Micro Surgery

It was September 1993 when I booked myself in for Micro Surgery.

This involved the Doctor removing the ‘donor’ hair using the universally recognised ‘Strip Removal Technique’. This method is unquestionably the most effective and successful way of removing ‘donor’ hair. The strip of ‘hair baring’ skin is removed from the previously anaesthetised ‘donor’ site with a scalpel, rather than a drill. Unlike ‘like plug method, the scalpel leaves no visible signs of any hair having been removed from the ‘donor’ areas.

Once the strip is removed, both sides of the wound are sutured (stitched together), leaving nothing but a fine-line scar completely covered by hair in the ‘donor’ area. The ’strip’, generally about four or five inches long and a half inch in width is dissected into the required graft sizes. Single and two hair units (micro’s) – for hairline reconstruction surgery, and grafts containing 3/5 hairs (mini-graphs), to give more volume to areas other than the front hairline. Micro’s are used to produce finer results. Planting single and two hair grafts along the hairline can produce exceptional results when performed by an expert. They can be virtually indistinguishable from the original growth.

This method is light years away from attempting to re-create a natural looking hairline, with large circular plugs, containing ten to fifteen hairs that only clever grooming can disguise. Most Doctors will suggest a hairline that will suit the patient, whatever his age, rather than position the new growth too low, risking his hairline looking unnatural in later life. The doctor then marked out the proposed ‘new hairline’ with a marker, having discussed the positioning with the patient. As all hair growth (apart from the crown), grows directly forward. When grown, the new hairline appears to be about 2/3 millimetres lower than it actually is. The Doctor then made a series of tiny slits with a scalpel into the anaesthetised scalp, (the recipient site), taking great care not to destroy any existing hair that may be of value for some considerable time.

It’s always to the patient’s advantage that any surgery applied to the front hairline or front section of the scalp is performed over TWO SEPARATE PROCEDURES. The grafts have to be initially placed with a tiny space in-between, to allow for blood supply. These spaces are ‘in-filled’ at a second procedure some 4 months later. This allows the surgeon to achieve optimum volume, critical to a good result particularly where front hairline surgery applies.

There is virtually no scarring with ‘Micro’ surgery. The incisions made by the scalpel are so fine they tend to heal without marking the skin, in much the same way as pricking your finger with a pin. It will bleed, but it heals without scarring. Having said that, the results of surgery depends on the operatives skills. The new grafts then ’scab over’ forming tiny little crusts that fall away 7 to 10 days after surgery, leaving the roots firmly in place. It normally takes the newly transplanted hair somewhere between 12 to 16 weeks to grow. This period, known as the ‘dormant’ period or ‘three monthly cycle’, is the time it usually takes for the new roots to catch on to their blood supply.

These days, the more experienced Doctors have ‘fined tuned’ the procedure, greatly reducing the time the ‘donor’ grafts are separated from blood supply before they are transplanted to their new site. Many of the grafts ‘pick-up’ on blood supply and grow from the day of surgery. ‘Instant growth’ is quite common.

The transplanted growth, as already stated, generally begins to appear between 12 and 16 weeks after surgery.
When the growth appears, it continues to grow at the same speed as it had at its original ‘donor site’, (about half an inch per month), which is twice the growth of hair it’s replacing on the top of the scalp. During the initial stages of growth, the hair grows in very much the same ways as babies hair grows – ‘fine’ in texture. It takes the new growth some time to achieve normal volume. The newly transplanted growth is also slightly coarser in texture.

Healing Time

All you have to contend with after surgery is a dull ache for a few hours after the anaesthetic has worn off. This is easily controlled by painkillers, however, the majority of people don’t bother after taking the first couple of tablets. You can normally return to work within a couple of days and the stitches in the ‘donor area dissolve after a couple of weeks. The tiny scabs that form following surgery generally fall away approximately 7 to 10 days later. More often than not, when a man has thinning hair, rather than a defined area of baldness, the surgery can be disguised throughout the healing period. A few days after surgery, hair piece wearers can continue using a hairpiece to camouflage the initial signs of surgery until the new growth appears. The procedure doesn’t require bandaging.

Apart from taking care not to bang your head during the first few days of healing, there is little need for aftercare.