal itself.
The Hair Transplant Process – What to Expect on the Day of Your Surgery
Before arriving at the clinic, you will need to get ready in the morning with the following recommendations in mind.
On the morning of your hair transplant surgery, wash your hair and scalp and avoid the use of any styling products.
Surgery is stressful on your physiology. So be sure to eat a substantial but moderate breakfast. Your doctor will tell you to avoid consuming coffee or any form of caffeine.
Also, when you get dressed, choose a loose fitting buttoned shirt that you can easily put and remove after your surgery without affecting the delicate scalp area.
Arriving at the Clinic
When you arrive, members of the clinic’s team will take before photos of your scalp to document your hair loss condition prior to the actual surgery.
Following this, the staff will shave your head to prepare the surfaces of the donor and recipient regions for graft extractions and insertions of the follicles into the recipient areas.
Local anesthesia is administered into your scalp through injections. Dr. U uses vibration to reduce the discomfort of local anesthetic injections. Dr. U would normally prescribe oral medications and intra-muscular mild sedatives to enhance your level of comfort. Patients won’t feel any pain. But they are able to remain awake and even watch movies during the procedure.
How to Transplant Hair with FUE
Harvesting and inserting grafts are the main two parts of the FUE hair transplant process during surgery.
During the first phase of your FUE surgery, the doctor extracts the necessary number of grafts from the donor areas of the scalp, beard or body. These are stored for several hours in a moist, cool environment.
In the second phase of your FUE Hair Surgery, your surgeon will make precise incisions and insert the grafts into the recipient areas of the scalp.
After A Procedure for Hair Transplant Surgery – Time Frames and Results
After your procedure, your doctor will prescribe medications for swelling, infections and pain. Follow the dosage and instructions closely.
The hair transplant process after your operation generally follows certain time frames for recovery and growth results
Scabbing After FUE Hair Transplant Surgery
Hair Transplant Process – Recipient Area Healing
Scabbing refers to the crusty surface of a healing wound. In the context of a hair transplant recipient area, the scabbing is a crust consisting of dried blood, skin tissue and caked protein secretions at the point of hair graft insertion. Scabs in the hair transplant recipient area can be expected to last between 7 and 10 days typically. The most important factor that influences how long the scabs last is the amount of moisture in the area. Dr. U encourages the use of fluid sprays and application of prescribed ointments to hasten the process along. During this time, it is important to treat the scalp area very gently. Your doctor may advise you to cleanse the area with water and a mild soap or shampoo. Avoid applying the water at high pressure, as with a regular shower head. Instead, use a pitcher to pour water over your head.
FUE Hair Transplant Downtime and Returning to Work
Recovery for hair restoration surgery is intended for cosmetic reasons, as these procedures do not result in functional impairments. Downtime allows the donor and recipient skin areas to undergo healing for issues such as:
- facial swelling
Also, a recovery period is an opportunity for hair transplant patients to overcome anxious emotions from having a shaved head. This is particularly prevalent in individuals with a previous strip scar which is quite visible through a short haircut.
Due to the visible wounds and scabs on the head, you may want to wear a loose beanie or hat when going out in public. After a Dr.UGraft FUE procedure, hats can be worn within 24 hours following the operation. With FUE hair transplant surgery, the scalp is able to heal sufficiently in 10-14 days. Because it is a much less invasive procedure, the overall downtime is much shorter compared to FUSS (Follicular Unit Strip Surgery).
Dr.U advises against the use of concealers after a procedure for hair transplant surgery. And he has special advice for using hair pieces, although it is best to avoid their use after an operation altogether.
The length of a hair transplant downtime period is often about 2 weeks. Afterward, most hair transplant patients are able to go back to work and resume their normal day to day schedules without feeling self-conscious from noticeable signs of surgery.
However, the actual time frame for recovery can be influenced by career demands and social circumstances. For example, an entertainment professional who regularly appears on camera and cannot wear a hat would need more time off from work compared to a hair transplant patients who work from home.
