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101 questions about hair transplants - ebook
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101 questions about hair transplants - ebook
101 Questions About Hair Transplants is a collection of genuine questions asked by patients during consultations and visits. Their curiosity and candor have allowed to gather and organize the knowledge that I hope will help future patients better understand the process, the possibilities, and the limitations of hair transplants. My goal has been to answer these questions in an accessible and reliable manner, grounded in years of professional experience. Artur Kierach, M.D.
| Kategoria: | Medycyna |
| Język: | Angielski |
| Zabezpieczenie: |
Watermark
|
| ISBN: | 9788397252684 |
| Rozmiar pliku: | 583 KB |
FRAGMENT KSIĄŻKI
A R T U R K I E R A C H, M.D.
101 Questions About Hair Transplants
H air transplantation is a topic that is gaining increasing interest among both men and women worldwide. Over more than a decade of working in this field, I have had the opportunity to observe how technology has evolved, how methods have changed, and how patient expectations have shifted. This book was created out of a need to compile, in one place, the most essential information to help readers understand the hair transplantation process - from its basics, through preparation, to recovery.
Since 2011, as a doctor specializing in hair transplants, I have spoken with thousands of patients, each with diverse stories, concerns, and questions, who have inspired me to create this book.
Over the years, I have encountered numerous questions: some straightforward, addressing the technical aspects of the procedure, and others more complex, tied to individual patient cases. Yet, all of them share a common thread — a desire for understanding and a sense of security when faced with the decision to undergo such a procedure.
In writing "101 Questions About Hair Transplants" I set out to answer the most frequently asked questions posed by my patients and those interested in the topic. My aim is for this book to become a trusted guide, helping readers comprehend the complexities of hair transplants, alleviating their concerns, and enabling them to make informed decisions.
"101 Questions About Hair Transplants" is a collection of genuine questions asked by my patients during consultations and visits. Their curiosity and candor have allowed me to gather and organize the knowledge that I hope will help future patients better understand the process, the possibilities, and the limitations of hair transplants. My goal has been to answer these questions in an accessible and reliable manner, grounded in years of professional experience.
I hope the information contained within will prove valuable for those considering the procedure, preparing for it, or awaiting the final results of a completed transplant.
Artur Kierach, MD
PART ONE
GENERAL QUESTIONS
1. Can grey hair be transplanted?
This question has been asked in my clinic numerous times, initially leaving me quite surprised - particularly since I have personally performed many such procedures, with grey hair growing back just like hair of any other color. Through conversations with patients, I came to understand the origins of such doubts.
To put you, the reader, at ease right away: yes, grey hair can indeed be successfully transplanted. The only difference between grey hair and black, red, or blonde hair lies in its color - or more precisely, the absence of pigment. The hair follicle, hair shaft, and overall structure remain identical, even though pigment is no longer produced.
Curious about the genesis of this question, I began to investigate why patients often ask it. The answer was predictable: misinformation circulating on the internet suggests that grey hair cannot be harvested using the FUE (Follicular Unit Extraction) method because it becomes invisible when trimmed to 1mm. This information is partially true. To harvest follicles using the FUE method, hair is indeed shortened to 1mm (with minor exceptions), and it is true that grey hair is less visible against light skin compared to darker hair. However, there are techniques to either indirectly or directly identify and harvest such hair.
The indirect method involves adjusting the surgical lamp to make grey hair cast shadows, thereby making it detectable. The direct method includes marking grey hairs, for example, by wiping them with the patient's blood that appears during follicle extraction. While the transplantation of grey hair is technically more challenging for this reason, it is entirely feasible and widely practiced.
2. Do transplanted hairs grow differently than other hair?
To begin with, we always transplant the patient ’ s own hair, so there is no need to worry about differences in color or texture. Hair taken from the back and sides of the head may sometimes appear slightly thicker compared to hair along the frontal hairline, which is due to the dynamics of hair loss. In cases of androgenic alopecia, hair does not fall out overnight; the process takes years. Initially, hair becomes thinner (a process known as follicular miniaturization), and instead of three or four hairs growing from one follicle, only one or two remain. Eventually, the hair becomes shorter until it stops growing altogether.
When patients seek a hair transplant, follicular miniaturization is often already underway, meaning the hair is thinner than it once was. To blend the “ old ” hair with the transplanted hair, several strategies are used. Pharmacological treatments can be introduced to halt follicular miniaturization and restore hair thickness. If these measures do not achieve the desired results, hair is transplanted approximately 1 cm into the existing hairline.
