Male Hair Transplant

 

Surgical Hair Transplant

Common Reasons for Hair Loss

The most common reason for hair loss is androgenetic alopecia, or pattern hair loss. Up to 80% of men and 40% of women will experience significant hair loss from this condition. It is a condition that is understood to be hereditary (passed down from parent to child in the genes) and related to the male hormone, di-hydro-testosterone or DHT.

This pattern of hair loss is progressive and the main feature of it is thinning of the shafts of the hair (i.e. each strand of hair appears thinner and limper) due to damage to the hair follicle (some refer to this as the hair root) – this phenomenon is called ‘miniaturisation’.

The condition is called ‘pattern’ hair loss because, in the large majority of those afflicted, it follows a ‘pattern’ of hair thinning. In male hair loss, it usually starts from the hairline or crown and spreads to involve the rest of the scalp. In female hair loss, it starts from the centre parting and spreads outwards to involve a larger area of the scalp. In women, especially, a prominent amount of shedding can occur as part of this type of hair loss.

 

Other reasons for hair loss include telogen effluvium, where shedding of hair is the main feature and does not follow any particular pattern, this type of hair loss is often seen around 3-6 months after a sudden stressful event such as childbirth, major surgery or severe emotional stress. If the shedding is severe, it can reveal more areas of the scalp, causing the appearance of balding.

If telogen effluvium persists for more than 6 months, hair restoration practitioners deem this as ‘chronic telogen effluvium’ and further investigations such as blood tests are warranted.

What Is Surgical Hair Transplant?

A hair transplant is a surgical technique that moves hair follicles from the back of the scalp – the ‘donor site’ – to a bald or balding part of the scalp known as the ‘recipient site’.

Primarily used to treat male hair loss and balding, hair transplants are known as the only permanent solution to hair loss and promises above 90% success rate. You can also have a surgical hair transplant in Singapore to restore or add facial hair and to fill in scars.

Dermoscopy Of The Scalp

Is A Hair Transplant An Invasive Procedure?

A hair transplant is a minimally invasive procedure where grafts containing hair follicles from the back of the head that are genetically resistant to balding are transplanted to the bald area.

Within a day, the donor area will dry up, small scabs will form on each graft in the recipient area and your head will no longer require bandaging. These scabs will shed approximately 7 – 10 days later. Life goes on as normal for patients.

Follicular Units Extraction

Are Results Immediate?

You can expect the implanted hairs to shed from the 1st month up to the 4th month post procedure at different rates. They usually start growing from the 4th month onwards, at the normal rate of 1cm per month, growing denser in the months to follow up until the 1 year mark, when you will see the final result.

How Many Hair Grafts Will I Need?

The number of grafts vary from patient to patient, depending on the size of the area to be transplanted as well as the intended density.

You may need anything between 500 – 2000 grafts up to 3000 grafts for the typical balding male. While many patients require only one hair transplant session, some may require 2 – 3 sessions to achieve good density.

If you have continued hair loss, we may need to repeat the procedure in the following 5 – 10 years, depending on donor availability.

Is It A Painful Procedure?

You will find that you feel very little to no pain during the hair transplant surgery and slight to moderate discomfort during the initial 5 – 10 minutes when the anaesthesia is being injected. You may feel some discomfort after the procedure but that will be controlled by the medication supplied to you.

How Long Will A Hair Transplant Procedure in Singapore Take?

Depending on the number of grafts, it typically takes 6 – 9 hours with a lunch break in between.

Patients are advised to have nothing else planned on the day of the procedure.

How Long Will I Take To Recover After A Hair Transplant?

It takes about 2 – 3 days to recover and up to a week for your hair to look socially acceptable. Most people choose to stay indoors for a period of 3 – 5 days. You can resume light physical activities after the first 3 – 5 days and return to normal activities after 10 – 14 days. Contact sports and extreme exercises are best avoided for 3 – 4 weeks.

Terra is a medical hair and aesthetic clinic that offers the latest techniques in hair transplantation. Each of our surgical procedures emphasise the creative components to hair restoration as much as the technical aspects. We carefully take into account factors such as age, sex, desires and expectations, degree of donor availability, facial contours, hair characteristics and ethnicity during consultation before finalising the surgical plan for each of our patients.

We ensure that every one of our patients are well-equipped with accurate do’s and don’ts before and after surgery, and we see them through the entire phase while they anxiously wait for results.

Common Procedures of Hair Transplant in Singapore

The most common techniques for hair transplants today are using the FUE (now termed FUEE) and the FUT strip harvesting method. It is worth noting that both methods are surgical in nature. By law, any surgical procedure has to be carried out by a licensed medical professional.