When To Expect New Hair Growth During Your Hair Transplant Process
New hair growth after a hair transplant will typically begin between the first to four months following your operation. This is one of the most exciting milestones during the hair transplant process. However, up to this point, you may notice a considerable amount of shedding of tiny hairs. The reason for this is that your hair follicles are actually preparing for new growth. So don’t feel alarmed when you start to notice the shed hairs. This is very normal and natural.
Final Hair Transplant Results
The outcome of a successful hair transplant process takes between 12 to 18 months to develop. At this point, the expected coverage and growth becomes apparent due to the survival of the donor grafts in the recipient area.
If you are interested in knowing what type of hair transplant result to expect from your procedure, schedule a complimentary consultation to speak to Dr. U.
Before and After the Hair Transplant Process
Side by side before and after images can help you see how their surgery impacted their appearance. This patient no longer has the sparse thinning on top of his head that resulted from poor growth from previous hair restoration attempts And he was able to achieve his objectives for his temples and hairline.
Video Showing Repair Patient Before and After His 6500 Graft BHT Hair Transplant Process
Video footage of patient cases should ideally show multiple views of their scalp before and after their procedure. But they also offer an opportunity for them to share actual feedback, commentary, and testimonials about their results and experience.
The patient in the photos above has this to say about his procedure for hair transplant surgery:
This was definitely a leap of faith. It was going to be my fifth procedure. After doing due diligence for about 3 or 4 years, it was really my last hope and it was honestly the best decision I’ve ever made in my life. The results speak for themselves.
Watch his video to learn more about his hair transplant experience.
Hair Transplant Complications
As with any type of surgery, certain complications can arise. After a hair restoration procedure, patients may experience:
Itching After Hair Transplant
Itchiness of the scalp is a common occurrence and is typically a sign of healing wound. However, significant itch accompanied by redness may be a sign of an allergy to a medication or the onset of significant dandruff. Normal itch is often managed by shampooing the area with a product approved by your doctor. Significant itch associated with redness would need to be reported to your doctor for management.
Bleeding After Hair Transplant
Very mild bleeding is normal during the first couple of days after surgery evidenced by mild blood stains on pillows and hats.
Excessive bleeding may occur as a result of:
- strenuous physical activity or exercise
- use of blood thinning medications
- picking a the scabs
- Significant bleeding can occur if a graft is removed before it settles into the recipient area. This would be within the first 48hours of surgery. After 72 hours grafts are typically settled in the recipient area
See your doctor as soon as possible if you are noticing a heavy amount of bleeding.
Folliculitis After a Procedure for Hair Transplant Surgery
This refers to the appearance of pimples in either the donor or recipient areas. There are two general types:
- Sterile folliculitis: infections that arise without the presence of bacteria. This is typically a result of an ingrown hair. In the donor area after FUE, it results when grafts damaged during extraction begin to regrow. So this can be observed within a few days to weeks of FUE surgery. In the recipient area, it typically begins at about 3.5 months and onward signifying the first bout of new hair growth sprouts. As some hair attempt to break skin, some would form ingrown hairs. In both instances, the pimples can be lanced in a sterile manner. Excessive folliculitis should be reported to the physician for treatment that could include the use of oral medications
- Bacterial folliculitis: infections caused by microbes. This would be purulent and would require treatment with antibiotics by your doctor.
Cysts After A Hair Transplant
Cysts may form in the recipient area, as a result, untreated folliculitis. of inserting too many grafts. However, the surgeon can recommend simple treatments to help them resolve in a short time.
Shock Loss After A Hair Transplant
Hair transplant shock loss is when the hair in the area of transplantation fall off without direct action of the surgeon. It is likely caused by the action of cytokines that a released from adjacent areas. In hair transplant surgery, shock loss can occur in two forms:
Recipient area hair transplant shock loss: This occurs when hair follicles become traumatized by the process of cutting slits into the balding area into which the grafts would be placed. Thinning of pre-existing hair may occur after inserting new follicles in the recipient area. Also, hair loss may occur with newly transplanted grafts that are trying to adjust to their new surroundings.
