1. Question: What is hair transplantation (H.T.) or hair restoration surgery?
Answer: It is a minor, outpatient surgical procedure, that takes from 4 to 8 hours depending on the number of grafts (usually 1000 to 4000 grafts) that are transplanted. Much of the time the patient is merely sitting watching movies while the technicians cut and prepare the grafts using a microscope. It involves transplanting grafts of hair follicles that will grow and remain with the patient for the rest of his life. These transplanted grafts are surgically donated by the patient’s own permanent hair area (the sides above and behind the ears, and the back of the head area of the scalp). The hair transplant surgeon doesn’t give the patient any new hair. He re-arranges (ex. taking the hair from the back of the head and putting it in the front) the patient’s hair, filling in the thin sparse areas, filling in the gaps of hair loss, giving the patient an amazing illusion of more hair!
2. Question: What causes hair loss?
Answer: The most common cause of hair loss (baldness, thinning) is hereditary hair loss (androgenetic alopecia). You inherit the genes for hair loss from one or the other of your parents or both. Testosterones’ (androgens) role in hair loss is not completely understood. You have heard of good and bad cholesterol; there is good and bad testosterone. 5a-reductase, an enzyme found in humans attaches to and converts testosterone (good) into dihydrotestosterone (bad).
The dihydrotestosterone (DHT) is toxic to genetically susceptible hair follicles and over time causes the hair loss process.
The myth that hair loss is inherited from your mother, is not true. Other things that do not cause hair loss are: wearing hats or wigs, frequent shampooing. It is a myth that dandruff or short term stress will cause a permanent hair loss.
3. Question: Does it really work? What is the re-growth rate?
Answer: Yes, it really works! The re-growth rate with the microfollicular unit transplantation method is 99-100% growth.
4. Question: How long after the procedure does it take to get results?
Answer: It takes 9 to 12 months for the patient to see 90 to 95% of his full resulting look. At 3 months post-operation you will see numerous new sprouting hairs, like whiskers coming in. Starting 3 months post-operation the new planted hair grows 1/2 inch every month on average. At first the new hair is fine and soft, and a few months later it becomes more course – giving you a thicker, denser look.
5. Question: Is it safe?
Answer: Yes. It is a minor surgical procedure and is only skin deep. It is one of the most safe procedures performed by physicians.
6. Question: Is it expensive?
Answer: No, not when you compare it to other methods. After this procedure you grow your own hair and there is no further expense. A wig or hair piece will have to be maintained, repaired, conditioned, tinted, and replaced on a regular basis.
How much does hair restoration cost? First visit consultation with Dr. Halby is $25.00. At consultation Dr. Halby will tell you what your hair transplant will cost depending on how many grafts you need, etc. Our patients typically invest between $5,500 – $14,000 for a scalp hair restoration procedure.
7. Question: Is there financial assistance?
Answer: We can refer you to a third party medical finance company and if you have a steady job they can usually help you.
8. Question: Does the doctor use “plug” transplants?
Answer: No. The plug transplant method was done in the 50s, 60s, 70s, and 80s. The plugs were large tuffs of hair, 10 – 30 hairs per tuff. Today the state of the art allows the doctor to use follicular unit grafts that consists of 1 to 4 hairs per graft. The follicular unit graft method gives the patient a natural look and the transplantation is undetectable.
9. Question: Why doesn’t transplanted hair fall out?
Answer: The hairs surgically taken from the patient’s permanent donor area (sides and back of scalp) are genetically programmed not to fall out. The hair in the patient’s thinning area (usually the front, mid-scalp, and crown area) is generally genetically programmed to be somewhat prone to fall out as the individual gets older.
10. Question: Is a hair transplant painful and what about the anesthesia?
Answer: Dr. Halby and other transplant doctors that are up to date in their technique provide a pain-free experience. The doctor numbs the scalp with a local anesthetic during surgery and generally gives the patient a mild sedative. Usually the patient watches movies (DVD) to entertain himself during the surgery.
11. Question: Will the patient miss time from his job after H.T. surgery? And how will I look?
Answer: Most patients will be able to return to work in 1-2 days after surgery. For appearance sake the patient may choose to take a few extra days off work. Dr. Halby generally doesn’t shave the surrounding hair in the recipient area and therefore the patient can in many cases comb his hair in such a manner to conceal the recent hair transplant. (Some other hair transplant surgeons for their own sake, not thinking of the patient’s well-being post-operatively, shave their hair transplant patient’s head in the recipient area). If you are sensitive about how you look for the first few days you can wear a hat, use a camouflage product, or try to schedule the procedure before your holidays.
