The hair transplant procedure is done in the office surgical room under local anaesthetic. You don’t need to be “put under” with a general anaesthetic. This means that you are awake, but the scalp involved is totally numb. You don’t feel any part of the surgery. Dr Elliott gives each patient a sedative medication before the surgery, so you will probably sleep for the first hour, or so. The area that receives the grafts is called the recipient area and the donor area is where the follicles are taken from. Both are planned out in advance. The donor area is removed and the scalp on both sides closed back together with stitches. The hair at the back of your head covers the stitches, so nobody will ever see them.
While the doctor makes the tiny incisions, one for each graft, in the recipient area the donor tissue is dissected into grafts according to the surgical plan. Dr Elliott makes all of the incisions and personally monitors all aspects of the procedure. The grafts are then implanted one at a time. Once all the grafts are in place, the surgical team double-checks everything until they are totally satisfied. Your hair is cleansed, dried and styled. No bandage is needed and you can leave wearing a hat. Dr Elliott then reviews your procedure with you, explains post-operative instructions, gives you medications to take home in case you have discomfort and his phone number in case you have questions. He also takes your number and calls you that evening.
What Do I Do This Whole Time?
The surgical chair is like a Dentist’s chair. It’s comfortable. Most patients nap, watch a movie or listen to music. If you are hungry or thirsty, you can eat and drink. If you need to get up and stretch, you can. If you have questions, they answer them. In short, the team does whatever they need to do to ensure your comfort.
Do You Have to Shave My Head?
No. Although some clinics insist on this, Dr Elliott and his team will work through existing hair to place the grafts. This makes it much easier to conceal afterwards.
Am I Going to Have Pain That Night?
Dr Elliott’s patients will tell you they either had none or just had to take a little pain medication to stay comfortable. Remember, Dr Elliott has had this done. He does everything that can be done to prevent pain, both during the surgery and with the special long-acting anaesthetics that he uses. If you have pain, you’ve got pills to take for it. If you still have a problem, he is always available.
What Happens the Next Day?
The following day, you come back to the office and the team washes your hair and the grafted area. Dr Elliott checks everything and answers any questions you may have. You are shown what to do and what not to do to take care of everything.
What Happens Then?
During the first week, you may notice that some of the grafts form a slight “crust” on the surface. This is normal and these will gradually come off as you wash your hair. Some of the crusts will have a couple of short pieces of hair in them. This is not the graft being lost, simply the release of the little hair fibre that the graft contained.
What About Swelling in the Forehead?
This happens sometimes after the procedure starting at 36-48 hours and lasting 2-4 days. It does not interfere with the success of your surgery, or how your hair will look. Through technical evolution, Dr Elliott has eliminated bruising or blackening around the eyes after the procedure.
What Happens to the Existing Hair After the Grafts Are Put Into an Area?
In the long term, it behaves just as it would if you not had transplants. Hopefully, you are using medical treatment so you won’t lose it. It is important that you realize that you may shed some of this hair in the first 3-4 weeks after the transplant. This is because some of those follicles will go into the telogen resting phase and shed their hairs. That hair will re-grow after a month or two unless it was almost shut down from AGA. Yet another reason to take Finasteride.
How Can I Minimize This Shedding?
Start Finasteride, ideally in combination with Minoxidil, at least a month prior to your transplant. The hair most vulnerable to shedding is hair that is withering from AGA. Get it into better shape before your transplant with medical treatment.
When Does the Hair Start to Grow?
The grafted follicles shed their hairs and rest for a few weeks. At 12-16 weeks after the transplant, the first growth appears. This gradually thickens over the next 4-6 months. This means a gradual improvement in your hair, rather than something everyone will notice.
How Do I Know Everything Is Fine Afterwards?
Your follow-up appointments are made for 8 days (stitch removal), 3 months, 7 months and one year. At each of these visits, Dr Elliott checks on your hair and takes digital photos to track your progress. He personally monitors the results of each surgery and each patient’s satisfaction. Anytime you have questions, you can call or see Dr Elliott.
What About Donor Area Scars?
Skilled surgeons know how to minimize scars from surgery. The donor scar in skilled hands will be a line 1-2mm wide in 95% of patients. The Trichophytic closure also causes hair to grow right through the scar, making it invisible in most patients. These patients find they can cut their hair as short as they want and still cover the scar. Five per cent of patients will form a slightly wider scar due to the nature of their skin. This does not mean they can’t have transplants, just that they may need hair length of 1-2 inches in the donor area. With FUE, the scars are multiple micro-dot scars that are not visible.
What About Scars Where the Grafts Are Inserted?
If the surgery is done expertly, there are no visible scars where the grafts are put. The scalp could be shaved and nothing was seen.