Hair transplants in Singapore: do they really work?

Hair transplants in Singapore: do they really work?

Hair transplant is a surgery that involves the doctor moving hair you already have (such as the back of your head) to fill areas of your scalp suffering from hair loss (typically at your frontal hairlines).

In Singapore, hair transplants are gaining in popularity as the transplanted hair behaves like natural hair and thus gives your hair a very natural look. [1] You would be the object of envy to be one of the lucky few to have escaped hair loss problems. Your mortifying bald patches would very much be a forgotten thing of the past.

We know – losing your crowning glory can be downright terrifying. Unfortunately, 30% of men experience hair loss by the age of 30 and 50% of men experience significant hair loss by the age of 50… and there’s little to do to stop it once it starts. [2]

And if going bald is not an option, a hair transplant procedure is the only permanent solution that can possibly help restore a mane worthy of (self) respect.

“What are hair transplants anyway?”

illustrations showing how hair transplant works
Hair transplant involves harvesting hair from the hair-dense, donor area to implanting hair at hair-loss areas.

To understand hair transplants, you’ll have to first start with our hair follicle life cycle. Human hair shafts grow in groups of 1 to 3 individual hairs. These groups of hair are called follicle units. [3]

Think of your scalp as a padi field and your hair on it would be the harvest. Some parts of the padi field are more fertile than others. It’s the same for our scalp – some parts have good hair growth while others don’t.

Thus, it follows that when a graft is taken from a lush hair-bearing area and transplanted to a hair-deficient, balding area, it will – over time – naturally grow hair in its new site as it would have at its original site.

With medical advancements today, hair transplants now involve transferring your own healthy follicular units to hair loss areas, i.e. your own real hair! It’s come a long way from the old hair plug method of hair transplant in the 80’s which involved “plugging in” artificial doll-like hair.

 “What causes hair loss in the first place?”

Androgenetic alopecia is by far, the most common form of hair loss in both men and women. [4] That means that it’s the androgen hormones in our bodies which negatively affect our hair follicles, resulting in hair loss.

The androgen hormones – specifically an androgen called dihydrotestosterone – attack hair follicles and causes the follicles to become smaller. As the follicles shrink in size, they produce thinner, shorter hairs. Eventually hair follicles completely shrink and hair stops being produced. This process is also called follicular miniaturization. [5]

In short, the #1 cause of hair loss is genetics. Whether or not you are susceptible to baldness and to what extent will your baldness be – it’s all pre-determined by your genes.

“What is male pattern hair loss (MPHL)?”

Male pattern hair loss (MPHL): Hair loss actually follows a distinct pattern in men.

Androgenetic alopecia in men is also otherwise known as male pattern hair loss (MPHL).

It’s because the hair loss process follows a defined pattern: at the start, hair thins at both sides of the head, above the temples. Then, the hairline starts to recede to form an “M” shape. Hair also thins significantly at the crown (right atop the head), and the bald patch enlarges from there. [6]

Slowly but surely, it progresses to a state of partial or complete baldness that is the very nightmare of every man. A whopping 95% of hair loss cases in Singaporean males are due to MPHL.

“What about females – do females suffer from hair loss too?”

It is possible for women to suffer from hair loss – it’s just that women are much less prone to genetic hair loss, also known as female pattern hair loss (FPHL).

The female pattern of hair loss is very different from men. It usually starts with thinning at the hair parting line and then increasingly, thinning of the hair at the top of the head, radiating from the parting line. Typically, FPHL does not affect younger women so much as it affects older women, due to hormonal changes after menopause. In any case, it’s rare for the hairline to recede and women rarely become bald. [7]

“I’m experiencing hair loss and bald patches – what can I do?”

Many of the people we know who experience hair loss have tried countless ways to treat their condition – from vitamin supplements, hair treatment and hair spas to herbal remedies – but alas, these methods are not medically proven. More often than not, these methods are ineffective and costly, and the only thing it gives you is a shred of hope.

There are two FDA-approved medications which are scientifically proven to slow down the progression of hair loss in men:

1. Finasteride (oral)

A prescription-only oral medication, you have to see a doctor in order to take it. Finasteride is a drug which helps to reduce dihydrotestosterone levels, thus slowing down the process of hair follicles shrinking.  It’s a temporary solution and you’ll have to keep taking it in order to slow down the progression of hair loss. Side effects include decreased sex drive. [8]

2. Minoxidil (topical)

Minoxidil is an over-the-country topical cream that you can buy at pharmacies. It helps to maintain and stimulate hair growth. Side effects include scalp dryness and itching, but it’s rare. [8]

Again, these medications can only help to slow down the progression of your hair loss situation and cannot help treat severe balding conditions.

