Welcome to the “Ask the Doctor” section of the Hair Restoration Center of Savannah.
Dr. Ron Finger, the first-board certified plastic surgeon in Savannah is here to answer any and all questions that you have about hair loss – from nutrition, supplements to surgery – Dr. Finger is “on call” and wants to hear from you.
Please allow 24-48 hours for a response. Thank you!
How long does a hair transplant procedure take?
Approximately 4 hours for each 1,000 grafts
Am I awake during the procedure?
Yes. You may be given a sedative and the area will be injected with an anesthetic before and during the procedure.
Is the procedure painful?
There is minimal discomfort during the procedure.
Do the transplanted hairs grow?
Yes. They will continue to grow just as they would have grown in the back of the scalp, from where they came. If properly done, they will grow for a life-time.
I was told that newly transplanted hair will fall out. Is this true?
Usually within 10 days to 2 weeks the transplanted hairs fall out, and the new permanent hair starts to grow at 3 to 4 months. About 50% have started growing at 6 months and 95% at 12 months.
What do the new hairs look like when they are fully grown?
They will be like the thicker hairs in the back of the scalp once they are mature, usually about 9 to12 months.
What is the immediate result after the transplant?
There is some swelling and some very small scabs for several days. Then at 10-14 days the hairs fall out as mentioned above. However, we have some patients whose hairs never fell out, but continued to grow. It takes between 9 and 12 months for full growth and the final result.
How long does it take for the new hairs to grow?
The first hairs start to grow at 3 to 4 months.
What do I look like after the surgery? Can I go back to work the next day?
Your scalp may be bandaged for the first 24 hours. After the bandage is removed, there is some swelling and small scabs on both the donor and recipient sites. These heal within 4-5 days. Those who have the procedure on a Thursday or Friday may return to work the next week. Actually, some patients return to work within 2 days, but they still have significant swelling, although it has begun to subside.
What causes hair loss?
Genetics from either mother or father. In addition, excess DHT (dihydrotestosterone) also causes hair loss. This can be reduced with medications, such as Propecia, which blocks the conversion from testosterone to DHT.
Where will my “new” hair come from? Will the results be permanent?
In a horseshoe shaped area at the very back of the head, permanent hairs and their follicles are found in good supply in virtually all men for their entire life time. This area is dubbed the “donor area”, because it is the area in which we “harvest” the hair follicles for the NeoGraft FUE (Follicular Unit Extraction) hair transplants. And, these hairs are permanent regardless of the area in which they are relocated.
The areas that receive the grafts are called the recipient sites. The follicles come as what we call follicle units, which contain from one to occasionally four hairs each. Hairs (with their follicles) from the donor site are relocated to areas that are thinning and balding on top, back, and/or at the front of the head.
This process must be carefully planned considering the age, density of the hair follicles, and even the thickness of each individual hair. People have about 100,000 to 150,000 hairs follicles on their heads, and each one must be utilized very carefully due to the finite number available (although body hairs can be used for grafts in some cases). The strategy and design requires a thoughtful process and the skill of a fine artist or sculptor.
A natural appearance and fullness requires grafting these follicles to different areas of the scalp according to the different numbers of hairs (from one to three, sometimes four) per follicular unit. Single hair follicles are used for the hairline, which achieves the most natural look, and the grafts with more hairs are used behind the hairline for more density.
Each graft is skillfully and tediously placed with the hairs at the proper angle at the recipient site. For example, hair on the sides of the scalp is placed at a sharp angle downward, whereas on the crown, the hair may be swirled, each hair angled outwardly from the center. Understanding the transplant process, you begin to appreciate how the expert in charge of your transplant must be equal parts artist and technician.
Our goal is one and the same with yours: to create a result that is natural and a hairline that’s right for you as an individual. We take into account the shape of your face, unique features, age and, importantly, your final approval. You should be comfortable with your doctor to ask whatever questions you have, and feel as if you’re a collaborator during the process.
Can you transplant hair to the eyebrows?
The loss of eyebrows is very common, especially in women who have over-plucked them. Unfortunately, plucking eyebrows often damages the hair follicle and the hair is lost forever in many cases.
