Hair Restoration For Men and Women

Approximately 70 % of men and 50% of woman will experience some degree of hair loss during their lifetime.  The most common cause of hair loss is hereditary pattern loss in men and woman. Other causes of hair loss can be; trauma, past surgery, age, drugs, medical conditions, etc.  Men and women can inherit the gene for pattern hair loss (Androgenetic alopecia) from either or both parents.

Pattern hair loss for men and woman is a continuous process that causes hair loss on various regions of the scalp and is secondary to the effects of the androgen hormones , especially dihydrotestosterone (DHT) on genetically susceptible hair follicles. DHT(dihydrotestosterone) is responsible for the miniaturization (shrinking) and gradual loss of genetically predisposed hair follicles.

Canidates

• Men or women with defined male pattern baldness or female pattern baldness.
• Men or women who want to restore, lower or just change the shape of their hairline.
• Men or women with hair loss from scarring, scalp injuries (trauma or burns) or cosmetic surgery procedures, such as   forehead, brow and face lifts.
• Individuals who wish to restore or thicken eyebrows, beards or sideburns.
• Men or women who had previous   hair restoration surgeries (transplantation, scalp reduction) and who are searching for a more pleasing result.

Description

Aging, heredity, and oversensitivity to testosterone (in males) are some of the common factors leading to baldness. Hair transplant surgery can potentially improve the lives of the many people who may feel embarrassed and frustrated with having noticeable baldness. This cosmetic procedure surgically restores hair to the scalp, which dramatically improves the appearance of hair; it involves removing hair from the back and/or sides of the hair and transferring it to the balding areas. Hair transplantation can also provide successful results for women.

Length

Approximately between 4 to 6 hours, depending on the extent of the procedure (per treatment session).

Side Effects

Headaches (due to tugging and manipulation of scalp area), scabbing, minimal bleeding, numbness or scalp tenderness, and swelling around forehead and eye area

Recovery

Mild to moderate discomfort controlled by medication; sutures from donor area removed in about 2 weeks. Patients should be able to resume daily routines right away, but strenuous exercise should be avoided for several weeks. Shampooing the hair can be resumed after 24 hours. Back to work: about 2 days.

Risks

Scarring; permanent numbness; infection (rare)

Results

Permanent; significantly improved hair growth several months after surgery and in order to obtain and maintain optimal results, more than one treatment session may be required. (The number of the sessions will depend on the 1) area of scalp treated 2) the number and size of grafts used and 3 )the density which the patient desires 4) the individual characteristics of the patient, e.g. coarse hair will provide a more dense look than fine hair. The estimate of the number of sessions can be discussed during the consultation with your surgeon.)

Technology

The hair transplant procedure relocates hair follicles from the donor site to the balding areas of the scalp. (Before the doctor does this, he or she will numb the donor site.) A portion of this area is then removed with a scalpel and the cut scalp is sewn together. Individual sections of hairs, which are known as “follicular units” and “micro grafts,” are extracted from the removed piece of scalp using a magnifying lens and sharp blade. Tiny holes are made in the area that will receive the hair and the donor hairs are carefully

Medical Therapy

Medical therapy often may be used in conjunction with hair restoration surgery. Minoxidil (Rogaine) is available in 2% and 5% topical solutions. Unfortunately, cosmetically useful hair is obtained in only about one third of cases and Minoxidil must be used indefinitely to maintain a response. Finasteride (Propecia) is a type 2 5 alpha -reductase inhibitor available in 1 mg tablets and given once daily. It lowers the dihydrotestosterone on the scalp and serum of treated patients. Clinical trials have show finasteride to be effective in preventing further hair loss and increasing hair counts to the point of cosmetically appreciable results. Interestingly, hair loss on the temples is not improved. Side effects are rare, less than 1%, and patients must remain on the drug indefinitely since the benefit may be lost after discontinuation.

Minigrafts and micrografts

Micrografts, which consist of one or two hairs per graft, and minigrafts, which contain 3-8 hairs per graft, became part of the new tools available to the hair transplant surgeon. These smaller grafts, when properly placed, provide a more natural, less abrupt appearing hairline in contrast to the standard graft of 4.0 mm. Nordstrom demonstrated that the smaller minigrafts and micrografts are best placed into incision sites termed "slits" placed in horizontal rows along the frontal hairline. His techniques changed the mechanics, appearance, and character of the procedure.

Slit techniques supported a simpler method for placing hair grafts. Large numbers of 1- to 3-hair micrografts are placed in slit incisions without using recipient punches to remove bald scalp. The technique can be used for younger patients with thinning hair without sacrificing existing hair follicles in the recipient area. Patients with female alopecia, cicatricial alopecia, and extensive alopecia were now candidates for slit graft hair transplantation. The older concept of removing bald scalp and replacing it with hair-bearing scalp thus had changed with the addition of slit minigrafting techniques. Many transplant surgeons converted to solely minigrafting and micrografting, and the old problems with the frontal hairline and its natural refinement were solved with these techniques. Fine micrograft hairs are placed in the front line and are backed up by larger micrografts and minigrafts.