If you are already experiencing severe and unsightly bald patches, a hair transplant would be your only solution to this hairy problem (soz, couldn’t help it).

“3 types of hair transplants: FUT, FUE and ARTAS”

Just to be clear, all three methods involve transplanting your follicular unit (i.e. your real hair) and achieve natural-looking results. It’s legit – your barber or hair stylist wouldn’t even know the difference.

They slightly differ in surgical method as follows:

Follicular Unit Transplantation (FUT)

FUT is also known as follicular unit strip surgery. It involves cutting out strips of scalp skin behind your head (hair dense area) and moving them to hair loss areas to harvest hair. [9]

How FUT is done:

  • First, local anesthesia is injected to numb the scalp and the hair is shaved at the hair dense area.
  • The surgeon would then remove strips of skin from hair-abundant scalp areas (such as the back of your head) and sew the wound close.
  • Next, he divides the strip of removed scalp into 500 to 2,000 tiny grafts, each with an individual hair or a few hairs, and transplants them onto hair-deficient sites.

A possible risk is scarring on the scalp.

Follicular Unit Extraction (FUE)

In comparison, FUE involves manually extracting each follicular unit using a pen-like tool which punches holes.

illustration showing the different between FUT and FUE

How FUE is done:

  • Similarly, local anesthesia is first injected to numb the scalp and the hair is shaved at the hair dense area.
  • The surgeon then uses a pen-like tool which punches a hole around each targeted hair follicle.
  • Next, the doctor and his team would manually remove each hair follicle unit and placed in a cool petri-dish.
  • After all the hair required is extracted, his team then proceeds to manually plant them at hairless sites.

Compared to FUT, FUE is more time and labour intensive for the surgeon. It will take hours and can be done in a single session or several sessions, depending on the severity of hair loss. It can range from a few hundreds to thousands of follicular units to be extracted.

The good thing about FUE is that it is scarless, less invasive and less painful for you as the patient. Recovery is also quicker. [10]

In Singapore, the majority of surgeons do FUE as they feel that it is more minimally invasive and comfortable for patients than the FUT procedure.

ARTAS Follicular Unit Extraction (FUE)

Well, it’s atas because it’s robotic.

Just kidding, ARTAS is the trademarked name for the technology used for robotic hair restoration. Definitely not a Singaporean slang.

For ARTAS FUE, the method is the same as FUE itself, just that the extraction is done robotically instead of manually, by a human. The ARTAS machine uses AI to detect the best hair follicles to be extracted and laser-guided robotics help to extract and harvest the hair. Since the process is automated, it not only helps to minimize error and risk, but also allows for minimal wastage (estimated at 85 to 90% yield). [11]

Combining the science and art of hair transplants, the doctor then manually transplants the hair grafts to achieve the best and most natural-looking hair line and results.

“How many hair grafts do I need for my hair transplant surgery?”

James Hamilton (1950s) and Norwood (1970s) created the Hamilton-Norwood scale   to classify male pattern hair loss (MPHL) into seven stages. [12] This scale is often used by doctors to measure the severity of baldness.

You can also use it to estimate the number of hair grafts you will need for your condition, by matching your condition to the table below.

Hamilton-Norwood Scale for Male Pattern Hair Loss (MPHL) Estimated no. of hair grafts required
500
700 – 800
1,000 – 1,600
1,000 – 1,800
1,600 – 2,000
1,800 – 2,000
2,000 – 2,500
2,400 – 3,000
2,800 – 3,400
2,500 – 3,600

Estimating the number of hair grafts needed according to the Norwood scale for male pattern hair loss

As you can see from the table above, you will need an estimated 2,000 hair grafts if you have moderate hair loss.

“Prices of hair transplant in Singapore”

The cost of hair transplant procedures in Singapore – done by a certified doctor – ranges from $6,000 to $10,000.

There are three main factors affecting the price of your hair transplant procedure:

  • The severity of your hair loss (i.e. number of hair grafts you need)
  • The price of each hair graft which is dependent on surgical technique – For example, FUE costs $6 – $8 per graft while ARTAS robotic FUE costs $9 to $12 per graft
  • Surgeon fees

Other additional costs on top of the surgery include:

  • Initial evaluation for suitability: $50-$100
  • Medications after the surgery: $50 to $200
  • Post-op reviews: $50-$100 per session

“Is everyone a suitable hair transplant surgery candidate?”

