Hair Transplant Expert.com

Anthony J. Mollura, M.D.
Hair Loss Specialist

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Frequently Asked Questions

Does it really work?

Will I get a full head of hair?

How long will it take to grow?

Will this procedure mean time off from work?

Is the procedure painful?

Is the procedure dangerous?

Is the surgery expensive?

"I've heard from other hair transplant doctors that mega-sessions don't often grow or can produce disastrous results. Is this true?

What steps should I take before surgery?

Is the hair transplant surgery painful?

How will the surgery affect me when I return to work the following day?

How many sessions of surgery will I need?

How long does it take the transplanted hair to grow out enough to fill in the balding area?

How long will the transplanted hair continue to grow?

Can hair transplantation affect the rest of my hair?

What are some possible complications?

Does it really work?

Yes! Hair transplant surgery redistributes existing, healthy hair, which is usually genetically encoded to virtually last a lifetime. Conventional hair transplant growth rates are at about 90-95%.

Will I get a full head of hair?

No. remember, the technique redistributes existing, healthy hair. It does not create any new hair. So it is not possible to provide a full head of hair. However, a comparatively small amount of hair transplanted expertly can produce the illusion of substantially more hair than there actually is. The results will improve how you look to others and to yourself.

How long will it take to grow?

Your transplant will be fully grown approximately 9 months after your All Follicular Unit Megasession.

Will this procedure mean time off from work?

Little or no time off from work is required. But if you are sensitive about how you will look during the days immediately following, you can wear a hat, or, if that's not possible in your work environment, Dr. Mollura recommends beginning the process just before your holidays. Many patients return to work the next day. In fact, many play a round of golf the day following their procedure!

Sun and salt water are said to speed the scalp's healing process, usually producing an acceptable looking appearance after just one week. However, every person is different. Beyond examination, your consultation is a good source to be informed of possible strategies for your unique situation.

Is the procedure painful?

Most patients watch a movie or take a nap while we work. Afterwards, they tell us that during the procedure they felt no pain. Any discomfort they feel afterwards is usually very temporary and nearly always minimal. Approximately 25% of patients elect to take pain relieving pills during the following 1-2 days.

Is the procedure dangerous?

No. It is minor surface surgery, literally only skin deep, and one of the safest surgical procedures ever performed. You are under the care of qualified medical staff at all times. Your transplant takes place (using equipment kept to hospital standards) in a private office.

Is the surgery expensive?

Comparatively, no. While there are costs involved, the benefits of growing your own hair make hair transplantation much more cost-effective than other methods, because afterwards no further expense is incurred. There are no expensive chemicals to be bought or used continually. There are no expensive hair pieces to be maintained, repaired, tinted, conditioned and replaced regularly every 18 months in order to look natural. So, weighed in the light of all possible alternatives, the hair transplant solution is not only the best, but is also the most economical overall.

"I've heard from other hair transplant doctors that mega-sessions don't often grow or can produce disastrous results. Is this true?"

Some doctors who have not kept abreast of these new advanced techniques (They perhaps don't want to go through the extra trouble and expense of purchasing the microscopes, hiring and training the extra staff- and handling the tremendous amount of administrative problems that come with it) often make untrue statements denigrating megasessions. They also probably don't wish to face the learning curve of this obviously more exact procedure.

Be that as it may, many of these doctors won't consider the Binocular Stereoscopic Dissecting Microscope procedure purely in terms of how it will affect their profit margin. Let's face it- these All Follicular Unit Megasessions typically run from 8-12 hours to complete, with the painstaking effort of a large attendant staff. To the average hair transplant doctor, this would greatly increase their workload and overhead. Of course, for them, it would be much easier to say"you can't do over a thousand grafts at one session" or "megasessions produce poor growth and waste hairs", or "megasessions produce too thin a result".

However, in fairness to some of these other doctors, it must be stated that without highly skilled technicians, adequately trained and practiced in the most advanced dissection techniques using the binocular stereoscopic dissecting microscope, and without extreme attention paid to detail at every step along the hair transplant process- other hair transplant facilities, especially those without a lot of experience with megasessions, may well frequently obtain poor results.

What steps should I take before surgery?
Maintain an adequate length of hair on the back of your head. This should be at least one inch long, or you may have a pro- blem  covering up the sutures after the surgery.  Your donor grafts will be removed from here and you should expect cover- age following your procedure. 

Two weeks before surgery 

Day before surgery 

Operating day


Is the hair transplant surgery painful?

You may have heard that the process is very painful. But with the proper technique in the application of anesthesia, it does not have to be a painful pro- cess at all. It all depends on how the surgeon applies the anesthesia, and our office uses the least painful process available for the comfort of our patients. For a hair transplantation process, every surgeon uses either a nerve blocking process or a local anes- thesia; general anesthesia is never used in this case. Any pain at all during our procedure would be during the initial needle injection. Our office uses several techniques to reduce even this small pain. The anes- thesia is warmed to reduce reaction time, the skin is pre-numbed before each localized shot and the finest gauge needle (30 gauge) is used to minimize this pain. Initially, the patient is given a sedative through an IV medication. This sedative puts the patient into a relaxed, "twilight zone" state to minimize any pain there might be from the subsequent injections. The tumescent technique is used for pro- longing anesthesia time. 
    

