Imagine YourHealth

These approaches to hair loss have always held a place of ridicule in our fashion-conscious society. Yet, hair loss and baldness affect millions of men and, to a far lesser degree, women. Hair restoration as a science has evolved from surgeries that once transplanted large areas of the scalp, such as flap surgery and punch grafts, to ever-smaller units such as the mini- and micrographs. Today, top hair restoration specialists are attacking hair loss using microscope-assisted follicular grafting. Follicular grafting restores hair follicle by follicle, making hair loss, even upon close scrutiny, virtually undetectable.

Be realistic-Patients need to be realistic in what they hope to achieve. "A patient who is 21 years old often wants their hairline brought down to the level they had when they were 17," says Edmond I. Griffin, MD, medical director of Dermatology Associates of Atlanta. "It's possible to do this. Problem is, by the time they are 35, the hairline is too low and no longer looks natural for a man that age." Many times, older patients (those in their 30s or 40s) have a more realistic understanding about how the hairline of a man their age should naturally appear.
Rate of hair loss-Individuals have different rates of hair loss. In the case of a fast rate of hair loss, Rogaine, Propecia, or a combination of the two may be prescribed to halt or slow the loss. Once hair loss is at a manageable level, hair restoration can lower the hairline and thicken the hair on the top of the scalp.
Size of donor and recipient area-The integral question here is whether or not there is enough hair to restore the area that a patient wants replaced. The larger the fringe of hair-bearing scalp (the donor area) and the smaller the area of baldness (the recipient area), the better the hair restoration candidate. Conversely, a large area of baldness and a relatively small fringe of hair-bearing scalp makes for a more difficult, or even impossible, procedure.
Color and type of hair-The darker your hair, the greater the hair-to-scalp contrast. What this translates to is a more noticeable scalp, making it harder to camouflage hair loss. Brownish, reddish, or gray hair makes for less contrast to the scalp and is therefore preferable for hair restoration. Thick, coarse hair tends to be less manageable than thin hair and presents more of a problem in predicting how it will ultimately look.

Hair restoration or transplantation does not stop hair loss; rather it transfers an individual's healthy follicles to the non hair-bearing part of the scalp. A strip from the hair-bearing rim is removed from the back of the head and divided under magnification into individual units or groupings of hair bundles. The bundles are then carefully inserted into tiny incisions in the bald part of the scalp, in order to recreate the natural appearance of hair. Hair restoration is performed under a mild sedative and local anesthesia, and many patients sleep comfortably during the procedure.

Ask most people to draw a hair follicle and, almost without exception, they will draw a single hair growing out of a follicle. In truth, hair follicles consist of a bundle of 1 to 6 hairs. This fact is reinventing the techniques used for hair restoration. One such procedure is Custom Openings. Here, the physician matches the specific follicular bundles with the tiny openings made on the scalp. In other words, if the physician has a two hair bundle, he or she is going to make an incision that matches the size and shape of that particular bundle. Custom Openings create a cleaner, more natural fit, and result in less scarring and faster healing.

Another technique is random hairline placing. "Years ago, surgeons used to start at one edge (of the new hairline) with the thickest bundles of hair," notes Dr. Griffin. "Today, we place the bundles with the fewest and finest hairs on the front few 'non-rows.' When we say non-rows we really mean a random line that gives the hair and hairline the most natural look and curve." By employing these techniques, follicular grafting results in less scarring and a faster recovery time. More importantly, follicular grafting is, up to this point, the most natural looking hair transplantation alternative available.

Hair restoration usually consists of two or more sessions, lasting anywhere from 2 to 8 hours. Some minor scabbing may occur, but to put it into perspective, patients can often lightly shampoo their hair the next morning with no complications. The small incisions basically heal overnight without sutures. Hair usually begins to grow by the second or third month, and it takes a good year for the hair to reach its maximum maturity. It's a lengthy process, but as Dr. Epstein comments, "I've had people who work in front of a TV camera, and we've gotten them back on the air, looking great, in four days." The cost for hair restoration can run anywhere from $3,000 to $10,000, varying by state and practice.

If you're seriously considering hair restoration, ask your surgeon for a list and photos of previous patients. In addition, find out about the physician's relationship with the clinic. If he or she comes in two days out of the month, they may not be available should problems arise. Remember to choose wisely--that new head of hair will be with you for awhile.