Why Choose Dr. Swinehart?
Why Does Hair Transplantation Work?
What Is State Of The Art?
How Is Hair Transplantation Performed?
How Many Sessions Are Required?
Follicular unit grafting has revolutionized our approach to many forms of hair loss. With his method, many hundreds, or even thousands, of your tiny living grafts ("follicular units") containing only one, two, three or four hairs are inserted in closely spaced fashion (as close as 1/16" apart) over the entirety of your bald and thinning areas. These micrografts, which approximate the one to three hairs which naturally originate from each of your original follicles, result in a very natural, aesthetic appearance. Randomly-spaced single hairs can create an especially pleasing, feathered hairline.In contrast, older or obsolete methods of hair transplantation practiced in the 1960's and 1970's nearly always resulted in a "clumped" or "bristle brush" appearance. The "Barbie Doll" appearance of hair transplant plugs (round grafts containing generally 9-10 or more hairs) is unfortunately nearly always quite conspicuous, and worse, permanent. During the 1980's minigrafts (smaller clumps containing 5-8 hairs) were an improvement, but only served to generate smaller "clumps". Indeed, approximately 1 out of 4 cases at our hair restoration surgery center involve the repair and/or hairline camouflage of these "plugs" or "minigrafts" placed at other clinics. Even more unfortunately, at some locations, these larger grafts are still utilized. |
Unsightly "Barbie Doll" hairline from hair transplant surgeon who still uses round "plugs" |
The benefit from follicular unit micrografting, versus plugs or minigrafts, can be visualized by viewing a group of tree trunks: even though the cross sectional area of each tree is large, one can clearly see space between the trees. In contrast, the tiny branches of a hedge, with a much smaller total cross sectional area, still create a much more dense visual barrier. |
29 year-old male with receding hairline |
Same patient, after only one session of 1-hair and 2-hair micrografts. Can you tell the difference between the grafts and his natural hair? |
The insertion of micrografts between your existing hairs, leaving them undisturbed, can systematically restore density to your scalp hair. Thus the grafted hairs may compensate for the loss of your natural hair. The successive placement of many of these micrografts over several sessions can even prevent the appearance of baldness in selected patients with remaining, but thinning, hair. |
Marked thinning, on crown, in patient in 50's |
Same patient, after 2 "hair-thickening" sessions of micrografts. An additional session would be add even more density |
21 year-old white male with anterior crown thinning with very strong family history of baldness. This patient did not want to wait until he was completely bald |
Same patient, after 3 "fill in" micrografting sessions with a beautiful result. Note that a mature hair line has been anticipated in preparation for the appearance that would be desirable during the patients middle-aged years |
We perform all procedures in an operating room fully equipped with monitoring equipment, emergency supplies, and sterile instruments. Prior to the procedure, photographs will be taken and the surgeon will carefully trace your hairline with your approval. Then, once an IV line has been started, you will be given relaxing and pain medications, usually by mouth. |
The essence of extensive micrografting: a small strip from the donor area is dissected and cross dissected into micrografts containing 1-4 hairs each |
The various sizes of micrografts are carefully matched to dilators (if used) and special needles; These micrografts are then inserted into "zones" of single-hair micrografts (in front) followed by 2-hair and 3-hair micrografts, with 4-hair micrografts placed into the crown for density. |
In patients who are quite bald, or who desire repair/camouflage of older plugs, small "microholes" of bald scalp or scar tissue may be removed prior to graft insertion.The hair is then patiently inserted under magnification with a jeweler's forceps, by the staff, until your scalp recipient area has been blanketed with micrografts. All grafts are carefully inspected and readjusted, if necessary, at the conclusion of the operation. No stitches are necessary in this recipient area - the body's own "glue" from the clotting process keeps the grafts in place.After application of a sterile dressing, you will be discharged from the operating room. You generally will receive a phone call that afternoon and that evening, and you will be seen the next day for a dressing change and examination of your transplant. |
This second dressing can be removed on the second day (48 hours), followed by a light shampoo. On the third postoperative day, following shampooing and hair styling, many patients can return to work. The stitches in the donor area are usually removed in 10-12 days. Tiny pinpoint crusts are generally present for 2 weeks; small red dots may delineate the graft sites for a month or so. Occasionally, a small "pore" may be present at the site of the graft insertion.Immediately after the operation, the grafts usually go into the "resting state". The transplanted hair then starts to appear in approximately 2-4 months, growing at a rate of approximately 1/2 inch per month after that. Thus, it will take a number of months to see the growth from any one session. |
33 year-old white male with deeply receding temples |
Same patient, after two sessions of 1-hair, 2-hair and 3-hair micrografts displaying a beautiful, natural result |
In each surgical session, the grafts are inserted in-between existing hairs or previously placed micrografts, yielding considerably increased hair density after 4 sessions |
Follicular units can generally be situated no closer than 1/16 inch from each other; closer packing would cause "popping" (extrusion) of adjacent grafts, and could interrupt the blood supply. However, normal human hairs are located much closer together than this. Thus, 3, 4, or even 5 sessions will be required to fill in these "spaces". The timing of these sessions depends, of course, on the rate of progression of loss of remaining natural hair and the needs of each patient. In general, however, sessions are spaced at least a minimum of 3 months apart in order to allow the new grafts, and blood supply, to become established.It is important to realize that a dense result cannot be achieved with one session of follicular units. Even 3 or 4 sessions, on a fairly bald scalp, will ideally result in a "naturally thin" appearance.The final result, under the best of circumstances (dense, coarse donor hair, with considerable remaining scalp hair) may approach your hair's original density. This is balanced, however, by the much more natural appearance of the tiny hair grafts. |
The gradual increase in density from micrograft sessions 1, 2, 3, and 4 is evident |
41 year-old white male with one of the most difficult challenges in hair replacement surgery: coarse, straight. dark hair contrasting with light skin |
Same patient, after 1 micrograft session |
Same patient, after 3 extensive micrografting sessions |
Same patient, after 4th session of micrografts: note natural hairline combined with considerably increased density in anterior crown |