Today's evolutionary high point - Ultra Refined Follicular Unit Transplantation

By relocating these carefully prepared bald-resistant follicular units, physicians doing "follicular unit hair transplantation" recreate a natural pattern of hair in the balding areas.

To do this properly is a very time consuming and exacting process. It requires a team of meticulous medical technicians working hand-in-hand with the hair transplant surgeon in a very lengthy surgical procedure.

Ultra Refined Grafting - Smaller Blades, Smaller Incisions, Smaller Grafts

Today's micro surgical blades, like the size of hair grafts, have become ever smaller and now enable hair transplant surgeons to safely make more tiny graft incisions in a given area then ever before. Surgeons are then able to "dense pack" select areas with as many as 40 to 60 follicular unit grafts per square centimeter. This graft density is as much as twice that of the standard follicular unit hair transplant procedure.

Such high densities of transplanted hair typically produce the appearance of fullness even after only one surgical session. Patients also experience rapid healing and no visible skin distortions due to the tiny size of these incisions.

Ultra Refined Follicular Unit Grafting - Hard on the clinic but easy on the patient.

Ultra refined follicular unit grafting raises the bar for physicians and their staff. This delicate and demanding hair transplant procedure requires more skill and careful attention to be performed properly. The smaller and more tightly packed incisions require more closely dissected follicular unit grafts that are carefully trimmed under microscopes. These small and densely packed incisions are also more difficult to place the grafts into.

This procedure also requires more careful patient selection, as "dense packing" of grafts is not appropriate for all patients.

Ultra Refined Follicular Unit Transplantation - the new "Gold Standard"

In the hands of a highly skilled physician and staff the Ultra refined follicular unit hair transplant procedure can achieve excellent new hair growth that is so natural that it is undetectable even under close scrutiny.

While the standard micro "follicular unit" hair transplant does produce natural looking results, its ability to achieve high density in only one surgical session is limited. Thus patients may have to do subsequent surgical sessions in a transplanted area to achieve a full look.

The many patient benefits of this new ultra refined procedure are significant and include:

• The ability to get excellent hair density in only one surgical session.
• Minimal trauma in the graft recipient area with rapid post surgical healing.
• Little or no visible pitting or distortions in the transplanted areas.
• More natural direction and angulation of the transplanted hair.

All physician members of the Coalition perform Ultra Refined Follicular Unit Hair Transplantation.

While many hair transplant physicians perform quality follicular unit hair transplants, only some of them are capable of performing large sessions of ultra refined follicular hair transplantation. However, all members of the Coalition of Independent Hair Restoration Physicians perform ultra refined grafting with excellent results.

The Future of Surgical Hair Restoration

The amount of hair you can transplant is ultimately limited by the amount of hair follicles you can safely relocate from the bald resistant donor area at the back and sides of your head.

Some day it may be possible for physicians to create multiple hair follicles from one original follicle. This process typically called Hair Multiplication or more incorrectly Hair Cloning is currently being investigated by several research scientists and hair restoration physicians.

If and when this process is successfully developed patients would no longer be limited by the finite amount of bald resistant hairs that can be relocated from their donor area. Hair multiplication would result in a virtually limitless supply of hair available for hair transplants.

This would be especially good news for men or women with extensive baldness and a very limited supply of donor hair. Even those with extensive baldness would theoretically be able achieve thick full heads of hair.

However, experts believe that we are at least ten years away from hair multiplication being available, if even then. But perhaps some day scientists will be able to use gene therapy to halt the balding process without drugs or surgery.

Learn about modern hair loss drug treatments that work.

Along with Propecia, Rogaine is one of the only proven hair loss medication options approved by the FDA for treating hair loss. Minoxidil, (Rogaine’s active ingredient), was originally created as a drug for treating hypertension (high blood pressure). It was then discovered that one of its side affects was growing hair. Minoxidil was then tested for use a topical application for regrowing hair. The results were sufficiently impressive that the FDA approved it as a treatment for hair loss.

Rogaine works by revitalizing shrunken hair follicles, thus increasing their size. When you use Rogaine every day, your follicles may increase in size, and the growing phase may become longer. This may then produce longer, thicker hairs.

