Men and women considering hair restoration in New York have a lot to think about. At the Quatela Center for Hair Restoration in Rochester, our specialists take the time to educate everyone who comes in for a consultation. Here are answers to many of the questions they are asked by people from Buffalo, Syracuse, and beyond about hair loss and hair restoration.
About Hair Loss and Hair Loss Treatment Options
If you don’t see your question here, please Contact Us. We’d be happy to hear from you.
Compassionate and dedicated to personalized patient care, Dr. Quatela is a board-certified facial plastic surgeon recognized worldwide for his expertise in facial rejuvenation. He established the Quatela Center for Plastic Surgery in Rochester, New York to provide excellence in aesthetic surgery.
The Quatela Center for Hair Restoration Frequently Asked Questions
1) What causes hair loss? The science behind hair growth is explained in detail at About Hair Growth. For those who want the short answer, heredity in men plays a major role, resulting in receding hair lines and balding scalp. A male hormone called dehydrotestosterone influences hereditary factors in androgenetic alopecia (or male pattern baldness). Changes in women’s health, including hormonal changes that occur in menopause, are mainly responsible for female hair loss and thinning. Accidents, burns, disease and a few medical treatments can also trigger hair loss. Frequent shampooing, poor circulation, wearing hats or any other personal habits are not factors that cause hair loss.
2) What is a hair transplant? Hair transplantation is a procedure involving extracting and moving the patient’s own hair. Hair is taken from the very back of the patient’s head (where it is genetically programmed to grow permanently). Hair from this site is separated into follicular units and transplanted to other areas of the head, where it will continue to grow as vigorously as your natural hair.
3) What’s so special about micro follicular unit hair transplantation? Our hair grows in naturally occurring units — follicular units of one to five hairs per unit. When we transplant hair based on this naturally occurring unit, we create the most natural appearing result. Micrografts that are one to two hairs each are used along the hairline to give the hair transplantation the most natural look. Minigrafts that are three to five hairs each are used more for density, to fill in areas behind the hairline with thinning or no hair. As the hair is placed in the new location we honor the orientation (natural direction) of the follicular unit, leading to a natural result. When hair is harvested and transferred without attention to these follicular units, the result is unnatural.
4) How do I know if I am a candidate for hair transplantation? A thorough review of your health history and a physical exam of the scalp lay the foundation for determining if a hair transplant is right for you. Realistic expectations play no small role. While the opinion of a caring hair restoration professional is essential, we believe that patients who take the time to educate themselves about hair restoration are the best judge of when and if hair restoration is right for them.
5) Are hair transplant results permanent? Yes. Hair from the lower side or lower back of scalp donor area (see illustration) is genetically resistant to the male hormone that causes balding. When hair is appropriately harvested for hair restoration, the results are permanent. This harvested hair retains its genetic characteristics even after relocation so it will continue to grow for the rest of your life.
6) Does it look natural? (Will everyone know I’ve had a hair transplant?) This is where careful selection of a qualified hair restoration specialist is essential. Applying the principles of hair restoration is not enough. Because hair restoration is an art, a natural result is not something that “just anyone” can manufacture. Most patients with realistic expectations want to have their hair reflect more the age and energy they feel inside while retaining a natural appearance of their own unique features. Consistently achieving an undetectable result is the sign of a successful hair restoration specialist. (Before and After Photos)
7) How do you determine where the new hairline should be? More than any other feature in hair restoration, placement and quality of the hairline determine surgeon and patient satisfaction. The final location for hairline placement starts at your QCHR consultation when we draw your hairline on your forehead so you can provide immediate feedback on what you have in mind. We provide a detailed explanation about the principles of hairline placement with regard to your individual facial features. Well-established hairline placement principles (such as the two listed below) serve only as a foundation.
Avoid placing the hairline too low. A hairline that is too low looks unnatural. A hairline should match the maturity of the patient to look natural. An age appropriate hairline can still be youthful by maintaining a natural shape that brings the center point of the hairline lower than the two sides.
Use 8cm above the eyebrows as a starting point and adjust that measurement to accommodate the individual facial features.
The essential qualities of a natural hairline include an effortless transition from forehead skin to hair. At QCHR, we concentrate many lower density single hair follicular units at the hairline and make a gradual transition to the higher density follicular units behind the hairline.