Another critical factor is the direction and angle of growth of the transplanted hair. This depends entirely on the skill of the physician performing the procedure. Hair will grow at the angle and direction at which it was implanted. If the angle is too steep, the hair will stick out, making it difficult to style. Correcting such a procedure typically involves removing those follicles and re-implanting them at the proper angle.
So, what is the correct angle for hair growth? There is no universal answer to this question. The best approach is to mimic nature and implant the hair at the same angle it naturally grows for each individual patient.
3. Is a hair transplant procedure painful?
I must admit this is one of the most frequently asked questions during consultations. But here ’ s the good news: a hair transplant procedure is painless. However, there is one caveat.
Local anesthetics, such as lignocaine, are used to numb the area, and they are administered through injections with a needle and syringe. Unfortunately, topical anesthetic creams are insufficient. Since the injections are relatively shallow, fine and short mesotherapy needles can be used, making the injection itself minimally painful. Additionally, vibrating devices can be employed to reduce the sensation of pain. The administration of anesthesia usually takes about 10 to 15 seconds, after which the patient feels no pain. The skin becomes numb, and patients often describe the sensation as feeling like wearing a „helmet”. What about after the procedure, when the anesthesia wears off? The most painful part is the incision phase, but during this time, the skin is numb. The micro-wounds, which are the extraction sites for hair follicles (approximately 0.9 mm in diameter), typically do not cause significant pain. If any discomfort arises, over-the-counter pain relievers such as paracetamol or ibuprofen are usually effective. Based on patient feedback, itching during the healing process is more commonly reported than post-procedural pain.
In summary, a hair transplant procedure is painless, though the administration of anesthesia may be slightly uncomfortable for some patients. The good news is that this discomfort lasts only a few seconds.
4. Are transplanted hairs permanent?
I wish the answer were simpler, but the truth is: not always. The internet often claims that transplanted hair will never fall out. I even came across a clinic that offers a “ guarantee ” for transplanted hair. Unless they can predict the future, such promises are at best misleading, and the "guarantee" is merely a marketing gimmick. Why? Because medicine doesn ’ t deal in absolutes like “ forever ”, “ certainly ”, or “ 100% ”.
Hair follicles taken from the occipital region (the back of the head) are indeed more resistant to dihydrotestosterone (DHT), which is evident in older men. Even if many lose hair on the top of their scalp, the hair around the sides and back of the head typically retains relatively normal density. However, after the age of sixty, even hair in the occipital region can become thinner and start to recede. Additionally, if a man suffers from aggressive androgenic alopecia, the transplanted hair may also thin over time.
So, does it make sense to undergo a transplant if the results aren ’ t always permanent? There ’ s no definitive answer. As with any surgical procedure, one must weigh the benefits and drawbacks. It ’ s impossible to predict whose hair will last for decades and whose may thin sooner. Using medications post-transplant to slow hair loss can help extend the effects. For how long? That depends on the individual - some may respond to treatments for decades, while others may see diminishing results after just a few years.
In summary, a hair transplant generally provides long-lasting results, but outcomes vary from patient to patient. This topic should definitely be discussed during a consultation with a physician, taking into account family history of hair loss and personal expectations to make an informed decision.
It ’ s also essential to understand that a hair transplant doesn ’ t halt further hair loss in untreated areas. After the procedure, you ’ ll need to care for your hair. While medication to prevent hair loss isn ’ t always required, adopting a healthy and balanced diet, using better hairstyling products, or undergoing hair-strengthening treatments are worthwhile considerations. If, after a few years, you notice that your hair is thinning or no longer covers the scalp as it used to, don ’ t delay consulting a doctor. Early intervention can halt follicular miniaturization and, in many cases, restore natural hair thickness.
5. Can women have hair transplants?
Of course, they can, and quite often they do. The largest group of female patients consists of those who have always had a “ high forehead ” and receding hairlines but dream of a more traditionally feminine hairline. While high foreheads and receding hairlines are entirely normal in women, they may cause dissatisfaction, as such features are more commonly associated with male appearance.
Another group includes women who lose hair for various reasons, such as hormonal imbalances, thyroid conditions, chemotherapy, or other medical issues. If the hair loss has been treated and stabilized, there are no contraindications to surgically enhancing hair density.
There is also a group of transgender women who seek a more feminine appearance, making hairline reshaping one of the first and most affordable surgical procedures in their gender affirmation journey. This typically involves filling in receding hairlines and extending the hairline over the temples.
