The most common reason for performing hair transplantation is for male pattern baldness. However, women can also suffer from thinning of their hair and there can be a wide spectrum of severity. Whilst society accepts a balding male scalp, it is less forgiving when the scalp becomes visible on a woman. Conversely, it is far more acceptable and even fashionable for women to wear wigs or hairpieces and therefore it is rare to see women with balding scalps in public. The most common cause of female hair loss is androgenetic alopecia due to the hormone testosterone. Although found in greater quantities in men, testosterone is also produced in women by the ovaries and adrenal glands. It causes involution and atrophy of the hair follicle bulb and results in thinning of the hair, more often in women over forty.

There are four main patterns of female baldness :-

The geographic pattern is the most common and starts a few centimetres behind the hairline so that a fringe of normal hair growth remains at the normally positioned hairline but balding extends towards the crown. The area at the lower part of the back of the head is usually unaffected as in male pattern baldness and can be used as a donor site.
The frontal pattern involves receding of the hairline giving a long forehead and the objective of hair restoration is to lower the hairline to a more natural position.
The temporal pattern has loss of hair at the temples and gives the patient’s hairline a masculine appearance. This is easily corrected with a relatively small number of transplanted hairs.
The diffuse alopecia pattern involves the whole scalp, including the back of the head. In contrast to the other types of balding, although there is decreased density, the remaining hairs are of good quality and rather than becoming fine and wispy. Hiding the donor scar may be difficult in these cases.

Historically, hair restoration procedures gained a bad reputation because the techniques available left an unnatural, “pluggy” appearance. This meant that it was often immediately obvious that the individual had undergone a surgical procedure. Current methods, however, give a natural hairline and pattern of hair growth, which is unnoticeable to all except the most informed observer. This involves the transplantation of individual hair follicles or groups of hairs, known as follicular units.

If a woman is planning to have a hair transplantation procedure, however, it is important to be realistic. Balding is often a progressive phenomenon as it is in men. If treatment is started early, before the genetically determined extent of balding is reached, then further procedures are likely to be needed and should be planned for. Likewise, if severe balding is present, there may not be enough donor hair to be transplanted to recreate adequate density over a large area and compromises may be necessary. It is these factors, amongst others, which make it important for anyone considering hair transplant surgery to meet with the surgeon who will be performing the operation and following the patient up for many years after.

When well planned and skilfully executed, hair transplantation can yield remarkable results, transforming not only how a woman looks but also how she feels about herself and interacts with society. It is no longer necessary for women who are balding to hide it under wigs. If losing your hair bothers you, a permanent solution is available!

The Procedure

The surgery is performed under a light sedation and administered by an experienced anaesthetist so that discomfort is kept to a minimum. Local anaesthetic is infiltrated, a strip of hair bearing scalp is removed from the back of the head and the wound is sutured. The individual hairs and follicular units are then carefully dissected by the team so that the roots are not damaged. Fluid with adrenaline is injected into the recipient sites to reduce the amount of bleeding and the hairs are then implanted using small stab incisions. Care is taken to create a natural hairline. The duration of the operation varies from one to five hours depending on the extent of the area to be grafted.

All surgery carries some uncertainty and risk

The procedure is generally extremely safe but the risks and complications that can occur will be discussed at the initial consultation. It is important, however, to recognise that results cannot be guaranteed and that your expectations may not be met. This is why a thorough discussion with Mr Williams is so important. Balding is progressive by definition and it is necessary to plan for future hair loss. Many women have been disappointed by overzealous procedures at an early stage of balding, which can be difficult to correct in later years. Mr Williams will help you set realistic and achievable goals for your hair restoration journey.