The answer, says Dr. Wasserbauer, depends on the needed treatment, and also on what folks define as “permanent.” According to Dr. Wasserbauer, hair that is taken from the back of the head (otherwise known as the donor area in transplant speak) is, in most cases, genetically designed to never fall out. Hairs in this region of the head may eventually grow thinner over time, but their nature is such that they are, for the most part, permanent. The hair that sits atop the head, by contrast, is far more prone to androgenetic alopecia – the medical equivalent of male or female pattern baldness.

Lasting a Natural Lifespan

When Dr. Wasserbauer talks about the longevity of hair transplant results, she prefers to explain that for the most part, the procedure will last “a natural lifespan” – particularly in the case of men. Since men do not typically experience widespread hair loss all over their heads, but rather, just in certain areas, the average male hair transplant should last a natural lifespan.

Women, by contrast, aren’t quite as lucky, as female pattern hair loss works differently than male pattern hair loss. Whereas male pattern baldness tends to follow a relatively uniform course, women can experience extensive hair loss all over the head, which can impact the donor area significantly. Without an ample supply of hair from the donor area, a woman’s chances of undergoing a successful hair transplant are limited. Furthermore, the progression of female pattern hair loss can often times upset the results of a transplant, thereby lending to the notion that not all procedures are actually permanent.

Dr. Wasserbauer tends to liken the phenomenon to a leaking bucket filled with hair. The larger, thicker hairs won’t escape through the leak, but many of the smaller, thinner hairs are likely to slip through the cracks. The same tends to hold true for hair transplant patients. They may experience thinning hair following their procedures, but those core patches of donor hair will generally stay firmly in place.

Containing that leak

Controlling hair loss is very much like repairing the above-mentioned leaky bucket. According to Dr. Wasserbauer, medications such as Rogaine and Propecia can certainly help stem the leak by stopping hair loss in its tracks, but as time goes by, some hair transplant patients may require follow-up treatment to account for ongoing native hair loss atop the head. In these cases, it’s important to understand that it’s not that the initial hair transplants didn’t work or last – it’s that the progression of hair loss eventually took its toll. The good news, however, is that an experienced hair restoration surgeon like Dr. Wasserbauer can always come to the rescue by way of a follow-up procedure.

While hair transplants do offer plenty of aesthetic benefits, for many, the notion of undergoing this type of elective surgery is downright unappealing. After all, the word “surgery” tends to be synonymous with follow-up concepts such as “pain” and “recovery period” that many patients would rather not endure.

Though it’s natural for people to balk initially at the notion of undergoing a hair transplant, Sara Wasserbauer M.D., a Diplomate of the American Board of Hair Restoration Surgery who runs her own hair restoration clinic in California’s Bay Area, insists that the procedure is not nearly as painful as some might expect. While she wouldn’t go so far as to liken a hair transplant to a walk in the park, she does like to emphasize the fact that today’s tools and techniques make for a much more comfortable experience for the patient. In fact, when it comes to hair transplants, gone are the days of scalpels and stitches. Instead, those who undergo this procedure can expect to emerge with minimal scarring and discomfort.

Dr. Wasserbauer tends to liken hair transplant surgery to the average visit to a dentist; it might not be pleasant, but it is certainly manageable. Furthermore, there are ways to make the patient more comfortable during the procedure itself, particularly through the use of local anesthetics to minimize pain right off the bat.

Getting through the first night

According to Dr. Wasserbauer, patients are more likely to experience slight discomfort following the procedure, as opposed to during the transplant itself. Although this discomfort should be manageable, it is most likely to present itself at the back of the head, as opposed to up front where most hair grafts are placed.

Fortunately, recovering from hair transplant surgery is often times a matter of just getting through that first night. While other types of procedures can come with multiple weeks of patient discomfort, in Dr. Wasserbauer’s experience, it is really only the first night following surgery of which patients tend to complain. To alleviate discomfort during that initial 24-hour period, patients can sleep at an angle to minimize swelling and take pain medication as necessary.

Numbness and Tenderness

It’s not unheard of for a patient to experience a degree of numbness and tenderness for about a week following his hair transplant. However, these side effects do not tend to be particularly disruptive or painful, and in Dr. Wasserbauer’s experience, most patients are able to deal with them without the use of heavy pain medication. Furthermore, these symptoms tend to dissipate within a week or two following the procedure.

Occasionally, following a transplant, some patients can experience minor discomfort when their hair grows in, as ingrown hair can pop up and become annoying. However, for the most part, recovering from a hair transplant is as easy as going through the procedure itself.

Boredom is a Bigger Issue

While hair transplants are generally not painful, they do tend to take multiple hours – a fact that often results in a fair amount of patient boredom. To help alleviate the tedium, many surgeons will provide patients with comfortable chairs, screens showing a selection of DVDs, quality sound systems, and other such amenities to make the whole experience as pleasant and entertaining as possible.