Donor area hair transplant shock loss: This kind of shock loss occurs in the donor areas of FUE surgery. The reason is the same as in recipient area shock loss in that the punch causes trauma to adjacent hairs during the scoring process. This leads to a release of a cascade of cytokines which can cause diffused loss of the donor areas. It can also occur in follicular unit strip surgery in the areas adjacent to the strip wound. The reason is similar to that described for FUE surgery donor area shock loss.
In both types of shock loss, the hair loss is typically temporary, resolving within 3 to 6 months of onset. In rare occasions, it can be permanent. Permanent shock loss is especially possible if the lost hair was already affected by miniaturization of androgenic alopecia. Resolution of hair transplant shock loss can be hastened by the use of minoxidil.
Bumps on the Head After Hair Transplant
Also, as new hair starts to grow, you may actually notice the formation of what appears to be bumps or pimples on the scalp. When the new hairs start to emerge upward from the hair follicles, they will encounter resistance from your skin. This contact can result in irritation and inflammation of the tissue, creating swelling in the form of pimple-like bumps. However, if this condition becomes prolific, it’s best to seek the help of your doctor.
The average patient continues to see increased signs of hair growth for up to 12-18 months following their surgery. Follow up visits during this time will allow you and your doctor to monitor the overall progress of the hair transplant results.
Frequently Asked Questions – The Hair Transplant Process
When can I return to work after my hair transplant process?
being minimally invasive, FUE hair transplant surgery patients are typically able to go back to work and resume their normal day to day schedules without feeling self-conscious from noticeable signs of surgery within 1 week. Follicular unit strip surgery would carry more restrictions being more invasive. it would have more pain and downtime with restrictions on head movement being imposed to prevent sutured wounds from opening up soon after surgery and to avoid scars from stretching in the first 6 months after surgery. FUE surgery does not have these issues and restrictions.
Will sun exposure create hair transplant complications?
Normal exposure to the sun will not necessarily harm your grafts or their ability to produce new hair. UV light may result in skin coloration. Nonetheless, it is still advised to protect your scalp with sunscreen and by wearing a hat for a month after your procedure. void getting sunburnt in the grafted areas, as the trauma and inflammation can deleteriously affect your yield /growth.
Can I go swimming during my hair transplant downtime?
Chlorine is a very harsh chemical and has the potential to damage new grafts. Also, ocean water is not very clean and may also cause infections in your scalp. It is best to wait until your scabs have fallen off and your skin has fully healed. Many doctors recommend that you wait about a month before deciding to go swimming.
What if I don’t see new growth 3 to 4 months after my procedure for hair transplant surgery.
The hair transplant process involves the surgery itself and the period of waiting for new growth to appear. Experiencing delays can be worrisome. But keep in mind that time frames for hair growth can vary across individuals. Generally, if poor or no growth prevails at the twelve-month point, this is a valid time to investigate the issue of graft survival. Regardless, feel free to speak to your doctor about any of your concerns in the meantime.
Can I continue to use Rogaine and Propecia during my hair transplant process?
Rogaine (Minoxidil) and Propecia ( Finasteride )are not necessary for treating your newly transplanted grafts. These follicles come from DHT resistant areas of the scalp. Grafts from body regions will also be DHT resistant. However, Rogaine and Propecia can help maintain your pre-existing hair. Soon after a hair transplant, Minoxidil can potentially reduce the chance of shock loss.
How can I tell if a doctor knows how to transplant hair from the body to the head?
When you are searching for a surgeon, look for before and after still images of real patient cases where body hair was used. Additionally, see if you can find BHT patient videos, like those produced by Dr. U which feature side by side photographs, in addition to the patient’s commentary.
Have more questions about the hair transplant process? Ask Dr. U using the button below: