Hair Loss Treatment Singapore

What Causes Baldness?

Scalp diseases masy sometimes lead to hairloss but most male baldness is the result of an inherited characteristic in certain hair follicles. This leads to these follicles becoming sensitive to the presence of the scalp hormone dihydrotestosterone. In the years after puberty these follicles become weaker and die prematurely. The gene causing this problem may be inherited from either side of the family, but certain other factors may retard or speed up the effects of the gene.

BACK to TOP

What Can Be Done About It?

Firstly you need to have your scalp examined by Dr R. Sundarason and have the cause of your hair loss ascertained. There are many scalp diseases which lead to hair loss. Some have no cure at present, but fortunately these conditions are rare and represent only about 1% of patients we see.

Patients with early male baldness generally respond well to the oral medication finasteride (Propecia or Proscar) and other drugs are likely to be approved soon. The topical medication Minoxidil is also known to be reasonably effective in the early stages of hair loss in both male and females. More advanced degrees of hair loss may require surgery.

Minoxidil

Minoxidil is a drug which was originally developed for the treatment of high blood pressure. It produces modest hair growth in about 30% of patients. Unfortunately, to maintain this hair growth, Monoxidil treatment must be continued daily for life or the results will be quickly lost.

Finasteride (Propecia and Proscar)

This is a drug developed to counteract prostate enlargement. In smaller doses it retards hair loss in males and in about 50% of patients some regrowth can be seen after 6-12 months. It is also quite costly as treatment must be maintained for life. Newer drugs are being developed but none of these is expected to produce a full growth of hair.

BACK to TOP

Wigs, Toupees, Hair Fusion, Hair Extensions, Hair Weaves and Hair Pieces

No matter what they are called, these are all artificial prostheses which are attached to the scalp by varying methods. The most common is the aid of double sided adhesive tape and miniature clips. Other methods have involved the use of wire loops sewn into the scalp. In the process of hair weaving, the hairpiece is firmly attached to the remaining natural hair but needs to be adjusted every 5-6 weeks as the unit becomes looser due to growth of the underlying hair. Problems may occur at these points of attachment as the continuous pulling may lead to permanent hair loss in these regions.

A further problem is that scalp sweating may cause odours and deterioration of the hairpiece. You can shower or swim in a wig but these activities may hasten the deterioration of the unit so that frequent refurbishment is necessary. Generally speaking hair pieces need to be replaced every 1-2 years and re-tinting can be necessary every 6 months or so.

Artificial Hair Implants

These have been available for a number of years and have improved greatly in appearance and texture so that they are difficult to distinguish from natural hair. They suffer from the major disadvantage that these hairs are gradually shed over a 3-36 month period and need annual "top-up" procedures. There are many other minor problems but the big advantage is that there is a limitless supply of artificial hair fibres.

Types of Surgical Procedures

1. Hair Transplantation – this is by far the most common procedure world wide
2. Alopecia excision – once popular but now only used occasionally in selected cases
3. Flap reduction surgery – still used on rare occasions by some Plastic Surgeons

Modern Hair Transplantation

Today’s hair transplantation aims, and succeeds in mimicking the natural hairline and randomness of normal hair growth. Hair implantation was invented in Japan in 1939 and reinvented in America 1956. Like automobiles, hair transplants have come a long way in 50 years. From crude but effective plugs, to modern state-of-the-art techniques. The procedures are completed under mild sedation and a “local” anaesthetic.

What Exactly Is A Modern Hair Transplant?

Healthy hair follicles are removed from the rear of both sides of the scalp where hair is at its thickiest and implanted into new sites prepared in the bald area. In the case of thinning hair, the sites are located between remaining hairs.

In recent years there has been a trend towards the use of very small grafts containing 1-4 hairs. These are popularly known as micrografts of follicular units. Two thousand of these units, up to 3000 follicles, may be inserted during the course of one procedure lasting up to 8 hours, although generally smaller sessions are recommended.

This technique of varying the size and density of grafts is the reason why the hair growth and hair line so closely resembles natural hair growth.

Dr R. Sundarason will discuss the most appropriate technique for your condition.

Can All Types of Baldness Be Helped By Surgery?

Generally speaking, yes. Modern hair transplant surgery is most useful for cases of both male and female hereditary baldness. It is also occasionally used for treating baldness caused by accidents, burns and certain skin diseases. In recent years, transplants have been used increasingly to conceal scarring following facelifts and other scalp surgery.

How Long Does It Take For The New Hair To Start Growing?

Transplanted hair is usually shed within 3-4 weeks. New hair growth is generally seen after about 10 weeks and grows at about 1 cm per month thereafter. Some hairs take longer to regrow than others. The operative process may cause temporary increases in the natural hair loss but many of these hairs will regrow over the following 6  months.

BACK to TOP

Why Does Hair Taken From A Donor Site Continue to Grow When Transplanted Into A Bald Scalp?

Every hair on your body has its own distinctive and inherited life cycle and these characteristics are not altered by transplantation to new sites. Some hairs are predetermined to fall out prematurely while in other regions the follicles produce hairs of a more permanent variety. Hair follicles at the back of the head are not sensitive to the effects of dihydrotestosterone, which is why they continue to grow strongly.

Enlarged photo of the donor site:

Is The New Hair Permanent?

The new hair will grow strongly for many years, but there will be some thinning and greying with age as with normal healthy hair.

Will The Operation Damage My Remaining Hair?

You may notice a slight increase in hair loss in the recipient area for a few weeks after surgery. Most of these hairs will regrow within 6-8 months but in some individuals the loss is permanent and further transplants will be required to replace these hairs.

Is Hair Transplantation Painful?

The operation is performed comfortably under local anaesthesia and preliminary mild sedation. Some patients find that the suture line is tender for a week or two, but most patients find that the experience is no worse than a routine dental procedure.

How Is The New Front Hairline Created?

This important aspect of hair transplantation will be discussed at your initial consultation and also before your operations. Factors which influence the placement of the new hairline are age, head shape, personal preference and the availability of remaining hair.

What Should I Do Before An Operation?

A comprehensive pre-operative instruction sheet will be given to you. In short you are forbidden to take alcohol containing drinks 24 hours prior or take aspirin containing drugs 7 days prior to your procedure. Herbal preparation Gingko Biloba and Vitamin E tablets should be ceased 1 week prior to surgery. Any medication your family doctor may have prescribed for you should be mentioned to Dr R. Sundarason. Fasting is not necessary and you are advised to eat normally. On the morning of your procedure you are asked to shampoo your hair.

How Long Does An Operation Take?

Operations take between one and eight hours depending on the number of grafts. It is recommended that you remain a further 30 minutes after the operation during which time refreshments will be provided. It is inadvisable to drive immediately after your operation. We suggest that you arrange transport with a friend. If required, we can call a taxi for you.

BACK to TOP

What Happens After An Operation?

Most patients leave without any bandages. Your scalp will be a little tender for several days.

Will There Be Any Scarring?

As with any skin surgery, faint scars may be detected on very close inspection. This is generally less of a problem with hair transplantation as the new hair growth usually conceals any residual marks.

In the donor region any faint scar is generally well hidden by your surrounding hair.

Are There Any Complications Likely From This Procedure?

In our experience, post-operative complications have been infrequent and never serious. The most common being swelling and occasional bruising around the forehead and eyelids on the third day. This may last for up to a week. Infection is extremely unusual and responds rapidly to antibiotics. Occasionally the glands behind the ears become a little enlarged and tender for a few days but this settles without treatment. Parts of your scalp may remain numb for some time after each operation due to temporary interference with the nerves in this area.

Do I Need To Take Time Off Work?

Many patients are able to resume work the next day and perform light sporting activities within 1 week. We recommend that vigorous sports such as football, water skiing, and weight lifting should be discontinued for at least two weeks. Should you require time off work to recuperate, Dr R. Sundarason will be able to furnish you with a certificate. Some patients prefer to schedule part of their holidays to coincide with the procedure.

BACK to TOP

How Many Visits Will Be Necessary?

This will depend on the size of the area to be covered and the type of procedure involved. Two visits are generally a minimum. If extra hair density is desired, futher transplantation sessions can be scheduled at intervals of 14-16 weeks although longer periods are preferred.

What Are The Cost Of Surgery?

This will depend on which technique Dr. Sundarason recommends and the number and size of procedures required. He will discuss these in detail with you at the time of your first appointment, outlining the full facts to help you make your decision.

A deposit is required 3 weeks before surgery and final payment should be made on the day of your procedure.

BACK to TOP

THE NEXT STEP

We suggest that you contact us and arrange a consultation with Dr R. Sundarason.

Dr R. Sundarason  will take a history of your hair loss and if necessary perform tests to arrive at a diagnosis of your condition.

He will then prescribe medical treatment or recommend surgery, sometimes both.
The cost of treatment will be outlined and you will be shown before and after photographs of likely results.

BACK to TOP