Hair Replacements, Hairpieces and Wigs

A hair replacement (hair system or hairpiece) is partial synthetic or natural hair prosthesis that covers a part of the scalp which is bald, whereas a wig which covers the entire scalp. A wig is worn usually by women whereas the men prefer to wear a cap because of persistence of the hair at the back and sides of the head (occipital and temporal fringe in men with male patterned baldness).

Hair replacements can be attached to the scalp through a variety of mechanisms. They are summarized below:

·     Tape adhesives: are used for daily adherence so that the hairpiece can be easily removed at night time.
·    Glue adhesives: provide more durable bonding and can be used to keep a replacement in place for upwards of a month.
·     Hair weaving: uses existing hair to provide anchorage to the hair system through inter-weaving the two together. Weaving can also provide a month of time for a hair replacement to remain in place before maintenance is required. 
·     Hair clips: Hair replacement is secured with several sets of little combs that clip to a person’s hair.

These hair replacements require maintenance like:

·         Cleaning
·         Coloring
·         Repairing
·         Replacing
·         Bonding it back on scalp

 Hair styling requires special sensitivity and technique to provide proper blending and is usually carried out in specialized salons where men who wear hair replacements can feel more comfortable in that environment dedicated to their needs.

The benefits of hair replacement are that:

      ·      They can provide immediate gratification as opposed to a hair transplant that requires 6 months or beyond to see the result
·         Look more denser that the look after a single sitting of hair transplant
·         Less expensive
·         It is a good option in individuals with cannot undergo hair transplant because of underlying systemic diease like cardiac problem, coagulopathies etc.
·         Individual with extremely poor density in the donor areas

The disadvantages are:

·         They require regular maintenance. The maintenance fee over the years may be too high
·      The maintenance requires a lot of labor and time investment. In contrast the transplanted hair don’t require much extra care
·         The hair of the artificial replacement don’t undergo growth
·         The wearer is under a constant fear of displacement of the hairpiece
·         The wearer may develop social inhibition due the risk of being “caught”

These hair replacements provide cover up for a patient who is has undergone hair transplant for the transition phase (i.e. the phase when the growth of transplanted hair has not started yet). Such persons should understand two things:

·         Hair transplant results cannot match the excessive density
·         Hair transplant cannot provide the very low hairline as that of a hair replacement
·         They need to make some adjustment in the way a hair replacement is worn after the hair transplant

Nevertheless, most people seeking hair transplant are willing to compromise hair density and selecting the hair transplant only of the front and top of the scalp. They also accept the exposed, bald vertex for the freedom of having their natural hair. They must understand the limitations and advantages of hair transplantation after proper and thorough counseling by their physician.

There are some situations in which a patient wearing the hairpiece can consider undergoing hair transplant like:

1.       For individuals with advanced stages of hairtransplant (Norwood VII pattern): In those advanced persons of hair loss, wearing a hair replacement may be the best choice for that particular individual. The density of the hair in a well-constructed hair replacement does not match the hair loss from the sides (temporal regions). This unnatural pattern renders a look as if the individual is wearing a baseball cap. This is also called “lid effect’’. This can provide an excellent compliment in order to achieve a more natural appearance by transplanting hair in the temporal region to match the hairline of the hair system.

2.       Some individuals require a thick and dense natural hair restoration in the frontal hairline. The rest of the frontal scalp and the vertex is covered with a hairpiece.

Great advances have been made to increase the natural look of hairpieces today. Unlike the older hairpieces that were thick, synthetic, and poorly shaped which looked like “hairy rug”, today’s thin, laced front hair replacements are made of natural hair and almost undetectable. 

The reason modern hair replacements look less obvious is that the hairs are woven through a transparent mesh base that attaches to the scalp that can simulate natural hair emanating from the scalp. Another reason is that they contain significantly fewer hairs (closer to the natural hair density).

Dr Arika Sethi

Dr Pradeep Sethi

http://www.directhairtransplantation.com