Piazza Center for Plastic Surgery and Advanced Skin Care
7900 Farm to Market Road 1826, Bldg 2, Suite 206
Austin, TX 78737
Phone: (512) 288-8200
Monday–Thursday: 8 a.m.–5 p.m.
Friday: 8 a.m.–2:30 p.m.

Hair Restoration

Hair loss, also known as alopecia, is a common concern for both men and women of all ages and ethnicities. It is a significant source of insecurity and anxiety for many individuals. While genetics play a large role in hair loss, medical conditions, environmental, and even emotional factors can contribute as well. Because several types of hair loss exist, treatments vary depending on cause. Board-certified facial plastic surgeon Dr. Marcelo Antunes offers effective hair restoration options including transplant surgery in Austin, TX, to help patients renew their confidence using their own natural hair.

Meet Dr. Antunes

Board-certified facial plastic surgeon Dr. Marcelo Antunes dedicates his practice exclusively to aesthetic procedures for the face. He can help you look your best and be confident in your appearance.

About Dr. Antunes Dr. Antunes' Credentials Dr. Antunes' Credentials

Reasons for Hair Loss

Men typically experience androgenetic alopecia (AGA), which is also commonly referred to as male pattern baldness. As the most common cause of hair loss, it affects close to 50% of all men before they turn 50 years old. It is an inherited condition and has a distinct pattern of hair loss. With androgenetic alopecia, hair loss begins at the temples and progresses along the forehead as the hairline recedes. Occasionally a bald spot appears at the crown or back of the head. Male pattern baldness can, but does not always, lead to losing all the hair from the head. Women can also experience androgenetic alopecia, but commonly lose their hair from a variety of medical or hormonal conditions, including autoimmune disorders, pregnancy, anemia, and thyroid conditions.

Hair Loss Grading Scale

The standard for defining the type and extent of baldness is the Norwood classification for men and the Ludwig classification for women. Classification helps determine and guide hair restoration while also allowing us to document and monitor progress throughout treatment.

men hair restoration diagram
woman hair restoration

Norwood Classification for Men

  • Type I – Minimal to no hair loss from temple to temple.
  • Type II – Hair loss across the forehead that does not extend farther than a line drawn across the top of the head 2 cm in front of the ear.
  • Type III – Hair loss extends across the top of the head, no more than 2 cm behind the ears.
  • Type III Vertex – Hair loss affects the vertex (or crown) region primarily with or without hair loss described in Type III.
  • Type IV – Hair loss greater than Type III accompanied by hair loss in the crown area but dense hair between the two areas.
  • Type V – Hair loss similar to Type IV but with only a small amount of dense hair around the crown.
  • Type VI – Hair loss that extends from the forehead past the crown.
  • Type VII – Hair loss of the entire scalp except a thin horseshoe along the back and side border of the hairline.

Ludwig Classification for Women

  • Stage I – Mild thinning on the top of the head and front of scalp, most noticeable when hair is parted down the middle.
  • Stage II – Moderate hair thinning at the top of the head and down the middle part, increased shedding, decreased volume.
  • Stage III – Most extreme stage of female hair loss. Hair is extremely thin and scalp is very visible throughout.

Hair Transplant Surgery

Hair transplant surgery involves filling in thinning or bald areas of the scalp with hair follicles (follicular units) from donor areas. The most common methods include:

Follicular Unit Extraction (FUE) removes individual follicular units from the donor area. The follicular units are “punched” out and removed with forceps or a suction device. The main advantage of this method is that avoids the presence of a linear scar on the scalp. FUE allows for 1,000 to 2,000 grafts to be performed in 1 session.

Follicular Unit Transplant (FUT) involves removing a strip of scalp containing many follicular units. Each follicular unit is separated from the strip using stereo-microscopic dissection and then relocated to the balding or thinning area. The main advantage of this method is that we can usually transplant more hair in a single session than with FUE (over 2,000 grafts) without compromising the viability of the grafts.

Hair Transplant Methods: FUE vs. FUT

Procedure Follicular Unit Extraction Follicular Unit Transplant
Ideal Candidate Men and women Men and women
Harvesting Method Small round sections (punches) of scalp are removed Linear strip of hair-bearing scalp removed from the back or side of the head
Donor Locations Scalp and body Scalp only
Scars Tiny white dots may be visible if the head is shaved but easily covered with short hair (< 4-5 guard) A long linear scar at the back or side of the head may be visible if the head is shaved but easily covered with longer hair (> 4-5 guard)
Post-procedure Pain Less pain reported than with FUT due to the lack of stitches and smaller graft areas Slightly more discomfort reported than with FUE, likely related to the larger area of scalp removed and the presence of stitches
Pre-procedure Hair needs to be trimmed prior to the procedure No hair trimming required
Sedation Yes, oral or IV Yes, oral or IV
Recovery – Wash and hat-wearing okay after 1 day– Avoid exercise for 2-3 days to avoid sweating on forehead
– Mild to moderate swelling over forehead and eyes for 2-5 days
– Small scabs may be visible for 5-7 days
– No sutures to be removed
– Wash and hat-wearing okay after 1 day
– Avoid exercise for 2-3 days to avoid sweating on forehead.
– Mild to moderate swelling over forehead and eyes for 2-5 days
– Small scabs may be visible for 5-7 days
– Removal of sutures 10-14 days
Graft Quality Very good, but higher risk of injury to grafts Great, less risk of injury to grafts

