Hair Replacement Surgery

What causes hair loss?

Hair loss can be part of the natural aging process, or can result from heredity, hormone changes, medications, illness or trauma, including burns and severe emotional stress. Some people experience hair loss due to a combination of these factors.

Hair loss patterns also vary between men and women. Men tend to see hair loss start at the temples, the hairline in an M shape and in the crown area (the “bald spot”). Women most commonly see hair thinning at the top of the head causing the part of the hair to become wider.

What is a hair transplant?

Hair loss can affect a patient’s appearance and self-esteem. The goal of surgical hair restoration is to fill in or recreate the thinning hairline and fill in other areas on the scalp where hair loss is noticeable.

Recent years have yielded major advances in hair restoration for both women and men, with natural looking results superior to the unattractive “hair plug” appearance resulting from treatments used in the past.

Hair Restoration Surgery: What You Need to Know from a Johns Hopkins Expert

Learn about hair transplant surgery from Lisa Ishii, a Johns Hopkins facial plastic and reconstructive surgeon, including what to expect at a consult, available treatment options and details about the procedure.

Consulting a Plastic Surgeon for Hair Restoration

A person making the decision to choose hair transplant surgery should meet with an experienced surgeon who has experience and skill in this procedure. During the consultation, the surgeon will examine the person’s hairline and scalp and may even take a small sample of hair or scalp skin.

The surgeon will consider:

  • The person’s general physical and emotional health

  • The person’s skin, hair, ethnic background, age and family history

  • The type of procedure that is most appropriate for the person

  • The results that the person expects and hopes for from the procedure

Hair Transplant Surgery: Richard’s Story

Delaware resident Richard Monkman traveled to see Johns Hopkins hair restoration expert Lisa Ishii about his hair loss concerns, including how they were impacting his professional appearance and confidence. Hear from Richard about his experience and the three steps involved in hair transplant surgery.

Hair Transplant Surgery: Procedure and Care

Hair restoration is actually hair redistribution, and is likely to take place in the surgeon’s office. First, the surgical team uses an anesthetic to numb the patient’s scalp so the procedure is comfortable.

Then the surgeon removes a narrow band of hair from the back and sides of the scalp, divides it carefully into tiny “micro” grafts, and transfers it to areas on the scalp and hairline to increase thickness.

Because the hair and root grafts are so small and replanted one by one, the result is natural-looking hair growth. The donor site at the back or side of the head heals as a straight scar, well concealed in the remaining hair.

The procedure itself takes five to eight hours, and in some cases, more than one session may be necessary to achieve the patient’s goals.

After the grafts are in place, they appear as small wounds. These heal quickly and blend in with the surrounding skin in a few days. In the meantime, patients can gently comb surrounding hair over the grafts or wear a loose-fitting cap.

After a month or two, the grafted hair may fall out, which is normal and almost always temporary. Within another month, hair will resume growing from the grafts.

It is extremely important to follow the surgeon’s post-surgery instructions carefully, especially:

  • Alerting your surgery team immediately in the event of any problem or unexpected change

  • Keeping follow-up appointments

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