Most patients have informed me that the process was less painful than a routine trip to the dentist. In addition, the day after the hair trans- plant process, 50% of our patients do not require any pain relievers at all, and the other 50% will take Tylenol for only a few days until the discomfort is gone. Few of our patients request a pre- scription pain reliever. We feel that our procedures are much less painful in compari- son to many other offices. The only disadvantage to this "twilight zone" anesthesia is that the patient will not be able to drive on the day of the surgery. However, should the patient forego the "twilight zone" anesthesia and opt instead for a local anesthesia, he will be able to drive on that day.

How will the surgery affect me when I return to work the following day?
For the first twenty- four hours, there will be a strip of bandage around the head. After that, you will be able to remove the bandage and shampoo your hair as usual. If you have the surgery done on the hairline, the small scabs will remain for seven to ten days. Some patients may want to cover the area with a cap or even a hairpiece at work if they desire. If you have partial hair, it is much easier to cover up the area, or you can use a camouflage product. 

When the small scabs fall off after seven to ten days, the freshly implanted grafts will be a pink, slightly shiny, skin which is usually a similar color to the surrounding normal skin and is minimally obvious at first. After approximately six weeks, the areas where the grafts were transplanted are barely visible.

Pre-existing hair adjacent to the trans- planted grafts may shed, giving a thinner look, but hair will begin to grow back within a few months. This temporary thinning of pre-existing hair is called Telogen Effluvia. Unfortunately there is a time lag between this increased thinning of pre- existing hair and re-growth of transplanted hair. 

How many sessions of surgery will I need?

If  you  have  a completely bald area, it may take two to three surgeries to cover your entire head. If you have an area partially covered with hair, it may take only one surgery to fill in the area. Our goal is to restore about twenty-five percent of the donor's original density in each surgery. After two surgeries, the density is at about fifty percent which is often adequate coverage to satisfy the patient. The time between each session is usually three to four months in order to see how the hair is growing out and to provide more equal distribution. 

How long does it take the transplanted hair to grow out enough to fill in  the balding area?

Usually it takes three to four months for the hair to grow out. After that it will grow about half an inch per month which is the same rate as the donor hair. Initial hair quality is usually very thin, like baby hair. Then, it becomes coarser over time. Sometimes the initial hair is curlier, then it straightens in about one year. The color of the initial hair may also be darker and later will be lightened by the sun. 

How long will the transplanted hair continue to grow?

Basically, the transplanted hair is the hair from the back of the head. Even though it is transplanted, it will still have the same life span. Normally, a hair follicle sheds every three to six years and then grows back from the same root. The transplanted hair continues the same life circle. 

Can hair transplantation affect the rest of my hair?

Hair roots are very tough and can tolerate surgery or any irritation

What are some possible complications?

Hiccups
It usually lasts several hours to several days. If left untreated, the hiccups may interfere when you eat and sleep, but there is a medication that the doctor can prescribe to ease the hiccups.

Itching
Some itching commonly occurs but is rarely troublesome and lasts only
a few days. Shampooing the hair daily will help the discomfort.

Swelling
There is some swelling in nearly all cases. It affects the forehead and the
area around the eyes and lasts two to five days, being maximal on the fourth day. In about one in fifty cases, a "black eye" develops. With particular patients, swelling can be considerable and temporarily disfiguring, especially after the first session. However, it does little harm and lasts no more than a week. A drug called Cortisone can be given to reduce these symptoms for those who are concerned about swelling, but Cortisone can be harmful if used often; it has numerous rare but potentially serious side effects.

Infection
This happens in one in several thousand cases and is easily cured with
antibiotics.

Scarring
Keloid scarring occurs only in pre-disposed individuals, and even more
rarely (1/1000 cases) has this keloid scarring been hypertrophic to the point of "ridging."

Cysts
One or more cysts may occur in the recipient area when many mini-grafts
have been inserted. They usually disappear by themselves after a few weeks or immediately with various simple treatments. They are not usually more than 2 or 3 mm in diameter, i.e., the size of small pimples.

Neuralgia
When a medium-sized nerve, such as the occipital nerve, is either cut
or bruised, patients can get either numbness, tingling or "pins and needles" sensations, sometimes even "shooting pains" and hypersensitivity of skin in that part of the scalp. Once in a while someone reports varying combinations of the above, usually lasting for one to four weeks. Very rarely have patients had neuralgia last a longer time period. Prolonged or severe symptoms are exceedingly rare and virtually always disappear within a few months.