| What are the reasons for male pattern baldness? |
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The tendency towards male pattern balding is genetic and can be inherited from either the mother or father i.e. it is not sex linked. Balding is started when dihydro testosterone molecules bond with special receptor sights on hair follicle cells. This causes the hair follicle to miniaturise and eventually to die. |
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| What is hair transplantation? |
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Even in the baldest man a permanent ring of hair exists at the sides and back of the head. For reasons unknown this hair is unaffected by the balding process. In follicular hair transplantation a strip of skin containing this permanent hair is removed from the back of the head. Care is taken that this strip is not too wide so that the flexibility allows the edges to be neatly sutured together after the strip is removed. The hair follicles are then carefully dissected out from the piece of skin and placed in very small surgical sites made in the thinning or balding areas of the scalp. Once transplanted this hair behaves as it was programmed to behave and should grow naturally for the rest of your life. |
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| In what type of baldness is this procedure helpful? |
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On some male pattern baldness and now more commonly in women who are thinning or occasionally balding |
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| Do women have problems with balding? |
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Women experience hair loss although as not as commonly as men. Some women have genetically determined hair loss while others may experience hair loss following injury, surgery or during an illness. Depending on their type of hair loss women may or may not make good candidates for surgery. Ladies should contact the clinic for a consultation with the Trichologist so that a specific diagnosis can be arrived at. |
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| What causes hair loss in women? |
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It has already been stated that hair loss can result from a series of medical conditions or genetic inheritance. It may also have followed surgery or injury. Because some hair loss in women can be caused by underlying medical conditions it is important that women are either evaluated by their own physicians or if preferred consult the Trichologist at the clinic. Examples include anaemia, thyroid disease, connective tissue disease, gynaecological conditions and emotional stress. There are also a considerable number of medications which can lead to problems. |
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| Why are some women not candidates for hair restorations surgery? |
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Hair transplantation involves the transfer of hair from an area of greater density to an area of hair loss. This is almost invariably from the back of scalp to areas on the front, mid scalp and crown. Some women have generalised thinning i.e. thinning at the back as well, and in this instance it may not be beneficial to transplant hair that has already been weakened. There is also the possibility that the hair in the recipient area is more fragile and some or all of the original hair in this area may be lost. This process is called "Telogen Effluvium" and usually it reverses in 3 to 6 months following the surgery. However this can be upsetting at the time to the patient involved. |
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| Is hair restoration surgery suitable for men considering gender re-assignment? |
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Yes. Hair transplanting can be very succesful for men embarking upon gender re-assignment. Any hair loss from male pattern balding will be arrested as soon as gender re-assignment hormone treatment commences. Consequently the maximum advantage can be gained in creating a very natural feminine hairline that varies significantly from a male hairline. Each case has to be considered individually and a personal consultation is always neccesary. |
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| Is this a painful procedure? |
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No. The procedure is performed under local anaesthetic and mild sedation. This means that both the donor and recipient sites are totally desensitised. You may experience a slight discomfort when the anaesthetic is infiltrated. Surprisingly patients feel very little discomfort in the recipient area but occasionally complain of discomfort for some days or weeks in the donor area. This is because small sensory nerves are inevitably divided and this can lead to a tingling sensation for some weeks. Discomfort in both sites is usually controlled by paracetamol. |
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| Do I need time off work after my transplant? |
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There is occasionally forehead swelling after the procedure although everything possible is done to avoid this. The little scabs where the grafts were inserted are visible for 7 to 8 days and if these cannot be hidden by existing hair then many men do take a few days off work or go on holiday. |
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| How many operations will be necessary? |
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This varies with the patient and the size of the bald region. In order to achieve acceptable density it is likely that a minimum of 2 sessions with a space of 6 months in between will be required. |
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| How should the patient prepare himself for the operation? |
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Very little preparation is necessary. The patient should shampoo the hair the night before, get a good nights rest, avoid over indulgences in food or drink and have a normal breakfast. If the patient is taking aspirin then this should be stopped 1 week before the operation. |
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| Should I have a hair cut immediately before the operation? |
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The longer the hair is in the donor area site the less conspicuous the site of the operation. |
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| How much time is require for each operative session? |
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The patient will be at the surgery for up to 5 hours and should have set aside a full free day. |
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| What medical conditions should the physician know about? |
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The patient should tell the physician of any unusual physical conditions and in particular any history of abnormal bleeding, haemophilia, heart attacks, epilepsy, allergic reaction to drugs or any drugs being taken to thin the blood. |
