Peter Galpin, M.D., FACS

Kahului, HI (96732)

200 Kalepa Pl # 203

(XXX) XXX-XX00 phone

(808) 877-7480 fax

Procedural Photos

Hair Transplant

Memberships & Affiliations


Hair: Frequently Asked Questions


These FAQ's are designed to help you with general information about a given procedure. They are not designed to give full detail, or take the place of informational consults with a Plastic Surgeon certified by the American Board of Plastic Surgery.

What causes baldness?

Balding is most commonly "Androgenic Balding," also called "Male Pattern Baldness." This is due to a sensitivity of certain hair follicles to male hormones. Both men and women produce these hormones, and so both men and women bald as they age (although the "pattern" in women is one of more diffuse loss rather than balding); this type of balding pattern can be treated by some type of "hair restoration" surgery. The more common surgeries done are scalp reduction, flaps, and/or hair grafts. It should be noted, "hair restoration" does not make new hair, but rather, moves existing hair into a new location.

How long does balding last?

Hair follicles, which have atrophied, died, will never return. Therefore, balding is permanent making it difficult to predict the extent a person will bald as time progresses. This is an issue with any method of hair restoration, which causes difficulty because with scalp reductions, with or without tissue expansion, and flaps, it is relatively inflexible in giving natural results which are long lasting. The hair that is moved, by hair restoration techniques, does not "respond" to hormonal changes, and therefore can be considered permanent, but can be modified as future balding presents itself.

What options are available for hair replacement?

In general, there are three major techniques (each major technique may have different modifications for individual patients): scalp reduction, flap reconstructions, grafting.

The goal with any technique should be a natural result and density. In general, grafting (specifically micro and minigrafting) gives the greatest flexibility in hairline placement/creation, with the ability to respond to future balding issues (if enough donor hair remains). It can also give satisfactory density (although this may take more than one session).

Scalp reduction, and flaps are good at moving density into an area. They suffer from the lack of natural appearance. In addition, scalp reduction moves hair, which is most at risk for future balding into a very prominent area. Micro and minigrafting can help hide some of these problems if you have undergone these procedures.

Do women go bald?

Yes, but they bald in a more diffuse pattern (thinning). Micro and minigrafting are an excellent way to fill in this thinning (also true for men who are only thinning). To date, about 30% of our patients are women and about half our male patients are only thinning.

What is a hair transplant?

A hair transplant is actually a follicle transplant. The hair follicle is a modified gland that produces hair. We take those follicles (and the attached hair) and move them into an area of balding. Because these follicles are taken from an area, which is not hormonally sensitive, they survive permanently in the new area.

Initially, in the first few days after surgery, all the transplanted "hairs" fall out. This is normal, and represents the follicle’s natural cycle after the trauma of transplantation. After a short dormant period, the follicle begins to grow hair again at your normal rate. This can be a frustrating time for patients as it takes several months for the hairs to grow in. However, it is very natural, as the increasing density, or change in the hairline occurs at a natural rate, and not overnight.

Like all tissue transplants, not all the transplanted follicles will survive. We currently have less than a 2% graft loss (10 grafts/500 transplanted).

What can hair transplants do for me?

The type of hair restoration, which is appropriate for you depends on your goals/expectations and your amount of balding. Quite frankly there are some patients who are better off with some type of "hair system" because of the amount of balding. The problem with hair systems is their maintenance, and their ability to look natural.

Hair transplants have the ability to recreate a natural frontal hairline, and to fill in thinning, or bald areas. We are currently limited only by the amount of donor hair available.

Equally important is to ask what can hair restoration not do for me? No type of procedure is going to restore you to the head of hair you had when you were a teenager. We are always trying to balance the amount of coverage needed, with the amount of hair available. We always have to consider future balding and try to plan for it. This involves your active input to jointly determine your priorities and overall plan. Our goal, though, is a result which will not only look good now, but also in the future, whether you have any further work or not.

Can I be done in one session?

We do at least 500 grafts per session, which moves anywhere up to 2,000 hairs. This can give a noticeable improvement to nearly everyone. We also do megasessions (1,000 grafts, up to 4,000 hairs). Which type of session, and how many sessions you need, are determined by your goals and expectations. One session, for most people, will at least reestablish a frontal hairline.

When will I see results?

It takes a period of months (if I had to guess, I would say average is two to four months) for the hairs to grow out to a reasonable length. The rate is determined by how fast your hair grows, and how long you keep your hair.

Who does the surgery?