Rogaine is a clear alcohol-based solution and should be applied to a person’s thinning area with its supplied dropper or spray twice a day.

The solution is approved and available in two strengths -- Regular (2%) and Extra Strength (5%). Individual users of Regular strength Rogaine have claimed success rates of 30-40%. Meanwhile, users of Extra Strength Rogaine have claimed success rates of 50-60%. Currently, the average price for a 2oz. bottle of Rogaine is about $20-30 per month. Minoxidil is also available as a generic and can be purchased over the counter without prescription.

It’s important to note that Rogaine (minoxidil) does not cure baldness and scientists have been unable to determine just how it works. What is known is that Rogaine increases the blood flow to the areas of the scalp that surround these balding areas. Currently some researchers believe that Rogaine (minoxidil) works by opening the follicle’s potassium channels located in the cells. It’s theorized that these channels, when opened, may regulate hair growth.

Rogaine can’t grow hair on completely bald scalps or in the frontal hairline areas. It has been found to be somewhat effective in maintaining or growing hair in the crown area (the top back of the head). However, Rogaine is only effective at delaying hair loss. It is also more effective in women than in men. And again, the reasons for this are not understood.

What can I expect with Rogaine?

Rogaine (minoxidil) generally only regrows hair in a minority of men and women. In most cases, the best case scenario for hair growth with these treatments is a thin coverage of thin hair.

The real benefits of Rogaine (minoxidil) is keeping what hair you have or slowing your thinning. Rogaine’s success depends on how advanced your hair loss has become.

You must apply it to your scalp twice a day for life to get and maintain any benefits. Research shows that using Rogaine (minoxidil) only once a day is ineffective. If you stop taking Rogaine (minoxidil) you will loose whatever hair you preserved or regrew within 2 to 4 months. And while Rogaine may stimulate hair growth, it may not prevent the hair follicles from their eventual deterioration.

It's also true that Rogaine's effects may diminish over time. Some doctors believe that patients can build up a tolerance after many years of use. But it's possible to fight this tolerance by taking a week or two off from the treatment every 3-4 months. However, it's not advised to take this break unless you've taken the hair loss medication consistently for at least 12 months.

Are there side effects from Rogaine?

There are only minor side effects with Rogaine. But some users do experience certain problems such as scalp irritation, itching, and dandruff. However, this can be treated with a good shampoo like Nizoral or Neutrogena T-Gel. There may also be an increase in hair shedding at the start of the treatment. You shouldn’t panic, as this may actually be a signal that the treatment is working.

Due to the medication’s alcohol content, some users may develop a contact rash or irritated skin. And with excessive doses, some users may experience dizziness or a rapid heartbeat. However, with normal use these effects are uncommon.

Rogaine users with severe, refractory high blood pressure experienced some problems. One such problem was “hypertrichosis,” hair growth on the face or other bodily areas. This side effect appears in about 3-5 % of women who use the 2% solution, and higher among women using the 5% solution.

Rogaine and Hair Transplants

Some hair restoration physicians have come to consider Rogaine to be instrumental right after surgery. This is especially true when grafts have been placed in and around existing hair.

The shock of surgery can result in temporary hair loss. Rogaine is thought to possibly help prevent this temporary loss of healthy preexisting hair. The 5% solution has been found to be more effective for men and women. However, some physicians believe that the hair loss medication should be stopped a week or two before surgery. They feel that Rogaine may increase bleeding, while dilating blood vessels.

After surgery, most patients wait a week or two before restarting Rogaine. This gives the graft areas time to heal. However, taking Propecia is not interrupted by surgery.

Click to learn more about DHT Blockers

Is it Effective in Stopping Hair Loss?

Use of low level laser therapy (LLLT) devices for treating hair loss has been heavily debated for some time by reputable hair restoration physicians and patients on our hair loss forum. While some physicians reject its use entirely, others use laser hair treatment as a regular part of their practice. Additionally, some physicians believe that laser light therapy can assist with postoperative healing after hair transplant surgery.

