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Permanent hair transplant involves the removal of the hair-bearing portion of the scalp surgically and its relocation to an area of absent or thinning hair. This option has become very popular in recent years as an alternative to medications and other hair loss solutions. The entire permanent hair transplant procedure comprised of three phases, namely the pre-operative preparation, the surgery and the post operative care. Pre-operative preparation involves a consultation where the surgeon analyzes the patient's scalp. He maps out a treatment plan with the patient, discusses the patient's preferences and expectations and recommends the best approach, while at the same time, explaining what can be expected after the operation. Days prior to surgery, the patient is instructed to refrain from using any medicines and from taking alcohol. He or she is also prescribed antibiotics to prevent infections. The actual transplant is conducted in an outpatient setting with mild sedation and topical anesthesia. The procedure lasts for about four hours after which, the scalp is shampooed. Treatment with an antibacterial prior to the donor scalp being harvested is given. A skin from the posterior scalp in an area of good hair growth is excised. While the surgeon is treating the wound where the skin was taken, his assistants will begin to dissect individual follicular unit grafts from the strip. Extra care is taken to remove excess fibrous and fatty tissue without causing damage to the follicular cells that will produce the patient's first crop of new hair. After the dissection, the surgeon will then puncture the sites for the receiving grafts, implanting them in a predetermined density and pattern angling the wounds in a consistent pattern to promote a realistic hair pattern. Assistants usually finish the procedure by inserting the individual grafts in place. At the most, surgeons can place 50 grafts per square centimeter. Prolonged surgery involves the implantation of over 2,500 to 3,000 grafts in one session. Certain advances in post-operative care allow for semi-permeable dressings for quicker seepage of blood and tissue fluid. Wounds should be dressed at least once a day. The patient is advised to keep away from the sun and to prevent shampooing the hair for about a week. For ten days after the surgery, almost all of the transplanted hairs will fall out as a reaction to their relocation. New hair will begin to emerge from the moved follicles after two to three months. The patient's hair will grow normally and will continue to thicken thorough the ensuing six to nine months. Subsequent hair loss will probably occur in untreated areas and patients can either use medications to retard such loss or schedule a subsequent permanent hair transplant procedure sometime in the future.
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