| Dr. Nicole Rogers MD is a member of the International Society of Hair Restoration Surgery. Here the Doctor has answered some of the common questions bizymoms visitors have about Hair transplant.
Q. Who would be a good candidate for hair transplant surgery?
A. Nowadays, both women and men of nearly any age who suffer from genetic pattern thinning can benefit from hair transplantation. With careful surgical planning, one can achieve aesthetic, long-lasting results. If there is any question about the cause of the hair loss, one should be seen be a board certified dermatologist to be sure there is no underlying scarring, inflammatory, or infectious cause which may compromise the long-term growth of hair follicles. Also, any ethnicity may benefit. African Americans, who often develop permanent hair loss from styling techniques, can especially benefit. For men and women, there must be sufficient donor density available in the back of the scalp, so that the surgeon can obtain enough hairs to make a cosmetic difference. For most patients this is not an issue because their existing hair covers the scar nicely.
Women can be safely transplanted nearly anywhere in the scalp because they maintain a frontal hairline that rarely recedes. They usually obtain the best results by focusing on the frontal 1/3 to ½ of the scalp where thinning is most apparent. For men it is especially important to consider their age and rate of thinning. For instance, it is unwise to transplant into the vertex of a very young man when this proverbial ‘bald spot’ may continue to enlarge, leaving an unnatural island of transplanted hair.
Q. How does hair transplantation work?
A. The process of hair transplantation takes advantage of the fact that hair taken from the back of the scalp will continue to grow as long as it was originally programmed to grow, but in a new location. Under local anesthesia, we harvest a horizontal strip from the back of the scalp which contains ‘donor’ hairs. This is similar to skin surgery but we have to go deep enough to harvest the hair follicles as well. Then, we divide the strip into individual follicular units of 1-4 hairs. While this is being done we create hundreds of individual nicks, or sites, in the area to be transplanted. As soon as the grafts are ready, they are individually placed into the sites where they are held in place by the body’s natural clotting factors. This entire process requires a team of 2-5 technicians, along with the doctor, and can take several hours.
Q. What can be done for people dissatisfied with previous mini/micrograft procedures?
A. A variety of options are available to patients who are unsatisfied with previous transplant surgeries. If they have grafts which are unnaturally large, these can be easily removed using a 4-5 mm punch biopsy where needed. If the patient desires, those hairs can be separated into individual, smaller grafts which are replaced elsewhere. They can help to soften the appearance of an unnaturally straight hairline or fill in any scarring etc. Finally, one nonsurgical option is to use laser hair removal to permanently remove transplanted hair altogether.
Q. What are the possible harmful effects of Propecia and Rogaine?
A. Rogaine (topical minoxidil) is the only FDA approved treatment for women with hair loss. Other options exist, such as Propecia (finasteride, see below) and spironolactone, but they have less data and are not FDA approved. Rogaine is usually well tolerated but a few women will report mild itching in the areas of application. Women who have unwanted hair in the face may notice an increase or darkening of this hair. However for most women it is not an issue.
Propecia (finasteride) has been used for over 10 years in treating male pattern hair loss. Over 90% of men will observe thickening of soft, vellous hairs for up to 2 years and most stay above baseline thereafter. It is NOT used in women of childbearing age because of a risk of birth defects. It has also not been found to be effective for postmenopausal women.
Q. How many grafts/hairs are needed for hair transplant surgery?
A. This depends on the degree of thinning and the size of the area to be transplanted. Small scars may improve with just 35-50 grafts, however larger areas often require 500-1500 hairs, which can be placed over a period of 1-3 surgeries. Patients who have excellent donor density will be able to supply more grafts, whereas patients with average or very poor density will have fewer grafts to work with.
Q. What are the advanced hair transplant techniques?
A. One advanced technique involves removing hairs one follicular unit at a time, called follicular unit extraction (FUE). This can help avoid the creation of a single linear scar in the donor area. The tradeoff is that it can be very time consuming and can result in more pinpoint scarring over a larger area. Another new technique involves removing a small strip of skin along the inferior portion of the donor region. This is called the trichophytic closure and can minimize the appearance of the scar.
Q. What are the new hair restoration treatments available for men and women?
A. Hair transplantation has evolved considerably in the last 10-20 years. With the advent of follicular unit transplantation, perhaps the single most important advancement, patients can achieve natural results that are cosmetically undetectable. Transplanted hairs blend beautifully with existing hairs in the recipient area. If you think you have never seen a good hair transplant, that’s probably because you didn’t know it was one! |
