Pre-operative preparation:-

At an initial consultation, the surgeon analyzes the patient's scalp, discusses his preferences and expectations, and advises him/her on the best approach (e.g.,single vs. multiple sessions) and what results might reasonably be expected.

For several days prior to surgery the patient refrains from using any medicines, or alcohol, which might result in intraoperative bleeding and resultant poor "take" of the grafts. Pre-operative antibiotics are commonly prescribed to prevent wound or graft infections.

Surgery:-

Transplant operations are performed on an outpatient basis, with mild sedation and injected topical anesthesia, and typically last about four hours. The scalp is shampooed and then treated with an antibacterial chemical prior to the donor scalp being harvested.

The surgeon harvests a strip of skin from the posterior scalp, in an area of good hair growth, about 2x10 cm in size. While he is closing the resulting wound, his assistants begin to dissect individual follicular unit grafts from the strip. Working with binocular microscopes, they take great care to remove excess fibrous and fatty tissue without damaging the vital follicular cells that will produce the patients' first crop of new hair.

The surgeon then uses a fine needle to puncture the sites for receiving the grafts, placing them in a predetermined density and pattern, and angling the wounds in a consistent fashion to promote a realistic hair pattern. The assistants generally do the final part of the procedure, inserting the individual grafts in place.

Post-operative care:-

Advances in wound care allow for semi-permeable dressings, which allow seepage of blood and tissue fluid, to be applied and changed at least daily. The vulnerable recipient area must be shielded from the sun, and is not shampooed for about a week.

During the first ten days, virtually all of the transplanted hairs, inevitably traumatized by their relocation, will fall out. After two to three months new hair will begin to erupt from the moved follicles. The patient's hair will grow normally, and continue to thicken through the next six to nine months. Any subsequent hair loss is likely to be only from untreated areas. Some patients elect to use medications to retard such loss, while others plan a subsequent transplant procedure to deal with this eventuality.

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