The average hair transplant patient can have the procedure completed in 2 or 3 sessions rather than 4, typical with standard grafts. Using these techniques, even poor candidates with thin dark hair can have natural, blended hairlines. Innovators such as Alfonso Barrerra have demonstrated that the "mega-session" approach allows the transplantation of thousands of micrografts and minigrafts during a single operative procedure. In most cases, an additional follow-up procedure, if necessary, is usually minor and brief.

Intraoperative Details

Topical anesthetic can be usually be used to decrease discomfort from the scalp block; however, sedation can be used during the administration of the local anesthetic. Bupivacaine (Marcaine) with epinephrine (1:200,000) is recommended to allow sufficient duration of action. This anesthetic is used to block the occipital and supraorbital nerves and to provide ample subcutaneous infiltration to the donor site and the upper forehead. In addition, approximately 100 mL of 0.25% lidocaine (Xilocaine) with epinephrine is used throughout the scalp for tumescent infiltration. The use of local anesthetic with epinephrine not only provides anesthesia to the scalp but also helps with hemostasis.

Some surgeons utilize the team approach. Assistants can help prepare the grafts while the surgeon closes the donor site and begins graft insertion. With the patient's head positioned on a head rest, the head can be turned from one side to the other to facilitate harvest of the grafts from each side. The donor site can be closed with a running monofilament absorbable suture.

Using preoperative markings, the anterior hairline can be created with the smallest grafts to obtain the most natural appearance. Large grafts can then be used to fill the more posterior areas.

Postoperative Details

At the conclusion of surgery, the donor grafts are covered with an adhesive or Telfa strip and the patient is wrapped in a head turban. The patient is kept for approximately 1 hour after surgery and given oral fluids and a light snack. The patient should be accompanied home and someone should stay with him or her overnight.

Follow-up

Patients are seen the day after surgery to check the transplanted grafts for positioning and survival. Dressings can be discontinued and the patient can begin washing the hair in 72 hours.

Complications

Intraoperative complications include hemorrhage, lidocaine toxicity, and pain.

Postoperative complications include hemorrhage, arteriovenous fistula, infection, scarring, poor hair growth, unnatural hairline, and doll's head appearance.

Normal Hair Growth

It is completely normal to experience some hair loss. Throughout your lifetime, your hair is in a continuous growth cycle, and all hairs shed sooner or later. At any given time, approximately 85 to 90 percent of your hair is in the anagen phase, constantly growing for anywhere from two to eight years. A small percentage of hair follicles are in the catagen phase, a transitional period that lasts several weeks. The other 10 to 15 percent of your hair is in its resting or telogen phase, which lasts two to three months. Hair is shed at the end of the resting phase, and new hair takes its place to begin the growing phase once again. Hair grows at a rate of one-half inch per month, but this growth slows as we age.

The human scalp sheds about 50 to 100 hairs each day, so normal hair loss should not cause alarm. If your hair appears to be thinning appreciably, however, you may want to consult a hair restoration specialist to discuss hair loss prevention and other treatment options.

Hair Loss Prevention

Hair loss is a circumstance that literally affects millions of men and women in the United States, as well as across the globe. While female hair loss may not be as apparent as male pattern baldness, there are a number of different hair loss causes and corresponding hair restoration remedies available to women. In some cases, the conditions that cause female hair loss can be treated with a doctor-prescribed medication, preventing further hair loss. For males, hair loss treatment options include hair restoration products and medical hair restoration.

Hair Loss Treatment Products

While there are a multitude of products purporting to be the next "hair loss cure," there are only two FDA-approved, non-surgical hair restoration treatments available: Rogaine® (minoxidil) and Propecia® (finasteride). These two products can be effective in hair loss prevention, and may even help to regrow hair for some men. However, once you start using Rogaine® or Propecia®, you must continue to use these products indefinitely, otherwise any new hair will fall out. Fortunately, there are other, more permanent treatments available to improve the appearance of thinning hair.

Medical Hair Restoration

Medical hair restoration is the name given to a group of surgical hair loss treatments designed to reduce baldness in men. There are several hair replacement procedures used to accomplish this, including hair transplant grafting, flap surgery, scalp reduction, and scalp expansion.

Some of our most popular procedures include:
• Facial Fillers - Restylane® / Juvederm® / Radiesse®         • Botox®
• Skin Rejuvination                                                           • Lasers and Intense Pulsed Light Therapy
• Micro Peels  (Dermabrasion and Chemical)                        • Spider Vein Treatments
• Permanent Makeup                                                         • Scar Revision
• Hair Restoration (Men and Women)                                  • Surgical Procedures

610-400-8300  •  West Chester, PA • Bala Cynwyd, PA  •   info@dimario.com