A TYPICAL HAIR TRANSPLANT PROCEDURE - A WALK THROUGH TOUR

About three weeks before the scheduled session, the patient is sent a list of "pre-op instructions", and also a map and a brief description of what to expect during the first week after surgery. Our nurse-receptionist may assist the patient with any other arrangements they need help with, such as motel or travel arrangements.

The day of the transplant procedure, the patient shows up either alone or with a driver. The hair transplant patient is encouraged to take a shower with shampoo that morning and to eat a normal breakfast. When the patient arrives, he is greeted by our staff and is handed a consent form and "medical history questionnaire" to fill out.

Reviewing Consent with the Patient

After taking about 10 minutes to review, discuss and sign consent forms, the patient usually makes one last trip to the bathroom and then is ready to get started. We first stop briefly in our small, in-office "photo studio" to take an initial series of photos from 7 different views, which can be looked at later on to measure the progress from the transplant sessions. The patient is then escorted into the operating room for his or her day's adventure.

Entering the Hair Transplant Procedure

The patient next enters our spacious and comfortable procedure room, with background stereo music playing and changes into a comfortable gown. Dr. Dauer then reviews the plan with the patient and draws the proposed hairline on the scalp, along with the zones behind it which will be filled in with the appropriate size grafts. The patient is given one last look at it with mirrors, to make sure he agrees with the plan. One final photo is then taken of the plan drawn on the patient’s scalp.

The patient is turned over on his stomach in the "prone" position, on the belly. With the patient in this position, Dr. Dauer, seated at the head of the patient with one of his assistants, then shaves a very narrow horizontal strip of hair down to about 1cm in length in the area where the donor hair will be harvested. This strip is located about 1/3rd of the way up from the bottom fringe border.

The donor area is then “tumesced” (filled by injection) with a saline solution which also has a weak concentration of adrenaline in it to control bleeding, and Lidocaine (anesthetic) to numb the region. Then, a single or double strip of donor hair is cut out by Dr. Dauer with a free-hand scalpel technique. Dr. Dauer then carefully cuts underneath the strip, leaving just enough fat to protect the follicular bulbs at the bottom of the grafts. The strips are then carefully removed and placed in iced saline.

An Infrared Coagulator device is then used to cauterize any small bleeders, and then the donor area is sutured in two layers, so as to create the thinnest possible donor scar.

The first part of the procedure is now over. The patient then lies down on his back, and the angle of the surgical table is adjusted to be very comfortable for the patient’s back and neck.

During the next 40-60 minutes Dr. Dauer carefully makes all of the hundreds of small recipient holes, into which the hair grafts will be placed. These are made, following the pattern of the zones which he drew at the beginning of the procedure, with special care taken that the direction of the hair is natural and the spacing of the grafts is random.

If the "crown" area is to be transplanted, then a few hundred narrow needle holes are made back here also, carefully following a natural "whorl" pattern. During this part of the procedure, just as in the donor area, Dr. Dauer "tumesces" the skin in the recipient area, so that the holes will be limited in their depth and not cut the blood vessels which reside deep in the subcutaneous layer of the scalp. Because of this new advanced technique, the small holes can be spaced much closer together than a few years ago.

While Dr.Dauer is making these small inicision sites, the assistants are busy cutting the harvested donor hair into hundreds (sometimes thousands) of small grafts. This process is done entirely under microscopic vision, which results in far superior grafts and better preservation of hair. There is ample communication between Dr. Dauer and the cutters, to insure that the exact number of holes that are made matches the number of grafts that are cut. Oftentimes, Dr. Dauer will make only a few recipient holes for a certain type of graft and then do a "test placement", to insure that the grafts and the holes match perfectly.

The final step in the hair transplant process is the placing of the grafts into the scalp recipient sites. At this time, the patient is quite alert and usually a lot of light-hearted back-and-forth conversation takes place while the assistants carry out the all-important task of placing the grafts. When they are finished, Dr. Dauer then puts on his magnifying glasses and gloves, and carefully inspects each graft to be certain that the position and placement of the grafts are perfect. He usually will lift a few, push a few further down, and rotate a few others – so that the hair comes out of the skin looking absolutely natural.

The procedure, which usually takes anywhere from 4-8 hours to complete (depending on the number of grafts the patient is to receive), is now over. A small bag of medications and instructions are then given to the patient and carefully explained and reviewed.

The patient the returns to see Dr. Dauer approximately 10 days after the procedure to have their sutures removed. If the patient is from out of town, arrangements are made for the patient to have the suture taken out by a physician close to their home.

The relocation process is minimally invasive and is a minor surgical procedure not much different than having a filling or crown at the dentist. While there may be some discomfort, there is rarely serious pain involved. Patients are awake and alert during the entire procedure and they can have a friend or spouse present, watch a movie and even have lunch during the procedure.

How Will I Look After a Transplant Procedure?

Some people are concerned about how they will look after the procedure. Since hair restoration is a minor form of surgery, directly following the procedure it may be possible to return to normal activities such as work. Some have visions of your entire head being bandaged and so on. We do however recommend rest during the day of the procedure.

During the days following the procedure, the patient can return to work and recreational activities. We recommend refraining from strenuous activities such as weight lifting, racquet ball or tennis for a week or two to avoid accidentally damaging the grafts. The hair can and should be washed gently with the fingers and a very mild shampoo.
After a few days, the redness will subside at the top of the head and the grafts will blend in with the existing hair.

Activities After Hair Transplants

It is reasonable to expect some discomfort after hair transplant, but there shouldn't be much pain involved. Most people also return to work the day following surgery and this is quite acceptable. While you may engage in recreational activities, try to refrain from strenuous activities or those where your grafts may be damaged, such as weight lifting, tennis or racquetball. While the hair transplant procedure is minor surgery we strongly recommend that you take off from work on the day of the procedure. Normally patients can drive themselves home after the procedure.

If you have any questions or in doubt about anything at all please do not hesitate to call Dr. Dauer immediately.

TO SCHEDULE YOUR NO OBLIGATION, FREE CONSULTATION, CALL 310.748.2224.