Fads come and go regarding the trends for eyebrow thickness, and many people become overzealous when they have their tweezer in hand. I have known people literally who plucked out all of their eyebrows and then were unable to grow eyebrows at all! And still, there are other cases when the cause of eyebrow loss is the result of burns or an injury resulting in scars to the eyebrow area.
Many of these patients resort to medical pigmenting or “tattoos”, and although it is helpful to have some color in the eyebrow location, it isn’t a natural-appearing eyebrow. You’ve probably seen the commercial for Latisse used for growing eyelashes. You can also use this product on the eyebrows, and it does result in hair growth in many cases, and I suggest using this initially. It’s available by prescription and is an easy-to-apply topical solution.
If Latisse is not successful, the next step is NeoGraft FUE (follicular unit extraction) transplantation from the back of the scalp to the eyebrows. This procedure works, but must be done meticulously and with great skill by someone who has experience in this subspecialty of hair transplantation.
Here’s how it works: the hairs must be surgically removed with the NeoGraft as single hair follicles from the back of the scalp. They must then be inserted into a previously designed brow at an extreme angle and also in the proper direction to achieve a normal looking brow. Typically from 250 to 350 grafts are needed for each brow. Remember that these are hairs from your scalp, so the will continue to grow and must be trimmed when too long.
The procedure is done under local anesthesia and takes from 3 to 4 hours to perform. After the procedure there may be some minor scabbing for a few days. The hairs will fall out at about the third week from “hair shock,” which is typical. They then regrow at about the third or forth month and then you’ll have eyebrows forever. If not done properly, the hairs may grow in the wrong direction and/or the brow may have visible scars. These would be rare when done with someone with the necessary artistry, skill and experience. NeoGraft is the state-of-the-art in hair transplantation for both the scalp and eyebrows.
What are the alternatives to a hair transplant?
Medications such as Propecia and topical Minoxidil will slow the hair loss and may even thicken the hair somewhat. Another alternative is to wear a hairpiece of some sort. The only permanent treatment is hair transplant, and the NeoGraft FUE system is far and away the best and most modern method. NeoGraft leaves the transplanted hair looking entirely natural.
What are the most common complications from hair transplant?
The most common problem with the “strip” methods are painful scars, numbness, prolonged recovery time and hair follicle transection, which reduces the number of grafts that take and grow. With the NeoGraft the most common complication would be folliculitis, which are pimples. These may show up when the new hairs are making their way through the scalp skin. This is a temporary problem and is treated with warm soaks to the involved areas.
What is the cost of NeoGraft hair transplantation?
We charge by the number of grafts, and if one opts to receive more grafts the charge per graft is reduced. With the NeoGraft, the percentage of “take” of the grafts is greater because of the reduced transection. I suggest looking for doctors who use the most experienced technicians for your procedure. Our experts have over twenty years experience each with hair transplantation, which assures you of the highest quality and “take” of the grafts.
I had hair transplantation 20 years ago, and they look like I sprigged my yard. Do they look more natural now?
Yes. It sounds as if you had hair plugs. We now use very small grafts, and each graft contains 1 to 3 hair hairs instead of the 8-10 that you have. Single hair grafts are perfect for the front hair line and look entirely natural.
If transplants are so natural looking, why doesn’t everyone who is losing hair have the procedure?
For many reasons. Most people are unaware of the advances made in hair transplant surgery. Very few NeoGraft machines even exist at this point, but they are increasing throughout the country rapidly. We, at Finger and Associates, were the first to have the NeoGraft equipment in Georgia, South Carolina, North Carolina or Alabama. I expect this to change in the near future. Another reason, some people are not good candidates for the procedure. Your physician will determine if the procedure is best for you.
Can I wear a hair piece after the procedure?
The density of the hair piece is thicker than natural hair density. We encourage people to discontinue wearing the hair piece before surgery. That way they can be more accepting of their hair loss and have realistic expectations of their final result. We also discourage using a hair piece following the surgery, as hair pieces often contain bacteria, yeast and are unclean. This can result in an infection which could compromise the final result.