Given the amount of the time it takes to complete the average hair transplant, Dr. Wasserbauer also has a policy of taking multiple breaks throughout the process – for both her own sake as well as the sake of the patient. In fact, Dr. Wasserbauer and her dedicated staff will do whatever it takes to make patients comfortable during their hair transplants, including going over all of the details beforehand so that patients know what to expect.

By taking the time to explain what the hair transplant process entails, Dr. Wasserbauer is often able to ease the minds of patients who are worried about the pain and recovery involved – which could be why more and more people are jumping aboard the hair transplant bandwagon to achieve remarkable results with very little discomfort.

Despite the documented success of today’s hair transplant procedures, the idea of undergoing actual surgery may not sit well with all hair loss sufferers. From financial limitations to logistical constraints, hair transplant surgery isn’t for everyone. Fortunately, those who aren’t thrilled with the notion of going the surgical route do have less invasive options when it comes to hair restoration.

Sara Wasserbauer M.D. is a Diplomate of the American Board of Hair Restoration Surgery based in Walnut Creek, California whose practice services the entire San Francisco Bay area, and according to her, there are several treatments that can help hair grow optimally that do not involve surgery, including the ever-popular Rogaine and Propecia. In fact, these options are ones that Dr. Wasserbauer will often encourage patients to try before jumping into the world of hair transplant procedures.

Rogaine is a topical solution designed to treat hair loss in men and women alike. The active ingredient in Rogaine is minoxidil, which works by increasing the blood supply to inactive hair follicles in order to stimulate growth. Although some find that the Rogaine formula causes itchiness on the scalp, plenty of patients can tolerate Rogaine and achieve thicker hair growth as a result. In fact, Dr. Wasserbauer insists that there’s no downside to giving Rogaine a try, as not everyone experiences an itchy scalp side effect. On the other hand, those who do begin a treatment regimen should be aware that it generally takes about six months for Rogaine to produce noticeable results.

For men who either can’t tolerate Rogaine or are simply unhappy with their progress, another option exists – Propecia. Propecia is a medication that slows down – or, in the best case scenario, completely stops – the progression of hair loss throughout the top of the head. While many find Propecia to be more convenient and effective than Rogaine, the downside is that the drug is known to produce unfavorable sexual side effects in a small percentage of men. Also, Propecia is not suited for women, so females suffering from hair loss cannot look to it as a viable treatment option.

While many patients, in Dr. Wasserbauer’s experience, are able to achieve terrific results using Rogaine and Propecia, another therapy that has also begun to show promise is laser hair therapy.

Laser hair therapy works in a similar fashion to Rogaine in that it improves the blood supply to hair follicles in order to stimulate growth. Like virtually all hair treatments, it typically takes six months to a year for patients to see results. Additionally, laser hair therapy can be combined with either Propecia or Rogaine without any detrimental side effects. In fact, even Rogaine and Propecia can be used in conjunction with one another to optimize hair growth, as the formulas will not interact in a manner that puts patients at risk.

While Rogaine, Propecia, and laser treatment are all practical alternatives to hair transplant surgery, some patients prefer to take an even more natural approach to fighting back against hair loss. According to Dr. Wasserbauer, supplements such as biotin, vitamin B12, iron, and zinc are all known to contribute to hair growth. Additionally, those looking to maximize hair growth are advised to make certain to get enough protein in their diets, avoid smoking, and steer clear of significant weight loss. Although a healthy lifestyle on its own is often times not enough to halt or prevent the progression of hair loss, those looking to improve their situations should realize that when it comes to stimulating hair growth, every little bit helps.

A hair transplant involves moving skin that is growing hair from one part of your scalp to another part of your scalp where hair is no longer growing. The process is similar to the type of grafting that is used to treat burns and other skin damage. In order to achieve the most natural-looking results, your surgeon will transplant the hair in naturally-occurring groups or “follicular units.” Once the hair-growing skin has been moved to the balding area of the scalp, the hair is expected to continue to grow.

Are You a Good Candidate?

Cosmetic surgeons agree that the best candidates for a hair transplant are individuals who have experienced noticeable hair loss on the top of the head while still maintaining healthy hair growth along the sides and back of the head. These are the areas from which your plastic surgeon will harvest the “donor” hair and move it to the area in which the hair loss has occurred.

Hair on the sides and back of the head tends to be more resistant to male pattern baldness and is more likely to grow through the entirety of a man’s life. By moving this hair to the top and front of the head, a surgeon can deliver not only hair that looks just like (because it is) your natural hair, but will also grow in a natural way.

Benefits

The latest hair transplant techniques offer extremely natural-looking results. Rather than the “hair plugs” that became easy fodder for sitcoms in the 80s and 90s, surgeons now use variable sizes of hair grafts applied with state-of-the-art precision instruments to mimic your hair’s natural growth patterns.

