FEMALE HAIR TRANSPLANT

It is common for the public to think of hair transplant as a procedure primarily targeted at males. On the other hand, Dr. Vikas Gawri regularly achieves hair transplants in females for several reasons. Women over the age of 30 experience thinning of hair, so hair transplant is a general procedure that improves lushness of the hair and provides a solution for hair loss in females. Hair transplant can also be chosen to restore the hairline in women who have either lost the frontal hairline due to an aging hair loss or were born with a hairline positioned high. Finally, in some cases, hair transplant becomes the only solution for women who have undergone prior surgical rejuvenation procedures like face lifting or brow lifting and lack of hair due to exposed scars in the sideburns, behind the ears, or elsewhere.

The hairline in females are usually low-positioned and rounded as compared to male. It provides structure to the face and adds youth, natural beauty, and feminine appeal to a female face. While restoring the female hairline, it is essential not only to create a natural shape but also to recreate all of the details of a female hairline with precision. A female hairline is generally on the rounder side, more oval, rounded rectangle or some intermediate between these shapes. The minor aspect of the hairline in the female has unique intricacies that display a very different constitution to the male hairline. The hairs start and rotate from a point centered usually a little off of midline on one side and flow diagonally down the temple area.

As said earlier, it is common for women to lose hair and have thinning hair as, they grow in age. Though hair loss in females may be genetic, there are several medical cases that either prohibit surgery or make surgery pointless or unsafe. Therefore, before the operation is executed, it is vital to check a woman very thoroughly for the possibility of additional medical assessment. If the hair loss is not stable, for instance, the hair actively falls out, then surgery may not be the answer for you. A study into the dermatologic or hormonal conditions may be a good starting point in many cases. Anemia, pregnancy, or low thyroid may be the underlying cause, and Dr. Vikas Gawri may refer you to a proper physician before going ahead with the surgery. However, in many cases, he may choose to schedule surgery if he is confident that these medical therapies could be dealt with concurrently to operation and would only enhance the surgical result rather than hinder it.

A surgeon must demonstrate creative skill in managing donor (scalp) and recipient areas while also showing the artistic talent in female hair transplant and proper decision-making on whether to do a procedure or when to do it. In women, it is common to see thinning in hair that extends into the scalp area, which limits the amount of good hair for the transplant and as a result can affect the outcomes. For example, if the size of the concerned hair area needing a transplant is more than the size and density of the scalp area, then Dr. Vikas Gawri may plan out a transplant pattern that would tactically improve the results and provide more effective hair styling choices.

A woman may choose a 'T' shaped transplant if she has a loss that is higher along the midline of the head or is in the desire of keeping her hairstyle parted in the middle. On the contrary, if she wants to part her hair on the left side, then the hair loss exposed with thinned-out hair part can be covered preferably with an “L” shaped design where the long side of the L follows the hair part. These are just some of the examples of designing hair transplants for various hair-loss conditions in women. Also, many delicate variations are specific for a particular woman's desires, wants, and available donor hair.

Women will rarely go entirely bald, which is right in case of men, but they still can lose a significant amount of hair density due to aging. In some cases, women do not lose as much hair on the outside, but they undergo a thinning of the hair shaft itself, meaning the hair becomes hollow on the inside. This thinning makes the hair look much thinner and the bald head more noticeable even though the number of hair strands may not be that much. Many a time, women undergo both a hollowing of the hair and an overall decrease in the number of hair strands. This type of combined hair loss is the most common scenario and poses a higher difficulty for surgical hair restoration. The success of the result mainly depends on the thickness and density of the donor’s hair as well as other factors like curling of hair, the color/contrast ratio of hair to the scalp, and many more. Consequently, hair medical therapies, are often a vital factor to the overall approach for aiding a woman with thinning hair and in some cases may be the only feasible option when surgical hair transplant is unsafe, or otherwise not desired. Dr. Vikas Gawri recommends several treatments, often coming up with the most effective procedures that may take into account the unique situation each woman.

Minoxidil, also known as the brand name Rogaine, has a very unbeaten streak for treatment in many women suffering from hair loss. Some women, however, stop using minoxidil in the middle for several reasons. One reason may be that they do not have sincere hopes for what minoxidil can achieve. For example, minoxidil used by itself may not fully restore the density but thicken the current hair, further reduce the hair fall, and overall improve one’s condition. Also, during the initial use of minoxidil, some women may undergo temporary shedding, which can cause them to stop the treatment. Dr.Gawri advises women to oblige to minoxidil for a minimum of four to six months before assessing its success. When under preparation for surgery, he guides women to be on at least a 6-week streak of using minoxidil before surgery to keep hairs that would otherwise have a higher chance of temporarily shedding. This temporary shedding is known as “telogen effluvium.”

