I had a hair transplant and this is what happened during and after the op
Over the course of five years my hairline started to recede – it was barely noticeable at first, but then I realised that the scar on my scalp - that had been hidden amongst my hair for almost 30 years - was now fully visible for all to see. Friends would say they couldn’t notice a difference, but many of them had commented on my scar, asking what clumsy accident I’d had to end up with that on my forehead. Every time someone pointed it out, I’d feel even more conscious of the fact that I had lost my hair and I worried about where it would end. Was more of it going to disappear? What was wrong with me? Why was this happening? Were the thoughts that would swirl around my head on a daily basis.
Medical testing
To get answers I started with a full panel of blood tests. I checked my thyroid, my hormones, vitamin and mineral levels, and more. Turned out I had high testosterone levels, which in women can lead to acne, weight gain, excessive facial hair, irregular periods, and hair loss on the scalp. Tick to all the above. And despite having lots of further tests the endocrinologist I was assigned couldn’t find an explanation for my elevated testosterone levels. So, he prescribed the contraceptive pill and spironolactone – both of which work by reducing androgens aka testosterone. By lowering my testosterone levels, there would be less of the stuff to convert into DHT, which in high levels can shrink hair follicles and shorten the hair growth cycle, eventually resulting in the hair loss condition known as androgenic alopecia.
So, while I had no idea why my hormones were out of whack, at least there was a solution – or so I thought. I’d been on spironolactone before to lessen my acne and facial hair, but I’d never combined it with the pill, and as soon as I did the effects where like nothing I’d ever experienced. I had been suffering with low mood for a while (one of the contributing factors being my hair loss), but this cocktail just ramped things up. I felt anxious all the time, would cry almost every day, couldn’t leave the house and fell into a depression.
I tried to stick it out because I was so worried I’d lose even more hair, but soon realised that this was no way to live. I contacted my doctor and slowly came off my meds, and thankfully subsequent blood tests showed my testosterone had gone down to normal levels and I just hoped it would stay that way.
Expert opinion
Now that I had my hormones under control, I wondered if the hair would grow back? I hotfooted it to see consultant dermatologist Dr Anastasia Therianou, for answers – but I was left in shock.
Turns out not only did she believe I had the onset of androgenic alopecia (also referred to as female pattern hair loss) – as she noticed hair thinning, but that the hair loss along my hairline was actually traction alopecia – caused by years of styling that had literally pulled my hair out.
To say I was confused was an understatement. “Tight styles like braids, tight ponytails, hair extensions, wigs, buns, and even wearing rollers while sleeping can lead to permanent hair loss,” said Therianou. Couple that with the fact that curly hair is naturally drier and more delicate than straight hair, and it’s little wonder that traction alopecia is most prevalent in those with curly and afro-textured hair.
While I’ve never worn braids, or wigs, I did wear my hair in a bun or ponytail on a regular basis and I would get weekly blow-drys to straighten my curls. I only ever worried about the state of my ends from the heat exposure and not the pulling that went along with it. Did Therianou think my hair would grow back? “There’s a good chance by changing your hair styling practices some of the hair will return. But the areas where you see shiny bald skin on the scalp with no hair at all, you’ll find that this indicates that the alopecia has entered a chronic state, where the hair follicle has been destroyed, meaning hair can no longer grow back,” she explained.
I decided there and then I would undergo hair transplant surgery to cover my scar, and for the rest of my hair Therianou suggested topical minoxidil (found in products like Regaine). It’s an active that increases blood flow around hair follicles, pushes hair into its growth phase and keeps it there for longer.
Hair transplant surgery
“The most common types of alopecia in women which are amenable to hair transplant surgery are female pattern hair loss and traction alopecia,” explained hair transplant surgeon, Dr Christopher D’Souza when I saw him at his Upper Wimpole Street clinic in London. This meant that I was theoretically a good candidate for the surgery, and after checking my donor site (the back of my head where follicles would be extracted) D’Souza confirmed that surgery would be viable. I was thrilled to hear that I could wave goodbye to my scar by restoring my hairline and couldn’t wait to do the surgery.
I decided on the FUT procedure, which is where a strip of skin is cut away and the follicles are extracted from that strip, then placed in incisions made in the recipient area – in this case my hairline. At the time the alternative FUE technique would have meant I’d have to shave a large area of hair so that D’Souza could individually extract follicles one by one.