After surgery you will have small scabs and red skin wherever grafts were implanted, that will be present for the next 10-14 days. You may have swelling of the forehead and occasionally the swelling due to gravity goes to the eye area. The swelling generally leaves by day 6.
Post-operatively you may have shedding of pre-existing hair around or adjacent to the transplanted grafts, giving you a thinner look. This pre-existing hair loss is only temporary and will grow back in a few months, so don’t be alarmed. See FAQs – Explain Shock Loss.
12. Question: Can I exercise after H.T. surgery?
Answer: Patients are not to do strenuous exercise, being careful with their new grafts for 3-4 days after surgery. Patients are to avoid lifting heavy weights for 1 week. Light weights are ok on the 3rd day post-operatively. No swimming (that is you can’t get your hair wet) in a chlorinated pool for 2 weeks.
13. Question: Why do women lose hair?
Answer: The typical pattern of female pattern baldness is not the same as that of male pattern baldness. In women the hair is usually thin over the entire head, although the frontal hairline is usually preserved. Moderate hair loss of the crown may occur in women, but only rarely does it go totally bald as it frequently does in men.
Some of the common causes of female hair loss are:
a) Hypothyroidism – low thyroid hormone may cause thinning and/or patchy hair loss.
b) Chronic blood loss
c) Severe acute or chronic illness
d) Telogen effluvium – there is shedding of hair involving the whole scalp. This may be chronic, but on the other hand it could be acute following stress to the body such as high fever, starvation, blood loss, etc.
e) Pregnancy, hormonal changes, and low estrogen (a hormone that counteracts the balding effect of testosterone).
f) Alopecia areata – a disease of unknown cause that comes and goes repeatedly and results in a patchy loss of hair to the scalp and/or eyebrow.
g) Loose anagen syndrome – a condition that causes shedding of hair before the hair’s normal growth cycle is completed.
h) Trichotillomania – a condition whereby the individual has a psychologoical problem and compulsively plucks his own hair resulting in permanent loss of hair.
i) Excessive harsh chemical hair styling.
j) Androgenetic alopecia – diffuse hereditary pattern hair loss.
k) Traction alopecia – sometimes caused by repeated tight braiding. Sometimes caused by repeated pulling of the hair.
14. Does Rogaine (minoxidil) help with hair loss?
Answer: Rogaine, a topical non-prescription agent, may help somewhat for some people (men or women). Only a 6-12 month trial will tell if it will help you. Rogaine may help halt the loss process or give you new hair, but this lasts only as long as the medicine continues to be used. Hair loss will begin again within a few months after minoxidil treatment is stopped. It is not near as effective as a hair transplant. Ask Dr. Halby about Formula 82M that contains 5% minoxidil and other medications that is more effective, less greasy, and less disruptive to your hair styling than Rogaine.
15. Question: Will health insurance help pay for a hair restoration procedure?
Answer: Hair restoration is a cosmetic procedure and is not covered by insurance as a rule. We accept all major credit cards and if needed will refer you to a 3rd party that can arrange financing for you.
16. Question: What would a patient’s visit be like while having a transplant procedure?
Answer: On surgery day the patient usually arrives at the office at 7:am. Dr. Halby will re-discuss with you the final design, and your expectations of the hair transplant procedure. Photos will be taken. Dr. Halby will use a China marker to draw in the frontal hairline. You will then put on a gown. You probably will be given a mild sedative. You will be given the 1st dose of your prophylactic antibiotic.
The doctor will numb up (anaesthetize) the areas to be worked on. Then your scalp is tested to make sure you have no feeling of pain and the doctor makes sure that you are very comfortable. If there is anything that you want or need you should ask the doctor or nurse because our job is to attend to your every need during your time at our office. The donor area will then be removed while you are watching TV, or a DVD movie in order to entertain you. Or sometimes the patient may rest or go to sleep due to the mild sedative. We make the experience very easy, very calm, pain-free.
After the donor area (strip) is harvested the technicians will take it and cut it into individual grafts that are 1,2,3, or 4 hairs apiece. Dr. Halby will then make the recipient sites on the patient’s scalp where the grafts will be placed. Complementary lunch will be taken by you and the rest of the office staff. We will strive to order carry out food from a restaurant that the patient likes.
Then we place the grafts one by one with jewler’s forceps and microscopic lenses into the tiny recipient slits. Sometimes a dressing and bandage is used at the end of the procedure. The doctor then explains to you verbally and in written form (post-operative instructions) on how to take care of your new hair for the next few days. The patient will then have his designated driver drive him home.
