Before we hop into the article, I am happy to say that I tried the entire hair transplant procedure for myself. I documented the entire process and I would love to share it with you guys. Check it out!
Never have your weave snatched when you get a hair transplant!
Jokes aside, it is true that a hair transplant is permanent and should not fall off if it was done properly.
Those hair loss treatment solutions that you see advertised on television? Forget them! They have not been scientifically proven and are non-medical treatments which cannot guarantee your hair back.
If you are just trying some treatments to nourish your hair, you may consider going for these hair treatment sessions.
However, if you are suffering from severe hair loss, you would be better off spending your money on a proper hair transplant.
If you are suffering or know someone who is suffering from hair loss and needs a hair transplant, this could be an informational and useful read!
So sit back, buckle in and let me bring you on a comprehensive journey of hair loss and hair transplant in Singapore.
Are there different types of hair loss?
Hair loss is also known as alopecia, and it is a condition which can affect just your scalp or your entire body .
Androgenic alopecia is a common type of hair loss in men and women, but is usually more prevalent in men as it usually occurs earlier, faster and more intensely. Androgenic alopecia can develop due to a combination of hormones and genetics .
Although the pattern of inheritance for androgenic alopecia is unclear, what we do know is that if your family has it or if a close relative of yours has patterned hair loss, the risk of you developing this condition increases.
Male-pattern baldness. Male-pattern baldness occurs in a well-defined M shape, where the hairline starts from about the temples and slowly recedes as adolescent young boys grow older . More than 50% of men above 50 years old suffer from male-pattern baldness .
Female-pattern baldness. Female-pattern baldness differs from men in that the hair thins all over the head in contrast to only a certain area. The female hairline also does not recede due to androgenic alopecia .
Female-pattern baldness usually begins when a woman is in her 40s to 60s, and is more common after menopause .
Telogen effluvium is a temporary condition that develops after our body undergoes certain stressful events or illnesses. Common triggers are childbirth, excessive dieting with nutritional deficiency, psychological stress, and major illnesses.
To understand this better, one must first understand the stages of hair growth. At any point of time, about 5 - 10% of hair on an average person’s head is in the resting or shedding phase, also known as telogen phase, which lasts about 2 to 4 months before hair sheds and is replaced.
In Telogen effluvium, up to 30% of hair stops growing and enters telogen phase prematurely .
Therefore, you might notice an increase in your daily hair loss count, from a baseline of approximately 100 strands to losing approximately 300 strands of hair daily.
It is certainly worrying to witness sudden hair loss over a short period of time. Fortunately, telogen effluvium is a temporary condition which seldom persists over 6 months after its triggers are resolved.
Furthermore, telogen effluvium does not affect your body’s ability to produce new, growing hair. Over time, your hair will grow and overall hair volume will return to normal.
Anagen effluvium is a reversible form of hair loss that is commonly associated with chemotherapy, a form of cancer treatment .
85-90% of our hair are in the growing phase, also known as anagen phase. When drugs or toxins injure and damage these growing hairs, there is abrupt widespread hair loss and shedding. Fortunately, this condition is usually reversible when the offending drug is discontinued.
What are the symptoms of hair loss?
There are various symptoms of hair loss, depending on the cause of hair loss. Some symptoms include :
- Gradual thinning of hair at the top of your head
- Circular/patchy bald spots
- Sudden loosening of hair (even after gentle tugging)
- Full-body hair loss
What are the causes of hair loss in Singapore?
To effectively treat your hair loss, you must first understand the reason your hair keeps falling. Some causes of hair loss includes:
Genetics. This is the most common cause of androgenic alopecia.
Medication side effects. As mentioned before, medication used for chemotherapy can result in hair loss. Drugs used for depression, high blood pressure and heart problems can also cause hair loss as a side effect.
Poor diet. Calorie and protein malnutrition can impact hair structure and lead to conditions like acute telogen effluvium .