For female patients, the entire head is not shaved. Only a small area from which the follicles are harvested is trimmed. This approach allows women to undergo the procedure without the distress associated with shaving their hair. Although performing the transplant without shaving the head carries a slightly higher risk of infection, the benefits of the procedure outweigh the potential risks. This is particularly true given the wide range of antibiotics available to address such concerns effectively.
6. What is the best age for a hair transplant?
In my opinion, there is no strict age criterion for hair transplants. I recall many patients aged 18 to 20 who began losing their hair very early. By the time they visited my clinic, they already had significant receding hairlines. Should they wait until they are 40 to decide on a hair transplant? I believe we can help them much earlier, and I often do so in my daily practice. However, there are a few conditions.
First, for such young individuals, the cause of hair loss must be thoroughly diagnosed. If reasons other than androgenic alopecia are ruled out, the procedure can be considered. Second, pharmacological treatment must be initiated before the procedure to halt further hair loss. A hair transplant does NOT solve the issue of ongoing hair loss. If we surgically restore hair in the receding areas but the natural hairline continues to move backward, the transplanted hair may separate from the natural hairline after a few years.
Hair transplants can be performed on younger individuals, but they must be approached carefully. With properly selected treatment to stop further hair loss, it becomes possible to restore the hair that has already been lost.
7. Is it better to wait until all hair has fallen out before opting for a transplant?
Patients have two options. The first is to wait for complete baldness or for hair loss to stabilize, which might take decades (it is estimated that hair loss slows down after the age of 50). The second option is to fight to preserve your existing hair for as long as possible and potentially restore the hair that has already been lost. Pharmacological treatments come in various forms, such as topical solutions, needle mesotherapy with medications, or oral tablets. These treatments involve relatively low, safe, and well-studied doses, designed for long-term use.
For example, finasteride, a medication that many patients are wary of, is used at a daily dose of 1 mg for hair regrowth. Interestingly, the same drug is prescribed in a five-times-higher daily dose (5 mg) for treating prostate enlargement, and it is taken chronically. Finasteride provides excellent results for male pattern baldness, and if side effects occur, the medication can simply be discontinued, and alternative therapies can be considered.
Let ’ s reframe the question: is it better to get a dental implant immediately or wait until all teeth are lost before acting? Most would likely agree that it ’ s better to place an implant immediately and then maintain the remaining teeth through care and treatment to enjoy them for as long as possible. However, there may be a group of people who prefer to wait and replace all teeth at once.
Therefore, there is no definitive answer to this question. A patient should consult with a physician about the available treatment options and only then decide on the solution that best meets their expectations.
8. Can my body reject transplanted hair?
101 Questions About Hair Transplants
H air transplantation is a topic that is gaining increasing interest among both men and women worldwide. Over more than a decade of working in this field, I have had the opportunity to observe how technology has evolved, how methods have changed, and how patient expectations have shifted. This book was created out of a need to compile, in one place, the most essential information to help readers understand the hair transplantation process - from its basics, through preparation, to recovery.
Since 2011, as a doctor specializing in hair transplants, I have spoken with thousands of patients, each with diverse stories, concerns, and questions, who have inspired me to create this book.
Over the years, I have encountered numerous questions: some straightforward, addressing the technical aspects of the procedure, and others more complex, tied to individual patient cases. Yet, all of them share a common thread — a desire for understanding and a sense of security when faced with the decision to undergo such a procedure.
In writing "101 Questions About Hair Transplants" I set out to answer the most frequently asked questions posed by my patients and those interested in the topic. My aim is for this book to become a trusted guide, helping readers comprehend the complexities of hair transplants, alleviating their concerns, and enabling them to make informed decisions.
"101 Questions About Hair Transplants" is a collection of genuine questions asked by my patients during consultations and visits. Their curiosity and candor have allowed me to gather and organize the knowledge that I hope will help future patients better understand the process, the possibilities, and the limitations of hair transplants. My goal has been to answer these questions in an accessible and reliable manner, grounded in years of professional experience.
I hope the information contained within will prove valuable for those considering the procedure, preparing for it, or awaiting the final results of a completed transplant.
Artur Kierach, MD
PART ONE
GENERAL QUESTIONS
1. Can grey hair be transplanted?
This question has been asked in my clinic numerous times, initially leaving me quite surprised - particularly since I have personally performed many such procedures, with grey hair growing back just like hair of any other color. Through conversations with patients, I came to understand the origins of such doubts.
