Hair restoration is a minor surgical procedure intended to address male pattern baldness. Hair transplantation moves grafts of hair from the back and sides of the head to bald areas of the front of the scalp.
This procedure actually transplants the roots of the hair. Once the grafts have established themselves in the recipient’s sites of the bald area, the hair follicles produce hair for as long as they would have, had they remained in their original site.
Why Does Hair Loss Occur?
Male Pattern Baldness (Androgenetic Alopecia) is the cause of 95% of hair loss or hair thinning in males. As young men reach early adulthood, they generally produce a higher level of Testosterone. Some Testosterone is naturally converted to Dihydrotestosterone (DHT). DHT can be the cause of hair loss, usually on the front and crown of the scalp.
Each male can produce differing percentages of DHT. Each person’s hair follicles vary in sensitivity to DHT. This is why male pattern hair loss is not the same in all men. In those men with extremely high levels of DHT or in those individuals whose hair follicles are very sensitive to DHT, hair loss may appear.
Fortunately, hair on the side and back of the scalp is more resistant to DHT. These hair follicles may be transplanted to the bald or thinning areas and can grow in spite of the DHT because they are genetically programmed to be resistant.
Baldness can occur in stages and can be progressive through life. As men grow older they can experience additional hair loss as they experience the natural decline in testosterone production. This may seem contradictory, but some testosterone is required to grow hair, and when some men lose the minimum requirement of testosterone, they may experience additional hair loss.
Female Hair Loss
Hair loss may occur in up to 30% of females. When it occurs in females, it is usually more diffuse, rather than more localized as with male pattern baldness. When females sustain hormonal hair loss, it is usually seen as a generalized thinning. Hair transplantation can help some women especially when there is localized hair loss. Some women have a high frontal hairline. In this type of case, a quick one-hour hairline advancement can actually move the entire frontal hairline forward.
Females naturally produce some testosterone and small amounts are required to grow hair. As females go through menopause and the female hormones decline, they also lose testosterone. If the minimum requirement of testosterone is no longer produced, hair loss can occur.
The following blood test may be important in determining the cause of female hair loss.
- Check hormone levels: Estradiol, Testosterone, DHEA’s, Follicular Stimulating Hormone, Prolactin
- Thyroid (T3, T4, TSH, reverse T3, free T3, Free T4
- Complete blood count
- Total Iron Binding capacity (Many people are Iron deficient)
Below are some questions you may be asked during your consultation to help better diagnose the onset of hair loss.
- When did you notice your hair loss?
- Are you experiencing hair breakage or is the hair fully intact when it comes out?
- Does hair loss run in your family?
- Do you have a history of thyroid problems, asthma, diabetes, lupus or anemia?
- Have you had any surgery that required general anesthesia?
- When was your last period?
What Can We Do About Hair Loss?
It is our opinion that a combination therapy, which may include hair transplantation, may be best. Some of the options include:
- Medications: Minoxidil (also known as Rogaine®) and Finasteride (also known as Propecia®).
- Low level laser therapy, approved by the FDA.
- Follicular Unit Hair Transplantation
- Hairline advancement.
Although all of the above treatments may help treat hair loss, we are not enthusiastic about all of them. Finasteride can help slow hair loss, but there are reports of the occasional damaging impact on male sexual performance.
Hair Transplantation is the most effective treatment we are aware of.
The technique of hair transplantation is not new. It has been used successfully for fifty years, and new refinements in hair transplantation methods continue to help improve results. Hair Transplantation does not increase the number of hairs, but it does redistribute the hair over a bald or thin area.
Although the transplanted hair is never as thick as it was prior to any hair loss, with proper styling a satisfactory result may be obtained following a hair transplantation procedure.
Tiny grafts of scalp containing 1, 2, or 3 hairs are used in our office. They are called Follicular Unit Grafts. Occasionally, slightly larger grafts may be used in certain areas of the scalp during the hair transplantation procedure.
The Hair Transplantation Procedure.
Hair transplantation graft harvesting is done as an out-patient procedure in our state of Tennessee licensed operating room. At other facilities some practitioners may give some forms of sedation, but this is often carried out in a room in a doctor’s office. At the Langsdon Clinic we are able to safely and legally carry out a mild sedation in our state licensed operating room that makes the harvesting process much more pleasant. Our licensed facility has all the back up equipment such as electric generators, oxygen alarms, etc. that the state requires of hospital or out-patient surgery center operating rooms.
Once the light sedation is given, the area is numbed and the grafts are harvested.
After the hair follicles are removed for preparation, the sedation is completed. Patients are then moved into a relaxing recovery area where he/she can sit up and relax. Placement usually takes a few hours, depending on the number of grafts needed.
How do we harvest the hair that is transplanted?
FUE (Follicle Unit Extraction) or the Strip Method can be used to harvest hair grafts. There is a lot of information on the Internet that implies that FUE is the best method. However, it is our opinion and the opinion of many practitioners that a higher percent of viable grafts are harvested from the strip method. There is a linear scar along the back and side of the scalp where the strip is harvested, but it is usually minimal and difficult to detect. Dr. Langsdon believes in this method and has had the strip method on his own scalp.
FUE uses a tiny drill to bore out each hair graft and thus this method does not leave a linear scar, rather tiny punch site scars. However, because the bore must match the exact angle of the hair to the drill, some grafts are severed and will not survive. No machine is capable of matching 100% of the hair shaft angles that are below the scalp skin surface. Therefore, the strip method harvests a higher percent and supply of viable grafts per harvest site. For people needing only a few grafts the FUE method might be a good choice. For those needing lots of grafts, we recommend the strip method. Additionally, there is a higher cost associated with the FUE method.
Immediately after the transplant?
Discomfort is usually minimal after hair transplantation. However, there may be some mild tenderness from the donor area that resolves in a few days.
There is some moderate swelling around the transplanted area. Most swelling resolves in the first week, but there may be some minor residual swelling that could take longer to resolve. This is usually not apparent to other people.
Crusting can occur around each graft site. This occurs because of tissue oozing from the tiny puncture made to accept the hair graft. Crusting will resolve in several days (usually by about 2 weeks) and we instruct each patient on how to rinse and care for his/her scalp in order to move this process along. We also help advise patients if their crusting takes a little longer to go away. Once this resolves the transplant sites may become a little pink for a few weeks.
How long does it take to see the new hair growth?
Many follicles go dormant after transplant. It can take a few months to see the hairs begin to grow. Although, some hairs may start growing right after they are transplanted you should not expect substantial growth for several months.
What growth can one expect?
The end density of transplanted hair depends on several factors such as hair type, donor density (amount of hair you have available to transplant), amount of hair loss, general health, area you are trying to cover, etc. Because there has to be enough space between grafts so that they can survive the process and obtain a healthy blood supply, no surgeon can place the hairs right next to each other. The satisfaction of density will depend on your hair shaft thickness, color and whether it is curvy or straight. Although many people achieve a nice redistribution of hair, you should not go into hair transplantation expecting one session to solve your concerns. Density may need to be increased or future thinning may necessitate additional grafting.
Click here to view more Before and After photos of Dr. Langsdon’s Hair Transplantation procedure.