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| What happens when the patient leaves the office? |
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No bandages are worn, full postoperative instructions are given and many patients who live in the London area come back to the practice for routine washing and after care. |
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| Can a hairpiece be worn after the operation? |
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Yes the hairpiece acts as a protective shield and as a cosmetic screen. |
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| How long does it take for the transplanted hair to grow? |
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The new hair starts to grow between 14-16 weeks and will take at least 6 months for the new hair to make a significant cosmetic difference to your appearance. |
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| Will the final results be natural? |
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Yes, the state of the art hair transplanting performed now using single and small grafts produces a generally convincing hair line. |
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| What will happen to the donor area from which the hair is taken? |
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We use a strip of donor hair about 1 cm wide. The width allows the edges of the skin to come together easily and they are sutured with an absorbable monocryl stitch without tension. There may be some minor discomfort for a few weeks, however as the excision is neither deep or wide the end result in virtually all patients is a fine hardly discernible linear scar easily hidden by the surrounding hair. At any subsequent surgery the excision is made incorporating the existing scar ensuring that the strip is not too wide and the closure is again carried out under minimum tension. |
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| How much hair do I have? |
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There are 7 classes of hair loss in the main series as originally described by Dr. O'Tar Norwood. Discussion with the surgeon at the Wimpole Hair Restoration Clinic will help you determine how extensive your hair loss may become. |
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| How much hair do I need? |
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When you have your consultation with the surgeon he will suggest how many grafts are available for your first procedure and any subsequent procedures. This number will be based on your present balding pattern and will take into account the predicted future and how much donor hair is available. |
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| What is the difference between density and fullness? |
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The word fullness rather than density describes the visual phenomenon in what we perceive as thick versus thin hair. The concept of fullness is boarder and more inclusive. Density i.e. the number of hairs per cm square is only one of several contributing factors that are required for the visual impression of hair that appears thick. Other factors include hair shaft diameter, colour, texture and curl. |
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| Is it better to begin early? |
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A hair transplant should begin when your degree of hair loss is unacceptable to you. Starting early will often require multiple small sessions and your expectations may be unrealistic at that time. |
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| Do large grafts produce a better denser result than smaller grafts? |
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High quality hair transplants require fine instruments and delicate small grafts. These grafts can only be prepared using magnifying loupes or the dissecting microscope and are ideally inserted as follicular units. The follicular units of the adult human scalp is a naturally occurring bundle of 1 to 4 occasionally 5 terminal hair follicles with associated sweat gland, erector muscles, a nervous and vascular plexus and fine fibre sheath which surrounds and defines the units. These grafts can be distributed in a way that provides the most natural result. Nowadays the patient should seek out clinics which are able to insert sufficient numbers of small follicular units to produce the desired result. |
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| Do scalp reductions save hair from future loss? |
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No. Hair is a limited resource, it is used up regardless of how it is moved and scalp reductions are just another method of moving hair around. However some men do still wish to have the mid scalp and crown area reduced by reduction and the surgeon at the clinic is able to discuss and advise on this procedure. |
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| Are lasers state of the art treatment? |
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No. The laser works by using a beam of very high energy to burn a hole in the skin. The beauty of follicular unit transplantation is that the tiny follicular unit grafts can fit into very small sites that are made with a needle slit rather than by an instrument that removes healthy tissue. In this way the blood vessel rich tissue that is to receive the grafts is not destroyed or cauterised (i.e. burnt.) |
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| Is it possible to restore a full head of hair? |
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No. All hair transplant procedures move hair around from an area rich in hair to one thinner. No procedure creates hair. However if performed skilfully hair transplantation can make an incredible improvement in your appearance. |
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| Will new medications make surgical hair restoration obsolete? |
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No. New medication works best by retarding or preventing future hair loss. There are no known medications that can significantly re-grow hair once it has been lost. |
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| Are there any complications from this operation? |
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Complications such as infection or bleeding are possible following any surgical procedure but in hair transplantation they are infrequent, usually minor and can be well handled by the surgeon and his nursing staff. |
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| How should I proceed? |
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It is now necessary to discuss the procedure with the surgeon. He will then examine your scalp, take into account various factors such as your age, skin colour, hair characteristics and balding pattern and advise on advisability of a hair transplant. |
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