To put you, the reader, at ease right away: yes, grey hair can indeed be successfully transplanted. The only difference between grey hair and black, red, or blonde hair lies in its color - or more precisely, the absence of pigment. The hair follicle, hair shaft, and overall structure remain identical, even though pigment is no longer produced.
Curious about the genesis of this question, I began to investigate why patients often ask it. The answer was predictable: misinformation circulating on the internet suggests that grey hair cannot be harvested using the FUE (Follicular Unit Extraction) method because it becomes invisible when trimmed to 1mm. This information is partially true. To harvest follicles using the FUE method, hair is indeed shortened to 1mm (with minor exceptions), and it is true that grey hair is less visible against light skin compared to darker hair. However, there are techniques to either indirectly or directly identify and harvest such hair.
The indirect method involves adjusting the surgical lamp to make grey hair cast shadows, thereby making it detectable. The direct method includes marking grey hairs, for example, by wiping them with the patient's blood that appears during follicle extraction. While the transplantation of grey hair is technically more challenging for this reason, it is entirely feasible and widely practiced.
2. Do transplanted hairs grow differently than other hair?
To begin with, we always transplant the patient ’ s own hair, so there is no need to worry about differences in color or texture. Hair taken from the back and sides of the head may sometimes appear slightly thicker compared to hair along the frontal hairline, which is due to the dynamics of hair loss. In cases of androgenic alopecia, hair does not fall out overnight; the process takes years. Initially, hair becomes thinner (a process known as follicular miniaturization), and instead of three or four hairs growing from one follicle, only one or two remain. Eventually, the hair becomes shorter until it stops growing altogether.
When patients seek a hair transplant, follicular miniaturization is often already underway, meaning the hair is thinner than it once was. To blend the “ old ” hair with the transplanted hair, several strategies are used. Pharmacological treatments can be introduced to halt follicular miniaturization and restore hair thickness. If these measures do not achieve the desired results, hair is transplanted approximately 1 cm into the existing hairline.
Another critical factor is the direction and angle of growth of the transplanted hair. This depends entirely on the skill of the physician performing the procedure. Hair will grow at the angle and direction at which it was implanted. If the angle is too steep, the hair will stick out, making it difficult to style. Correcting such a procedure typically involves removing those follicles and re-implanting them at the proper angle.
So, what is the correct angle for hair growth? There is no universal answer to this question. The best approach is to mimic nature and implant the hair at the same angle it naturally grows for each individual patient.
3. Is a hair transplant procedure painful?
I must admit this is one of the most frequently asked questions during consultations. But here ’ s the good news: a hair transplant procedure is painless. However, there is one caveat.
Local anesthetics, such as lignocaine, are used to numb the area, and they are administered through injections with a needle and syringe. Unfortunately, topical anesthetic creams are insufficient. Since the injections are relatively shallow, fine and short mesotherapy needles can be used, making the injection itself minimally painful. Additionally, vibrating devices can be employed to reduce the sensation of pain. The administration of anesthesia usually takes about 10 to 15 seconds, after which the patient feels no pain. The skin becomes numb, and patients often describe the sensation as feeling like wearing a „helmet”. What about after the procedure, when the anesthesia wears off? The most painful part is the incision phase, but during this time, the skin is numb. The micro-wounds, which are the extraction sites for hair follicles (approximately 0.9 mm in diameter), typically do not cause significant pain. If any discomfort arises, over-the-counter pain relievers such as paracetamol or ibuprofen are usually effective. Based on patient feedback, itching during the healing process is more commonly reported than post-procedural pain.
In summary, a hair transplant procedure is painless, though the administration of anesthesia may be slightly uncomfortable for some patients. The good news is that this discomfort lasts only a few seconds.
4. Are transplanted hairs permanent?
I wish the answer were simpler, but the truth is: not always. The internet often claims that transplanted hair will never fall out. I even came across a clinic that offers a “ guarantee ” for transplanted hair. Unless they can predict the future, such promises are at best misleading, and the "guarantee" is merely a marketing gimmick. Why? Because medicine doesn ’ t deal in absolutes like “ forever ”, “ certainly ”, or “ 100% ”.
Hair follicles taken from the occipital region (the back of the head) are indeed more resistant to dihydrotestosterone (DHT), which is evident in older men. Even if many lose hair on the top of their scalp, the hair around the sides and back of the head typically retains relatively normal density. However, after the age of sixty, even hair in the occipital region can become thinner and start to recede. Additionally, if a man suffers from aggressive androgenic alopecia, the transplanted hair may also thin over time.
