Surgical Hair Restoration

The only way to increase the actual amount of hair is to increase the amount of hair follicles in an area through hair transplantation.  Since we cannot make hair out of nothing we need to harvest and transfer your own follicles into the area of need.  The science and techniques for surgical hair transplantation have changed significantly over the past decade.  No longer do we do slits and rows of hair or place plugs.   These more ancient techniques left a result that was not natural and did not look good.  Current techniques that we use are natural and artistic with single follicles being placed in the recipient site so the new hair is indistinguishable from non-transplanted hair.   The term transplant is actually better termed as a hair transfer.  We are using your own hair to restore areas of loss.  The hair we take is from back of the head where the hair grows dense and is resistant to testosterone effects and we place it in the areas of deficiency.  Similar to Robin Hood, we steal from the rich and give to the poor.  The two techniques we use are follicular unit transfer and follicular unit extraction. 

Follicular unit transfer involves harvesting a strip of scalp in the back of the head and closing with a fine linear incision that is hidden by hair.  The strip is separated into individual follicular units, which are then placed artistically in the areas in the recipient sights commonly the top of the head or the temporal hair loss regions.

Follicular unit extraction involves removal of each individual follicular unit with an extraction device or a machine. This procedure does not produce an incision in the back of the head as it removes an even distribution of hair follicles throughout the back of the head.  There are multiple machines that are able to accomplish this, including the Neograft Machine ® . Hair transplants can also be done to hide incisions from facelifts or forehead and brow lifts.  We are also able to transplant hair to the eyebrow or to fill in a beard or facial hair.

before and after hair transplant


Dr. Hollabaugh is fellowship trained in hair restoration, and has performed many hair transplants in both Louisiana at Perenack Aesthetic Surgery and in Dallas/Ft. Worth at the Hair Restoration Institute prior to moving to Missouri to open a practice with Dr. Lohr with an emphasis in hair restoration in addition to facial cosmetic surgery.  Hair restoration surgery requires not only surgical experience but understanding of the art and science of hair restoration to achieve amazing and predictable results.  During your consultation we will discuss your hair loss and current or past treatments.  We will then give you a realistic prediction of what we will and wont be able to do.  Understanding how hair restoration works is key to a successful outcome and happy patients.  We will not promise something if it is not possible, we will be honest in helping you achieve a life with better quantity and quality of hair and do everything in our power to get you there.   


man getting hair transplant

The procedure is typically done with local anesthesia and takes 1-4 hours depending on the amount of hair restoration planned.  Occasional a pill sedation, nitrous oxide sedation or a light IV sedation can be done during the numbing portion of the procedure.  After your scalp is numb, there should be no discomfort for the remainder of the procedure.  We use long acting local anesthetic medications to help with postoperative discomfort.   Hair restoration is time consuming, and honestly can be boring for patients.  We recommend bringing a lap top to work,  you can watch a movie, listen to music or read a book while your hair surgeon and our technicians perform your procedure.  The hair follicles will be harvested then placed during this session, most patients state that the procedure was much easier than they had envisioned and that they agree the hardest part was keeping entertained while we worked meticulously to achieve our goal of giving you your hair back.


In the first 3 days following the procedure, it is important to keep the sites moist by misting the hair grafts with a saline water bottle similar to watering new grass seed or sod in your yard.  Keeping the grafts out of direct sunlight for the first week.  Postoperative care is very basic, there really is not much you need to do but we will walk you through the process.  It is important to know that most of the grafts will actually shed their hair within the first few weeks.  This is normal, and the hair follicles have already set up in the scalp.  It takes about 4-9 months for the follicles to wake up and start producing a new transplanted hair.  This is important because, hair restoration is not an immediate result.  Even though grafts start waking up in 4-9 months, the hair still needs to grow to length before final results from a grafting session are to be seen. We typically take final photos at 15 months post surgery.  Something to also be aware of, there is sometimes an initial “shock loss” of your native hair in an area if hair is grafted among other hair.  This is due to transection of hair shaft due to micro-incisions as well as swelling of native hair follicles that then results in the follicle shedding the hair.  These follicles rebound and immediately begin the cycle to produce another hair so this “shock loss” will rebound fairly quickly.  This can be distressing to patients if they weren’t informed of this phenomenon.  When grafting into a completely bald area, this will usually require 2-3 graft sessions to achieve our desired fullness.  There is a limit to how many grafts that can be placed in a single session.  We like to set these expectations at the consult so patients are aware of the number of grafts and sessions to get to a final desired result.  We believe that with patient education and setting realistic expectations in regards to the hair restoration process that we are able to make our patients happy with their results.