Many factors have been found to contribute to hair loss in women. These include:
Many things can be done to improve the density of your hair and to stop or slow the rate of hair loss in women. A full medical workup is required to assure additional medical causes aren’t contributing to this thinning of hair. Transplantation of hair follicles remains a good option for many women and it can be done using two techniques, FUE or FUT, depending on your desired goals.
Dr. Elise Ludwig developed a classification system which groups women into three main subtypes. In Type I, hair starts to mildly thin at the crown. Type II will have a noticeably wider thinning of the crown. In the most advanced stages, Type III, extensive thinning will be seen at the top of the head.
Follicular Unit extraction (FUE) is performed by taking single hair follicles out of a donor area, commonly the back and sides of the head and transplanting them into the balding area. This technique is best for those who wear their hair short and are concerned about a linear scar in the back of the head. Tiny round 1 mm scars where the hair is harvested often heal very well.
Follicular Unit Transplantation (FUT) is performed by taking a strip of hair from the back of the head and with the help of multiple technicians the hair is slivered down into individual follicles on a table near the patient. Once the follicles are prepared, they are transplanted into the area needing hair. This technique is best for large volumes of hair transplantation as it allows multiple people to prepare the hair follicles at one time and a larger number of follicles are harvested.
Please come to the office the day of your procedure having washed your hair using a mild shampoo. After arrival, Dr. Wallin and his team will help assist you to maintain your comfort. The day starts with photographs to be able to track your progress. Bring the prescribed medications with you on your day of surgery. The donor area is commonly shaved to a length of 1-2 mm. The scalp will be numbed using an injection and your head cleansed to assure a clean maintain a sterile environment.
The procedure can take several hours to complete and breaks can be taken as needed.
Sleep in an upright position the first night after surgery using a recliner or pillows to maintain your head above your heart. This will help reduce swelling of the scalp and forehead. Try not to sleep on your face as this can add to facial and eye swelling that is common 3-4 days after surgery.
The dressing applied the day of surgery should remain in place for 24 hours. Mild donor site bleeding can occur the first night after surgery and an old pillow case is recommended. If not self-limited, the bleeding can be stopped using firm pressure on the area for 5-10 minutes with a dampened gauze pad. Please do not rub the area.
Some patients will experience facial swelling after the transplantation on the third or fourth day. To reduce swelling of the forehead or around the eyes, apply an ice pack around the eyes for 5-10 minutes every hour while awake for 24 hours using caution to avoid direct contact on the skin which could be numb. PLEASE DO NOT APPLY ICE TO THE GRAFTS. Please avoid heat to the head as this will worsen the swelling.
Scabbing will form over the transplant sites and solidify the first few hours after the procedure. These scabs will naturally fall off within 1-2 weeks. PLEASE DO NOT PICK OR SCRATCH AT THESE SCABS. Doing so will endanger the healing of the graft and could cause scarring or increase the chance of infection. Don’t be alarmed if there are short hairs in the scabs when they fall off as the hair bulb will remain in the scalp. The scabbing period is shorter in time if you use the supplied saline spray to spray the recipient area every 20 minutes for the first 48 hours.
You may shower after 48 hours. Lightly wet the hair in the shower without letting the full strength of the flow hit your head, spread shampoo in your hands, and gently pat the shampoo on. Most patients find a plastic cup helpful to apply water. PLEASE DO NOT RUB YOUR SCALP. During the first 5-7 days the grafts can dislodge in the shower if you are not careful. The grafts are secured to the recipient site between the sixth to ninth days. It is recommended to wash your head daily for the first 2 weeks.
Some patients will experience localized swelling around the transplanted hair during the first two weeks. This is self-limiting and resolves with time without harming grafts.Aloe vera can be used to reduce inflammation around the follicles and the healing of the donor site after 7 days.
It is common for the transplanted hair to experience “effuvium” or “shock loss” and the hair will shed from the transplanted follicle. After the hair follicle has had time to heal it will grow again most commonly between six to nine months after surgery.
Avoid strenuous activities including having your head down/bending, exercise, and swimming for one week. Heart rate elevation can lead to bleeding and sweating can present problems with your healing. Most activities in the workplace should be easily resumed a day or two after the procedure. Sun exposure should be avoided and a loose-fitting hat should be worn while the surgical areas are healing.
PLEASE DO NOTE USE PEROXIDE on your scalp or other ointments unless instructed by the physician. This could affect the healing or success of the procedure.
If you’d like to learn more about any of these options, Dr. Wallin would love to talk with you. Call us at (435) 627-8150, or reach out to us online to set up an appointment to meet one-on-one with a talented plastic surgeon.