Understanding hairline placement, follicular unit density, follicular unit orientation (direction of hair growth), the color and quality of donor hair, the dynamics of hair growth and the relationship of hair to each individual’s facial features is vital to achieving a great hair hairline and great hair transplant. This is the science of hair transplantation. However, like all facial plastic surgery, there is an art and a talent to creating a natural hairline that best highlights an individual’s facial features that we believe is best demonstrated through the results achieved on previous patients. We invite you to look at our Before and After Photos, read our patient Testimonials and Contact Us with any questions not answered on our website.
8) What does the donor area look like after a hair transplant? The donor area varies dependent upon the type of hair transplant the patient undergoes. During a FUT procedure, once the donor grafts are obtained, the donor area is sutured leaving only a fine line. Time and again our patients tell us that they swim, shower and have the wind blow their hair with the donor site remaining undetectable. Most patients will tell you that this area heals so well that even their hairdressers are genuinely surprised to hear that they have had a hair transplant.
During a FUE procedure, the donor area is shaved to the desired length needed for the procedure. After the procedure, the hair in the area that was shaved will start to grow back at the rate of your normal hair growth – which is usually a few weeks.
9) How many grafts will I need? How many sessions? That will depend on the extent of your hair loss and the number of implants per hair restoration surgery. Also, the number of sessions required to fill in a given area depends on the density that is desired. The color and quality of the donor hair, the degree of original hair loss, an individual’s facial features and many other factors can also affect patient satisfaction with one session. For example, a natural appearing hairline can be achieved with one session. However, the density and hairline refinements desired by most people requires two or three hair restoration sessions.
10) How much time for one session? Microscopic dissection (creating individual grafts under microscopic magnification) takes time! A hair transplantation procedure may take from 6-10 hours. This time is depended upon the amount of work to be done, and how well you follow pre-op instructions. We ask that you plan to spend the day with us when you are having a hair transplant.
11) Is it painful? Some patients report only a small amount of discomfort associated with a hair transplant. We use a local anesthetic in the area that we will be working with. If you feel any aching feeling during the operation, we can give you a pain relief medication to take the edge off. Many hair restoration patients report no pain whatsoever.
12) When will I see the new hair growth from the grafts? It will take about four to six months after your hair restoration procedure to see new growth.
13) Can I meet with or talk to someone who has had it done? Absolutely! Our hair restoration consultant will meet with you and show you first hand the results we achieve at QCHR. Regardless of whether or where you elect to have hair restoration surgery, we strongly recommend that you meet with a consultant who has had hair restoration surgery before scheduling your procedure. You need to see for yourself what a hair restoration surgeon can achieve and learn first hand what is involved. The more you know, the better prepared you will be and the better your experience will be when and if you decide the time is right for you to have surgery yourself.
14) Is hair restoration surgery safe? This is one of the most frequent and most important questions we are asked. The risks of hair transplantation surgery reported in the medical literature are quite uncommon. Please don’t hesitate to discuss any concerns you have. We’ll be happy to provide a report of any complications associated with procedures your considering. Along with the qualifications, training and experience of our Surgeons & Staff please see the QCHR facility Accreditations located at Lindsay House.
18) I’m unhappy with my previous hair transplant. Can you fix it? For most patients, yes. We all agree that “getting it right” the first time is so vital in hair restoration. Unfortunately, it’s not uncommon for patients to be referred to us for revision hair surgery. Whether due to trauma, disease, pre-existing conditions or surgeon error, revision hair restoration has its own set of special circumstances.
Although the preoperative and postoperative instructions for revision hair restoration are the same as for primary (first-time) hair surgery, revision hair is more challenging than primary hair restoration for several reasons. First is the altered “geography” of the scalp including scar tissue and often times placement of hair “plugs” of inappropriate size and orientation. The presence of scar tissue increases the complexity of revision hair transplant surgery. Therefore, amount of surgical time required to perform revision hair surgery can be longer than primary hair restoration.
19) What about scalp reductions? Scalp reductions are rarely performed any more due to significant advancements in the art of hair transplantation. With the superior results from follicular unit grafting, scalp reduction has become a procedure of the past. Although we are trained and highly qualified, with both education and experience performing scalp reduction surgery, we encourage a thorough discussion prior to undergoing this procedure. We strongly recommend a second concurring opinion prior to undergoing scalp reduction. If you have had previous scalp reduction and are dissatisfied with the results, please don’t hesitate to contact us with any questions.
