Avoiding the hair transplant look

Avoiding the “hair transplant” look

A bad hair transplant is easy to spot. The uneven, patchy effect of large, pluggy grafts occurs when a surgeon uses larger grafts containing many follicular units and the spaces between the grafts are wide. As the grafts heal, they contract and create a contrast between the bald skin and the islands or clumps of hair. Ultimately, the patient is left with a scalp resembling a doll’s head. Larger graft hair transplants took more skin from the scalp, and it produced subtle deformities in the scalp. Skin abnormalities with larger grafts occur for three reasons:

The surface of the transplanted skin may not be aligned with the surface of the surrounding scalp. This problem develops in larger hair grafts when the transplanted skin has enough mass to produce the problem.
Scar contraction and/or skin dimpling may occur at the recipient site during the healing process. As the grafts increase in size, these abnormalities occur with increasing visibility.
As the skin of the graft heals, the melanocytes (the part of the skin that produces pigment) may not recover from the transplant process and give the graft a whitish appearance. This is particularly a problem for anyone with a dark skin color.

Hair in its natural state is composed of hair groupings of follicular units that have one to four hairs close together. In nature, the leading edge of one’s hairline is comprised solely of single-hair follicular units with less density than the hair further back on the head. To appear natural, a hair transplant should simulate that look as closely as possible.

To understand the terminology of hair grafts used by different surgeons, hair grafts can be divided into four general categories:

A traditional standard graft, or plug, is 3 to 4 mm in diameter and has 12 to 30 hairs.
A minigraft is 1.2 to 2.5 mm in diameter and has 4 to 12 hairs.
A micrograft is 1.0 to 1.5 mm or less in diameter and has one to three hairs.
A follicular unit is a naturally growing group of one to four hair follicles. Follicular units are smaller in size than minigrafts or micrografts containing the same amount of hair because the hair exit the skin from roughly the same pore on the scalp.

You should discuss the size of the grafts and the planned distribution of the grafts in detail with your surgeon. Some surgeons use larger grafts for some of their work and then use smaller grafts in an attempt to hide the larger grafts. Others only transplant small grafts.

Some hair transplant surgeons invent unusual terms for grafts to make it appear that they have some special, unique knowledge or technique. These terms are intended to imply special variations in graft sizes or an invisible appearance of the grafts. Don’t be fooled by this terminology.

You should be wary when a doctor claims to have a unique technology or technique that no other doctor knows about or uses, unless it’s documented and published in a peer-reviewed medical journal.

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Avoiding the hair transplant look

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