Now however, D’Souza is able to use this technique without shaving down the area which is more ideal for those with long hair like mine. With that said, while “every hair type has the potential to be suitable for hair transplant surgery. Some hair types are more suited to particular techniques, and due to the underlying curl beneath the skin, afro-textured hair can be difficult to achieve high yield graft numbers using the FUE technique - making the FUT technique more suitable,” explains D’Souza.
Surgeries can take up to eight hours but as I only had 1200 grafts (a small piece of tissue that contains up to three hair follicles) opposed to 3000 which tends to be the max you should do in one procedure – so I was heading back home after five hours. And it wasn’t as painful as I thought it would be – the local aesthetic injections where uncomfortable but not much worse than PRP injections in the scalp of which I’ve had many. While the strip removal and incisions were totally painless. And I didn’t need painkillers post procedure even though I was sent home with a comprehensive kit made up of a travel pillow to keep me upright when I slept, saline solution to spritz on my recipient area every 30 minutes for three days post procedure and absorbent pads to protect my pillows.
Surgery aids
Hair transplant surgery is a long game as it takes between a year to a year and a half to see the full results, and so during the months post my surgery I had to remind myself to be patient. While I waited to see how successful it would be I started taking a range of supplements to support my hair health. Together Health Vitamin D3, £6.99, to help strengthen hair follicles. Oskia MSM Bio-Plus, £66, to aid in the production of collagen and keratin, two proteins vital for hair growth, and Vida Glow Hairology, £45, which includes Anagain, an active derived from pea sprouts that’s been clinically proven to reduce hair loss by 34 per cent.
I also overhauled my cleansing and styling practices too. I swapped out my shower head for the Hello Klean Purifying Shower Head, £64, which filters out metals and impurities in hard water – which is undoubtable better for the scalp and hair. And when I did blow dry my hair which was not often, I used the high-tech Zuvi Halo Hair Dryer, £329. It’s spenny but the patented LightCare technology uses infrared light and cool air to dry the surface of the hair while reducing moisture loss and leaving my curls shinier, softer, and less frazzled.
Hair transplant results
As I approached the 12 month mark I could really appreciate how much not only my hairline had changed but how much I had changed. Just a year before my confidence was at an all-time low, I had found it hard to look people directly in the eyes when talking to them, I dreaded someone commenting on my scar, and every time I left the house, I felt anxious and self-conscious.
But just a year later I felt more like my old confident, social self. The transplanted hair was thriving, and the area around my scar had hairs growing all over. However, when it came to the scar itself the hair placed there, never materialised. D’Souza explained at my one-year check-up that, “scar tissue tends to have less blood supply compared to normal skin tissue and good blood supply is essential for transplanted follicles to thrive in the new location they have been placed.” Thankfully the hair around my scar did a pretty good job of hiding it, at least when I wore it curly. However, when I wore my hair straight it was a different story.
I always knew there was a possibility that I would have a second hair transplant, as getting a close as possible match to the density in the areas where you haven’t experienced hair loss isn’t always possible first-time round. I’m also a person who lives by the mantra of ‘more is more’ and I knew that I’d be even happier if I could get more hair transplanted around my scar and the areas around my hairline where there was a big difference in density between my transplanted hair and my non transplanted hair. So, yes, you guessed it, just over a year later I had a second surgery. It went as well as the first and the hairs are growing in nicely.
Needless to say, restoring my tresses has been a long process, there have been tears, and frustrating moments – living with a halo of frizz as I waited for my new hair to grow and for my curls to fully form was not fun – but I’d do it all over again (which of course I did). I’d also absolutely recommend hair transplant surgery to anyone suffering with traction alopecia or androgenic alopecia who haven’t seen improvements going down the non-surgical route – think, alternative styling, medication, supplement, PRP, exosome and light therapy.
I feel a sense of freedom now that I’m not constantly worried about how my hair looks, and I’m so relieved it worked as in all honesty I think it would have taken a lot of inner work to be OK with my hair loss. Thankfully I had the option of surgery, so I didn’t feel the need to push myself to rationalise my insecurities, and question why losing a patch of my hair affected me so profoundly. Though I hazard a guess that the influence of western beauty ideals, working as a beauty editor, being a perfectionist, getting older, and being (reluctantly) single all played a role.
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