Hairs that are 'lose and unstable' have a higher chance to be affected by the scalp management that happens during a hair transplant, as many women are likely to shed hairs around an operation following a surgical procedure. Although hair shedding of this type is limited, it can be disturbing to women and can be lessened with proper medical therapy before the operation. New evidence claims that in many cases of hair loss in female, the primary condition is irritant in nature, i.e., the scalp shows signs of subtle swelling. Accordingly, a short 3-month period of up-to-date steroid with minoxidil may help reverse or slow down this swelling process. Science is always heading toward the advancement, and Dr.Gawri stays updated with all medical facts and research regarding hair loss and hair transplant. Therefore, he may adopt and mold this information to you as is justified clinically.

Low-Level Laser Therapy (LLLT) – This is one of the critical advances in the treatment of hair loss is the home-based remedy for hair loss using low-level laser therapy or in short, LLLT. It has been in use for quite some time, but the availability of the treatment is scarce. In the past, a person was asked to make multiple weekly visits to a physician for such treatments making an agreement to the treatment near to impossible. In recent years, advances have taken place that allowed far superior home technology that is easy to use that can be very valuable for women and men who are losing hair and can either ingest minoxidil or serve as a separate method of treatment.

Scalp Micro-pigmentation (SMP) refers to the use of medical tattooing in the scalp to disguise open spaces in the scalp. It can be convenient for women who do not wish to undergo a hair transplant, or it can be used subtly to improve a hair-transplant result. The procedure is quick and efficient, and it gives immediate results by decreasing the color difference between the scalp and hair color. Scalp micro-pigmentation is especially of value for women who color their hair.

PRP (Platelet-rich plasma) and acellular porcine bladder matrix (ACell) are valued in every surgical case to improve surgical results. PRP is a substance used to improve the outcome of several of our medical treatments. While PRP comes in use in several procedures regarding skin, it has also proven very beneficial for hair transplants and the slowing down of hair loss. However, in some cases, a few women prefer to have PRP/ACell injected without surgery to improve hair-loss conditions as a completely separate office procedure.

KEY POINTS FOR FEMALE HAIR TRANSPLANT:

1. Ideal candidate

• Women who have a high hairline or low hair density from birth and feel their forehead is 'too big'.

• Women who have been gradually thinning and are positive with female hair loss (and possess sufficient donor hair (hair in the scalp) to undergo hair transplant).

• Women who are facing an aging hairline also called receding corners.

• Individuals who have undergone transgender therapy (male to female [MTF] transition) and are on hair-loss management or hormone therapy.

2. What to do

• Make time for your treatment and plan to leave one week for recovery during which time you are functional but may not be presentable due to visible and swelling around the eyes.

• If you live out of town, you will be asked to arrive the day before the procedure and will be only allowed to travel the day after staying for two entire nights. However, if you are not able to stay in town within the two weeks after the procedure, you will need an expert to remove your stitches. Dr. Vikas Gawri has many colleagues around the world who may be able to help lift your sutures.

• If you are not on any hair-loss management therapy, you may be requested to start one or more (like minoxidil or laser) to prepare you for the procedure. Depending on your unique circumstances, you may be asked to be on a hair-loss management regime for a minimum of four to six weeks (maybe longer) to reinforce your hair and to minimize a chance of additional procedures after the treatment, and reduce the effects of temporary hair shock.

3. What to expect

• You may have inflammation around the eyes that may last a week. Due to the natural healing process and tiny scabs around the new hairs, your eyebrows may look darker for the first week. Do not be anxious by the observation.

• You can wear a hat and sunglasses directly after the procedure, and you can wash your hair from the day afterward and resume most physical activities after two days. You can even travel the next day.

• You can wear a wig or camouflaging products starting a week later and color your hair two weeks after the procedure. Your stitches need to be removed two weeks before the process, and we will help you plan your visit.

• You may experience loss of post-operative shock that may start 4 to 6 weeks after a procedure. If this happens, the shedding of hair in this stage is temporary. There is no need to be anxious, and this means weak hairs are being pushed into an inactive phase, which should regrow around the same time as your transplanted hairs.

• Transplanted hair should start growing 3 to 4 months after the procedure (but it may take even longer to witness substantial growth) and should improve in growth up to 12 months post-procedure (or slightly longer than this period).