 

FUT Strip Harvesting Method

FUT strip harvesting is a method of removing living hair follicles from the donor area by surgically removing a strip of scalp-containing skin. After harvesting the strip of donor follicles, they are dissected into individual follicular units for reimplantation into the areas of balding. The surgical wound is then closed, allowing the hairs just next to the surgical wound to be as close as possible to each other, minimizing the large visible scars that were common in the past.

FUE Method

FUE stands for Follicular Unit Extraction whereas FUEE stands for Follicular Unit Excision and Extraction. The revised terminology highlights the surgical nature of the procedure, having to excise and dissect scalp tissue from a patient’s scalp.

The FUE (or FUEE) procedure involves individually harvesting follicular units using a harvesting punch (excision), taking great care not to damage any part of the follicles. To perform this well requires training and experience. The same microscopic follicular units are retrieved from the scalp (extraction) and assessed by a team of trained technicians under high powered microscopy – these are now called ‘grafts’ that contain hair follicles and surrounding tissue that supports the follicle’s survival. Suitable grafts are arranged and put in a specialized storage medium called hypothermosol to improve survival for implantation into areas of balding.

The FUE (or FUEE) method has gained in popularity over the last decade. A major reason for this is that the patient can be close to being scar-free (but not scar-less) after the procedure. FUE hair transplant has also gotten popular due to advancements in FUE punch technology . Hybrid punches ensure that grafts come out with minimal or no damage, meaning that we end up with healthier grafts when compared to older systems. At Terra Medical, we use Devroye Instrument’s WAW FUE Hybrid punch system.

FUEE procedures are also carried out by robotic applications like the ARTAS robot. In my opinion, despite being ARTAS-qualified and having utilized it for 3 years, I believe that not everyone is suitable for an ARTAS procedure and that hybrid punch technology has equalled or bettered ARTAS graft quality in recent years. With my patients, I normally do a thorough consultation before recommending which method is more suitable.

What Is FUE And How Is It Different From FUT?

FUE is the first hair restoration technique known to be minimally invasive. It has been around for more than 15 years and has gained popularity in the recent years compared the the original “strip” technique or FUT that leaves a linear scar on the back of the patient’s scalp.

This technique involves using the aid of a motorised punch to harvest follicular units, which are groups of hairs containing 1 – 4 follicles. The tip of the micro motor penetrates into the skin by spinning during the extraction of follicular units and allows easy extraction of bulbous healthy grafts.

FUE hair transplant in Singapore is a versatile and excellent method for hair transplantation when performed by experienced hands. At Terra, we ensure our doctors and team are properly trained and qualified to give you the best results you can ask for!

Tip: Wearing a shorter haircut before and after the hair transplant procedure is recommended for better recovery. As soon as the clinical downtime (healing) is over within a few days, your surrounding hairs in the donor zone will grow out, leaving you with hardly any social downtime after 5 – 7 days.

Follicular Units Extraction
Follicular Units Transplantation

10 Steps of A Hair Transplant

  1. Trimming of donor hairs The donor area is trimmed according to the number of grafts to be harvested.
  2. Anaesthesia The area is numbed with administration/injection of local anaesthesia.
  3. Harvesting/Extraction Follicular units of 1 – 4 hairs are loosened from the scalp and picked up for inspection.
  4. Quality check Every one of these grafts are looked at under high-magnification microscopes to ensure the follicles are intact and there is a sufficient amount of supporting tissue surrounding them. They are then placed into a dish containing Hypothermosol solution, a bio-preservation media which protects the viability of the grafts.
  5. Lunch break for you
  6. Marking/hairline design The doctor draws out the hairline and marks out recipient areas in accordance to the plan.
  7. Recipient site preparation Area is cleaned and numbed with administration/injection of local anaesthesia. Trimming/removal of surrounding hairs in the recipient areas may or may not be required.
  8. Site-making The doctor uses small customised blades to make size-specific incisions, placing them in a predetermined density and pattern, and angling the wounds in a consistent pattern to promote a realistic hair design.
  9. Hair Implant The earlier harvested grafts will be carefully placed into the pre-made sites by a team of trained nurses and hair technicians.
  10. Dressing Antibiotic ointment and Calecim Stem Cell serum will be applied to the donor area and the area will be bandaged for 1 day. The recipient area is left exposed to be sprayed with a special solution provided to you to keep the area moist and healthy.

What To Expect After A Hair Transplant?

For the first two weeks…

Life goes back to normal for most patients the day after a procedure. That being said, there are some things you must avoid to encourage recovery and prevent grafts from dislodging in the first week.