Hair loss, particularly when it occurs prematurely, can have a significant impact on your self-esteem. According to the American Hair Loss Association, most men who’ve experienced hair loss are extremely unhappy with their situation and would be willing to do almost anything to change it.  Hair loss can make men feel that they are perceived as less strong, less energetic, less successful and less attractive to women. Many believe that their lives would be better if they had more hair. A youthful hairline again can make you feel as though you’ve been given back your youth—you are likely to have more confidence in social situations, feel more attractive, and in general, experience an enhanced quality of life.

Hair restoration may also have some surprising social benefits as well. Studies show that hair loss is often associated with negative stereotypes. You may be perceived as weaker, less successful or older than you really are. Although attitudes toward baldness are changing, most men who undergo hair transplant surgery believe that they are perceived in a more positive light following the procedure.

Risks

Hair transplant surgery is generally safe, and, in most cases, is highly effective. However, the procedure is certainly not without risks. As with any type of surgery, there is a possibility of developing an infection. Infections are rare and most frequently occur when the patient doesn’t follow the doctor’s instructions for post-surgical home care. If an infection does occur, it can usually be treated with a course of antibiotics.

A less physically significant but still troublesome risk is the possibility of unexpectedly slow or sparse hair growth in response to the surgery. If this occurs, your surgeon will likely recommend repeating the procedure to see if he or she can achieve a better result. No one knows why some hair transplants fail in this way, but it is important to follow your doctor’s instructions for at-home follow-up treatment in order to give yourself the best possible chance for successful continued hair growth.

Scarring, though your surgeon will make an attempt to minimize it, can be an issue with hair transplant surgery. Whether or not you will have visible scars depends on a number of factors—the skill of the surgeon, the placement of the excision in the donor areas, and your own ability to heal.

Changes in pigmentation (darkening) in the area of the transplant are possible as well, and are more common in patients with darker skin. Because of this possibility, your doctor may advise you to take extra precautions with regard to sun exposure for some time after your procedure.

The Bottom Line

Hair transplant surgery has come a long way since the days of visible plugs and social stigma. Today’s surgical techniques make it possible to get a full, natural-looking hairline in a single procedure.

Laser hair restoration is as unlike hair transplanting as you can get. Hair transplants involve the surgical process of grafting hair-growing skin and inserting it in bald areas. Laser hair restoration is non-surgical. It’s a procedure that seems like the opposite of anything surgical in another way: Rather than being an invasive procedure that cuts into the flesh, laser hair restoration is a flashy (literally – it’s all lights!) low-level laser show that is all external, outside the surface of your scalp.

Laser hair restoration focuses low levels of infrared light energy directly onto the scalp in a process called photo-biostimulation. The heat from the infrared energy massages the scalp, expands the skin’s pores, increases cell metabolism, and increases the capacity for capillaries to carry blood (increasing blood flow to the scalp). All these factors – the results of exposure to the laser’s infrared light – contribute to a situation on the scalp that is conducive to healthy hair growth.

This treatment is designed in this way because it produces an environment on the head that no longer exists (because of baldness).

Here’s one way to think about the whole process. In the summer you may notice that your hair – or your friends’ hair – grows extra strong, extra thick, extra beautiful, extra vibrant, and extra full. This is attributed to the prolonged exposure to the sun’s pure red light that many of us experience during the summer months. We’re outside more often, and the sun’s rays are generally stronger.

So laser hair restoration seeks to reproduce that kind of environment for the scalp in an effort to re-jumpstart hair growth.

The classification low-level laser therapy (LLLT) describes any kind of laser treatment that is non-surgical, and only topical (i.e. on TOP of the surface of the skin).

Who is it for?

If you want to regain that thick healthy head of hair that you associate with youthful rigor, with life, with endless possibility, then you may want to look into laser hair restoration treatments.

Some people don’t really mind hair loss. They see it as a natural – and even handsome – side effect of the aging process. But others don’t want to accept it because they think it takes away from their look; or they want to feel the same vivacious energy that at one time they derived from the youthfulness of a lush, full head of hair.

What are the pros and cons of this procedure?

Remember, laser hair restoration is non-surgical. No bleeding, no cutting, no anesthesia: just flashing lights.

It’s the only FDA-approved hair-growth remedy that is not a drug, medicine, or surgical procedure.

Indeed there are no known side effects. Perhaps this is because laser hair restoration treatments use less energy than a 40-watt light bulb. The only precaution the patient must take is to make sure never to look directly into the laser beams.

But it’s not all so positive: there’s a list of drawbacks you’ll need to consider.

Let’s start with the number of treatments necessary and their cost – it’s steep. It takes  25 to 50 sessions. The 25 sessions will cost over $4,500. And that’s only half of the usually prescribed number of sessions.

Laser hair restoration is still heavily debated among medical specialists. While some physicians reject it entirely, others use it regularly. Who to trust? On top of that, the physicians who offer laser hair restoration often do so only in combination with hair restoration drugs like Rogaine or Propecia.

The bottom line

Laser hair restoration could be an excellent alternative to surgical hair transplants. But it can be expensive, and physicians aren’t yet unanimous on the procedure’s effectiveness.