20) Will I be awake during surgery? During the procedure, a patient may listen to music, watch a favorite sporting event or enjoy a movie. Some patients simple choose to relax or even take a nap. We use local anesthesia (numbing medicine) in the donor area to obtain the grafts and close the area with sutures that are removed in a few days. A light, oral sedative is provided prior to the start of the procedure to ensure you are relaxed and comfortable for the entire length of the procedure.
21) Can I drive myself home? No, you cannot drive yourself home. We require arranging for a ride after your hair transplant surgery. Oral sedation is administered to our patients prior to the procedure and throughout the day for patients who are nervous or have difficulty sitting still for long periods of time. To ensure your safety after the procedure, you must have someone drive you home and public transportation is not allowed. For our hair restoration clients who travel from a distance to our Rochester, NY facility, please contact us for assistance with transportation and accommodations.
22) When can I wash my hair? We ask you to return to the office the day following hair restoration surgery so we can remove the dressings. You can very gently wash your hair on postoperative day three and vigorously wash your hair on postoperative day seven. We ask you to avoid hair dryers and curling irons for a week following hair transplant surgery. Also at one week postoperatively, you may resume mousse, gels, and hairspray along with gentle brushing of grafts and return to regular brushing of nongrafted hair. We also request that you avoid curling irons for two weeks following hair transplant surgery.
23) Following hair transplants, when can I resume Rogaine or Propecia after hair surgery? Propecia may be resumed on post-operative day one, and Rogaine may be resumed four weeks after surgery.
24) Following hair transplants, when can I have a perm or have my hair colored? On postoperative day ten you may have your hair permed or colored.
25) How long am I out of work? You may return to work the next day and resume full activity within seven days. However, you will have tiny red spots where grafts are planted for about a week after the procedure. If work is physically strenuous, you should plan to take 1 week off. Patients are asked to avoid any heavy lifting, bending and straining for one week following surgery. For several days after the procedure, many patients wear a cap to cover the new transplants.
26) When can I work out? You may resume light walking the day following hair restoration surgery. Aerobic activities should be avoided for one week following surgery, which includes running, aerobics, swimming and other sports. As we mentioned above, it’s important to avoid prolonged bending, lifting or straining during the first week postoperatively as these activities can increase swelling and delay healing. It is vital to protect the scalp from sunburn or tanning beds.
27) How much does it cost? At the time of your free hair transplant consultation, we will assess your unique needs and quote a price to meet your individual objectives. The total fee includes the procedure and six months of follow-up care. Although hair transplantation is a substantial investment the results are permanent and may be less expensive than other hair loss treatments when factored over a lifetime. The improvement in self-image and confidence is well worth the cost for most people.
Hair replacement surgery — sometimes considered a luxury for the wealthy — is actually more frequently sought by middle income patients. We are happy to discuss our fees with you at any time. To discuss costs, just Contact Us or call(585) 244-0323. At that time, we can also share information on financing plans.
28) How do I select a hair transplant surgeon? Our hair transplant surgeons are board certification and members in the American Board of Hair Restoration Surgeons and members of the Hair Loss Council. These national organizations are comprised of medical professionals specializing in hair restoration procedures. At QCHR we welcome your review of our Surgeons & Staff including education and training, contribution to research, extensive medical publications and ongoing continuing medical education. Because our hair transplant surgeons are entrusted in teaching others about hair restoration, they continually update their knowledge and techniques to provide the most up-to-date alternatives in hair restoration.
29) Why chose QCHR? At QCHR we believe that most people seeking hair transplants want the following:
Hair restoration using their own natural hair
A minimum “down time” (return to work the next day)
No heavy anesthesia (watch TV, watch a video, listen to your favorite music)
30) How long should I stay in Rochester following surgery? Most hair restoration patients stay in Rochester New York overnight. After that it’s ok to fly or travel long distances.
31) I’m from out of town. Where can I stay overnight in Rochester? Accommodations are comfortable and convenient for QCHR clients. The Strathallan, located “just down the street” provides upscale, affordable accommodations. For added convenience following ambulatory surgery, some hair transplants patients elect to stay in our Carriage House, located adjacent to the Lindsay House. For guests without the benefit of family or friends in the Rochester area, our staff will be happy to assist you with arrangements for a smooth, restful experience following your procedures.
32) Are there any special instructions before surgery? Glad you asked!