17. Question: What is required prior to surgery?
Answer: The doctor does a history & physical and a scalp exam which is included in the surgical fee. The doctor requires a blood test. Usually if you have had a blood test by another prior doctor that is less than 1 ½ years old this is sufficient. Just fax us the results. If Dr. Halby draws the blood there will be an additional charge, usually $205.
18. Question: Do you have prior patients that I can see or talk to?
Answer: We have many before and after photos and written testimonials from our past hair transplant patients that gave us written permission to allow you to look at their photos and written testimonials. Some of our patients have said they would be happy to talk via phone to a prospective hair transplant patient. Call us for more information on this: 702-258-6229.
19. Question: Does it look natural?
Answer: Yes. Hair transplant surgery has come a long ways since the old “plug days”. A Plug is a grouping of 6-20 hairs per graft. Dr. Halby and his staff excels at Microscopic Follicular Unit Transplantation whereby the donor strip is precisely and meticulously dissected down to 1,2,3, and 4 hair grafts – just like they are found in nature. These naturally occurring clusters of 1,2,3 or 4 hairs are called Follicular Units (FUs). These individual follicular units are artistically relocated to the bald and thinning areas one at a time. Our patients remark, “It’s so natural”!
20. Question: Can someone else donate hair to me?
Answer: No, your body would reject the donated hair grafts. It is impractical to look for 3-4 years for a matching donor as they do in heart and kidney implants and then use excessive steroids and other medication with serious side-affects to counter your body from rejecting the implants.
21. Question: What is the current status of hair cloning?
Answer: Hair cloning is in the experimental stage and it will be a very long time before it will give natural looking hair growth and reverse hair loss. At this point in time the hair that scientists grow with cloning looks like gum.
22. Question: How thick will it look?
Answer: How thick a person’s hair looks is dependent on several factors: hair shaft diameter, number of hairs per square inch, hair styling, hair and scalp color, straight or curly hair, and hair angle.
23. Explain Shock Loss.
Answer: Shock loss is the shedding of a patient’s existing hair due to the stress of a surgical procedure. Women will have more trouble with this than men. It can be very distressing for the patient particularly if the patient is not forewarned. The good thing about it is that it is a temporary problem that clears in a few months. I tell my patients to remember: “You will be thinner, before thicker”. After a procedure the patient may look worse, before he looks better. Shock loss after a hair transplant procedure occurred more often a few years ago. However, by using Propecia, finasteride, or minoxidil at the time of a hair transplant procedure will decrease the incidence of shock loss.
24. Question: How many sessions of surgery will I need?
Answer: If you have thinning of the scalp only, then one session of surgery is probably needed. If you have areas of complete baldness, then two or three surgeries may be needed. The patient needs to wait 4 to 6 months between each session because the doctor wants to see how the hair is growing out and its distribution.
25. Question: What things do I need to do to get ready for my scheduled surgery? What are the doctor’s pre-operative instructions?
Answer: A. Fill out the Health questionnaire and fax or email it to Dr. Halby
B. Do your scalp stretch exercises – if you are having a large procedure done and Dr. Halby asked you to do so.
C. Leave your hair long prior to surgery: ¾ of an inch on the back and sides of your head, and long in general to hide the redness and scabs that are present after surgery for a few days.
D. Two weeks prior to surgery:
1) do not use Aspirin 2) No Rogaine or Minoxidil
E. One week prior to surgery:
1) No Aspirin 2) No Ibuprofen 3) No excessive alcohol 4) No vitamin E 5) Do not use fish oil, garlic and chromium picolinate
F. Two days before surgery: no alcoholic beverages, no marijuana, no high dose of niacin, no gingko
Make arrangements for someone to drive you to and from the clinic for your surgery day. – We will be giving you a sedative. Call office and confirm your surgery appointment.
G. Wash your hair with regular shampoo the night before surgery and the morning of surgery. Add some conditioner, but do not add other gels or hairspray.
H. On surgery day:
Eat some breakfast, avoiding caffeine. You may also want to bring a snack, however, lunch will be provided for you. Let us know what kind of food (lunch) you like. Wear a shirt that buttons down the front. If you want bring a clean oversized baseball cap, bandana or scarf. Operating room is equipped with a DVD player to show movies or you may want to bring your own.
I. You will be returning in 1-3 days for a post-op re-check and also 7- 14 days for suture removal.
J. If you wear a hair system please discuss this with Dr. Halby.