These include:

  • Physical exercise, including activities such as golfing. Although most patients can resume light exercise such as walking or jogging after a few days, we caution against physical activities for the first week.
  • Submerging your scalp in a bath or pool
  • Usage of styling or chemical sprays
  • Excessive sun exposure, as this can cause damage to both the scalp and hair follicles. The scalp is very sensitive to UV rays after the procedure!
  • Alcohol and tobacco, as both affect circulation to the scalp which is vital for recovery.
  • Hair dye, due to chemicals
  • Touching or rubbing your head
  • Bending or lying down. Keep the head elevated by sleeping in a recliner or with up to 2 – 3 pillows for the first 2 – 3 days.
  • Wearing a hat, however loose-fitting, for the first 2 days might dislodge the grafts

FAQS on Hair Transplant

Will I feel pain during and after the transplant?

The first 5-10 minutes will involve the injection of local anaesthesia which will then numb the area of harvesting. You may experience some discomfort during this period of the procedure but after that, the excision and extraction are painless.

There will be another round of smaller local anaesthetic injections to prepare the recipient area (bald area) for implantation of the follicular grafts, which can be slightly uncomfortable as well, during the 2nd part of the hair implant procedure.

After this, you will not feel any pain and your scalp will feel numb for up to 18 hours.

Most patients may require 1-2 days of mild painkillers post-operatively but prolonged pain is uncommon. It is important that you inform your hair restoration doctor if you experience prolonged pain after a hair transplant procedure.

 

Does the transplant procedure leave scars?

Using the hybrid punch FUE hair transplant technique, the donor area skin heals very well. Note that FUE (or FUEE) is not a scar-less procedure – upon close inspection tiny spots of 0.8mm hypopigmented (lighter colour than your original skin colour) marks can still be noticed if you shave your head.

If you leave your hair out to 3-5mm in length at the donor area, these ‘scars’ will not be visible.

 

Can the patient go back to work right after the surgical procedure?

While we have had patients go back to work after the procedure, this is not advised unless your work is completely sedentary. There will be a bandage that covers the donor area to keep the area free from bacteria and to ensure quick healing. The bandage will be removed one day after the procedure and your hair and scalp will be washed in the clinic by our team, to ensure that the grafts are not damaged.

Further instructions will be given to you on how to care for the areas operated on over the following few days including hair washing techniques, skin healing serums and a regime of antibiotics to prevent infections.

 

How many days to fully recover?

At the 1-week mark, the donor area hair would have grown out sufficiently to cover up the punch marks caused by the FUE (or FUEE) procedure. At this point, scabs would have formed, which signify that the healing process has started and some scabs may have already started to drop off at the 1-week mark.

We advise that you avoid heavy physical activity for the first 2-3 days after a hair transplant procedure. We also advise against steam rooms, saunas and chlorinated pools for 1-2 months after the procedure.

 

How long will it be before the patient notices a difference after a hair implant?

The first 1-4 months after surgery involves hair shafts detaching from the implanted roots and you may feel that all the implant hair has ‘been lost’. From 4-6 months, new strong transplanted hairs will start to sprout. From 6-9 months, the implanted hairs will appear denser and you will see 80% of the results at 9 months.

It is usually one year after your hair transplant procedure that you see full results, as hair follicles go through a cycle of shedding and then growing. Some hair restoration physicians state that there will be further improvement up to 18 months.

 

What are the most important considerations when patients are thinking about going for a hair transplant?

You should feel comfortable with the clinic and team that is treating you. You should be consulting the doctor who is performing the surgery for you and he or she should be able to answer all your questions pertaining to your condition.

While hair transplant may be touted as a permanent solution to your hair loss woes, you may not be the most suitable candidate for the procedure. At Terra, we may suggest that you go on medications or perform a regenerative medicine procedure such as Regenera Activa to stop further hair loss and optimize the condition of the existing hairs first.

For general hair restoration procedures involving the hairline, your doctor will discuss your expectations with you. Because the procedure is a permanent surgical treatment, the hairline that you decide on with your doctor should be able to ‘age’ with you. In other words, the hairline should still look natural 30 years down the road.

Most importantly, hair transplantation surgery or hair restoration surgery is a medical procedure and must be performed by a team that involves a medical doctor trained in the procedure. The ISHRS position statement that physicians are in charge of all the surgical decisions and incisions should be adhered to.

 

What are the general costs of treatment?

Hair transplant in Singapore costs around SGD$6000 for small cases and up to SGD$15-20k for complicated, larger cases if performed by a professional team led by a doctor. If you would like to know more, contact Terra Medical Clinic for further information.

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