Follicular Unit Extraction

Ideal Candidate
Men and women

Harvesting Method
Small round sections (punches) of scalp are removed

Donor Locations
Scalp and body

Scars
Tiny white dots may be visible if the head is shaved but easily covered with short hair (< 4-5 guard)

Post-procedure Pain
Less pain reported than with FUT due to the lack of stitches and smaller graft areas

Pre-procedure
Hair needs to be trimmed prior to the procedure

Sedation
Yes, oral or IV

Recovery
– Wash and hat-wearing okay after 1 day
– Avoid exercise for 2-3 days to avoid sweating on forehead
– Mild to moderate swelling over forehead and eyes for 2-5 days
– Small scabs may be visible for 5-7 days
– No sutures to be removed

Graft Quality
Very good, but higher risk of injury to grafts

Follicular Unit Transplant

Ideal Candidate
Men and women

Harvesting Method
Linear strip of hair-bearing scalp removed from the back or side of the head

Scars
Scalp only

Donor Locations
A long linear scar at the back or side of the head may be visible if the head is shaved but easily covered with longer hair (> 4-5 guard)

Post-procedure Pai
Slightly more discomfort reported than with FUE, likely related to the larger area of scalp removed and the presence of stitches

Pre-procedure
No hair trimming required

Sedation
Yes, oral or IV

Recovery
– Wash and hat-wearing okay after 1 day
– Avoid exercise for 2-3 days to avoid sweating on forehead.
– Mild to moderate swelling over forehead and eyes for 2-5 days
– Small scabs may be visible for 5-7 days
– Removal of sutures 10-14 days

Graft Quality
Great, less risk of injury to grafts

Areas Treated with Hair Transplantation

Dr. Antunes uses hair transplant surgery to help both men and women address a variety of concerns, including:

  • Receding hairline (hairline redesign)
  • Crown baldness
  • Eyebrows that are thin or have bald spots
  • Scalp scars (from previous hair transplants, other procedures, or trauma)

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Nonsurgical Hair Loss Treatments

Dr. Antunes offers the following nonsurgical treatments for patients who are not ready for surgery or want to enhance their hair transplant results:

Platelet Rich Plasma (PRP)
PRP is a concentration of the body’s own growth factors that are present in the blood. Human blood consists of several types of cells and proteins. Once the blood is separated, platelets and plasma are separated to isolate platelet-derived growth factors (PDGF), vascular endothelial growth factors (VEGF), transforming growth factors (TGF), and other bioactive proteins that aid in the stimulation of hair follicles. When injected back into the scalp, PRP can stimulate and strengthen underperforming hair follicles to grow and become thicker.

Laser & Light Therapies
Low laser light therapy (LLLT) is an effective, nonsurgical hair restoration therapy that treats hair loss in ways other therapies cannot. It is often used in combination with other therapies to provide optimal and long-lasting results. LLLT is most effective, however, in those who have thinning hair rather than complete baldness of areas. This treatment works well to reverse thin or miniaturizing hair in both men and women and is a great addition to pre and post-surgical hair transplant procedures to strengthen and improve hair grafts.

Hair Transplant Surgery at a Glance

Goal: Restore the appearance of the hairline and scalp by transplanting hair to bald/thinning areas.

Procedure: Chin implants are inserted through a small incision under the chin. Sliding genioplasty involves adjusting the placement of the chin bone.

Anesthesia: Local anesthesia with oral sedation.

Length of procedure: From 4 to 6 hours, largely depending on the amount of grafts planned for the procedure.

Aftercare:When the procedure is complete, the patient goes home under the care of a friend/family member. A hat must be worn to protect the scalp from the sun. Pain is not common after surgery, but occasionally patients may have a headache. It is normal to feel some tightness on the scalp and forehead. Patients are given specific instructions on how to care for the surgical site, which medications to take, and how to care for the transplanted area of the scalp.

Recovery:Typically, 1 to 2 days. On the second day, patients wash their hair and resume normal work activities. Post-procedure instructions include rest, plenty of fluids, and avoiding sun exposure to the scalp. Dr. Antunes will see patients several times during the first 2 weeks, and patients always have direct access to him. During the initial recovery, having a series of appointments set up in advance can ease some of the anxiety about the recovery process. Dr. Antunes’ core objective is to provide a safe, comfortable experience that achieves the patient’s goals.

Timeline

  • Surgery
  • Day 1: Patients may wash their hair 24 hours after the procedure. There is some tightness and oozing of the scalp.
  • Day 2: Typically, the scabs are mostly gone. There is some swelling of the forehead and brows.
  • 1 week: Swelling and redness are nearly resolved. Transplanted hairs feel like a week-old beard to the touch.
  • 2 week: The grafts are stable; any residual scabbing may be gently scrubbed off. The transplanted hairs begin to shed. Patients return to normal shampooing, brushing, and combing. /li>
  • 3 week: The majority of the transplanted hair has shed.
  • 1 month: Hair follicles enter a resting phase. Patients look very similar to how they looked before surgery.
  • 2 to 3 months: Newly transplanted hairs start to grow.
  • 6 months: Hair continues to grow and thicken. Typically, patients have 70% growth in 7 months and 80% at 8 months.
  • 1 year: Final result of the hair transplant is achieved.