Stress. Going through an emotional or physical shock can result in the general thinning of hair for several months. Hair loss due to stress is usually temporary.
Up to 95% of hair loss in Singaporean males is due to genetics.
Hence, a common practice for me would be to check the patient’s history.
Other necessary examinations and blood tests would also be carried out to eliminate certain causes of hair loss and allow us to optimally treat the cause of your hair loss condition.
How do I choose the best treatment for my hair loss?
As mentioned before, to know the best treatment for your hair loss, you should know the cause of your hair loss. Scroll back up if you have not identified the cause of your hair loss, although you should consult your doctor for a proper check up.
If you already know the cause of your hair loss, you can also determine the severity and predict the progression of your hair loss. When choosing the treatment that you wish to undergo, it is important to keep these factors in your mind to slow down the process of hair loss.
On top of that, you should also consider your lifestyle when you choose your treatment. It is important that you share with us your concerns so that we can recommend the most suitable treatment option for you.
What types of medications are there for hair loss?
There are 3 main types of medicine used to treat hair loss and you can find out more about them here.
Finasteride is used for androgenic alopecia and helps to increase the number of hairs growing on the scalp but not body hair.
Androgenic alopecia is caused by selective hair loss in areas of the scalp that are dense in testosterone receptors. We can slow the progress of this disease process by reducing the level of testosterone.
Finasteride works by blocking the actions of the enzyme 5-alpha-reductase , which converts testosterone to its more active form dihydrotestosterone (DHT) It’s high levels of DHT that cause hair loss.
However, the effects of this only sustains if the medicine is taken. Once medication stops,the effects last for another 6 months before hair loss restarts again.
Finasteride is typically used in males, but with proper warning of the possible side effects to babies when conceiving, Finasteride can be used off label for women too.
Dutasteride is an orally-administered drug and comes only in the form of a capsule. Dutasteride works the same way as Finasteride in that it blocks the activity of 5-alpha-reductase enzymes.
Dutasteride is a more effective choice as compared to Finasteride, but the side effects are also more frequent .
As such, dutasteride is recommended as an “off-label” drug in Singapore by doctors who prefer this over Finasteride.
Finally, minoxidil is a spray which helps to slow down hair loss and not promote the growth of new hair. However, you can combine Minoxidil with other treatments to see more prominent results. It is also the only treatment that is FDA-approved for female-pattern baldness .
Minoxidil (sold as Rogaine) can be bought over-the-counter in Singapore at a cheaper price as compared to buying expensive shampoos with Minoxidil added in them.
What types of hair transplant are there in Singapore?
There are 2 choices to hair transplants - Follicular Unit Extraction (FUE) or Follicular Unit Transplantation (FUT).
Follicular Unit Transplantation (FUT)
FUT involves taking a strip of skin with hair follicles from the donor site and separates them into small groups of tissues called hair grafts.
Small holes are made in the areas experiencing balding and the hair grafts are then individually placed into these holes.
However, FUT does have its drawbacks. FUT does leave a scar which runs horizontally across the back of the head and patients would have to not only take care of the area of transplant but also the wound at the back of the head.
Follicular Unit Extraction (FUE)
FUE harvests individual hair follicles from a donor site at the back of the head and inserts these individual hair follicles into small incisions made on the areas of hair loss . While FUE may take a longer time as compared to FUT, there would be no linear scar and wound care is not needed. As such, downtime is also reduced alongside post-surgery discomfort.
Which hair transplant procedure is the best for me?
The answer to this depends on your preference and your budget. Hair transplant procedures can be done manually or using ARTAS. The ARTAS system utilises artificial intelligence to perform minimally-invasive hair transplants, making it more precise as it reduces the risk of human error .
Both procedures have high success rates with only marginal differences:
95 - 96%
However, the cost of using the ARTAS for hair transplant can be double or triple the cost of a manual hair transplant.