HAIR RESTORATION PREOPERATIVE INSTRUCTIONS
1) What do I do to prepare for surgery? Although the preparation for hair restoration surgery is pretty simple, it is an essential element in a successful outcome. We provide written instructions at the time of your initial consultation, well in advance of your hair transplant surgery. We will ask you to read both the preoperative and postoperative instructions two weeks before hair transplant surgery to allow time for any questions you have about care after surgery. Our nurse practitioner will also arrange a preoperative telephone call with you well before the hair replacement surgery.
2) Tell me about the preoperative appointment. One to two weeks prior to hair restoration surgery you will talk with our nurse practitioner who:
answers your questions
reviews your health history: it is extremely important that we know if you have ever experienced high blood pressure, asthma, chest pains or palpitations, liver or kidney problems, or shortness of breath
reviews daily medications (please have list handy)
instructs you on how to prepare for hair restoration surgery, including refraining from any type of exercise three days prior to surgery and avoiding alcohol for one week prior to surgery
calls in prescriptions for use after hair restoration surgery (please have your pharmacy name and phone number handy)
tells you what to expect
Most of the instructions are listed here below. This list of questions, however, will not take the place of a preoperative evaluation, which is essential in determining a patient’s understanding and readiness for surgery. We will be sure you are signing an informed consent.
3) What does informed consent mean? Informed consent means you have an excellent understanding about the benefits of hair restoration surgery as well as any risks, and all the preoperative and postoperative information. You are making an “informed” decision as to whether hair transplant surgery is right for you.
4) What are the benefits and risks of hair restoration surgery? As part of your initial consultation, your physician will review your expectations for hair restoration surgery. At that time, he can provide a realistic picture of what surgery can and cannot accomplish. We will provide you with a list of any risks reported in the medical literature associated with any hair surgery you are considering. Although risks from hair transplant surgery are uncommon, every patient should be fully informed of any risk associated with surgery.
5) What are some of the other things to do to prepare for surgery? We review your health history and any daily medications you may be taking. Also, on the day of surgery we will ask you to leave cell phones and valuables at home. Many patients with busy schedules let contacts know they will not be available on their hair restoration surgery day.
6) What about my daily medications before surgery? Two weeks before your procedure you will need to stop taking Aspirin, Ibuprofen (e.g. Motrin, Aleve, Advil etc.), herbs (Echinacea, Gingko biloba, Garlic), and vitamin E. These medications increase your risk for bleeding making it very difficult for your newly transplanted grafts “to take.” Bleeding during the procedure also adds hours to the amount of time necessary to complete the hair restoration procedure.
Our nurse practitioner will also review any daily mediations you take. If you are on “blood thinners” such as Coumadin or Warfarin, you will be asked to stop them approximately one week prior to hair restoration surgery. We will also ask you to start taking Vitamin C two weeks before procedure…this helps with healing.
7) When do I stop Rogaine or Propecia prior to surgery? Stop taking Rogaine or Propecia two weeks before your scheduled hair replacement procedure.
8) Do I need any special prescriptions before surgery? Most patients do not need any special prescriptions before hair restoration surgery. Please let us know of any special medical concerns you may have. Because tobacco abuse impedes wound healing, you will be asked to stop for one week before surgery and two weeks following hair transplant surgery. Our nurses will be happy to discuss over-the-counter aids to help you with this. In the postoperative instructions that follow, we will discuss all medications needed after surgery. It is important to obtain any prescribed medications prior to your surgery date.
9) What happens when I check in for surgery? The day before surgery, wash your hair using the shampoo that is provided to you during your preoperative appointment. On the day of surgery, wear a button down shirt to QCHR. Please do not wear anything that needs to be pulled tightly over your head. When you check in, our nurses will help you get ready for surgery. We check your vital signs, help you change into a gown, and make sure you’re comfortable. Please let us know of any special needs you may have. Also, be assured that you have plenty of time for any last minute questions with your hair transplant surgeon.
10) I’m concerned about privacy. During a recent independent study, privacy was found to be one of the advantages that attracted people most to the Quatela Center for Hair Restoration. Because all consultations, office visits, surgical and nonsurgical experiences take place at the same address, the check-in process is completely confidential.
11) Does someone have to stay at the QCHR while I have my surgery? No one needs to stay at QCHR during your surgery. However, it’s a good idea to have someone available by telephone at all times during your hair restoration surgery.
12) What other instructions are there? Glad you asked! See the postoperative instructions below.
Heather Lee, M.D.