All surgery is done here in Hawaii by qualified Plastic Surgeons, who are licensed and live here. Currently all surgery is performed on Maui (although we will be expanding surgery to Oahu when demand warrants). If you are traveling from a neighbor island, we pay completely for your airfare, transportation, and accommodation. We have golf, windsurf and diving packages available for mainland and pacific clients.

How long does it take to recover?

Recovery is usually within a few days. For a frontal hairline (which has the longest recovery), you may have some swelling, which will persist for three or four days. The sutures (we never use staples) in the donor area will be removed at one week (unless your hair is very short in the back these will not show at all). The scabs in the graft area will come off after a few days (three - four days). You can wash your hair gently (see postoperative instructions) 48hrs after surgery, and normally at one week. No aerobic exercise for three weeks (A good rule of thumb is anything which raises your heart rate or blood pressure. Another good rule of thumb is: if you think you need to ask us if it is O.K.... it isn’t).

Do I need to miss work?

We typically seem to do surgery on Saturdays to minimize work loss. I think, though, it is good to plan on a few days off in case the swelling is more than expected. We had one client who went out to a dinner party the night of his surgery (definitely not a recommended plan) but no one noticed.

How long do I need to wait between sessions?

We usually recommend at least three months, but four months is better. It allows the initial grafts to grow out sufficiently, and for the donor site to soften.

What about Rogain, Minoxadil, Propecia, Kevis?

These are all types of topical or oral agents, which claim to grow hair. It is our experience that these claims are usually greatly exaggerated. The quality of new hair growth is usually limited, and seems to resemble "peach fuzz", when it occurs at all. All of the drugs have various side effects gynecomastia (female development of the male breast), impotency and skin reactions are some of the most common.

Rogain is a hormonal derivative, which acts locally. It essentially shields the follicles from the hormonal environment, which is causing the balding. We have yet to see significant improvement with Rogain. Some of our patients, however, have told us they think it has slowed their hair loss. The problem is, if Rogain use is not maintained, the follicle is once again exposed to the mature male hormonal environment, and balding will progress to the point it should be at for that age.

Propecia is one of the newest drugs. It was originally developed to deal with prostate problems, and as a side effect was noted to grow hair in some patients. Again, the greatest effect we have seen is to slow the current rate of loss, rather than promote real growth of new hair. A percentage of patients are troubled by impotence on this medication. As with other medications, when treatment stops, hair loss progresses.

Kevis is marketed as a "natural, drug free" treatment. It is a hyaluronic acid derivative, which has not been subjected to critical scientific study. It is non-prescription, therefore, the chances for significant side effects are not known.

What is transillumination?

Transillumination is a technique of graft preparation. It utilizes state of the art backlighting to allow for more accurate graft preparation. Although more time consuming, this increased accuracy allows for larger graft yields, with greater graft survivability. HHTC is the first center in the state to utilize this state of the art technique.

Do we have payment plans?

At HHTC, we understand this is a big investment, and want to make grafting as available, as possible. We participate in the "AMS Patient Financing Program." This is a program developed with the American Society of Plastic and Reconstructive Surgeons. They are used to, and understand financing for cosmetic procedures. They take an application by phone, and will give approval within twenty-four hours (sometimes in as short as a few minutes). Once approved, they will start a "line of credit" for up to $20,000, to be used for surgery. Their interest rates start at less than 15%, depending on your credit history. Of course, we also accept major credit cards and personal checks (one week prior to surgery). Please feel free to discuss these options with our staff.

What is Board Certification?

All surgeons at HHTC are certified by the American Board of Plastic Surgery (ABPS). The American Board of Plastic Surgery is in turn certified by the American Board of Medical Specialties (ABMS). ABPS certification means a doctor has completed rigorous supervised training criteria after graduating from medical school. This includes not only 3-5 years of general surgery training, but also 2-3 years of training exclusively in Plastic Surgery. After passing a written exam, his/her cases are then reviewed by a committee of Board Certified examiners.

There are several "boards" out there which are not ABMS certified. Their training requirements and techniques have not been evaluated, or do not meet the requirements of the ABMS. Even though this surgery can/often is performed in the office, you should ask your surgeon which hospital he/she is affiliated with, and then check to see if he/she has privileges to perform that procedure there. This means the hospital has checked the doctor’s level of training and capabilities.

Do you do other types of surgery?

All the surgeons affiliated with HHTC have broad based Plastic Surgery practices. This allows our surgeons to bring a well-rounded perspective and multiple resources to any individual patient.

See Hair Transplant Procedural Photos