“Hair – something that we do not cherish till it is gone.”
Non-invasive medical hair loss treatments like topical Minoxidil, oral medications like Finasteride and Low Level Laser Therapy are effective and safe. However, not every hair loss patient responds to these treatments.
This is when Hair Transplant should be considered. Sooner, rather than later.
1. When do I need a hair transplant?
Amongst medical treatments for male pattern hair loss, hair transplant surgery or hair restoration surgery is the only permanent solution and the results are lifelong.
If you are still suffering from Male Pattern Hair Loss even after an adequate trial of the non-invasive medical hair loss treatments, you should consider Hair Transplant/ Hair Restoration Surgery.
2. What is a hair transplant?
Hair transplant surgery or hair restoration surgery is a minimally invasive medical procedure that removes hair follicles from one part of the body, called “donor site”, which is typically the back of the head, to a balding part of the body, called “recipient site”.
3. What is the science behind hair transplants?
The principle of hair transplant is “donor dominance”.
Hair follicles are the sides and back of your scalp are androgen-independent, whereas hair follicles at the top of your head are androgen-sensitive.
This is why hair at the sides and back of the scalp are preserved even in advanced male pattern hair loss.
The androgen-independent hair follicles retain their resistance to Dihydrotestosterone (DHT) even at the recipient site.
4. How is a hair transplant carried out?
There are two primary techniques for hair transplantation currently in use. The FUE (Follicular Unit Extraction) and the FUT (Follicular Unit Transplantation)/ Strip methods. They differ in the way hair follicles are extracted from the donor area.
In Follicular Unit Transplantation (FUT/Strip), a long, thin sliver of tissue removed from the donor area in the back and sides of the scalp and the individual follicular units are removed from that strip via stereo-microscopic dissection. The wound edges are then closed leaving a single linear scar.
In Follicular Unit Extraction (FUE) hair is harvested through small circular incisions over a larger area of the donor zone leaving tiny, round scars less than 1mm in diameter.
5. FUE – the choice for faster recovery
No linear scars will develop from the procedure, which is good for those who have a history of keloids and hypertrophic scars.
Recovery time is shorter because the small holes that are created for the FUE heals within a shorter period of time compared with the strip method used in FUT.
6. Robot-assisted FUE- a cut above the rest?
As hair transplant is a tedious process which requires much concentration, manual dexterity and time, the use of robotic assistance claims to improve the accuracy and precision of the graft-harvesting process for FUE as the robot does not tire or fatigue. It also allows for the intelligent identification of the quality and robust hair to be selected as grafts.
While robotic FUE sounds like a definite game-changer in the field of hair transplant, the use of robots tends to be more expensive due to the patented technology. Experienced hair transplant doctors and technicians have claimed to be able to give comparable results as robot-assisted hair transplants.
7. Where else can hair be transplanted to?
While too much facial hair might be a hassle, having the lack of facial hair as an equally problematic issue for others. Men who look “baby faced” due to a lack of facial hair have sought out hair transplant to their beard as a solution to look more mature and authoritative.
It is also possible to transplant hair to other facial regions such as eye brows and eye lash.
8. How much does a hair transplant cost in Singapore?
The cost of a hair transplant in Singapore is usually priced based on the number of grafts transplanted.
The price variations depend on:
- Technique – manual FUE ($4/graft and beyond) vs Robot FUE ($6/ graft and beyond)
- Experience of doctor and hair technicians
- There are also costs related to the initial consult as well as after-care products.
9. What makes a good hair transplant result?
Hair transplant is an art as much as it is science. A well-constructed hair line helps to frame the face and enhance one’s overall appearance.
A bad result is when there is suboptimal growth of hair at the recipient site and the appearance of the hairline is unnatural.
10. Why should you choose your hair transplant doctor in Singapore wisely?
Just like how you choose a hair stylist, you should pick your hair transplant doctor in Singapore wisely.
It is important to go to a well-trained and experienced hair transplant doctor who understands your aesthetic goals because:
You have limited number of grafts at the sides and back of your scalp. Grafts that do not survive leave you worse off than before – you have less hair at both donor and recipient sites. Extracting the follicles is only one part of the hair transplant process.
Surgeons also need to have expertise and experience in selecting the grafts, as well as storing, handling and inserting them.
A natural hairline is dependent on several qualities such as angle of placement and density.
11. How long does a hair transplant take?
The duration of the procedure depends on the number of grafts implanted, type of procedure, technology and experience of the hair transplant team.
A typical procedure involving 1500 to 2500 grafts can take 5-8 hours.
Robotic FUE is faster than manual FUE.
12. How is the recovery process after a hair transplant?
Immediately after the procedure
You will be able to see the shape of your new hairline immediately after the FUE transplant. However, do not be shocked to see scabbing around each follicle.
There might be some side effects such as swelling and discomfort at the donor and recipient sites. This is only temporary and will resolve within a matter of days.
Within the next 1 month
Around two weeks after your FUE surgery you may be horrified to discover your newly transplanted hairs are all falling out. Don’t worry! This is a normal part of the procedure. The old hairs falling out are a natural and essential part of the life cycle and make way for new hairs to grow at the graft site. It does not mean that the grafts haven’t taken root.
Hair only grows around 1cm per month so it could take some time for your new hair to become visible.
After 4-5 months you should start to be getting a good idea of the final appearance but it can take as long as 18 months for the full hair transplant to be visible.
Beyond 6 months
You can trim, cut, shave, or clip the hairs as you choose without fear of doing any damage. A hair transplant is a permanent procedure and the results are lifelong.
13. Next frontier – transplanting hair from body to scalp
What if there isn’t enough hair at the scalp donor site due to scarring or advanced Male Pattern Hair Loss?
There is on-going research on transplanting hair from the beard and body regions to the scalp. While the concept seems promising, body hair characteristics such as thickness, length, and hair cycle may not completely match to that of the scalp hair.
This is a timely reminder to seek out a hair transplant sooner rather than later as hair from the back of the head is still the best choice of donor sites.
Dr Justin Boey set up his own aesthetic clinic after practicing at the National Skin Centre (Singapore). He has previously carried out clinical preceptorships in Seoul, London, and Boston. He is an avid athlete who enjoys regular exercise.
- Gupta AK, Danika CA et al. “Progression of surgical hair restoration techniques.” J Cutan Med Surg. 2015 Jan-Feb;28(1):17-21.
- Rogers NE, “Hair transplant update.” Semin Cutan Med Surg. 2015 Jun;34:89-94.