So, does it make sense to undergo a transplant if the results aren ’ t always permanent? There ’ s no definitive answer. As with any surgical procedure, one must weigh the benefits and drawbacks. It ’ s impossible to predict whose hair will last for decades and whose may thin sooner. Using medications post-transplant to slow hair loss can help extend the effects. For how long? That depends on the individual - some may respond to treatments for decades, while others may see diminishing results after just a few years.
In summary, a hair transplant generally provides long-lasting results, but outcomes vary from patient to patient. This topic should definitely be discussed during a consultation with a physician, taking into account family history of hair loss and personal expectations to make an informed decision.
It ’ s also essential to understand that a hair transplant doesn ’ t halt further hair loss in untreated areas. After the procedure, you ’ ll need to care for your hair. While medication to prevent hair loss isn ’ t always required, adopting a healthy and balanced diet, using better hairstyling products, or undergoing hair-strengthening treatments are worthwhile considerations. If, after a few years, you notice that your hair is thinning or no longer covers the scalp as it used to, don ’ t delay consulting a doctor. Early intervention can halt follicular miniaturization and, in many cases, restore natural hair thickness.
5. Can women have hair transplants?
Of course, they can, and quite often they do. The largest group of female patients consists of those who have always had a “ high forehead ” and receding hairlines but dream of a more traditionally feminine hairline. While high foreheads and receding hairlines are entirely normal in women, they may cause dissatisfaction, as such features are more commonly associated with male appearance.
Another group includes women who lose hair for various reasons, such as hormonal imbalances, thyroid conditions, chemotherapy, or other medical issues. If the hair loss has been treated and stabilized, there are no contraindications to surgically enhancing hair density.
There is also a group of transgender women who seek a more feminine appearance, making hairline reshaping one of the first and most affordable surgical procedures in their gender affirmation journey. This typically involves filling in receding hairlines and extending the hairline over the temples.
For female patients, the entire head is not shaved. Only a small area from which the follicles are harvested is trimmed. This approach allows women to undergo the procedure without the distress associated with shaving their hair. Although performing the transplant without shaving the head carries a slightly higher risk of infection, the benefits of the procedure outweigh the potential risks. This is particularly true given the wide range of antibiotics available to address such concerns effectively.
6. What is the best age for a hair transplant?
In my opinion, there is no strict age criterion for hair transplants. I recall many patients aged 18 to 20 who began losing their hair very early. By the time they visited my clinic, they already had significant receding hairlines. Should they wait until they are 40 to decide on a hair transplant? I believe we can help them much earlier, and I often do so in my daily practice. However, there are a few conditions.
First, for such young individuals, the cause of hair loss must be thoroughly diagnosed. If reasons other than androgenic alopecia are ruled out, the procedure can be considered. Second, pharmacological treatment must be initiated before the procedure to halt further hair loss. A hair transplant does NOT solve the issue of ongoing hair loss. If we surgically restore hair in the receding areas but the natural hairline continues to move backward, the transplanted hair may separate from the natural hairline after a few years.
Hair transplants can be performed on younger individuals, but they must be approached carefully. With properly selected treatment to stop further hair loss, it becomes possible to restore the hair that has already been lost.
7. Is it better to wait until all hair has fallen out before opting for a transplant?
Patients have two options. The first is to wait for complete baldness or for hair loss to stabilize, which might take decades (it is estimated that hair loss slows down after the age of 50). The second option is to fight to preserve your existing hair for as long as possible and potentially restore the hair that has already been lost. Pharmacological treatments come in various forms, such as topical solutions, needle mesotherapy with medications, or oral tablets. These treatments involve relatively low, safe, and well-studied doses, designed for long-term use.
For example, finasteride, a medication that many patients are wary of, is used at a daily dose of 1 mg for hair regrowth. Interestingly, the same drug is prescribed in a five-times-higher daily dose (5 mg) for treating prostate enlargement, and it is taken chronically. Finasteride provides excellent results for male pattern baldness, and if side effects occur, the medication can simply be discontinued, and alternative therapies can be considered.
Let ’ s reframe the question: is it better to get a dental implant immediately or wait until all teeth are lost before acting? Most would likely agree that it ’ s better to place an implant immediately and then maintain the remaining teeth through care and treatment to enjoy them for as long as possible. However, there may be a group of people who prefer to wait and replace all teeth at once.
Therefore, there is no definitive answer to this question. A patient should consult with a physician about the available treatment options and only then decide on the solution that best meets their expectations.
8. Can my body reject transplanted hair?
więcej..