As it happens, hair transplant today requires using your own hair, so you’ll have to have enough hair to begin with. Thus, if you have severely widespread balding and thinning of hair, you may not be a suitable candidate.

That is why you will also need to come down to the clinic for an evaluation to determine your suitability for hair transplant. The criteria include a good number of existing healthy hair follicles to “harvest” and also a stabilized balding pattern. In general, those who are younger may not be suitable yet for the procedure.

It’s also unsuitable and unsustainable for people with hair loss due to chemotherapy or other medications.

“Is hair transplant surgery safe? What are the risks and success rates?”

Modern hair transplant surgery such as FUT and FUE are minimally invasive and generally safe as long it is done properly and by a qualified surgeon. It’s important to pick a good and skilful surgeon to do it.

That being said, as with all surgery, there are always risks involved. Some risks include:

  • Infection
  • Bleeding and swelling
  • Noticeable scarring

There is also risk of unsuccessful hair grafting, i.e. some hair grafts not surviving the transplant and dropping out. This depends fully on your hair surgeon’s skill and experience. A skilled surgeon would have done thousands of hair transplant procedures and have an average success rate of 95%.

“Expectations, recovery”

After the procedure, expect your scalp to be very tender. You may also need to take painkillers and wear scalp bandages for a day or two. Expect to return back to work in 5 days. 

“When can I expect my new transplanted hair to grow?”

The transplanted hair follicles typically take 9 to 12 months to develop and grow. So, if you’re considering a hair transplant procedure to look your best on your big day, remember to plan ahead and factor in enough time for the transplanted hair to grow out naturally.

Going for a hair transplant procedure can be daunting. But if hair loss has snowballed into a problem that is affecting your self-esteem or your life, a hair transplant procedure could just be the life-saver you need. The best way to move forward is to schedule a consultation with a hair surgeon to hear more about the procedure and make your own assessments from there. Till then, don’t stress too much and do your research!

References:

[1] SingHealth (2020). Hair transplantation. Retrieved from https://www.singhealth.com.sg/patient-care/conditions-treatments/Hair-transplantation/

[2] Godwin, R. (2018). How close is a cure for baldness? The Guardian. Retrieved from https://www.theguardian.com/fashion/2018/sep/02/hair-today-gone-tomorrow

[3] Vogel, J. E., Jimenez, F., Cole, J., Keene, S. A., Harris, J. A., Barrera, A., Rose, P. T. (2013). Hair Restoration Surgery: The State of the Art, Aesthetic Surgery Journal, Volume 33, Issue 1, January 2013, Pages 128 – 151, https://doi.org/10.1177/1090820X12468314

[4] Cranwell, W., Sinclair, R. (2016). Male androgenetic alopecia. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK278957/

[5] U.S. National Library of Medicine. (2020). Androgenetic alopecia. Genetics Home Reference. Retrieved from https://ghr.nlm.nih.gov/condition/androgenetic-alopecia#statistics

[6] Hamilton, J. B. (1951). Patterned loss of hair in man; types and incidence. Annals of the New York Academy of Sciences; 53:708-728

[7] Harvard Women’s Health Watch (2018). Treating female pattern hair loss. Harvard Medical School: Harvard Health Publishing. Retrieved from https://www.health.harvard.edu/staying-healthy/treating-female-pattern-hair-loss

[8] Chandrashekar, B. S., Nandhini, T., Vasanth, V., Sriram, R., & Navale, S. (2015). Topical minoxidil fortified with finasteride: An account of maintenance of hair density after replacing oral finasteride. Indian dermatology online journal6(1), 17–20. https://doi.org/10.4103/2229-5178.148925

[9] Rousso, D. E., Presti P. M. (2008)  Follicular unit transplantation. Facial Plast Surg. 2008 Nov; 24(4):381-8. Epub 2008 Nov 25.

[10] Mysore V. (2010). Hair transplantation surgery – its current status. Journal of cutaneous and aesthetic surgery3(2), 67–68. https://doi.org/10.4103/0974-2077.69013

[11] Freia website (2020). Artas hair transplant. Retreived from https://freia.sg/treatment-options/hair/artas-hair-transplant/

[12] Khanna M. (2008). Hair transplantation surgery. Indian journal of plastic surgery: official publication of the Association of Plastic Surgeons of India, 41(Suppl), S56–S63.

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