Hair Replacement and Hair Restoration

Baldness or hair loss is common. It affects men a lot more than women and is primarily related to testosterone levels. In the past, hair loss was considered part and parcel of daily life and once it occurred, individuals just went with it. However, these days that have been numerous advances in this particular area and cosmetic practices and plastic surgery practices are now offering hair replacement and hair restoration surgeries.

In this article, we shall take a brief look at these procedures and how they are performed.

Hair replacement

Hair replacement is a nonsurgical way of covering up bald spots by using artificial hairpieces. It consists of an underlying prosthesis to which hair fibres are attached. The prosthesis may be made of mesh fabric or silicone polymers. Typically, mesh fabric is made of polyester or nylon and offers a natural look with a hairline that is undetectable. Unfortunately, mesh fabric can be fairly expensive and does not last for too long, requiring frequent replacements. On the other hand, the silicone polymers based head replacements last a lot longer though they can be quite uncomfortable to wear.

Within the hair piece are natural hair fibres that match the skin colour and tone of the person wearing them. Usually, the hair fibres are human hair though in some cases artificial fibres are also utilised. Care must be taken to look after these hairpieces. In addition to this, it must be borne in mind that hairpieces can damage underlying normal hair that is already present on the scalp and can cause further hair loss.

Hairpieces can be attached using adhesive gums or through clips. The video below demonstrates how hair replacement is performed.

Hair transplant

A hair transplant is a form of hair restoration surgery. It is a widely utilized form of treatment these days, particularly due to the benefits that it brings to patients who undergo the procedure.

The underlying principle

The basic principle that underlines hair replacement i.e. hair transplantation is removal of hair from one part of the body and implanting it to another part. The common site where hair replacement and restoration procedures are performed is the scalp. The scalp hairs often occur in clumps called follicular units. Each follicle unit contains between 2 to 4 hairs and when performing hair transplants, this is replicated. Doing so allows for a completely natural look.

It is essential to recognise that male pattern baldness is likely to be due to testosterone levels rather than due to poor circulation or frequent use of hair products. Hair loss can also occur in women though the clear cause for this has not been identified. Women may suffer hair loss if they have problems with their thyroid or ovaries, iron deficiency and even from unhealthy dieting.

Hair replacement procedure

Hair replacement and restoration surgeries are often performed under local anaesthetic. The procedure is performed in two stages and involves the removal of hair from one area (these are donor hairs) and preparation of the area where the hair are to be transplanted (called the recipient area).

The donor hair can be obtained by extracting each follicular unit using special tools (follicular unit extraction – FUE). Alternatively, the entire section of scalp hair may be removed and utilised in transplantation (strip harvesting). The decision on which method to use is ultimately down to the performing physician who will be fully aware of the advantages that each of these procedures bears. Follicular unit extraction bears the advantage of not leaving behind any scars though it can be a lot more expensive to perform as a procedure.

There are a number of different aspects that need to be considered before performing a hair transplant. The recipient area needs to be prepared so that the follicular units can be implanted successfully. Each unit needs to be placed within the scalp tissue at particular distances so that when the hair follicles grow, they do not leave any empty patches anywhere on the scalp.

Once the recipient area has been prepared, the donor area of the scalp is injected with local anaesthetic and the required hair is removed. This hair is then transplanted at the recipient area in a strategic fashion.

Depending on how much area needs to be covered, the procedure can take anywhere between 6 to 8 hours. Often, multiple sessions are required which are performed months apart to obtain a perfect result.

Following the procedure, the patient is discharged home following a brief period of observation.

The videos below demonstrate how hair transplant is performed.

After the procedure

After the procedure is concluded, a semi-permeable dressing is applied to the area. This helps absorb any leaking blood or fluid. Patients are advised to ensure cleanliness of the scalp and maybe given shampoos that they can use at home that will prevent crust formation and scab formation. This is an essential step as scabs can cause newly transplanted hair to fall.


Side-effects are rare but can include mild amount of swelling and a bit of bleeding in the site of transplantation. This usually resolves in a few days. If required, patients may be prescribed medication that will help manage this. Patients may notice irritation at the site of the procedure and may be tempted to scratch the area. This is not advised as it can dislodge the transplanted hairs. Instead, using a medicated shampoo can help prevent this.

Thinning of the hair may occur at the site of transplantation. Natural hair loss can continue to occur as well and this can result in the formation of bald spots. This aspect is taken into consideration when the procedure is performed to ensure that any bald spots that may occur are adequately covered by the transplanted hair.

Hair replacement and hair transplantation are two common avenues sought after by men and women suffering from hair loss. The procedure is generally safe and although they have only been in practice for a few years, the results so far have been excellent. It is essential that a competent surgeon performs a procedure to limit complications and to improve overall outcomes.

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