Types of Hair Restorations

The need for hair restoration is, more than likely, the result of genetic hair loss in males and females. Hair loss is simply due to a genetic gene from a parent. With men, it is typically just genetics. However, it can be genetics as well as other factors in women.

HAIR RESTORATION OPTIONS

When considering hair restoration, there are several different options with the most common of them being follicular unit transplant. This process involves transferring an individual follicular unit or graft from the back of the head to the area lacking in hair. The back of the head is what many physicians call “the safe zone”. People often believe that the genetics of one area of hair is the same all around. However, the front, top, crown, and areas where a ponytail would go all have different genetics.

With follicular unit transplant, there are two methods of moving the hair. The first method involves removing a linear area of hair and is called the strip technique or FUT. This technique is noted for the least amount of scarring leaving only a tiny line. The other technique is called follicular unit extraction (FUE) or diffused dotted extraction. This procedure leaves more scars but the scars are diffusedly arranged and they can be seen as tiny dots within the safe zone.

NON-INVASIVE METHODS

Other non-invasive methods include:

• Rogaine which works well but takes 6 to 12 months of dedicated use depending on how much hair loss a person already has. Like most products, Rogaine only works as long as a patient continues using it.
•  Finasteride is mainly used with males. If administered to a younger guy, it can re-grow hair. For males over the age of 33, it generally just stabilizes hair loss.
• Laser therapy, otherwise known as low level light therapy, uses wavelengths to re-grow hair. It is important to use a wavelength of 668-684 nanometers for the best results.
• Shampoos such as Nizoral, Head and Shoulders, Neutrogena T/Gel shampoo and Selsun Blue can stimulate the scalp and re-grow hair. With this method, the patient simply needs to leave it on the head for 5 minutes. If a person is down to just fuzz or a slick bald head, these products cannot help the dead hair.

CANDIDACY

A doctor will help a patient determine which follicular unit transplant method is best for them. A man who typically shaves his head would probably do better with FUE because of the diffused dotting. A woman who commonly puts her hair in an updo, or maintains long hair, would be inclined to have the linear technique due to the fact that a person tends to get more permanent hair with this technique. In rare cases, a patient needs to have a lot of hair transplanted and they might require a combination of both techniques. In any case, either of the procedures will remedy or improve a hair loss condition. It simply depends on what type of scarring a patient is willing to tolerate.    

LIMITATIONS

When doing hair restoration treatments, a surgeon is limited to how much hair they can remove at one time. If too much hair is taken at once, the patient could end up with excessive scarring. The amount of donor hair within the safe area is also limited. If hair is taken from outside the safe zone, it will be temporary and will eventually fall out.

It is possible to have so many treatments that a patient runs out of hair from their safe zone. At times, a surgeon might be able to take hair from the patient's body to fill in the gaps if the patient has excessive body hair. However, this is not an optimal solution due to the fact that body hair is more delicate and may not survive the transplant. Furthermore, body hair tends to be crinkly and not smooth-flowing like hair from the head. Since body hair really does not match the rest of the hair very well, it should only be used as a last resort and never on the top of the head. On the other hand, body hair can be a great source for restoring facial hair such as eyebrows particularly when a patient comes in due to facial burns.

In rare cases, a person may not be able to have hair transplant surgery due to scarring alopecia. Scarring alopecia is an inflammatory disorder under the scalp which causes hair loss. The hair cannot be transplanted due to the fact that the new graft will be subject to the same inflammatory issues and the hair will not grow.   

RISKS

With any surgery, there are risks associated with anesthesia and antibiotics. However, the main risk of hair transplant surgery is losing more hair over time and/or having the transplanted hair not blend well with the rest of the hair. This is why it is very important to choose a skilled cosmetic surgeon who has been doing hair transplants successfully for many years and to maintain healthy native hair using other resources.

SIDE EFFECTS

The only side effect of Rogaine is hair growth in any area where it is put so it is important to use it only where the patient wants hair to grow.  Propecia or finasteride has several side effects such as an increase in sex drive, breast tenderness, and decreased ejaculation. A patient using finasteride will not be able to donate blood.

RECOVERY

Recovery for FUE and FUT on the front section of the head lasts 3-5 days. There will be some redness like a sunburn with tiny grafts sticking out. There could also be a little swelling. In addition, the little grafts may develop some crustiness.

When a FUE procedure is done on the back of the head, that area will need to be shaved which leaves the head looking a little raw with tiny holes scattered in the same motion. Eventually, small dot or freckle size scabs will form and will be visible for about 10 days or until the hair re-grows around it. The downtime for FUE is mainly associated with hiding from the public for visual purposes.

When a FUT procedure is done, it is much easier to hide because the hair is kept long. The hair is lifted up during the procedure and taped out of the way. A strip of tissue is then removed and stitched up. Once the tape is removed, the rest of the hair covers the stitches. Therefore, recovery is much quicker when it comes to appearances. However, it still takes the back of the head approximately 10 days of healing before the stitches can come out.  

RESULTS

A good hair transplant should last a lifetime. Many people believe that transplanted hair is weaker than native hair but that is not true. Due to genetics, the transplanted hair is actually stronger and behaves similar to where it was originally taken from. However, a patient should keep in mind that further hair loss can be an issue. Therefore, other means of treating the native hair should be maintained.  

FINAL THOUGHTS

Many people turn to the Internet when searching for a skilled hair transplant surgeon and The International Society of Hair Restoration Surgery (ishrs.org) and the American Board of Hair Restoration Surgery (abhrs.org) are a few non-profit organizations that can steer a patient in the right direction. These organizations can provide the names of doctors who might be members or might have taken the board exams provided by these organizations.

Written by Cosmetic Town Editorial Team- SP

Based on an exclusive interview with Sara Wasserbauer, MD in Walnut Creek, CA