Hair Transplant | “Long Hair” Hair Transplant Procedures - Do They Make Sense?

“Long Hair” Hair Transplant Procedures - Do They Make Sense?

I have been reading about “long hair” hair transplant procedures where you can have the ability to see the basic outcome of the hair transplant the very day you have the surgery done. Is there a downside to having this done or will the outcome remain the same?
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I have never embraced the concept of “long hair” surgical transplantation. There are simply too many disadvantages with this method that far outweigh the single advantage of being able to see long hair in the grafts immediately upon completion of the procedure. The list of disadvantages includes, but is not necessarily limited to, the following:

1) Many patients who undergo large graft sessions will need to have the recipient site shaved to facilitate accurate graft placement. Long hair grafts make no sense in this case since they will not give an accurate idea of the final result with the recipient site having been shaved in the first place.

2) Working with long hair grafts will dramatically prolong a procedure. Long hair grafts slow virtually every component of the procedure, i.e. - the donor strip harvest, the microscopic graft dissection, and the graft insertion. Hair grafts are subjected to tremendous stress once they have been separated from the protective confines of the well-vascularized donor area. Prolonged exposure to the environment risks graft injury from dehydration. Long hair grafts require more manipulation during the various phases of the procedure, thereby increasing the risk of traumatizing the grafts. Prolonged graft exposure and increased graft manipulation can result in a lower long-term graft yield. The hair one sees at the end of the procedure may not materialize over the long-term if the graft yield is reduced.

3) Grafts require several days for the healing process to produce a stable bond between the graft and the scalp. Any manipulation of the graft while shampooing, combing, brushing, or even rolling around on the pillow, will increase the risk of grafts being dislodged from their insertion sites.

4) The graft majority of grafts enter a resting phase within a few days or weeks after the transplant procedure. This predictable event results in the shedding of the graft hair. The shed hair does not reappear for about three months when the follicle begins a new hair growth cycle. Any gain from seeing the long hair at the end of the procedure is very short lived anyway because of this normal physiological event.

In summary, the single advantage of getting a quick peek at long hair immediately after the procedure is far outweighed by the many more significant disadvantages that this method is associated with. My advice is to be patient and opt for the higher graft yields that are associated with the traditional method of using trimmed grafts.

Raymond J. Konior, MD
Member, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association