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Plastic Surgery Associates of New York

The Hair Loss Center at Plastic Surgery Associates of New York

Facts About Hair, Hair Loss and Hair Loss Treatments

Hair Transplantation

Hair transplantation is the most common surgical method of hair restoration. The most common reason for hair restoration is hair loss due to an inherited tendency for androgenetic alopecia (AGA). In men, AGA is better known as male pattern hair loss, in women as female pattern hair loss. While hair transplantation is performed more often in men, it is also a successful method for surgically correcting the diffuse pattern of female pattern hair loss.

Hair transplantation is an operation that takes hair from the back of the head and moves it to areas of hair loss elsewhere on the scalp. The fringe (back and sides) of hair on a balding scalp is known as donor dominant hair. It is hair that will continue to grow throughout life, even in men who have the most extensive form of male pattern hair loss. Donor dominant hair follicles are under a different form of genetic control than follicles on the front and top of the head; they are not subject to inherited effects of "balding genes".

When donor dominant hair follicles are transplanted to bald areas of the scalp they continue to grow hair. Donor dominance is the scientific basis for the success of hair transplantation.

The area to which donor dominant hair follicles is transplanted is called the recipient area. Candidates for hair transplantation are those individuals with hair loss who have sufficient donor dominant hair from the back and sides of the scalp to transplant to recipient balding areas.

The most common method for harvesting donor dominant hair is to slice it out in strips with a special scalpel-like device. Follicles are separated out from the strip and prepared for transplantation. The transplant grafts are placed into the recipient areas. Depending on how large a recipient area is involved, and on individual patient characteristics, transplantation of the recipient area may be accomplished in one, two, three or more sessions. Multiple sessions are usually spaced several weeks apart.

Among the assessments made by the physician hair restoration specialist are (1) how rapidly, and (2) how much of the patient's remaining hair is likely to be lost. A man with progressive male pattern hair loss may require a number of hair transplantation procedures over a number of years to keep pace with hair loss. In these patients the physician hair restoration specialist wants to be certain that an adequate supply of donor dominant hair will be available for future transplantation. In some cases the progression of hair loss between transplant procedures can be slowed or halted by supplementary medical therapy with an FDA-approved hair restoration drug-topical minoxidil (Rogaine®) or orally administered finasteride (Propecia®).

Hair transplantation surgery techniques have improved enormously over the past decade and are still improving. The first hair transplants were characterized by "plugs" and "corn rows" of transplanted hair. Today, most hair transplantation is done with mini-grafts of fewer than 5 hair follicles, micro-grafts of 2 or 3 hair follicles, and single-hair grafts. Plugs are occasionally used for special purposes in individual patients. Employing newer techniques and newer instruments, the physician hair restoration specialist can create a natural hair appearance that is appropriate to each individual patient.

Naturalness of appearance is the goal of all hair transplantation today.
Mini-, micro-, and single-hair grafts provide the "softness" necessary for creating a natural hairline. Graduated placement of single-hair, micro-, or mini-grafts allow creation of a gradually increasing hair density from hairline to mid-scalp. Individual physician hair restoration specialists make their own adaptations of new technology to achieve desirable aesthetic results for individual patients.

Side effects of hair transplantation surgery are usually minor: mild pain and discomfort for a few days postoperatively, swelling over the operated areas, and scab formation. The physician hair restoration specialist provides medicine for discomfort control and information about scalp care. The physician also provides information and recommendations for long-term hair and scalp care to maximize the patient's appearance.

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