Board-Certified Facial Plastic Surgeon
A board-certified facial plastic surgeon and a board-certified otolaryngologist–head and neck surgeon, Dr. Lee is dedicated to improving the lives of adults and children by using her surgical talents. She specializes in procedures of the face and head including facelift, functional and cosmetic nose surgery, blepharoplasty, and injectable treatments.
1) What do I look like after surgery? Following the hair restoration procedure, you will have small red spots looking like a brush burn where the hair was transplanted. If your hair has a little length, the back donor site will be camouflaged.
2) What does it feel like after surgery? Most patients report only mild to moderate discomfort, which may be associated with some numbness, itching, tightness or a pulling sensation in the donor area. These postoperative symptoms subside with in a day or two. Your nurse will be checking your comfort at every step along the way and is there to give you special attention.
3) Tell me more about the donor incision and grafts. Most patients do not have a dressing following hair transplant surgery. You are discharged with a surgical cap to wear overnight and remind you not to touch the newly planted area. If you do have a head wrap dressing, it will be removed in the office the morning following hair restoration surgery. After the cap or head wrap dressing is removed, you will notice a little redness and some “scabs” at many of the graft sites which typically fall off by the end of the first week. Please don’t pick at them or you may disturb the newly planted grafts.
4) When can I shower? You may shower without washing your hair for seven days. You will be allowed to gently shampoo your hair on postoperative day three and resume routine hair washing on postoperative day seven.
5) Will I need any special prescriptions following surgery? Yes. Postoperative prescriptions are provided well in advance of surgery day so you arrive home completely prepared. Postoperative prescriptions and over-the-counter medications for hair restoration patients include the following: A) An antibiotic (most commonly Keflex/cephalexin) to prevent infection. B) Pain medication (Vicodin/hydrocodone) to minimize any discomfort. C) Swelling medication (Medrol Dosepak) to reduce swelling. D) Vitamin C for one week following surgery to promote healing. It is important to continue to avoid aspirin, ibuprofen, Vitamin E, etc. for three days following hair restoration surgery to prevent bleeding in the postoperative period.
6) When do I start taking these prescriptions? Patients take their pain medication as needed. The other medications all begin on the day following the procedure.
7) Are there any dietary restrictions following surgery? We ask that you avoid alcohol for one week following hair transplant surgery. Otherwise, patients can eat whatever they want.
8) Are there any instructions about regular daily activities? Sleep with head of the bed elevated or use two to three pillows for one week. Facial fullness, headache and disrupted sleep are very normal postoperative symptoms and will decrease as the healing process occurs. Avoid strenuous activity including bending, lifting or straining for one week after hair restoration surgery. If you have little children, bend at the knees or sit on the floor and let them climb on to your lap.
9) When will I look “normal?” Most patients return to work the following day. Once new hair is transplanted, it undergoes a brief resting period and then begins growing vigorously. Your final hair transplantation result will be evaluated at one year.
10) How long does healing take? As numbness wears off some patients experience a “pins-and-needle” sensation. It is important not to scratch as scratching can thin the hair. Numbness and itching resolves quickly. The transplanted hair (not the follicles) falls out in about two weeks and generally begins to grow again in about four to six months. Evaluation of the final result takes one full year.
11) I really want to do this but I’m nervous. What if I get stressed? It’s ok to be nervous. (Frankly, we would be nervous if you were taking this step lightly!) One of the best ways to deal with nervousness is to see what other hair restoration patients have gone through. Take a moment to look through our Before and After Photos.
12) How can I learn more about hair transplants? Several ways. First, Contact Usonline or call(585) 244-0323for any specific questions. If our Hair Restoration Consultant can’t answer them, she will gladly forward them to the appropriate physician or staff member. We also have patients who have had hair replacement surgery who are willing to discuss their experience. Also, you can learn more about what happens at your initial consultation appointment, or more about the training and experience of our Surgeons & Staff. We can also suggest some other hair restoration resources for you to explore.
Dr. Alex Montague, M.D.
Board-Certified Otolaryngologist—Head And Neck Surgeon
Known for his exemplary skills in both technique and patient care, Dr. Montague is a highly-trained facial plastic surgeon and board-certified otolaryngologist-head and neck surgeon. He specializes in cosmetic and functional facial surgery and injectable treatments.
The Quatela Center for Hair Restoration is a leading name in hair restoration across upstate New York. Men and women frequently travel from outside the area—even internationally—to enjoy our refined expertise in creating natural-looking hair transplant results.