$5,000 - $7,000 / 1,000 follicles
$14,000 / 1,000 follicles
What is the most popular type of hair transplant in Singapore?
The most popular hair transplant procedure in Singapore, and Asia in general, is Follicular Unit Extraction (FUE). This is because Asian skin is thicker and tighter, resulting in poor wound healing . As such, FUE is preferred over FUT since FUT has a higher risk of scarring for Asians.
Am I suitable for Follicular Unit Extraction?
In general, you are suitable for FUE if you:
- Do not have any major medical condition which could potentially complicate the transplant procedure
- Have a healthy donor site with sufficient follicles
- Have healthy blood vessels on the balding area
However, you may want to reconsider having a FUE hair transplant if :
- Your hair loss pattern is widespread throughout the scalp
- You form keloid scars after surgery
- The cause of your hair loss is a result of medication side effects
What can I expect during a FUE hair transplant?
There are 4 main steps to a FUE hair transplant and they can be summarised as:
1. Anaesthetic and Extraction
Your donor site will first be cleansed with antiseptic solution and then numbed with anaesthetic to prepare for the extraction of hair follicles. Donor sites can be the back or side of your head, your body and even your underarm.
Each hair follicle is extracted individually from the donor sites using a pen and are then stored in a special solution to preserve them for implantation.
2. Hair graft inspection
Each individual hair graft undergoes a selection process whereby they are inspected carefully under a microscope and only the best and most usable hair grafts are selected. This process helps to ensure the quality and increase the survivability of the hair grafts.
3. Planning and Implantation
After the best hair grafts have been chosen, we will plan the positioning of the grafts to make the transplant look as natural as possible. The factors we take into consideration are the angle, direction and distribution of the grafts.
After the plan has been finalised, the hair grafts that were extracted are then implanted onto the areas of your head that are experiencing hair loss.
Immediately after the surgery, you may experience swelling at the donor site and across your forehead for a couple of days.
Your doctor would advise you on how to best take care of your transplant after surgery to increase its survivability. Recommendations may include keeping your head inclined when sleeping, restrictions on washing your hair or even time off from work for a week or so .
How long is the downtime and when will new hair start growing?
The recovery process after a hair transplant can go up to a few weeks. As mentioned above, immediately after the procedure, you may experience swelling which can be painful and pain-killers may be prescribed to ease the pain.
2 weeks post-surgery, you may be shocked to see the newly transplanted hair falling out. This is a normal occurrence in the recovery process which loses the old hairs to make way for new hairs to grow in the new site.
You may also see some blood scabs falling off in the first few weeks after surgery from the area where the hair grafts were transplanted into.
The results of the hair transplant can be best seen after 9 months to 1 year of recovery. However, if the operation was highly successful, satisfactory results can be seen in just 6 months.
Is the hair transplant process painful?
The procedure itself is not painful since local anaesthetic would be administered. I would say the most pain you would feel is the small needle prick when the anaesthetic is injected.
After the procedure, your scalp may be swollen and feel sore. Certain medication could be prescribed by your doctor to reduce the effects of the surgery , such as:
- Pain killers
- Anti-inflammatory medicine
Is it safe to undergo hair transplant in Singapore?
It is extremely safe for you to undergo FUE hair transplantation in Singapore since it is a procedure that has been well-researched and frequently performed.
Some minor risks, however, are still present if you decide to go for a hair technician that is not as well-versed in this procedure. Results of this could lead to you experiencing:
- Poor wound healing
How long can the hair transplant last?
Hair transplants are a permanent treatment for hair loss and patients usually see them lasting for a long period of time. However, there are times where this can be compromised.
Like we mentioned before, the abilities of your hair technician can play an important role in the survivability of your transplanted hairs. If your hair technician:
- Implants the hairs too close to the surface of your scalp
- Does not anchor the implanted hairs properly
There is a low chance of the hair transplant having a successful outcome. Poor recovery and infections after the procedure can also decrease the survivability of the transplanted hairs.
As such, it is very important that you take the time to research about the doctor and clinic you would like to receive treatment from!
Will it be obvious that I have a hair transplant?
This would depend on your doctor’s ability to plan well during the hair transplantation process! Hair design, hair density, direction and angle of the hair grafts all play an important role in ensuring that transplant gives you a natural look.
How can my doctor increase the survival rate of my hair grafts?
There are two phases in which your doctor can increase the survivability of your hair grafts - the extraction phase and the implantation phase. If both phases have been expertly executed by your doctor, the survival rate of your hair grafts can increase to 99% or more.
Extraction phase. If your hair technician can extract the hair follicles in the same direction as your hair, this would greatly reduce the trauma that the hair graft and donor site experiences.
Implantation phase. During the transplant, extracted hair follicles have to be properly preserved in order to ensure a high survival rate. These hair follicles should also be implanted at the ideal depth on your scalp.
The performance of your hair technician is crucial in this phase as implanting the hair grafts too shallowly can cause them to fall within the first 2 weeks. However, if your hair technician implants them too deep, these implanted hair grafts would not be able to receive enough blood supply from the scalp to stay healthy.
How do I ensure that I get the best result?
Once your doctor has done their best during the surgery, it is now up to you to ensure that your hair grafts can properly grow! Taking proper care of your hair after the surgery can reduce the chances of infection and the probability of implanted hairs falling off.
Within the 1st month after the procedure, you should:
- Be gentle when washing your hair
- Avoid blasting water directly onto your scalp, use a cup to rinse instead
- Avoid scratching the scabs off your scalp, or scratching your scalp at all
- Dying your hair
Other activities you should avoid would be:
- Going swimming
- Excessive sun exposure
- Drinking alcohol and smoking
- Exposing yourself to dirty environments
What are the costs of treatment in Singapore?
A Follicular Unit Extraction (FUE) hair transplant in Singapore can cost anywhere between $6,000 to $10,000. The final cost is actually dependent on the condition of your hair loss because FUE transplants are customised to the needs and preference of the patients. You can ask a doctor about it here.
Follicular Unit Extraction
Some factors that may affect the cost of the treatment would be:
- The number of grafts needed
- The surgeon’s fee
- The procedure that was chosen (ARTAS vs Manual)
- The survival rate of your hair grafts
The survival rate of your hair grafts is a huge factor in the overall cost of the treatment. It is a factor that is more important than the number of grafts needed. If the survival rate of your hair graft is low, it means that you would have to spend more in the long run to repeat the hair transplant procedure.
It could also affect your ability to fix your hair loss problems because once a hair graft does not survive, it is gone forever. And there are only so many hair grafts that you can extract again for your hair transplant.
Before deciding on getting a hair transplant, it is important to do thorough research on the various factors that may affect your experience. As mentioned throughout this article, a good doctor can lead to great results when undergoing a hair transplant. So here are some questions that you can ask your doctor when weighing which doctor to get your hair transplant from:
- How many hair transplants have you performed in total?
- What is the success rate of your hair transplants?
- What is the cost breakdown for your hair transplant procedure?
- What adjuncts are available to improve results after the procedure?
- What kind of results can I expect to see?
If you are able to find satisfactory answers to those questions, then you have found the right doctor for you!
If you have made it thus far, kudos to you! It was a rather long read, but when it comes to medical procedures, it is always better to be more thorough in your research. I hope you’ve enjoyed this article and have a better idea on what hair transplants entail!
Dr Chua Cheng Yu (Veritas Medical Aesthetics) is a frequent trainer at medical seminars. He often shares his knowledge on multiple aesthetic technologies, including the Ultraformer HIFU and Teosyal fillers. Besides that, his clinic mirrors his philosophy of functional aesthetics: holistic health and beauty. Also, in his spare time, he plays the piano, dabbles with amateur photography, and maintains a personal blog.