History of Laser Light Therapy

Shortly after the first working laser was invented in 1964, a researcher from Semmelweis University of Budapest named Andre Mester developed a theory that exposure to cold laser light (similar to UV radiation emitted by the sun) may eventually lead to cancer. To test his theory, Mester shaved a group of mice and trapped some of them in a cage with constant cold laser light exposure leaving the other half unexposed as a control group. To his surprise, the light didn’t cause cancer in any of his animal subjects. Instead, mice that were exposed to the laser light therapy grew back their shaved fur much faster than the control group. Mester named his discovery photo-biostimulation. His theory was that somehow, the laser light had stimulated the hair cells into an accelerated state of hair growth.

Laser Therapy as a Hair Loss Treatment

Today, low level laser therapy is being used as a hair loss treatment. To treat baldness with laser light therapy, laser rays are directly applied to the scalp by a mechanical device so that red blood cells are stimulated. Lasers are said to work by converting ATP (Adenosine Triphosphate) to ADP (Adenosine Diphosphate), releasing energy and causing cellular metabolic changes. During this process, additional nutrients and oxygen are provided to the scalp assisting the normal chemical processes performed by those cells, increasing overall blood circulation. Lasers, when applied to the scalp and hair, have been said to improve overall hair quality, promote hair growth, and increase hair shaft diameter.

Laser treatment devices have a similar appearance to a hood hair dryer which is placed over top of your head. The low level laser toll will rotate allowing laser rays, usually red in color, to be discharged into your scalp. Hand held devices such as the Hairmax comb have also been developed and resemble a brush in appearance.

Promoting healthy hair growth however, is not the same as the regrowth of miniaturized hairs brought on by genetic female hair loss or male pattern baldness (MPB). So what clinical evidence exists, if any, that laser therapy is an effective treatment? Below we take a closer look at the available data including exclusive interviews of leading hair restoration physicians.

Varying Opinions of Well Respected Physicians

Physicians have long shared varying views on whether or not laser treatment is viable. While some well respected physicians reject its use entirely, some believe that LLLT can provide marginal benefit for men and women suffering from androgenic alopecia (genetic baldness). Additionally, some physicians believe that laser hair treatment can assist a hair transplant patient’s postoperative wound healing process and expedite hair growth.

Dr. Charles (one of our well respected members of the Coalition of Independent Hair Restoration Physicians) believes it may provide similar hair loss prevention benefit to Rogaine in the mid vertex area and crown. Benefits in the frontal area include an increase in overall hair quality rather than hair loss prevention.

Dr. Charles believes LLLT works better when combined with Propecia (finasteride) and Rogaine (minoxidil). Like Propecia and Rogaine, he believes low level laser therapy may help some patients more than others and works better in patients with only minimal thinning hair.

Dr. Charles believes in helping balding men and women develop and maintain realistic expectations and he doesn’t oversell its benefits. Because lasers are free from side effects, he always tells his patients that the biggest risk is the money. Dr. Charles believes more research on laser hair treatment is needed.;

Dr. Williams of the Coalition has been using laser hair treatment as a regular part of his practice for over 2 years and feels quite confident in its success in some patients. In his experience, LLLT promotes healthy hair growth and can increase hair shaft diameter of miniaturized hair affected by genetic female hair loss and male pattern baldness in some patients.

Dr. Williams offers 16 free laser therapy sessions to local males following hair transplant procedures and encourages his female transplant patients to undergo laser light therapy for one full year at a highly discounted rate. Dr. Williams usually notices faster transplanted hair regrowth and a quicker resolution of postoperative telogen effluvium or “shock loss”, if it occurs.

Because androgenic alopecia is a progressive condition, Dr. Williams encourages male patients to use Propecia while encouraging out of town females to use the Hairmax laser comb to help maintain their existing hair. Dr. Williams would like to see more formal studies defining the benefits of lasers as a hair loss treatment, but he is encouraged by his experience with it to date.

Dr. Alan Feller (also a member of the Coalition) is one doctor who remains skeptical. "Medical lasers work in only one way, and that is to deliver energy to a target. When it strikes the target the energy is absorbed and converted to heat. That's it". Dr. Feller believes that more compelling evidence is needed to promote low level laser therapy (LLLT) as a hair regrowth solution or to stop hair loss.

Recent Scientific Studies

study presented at the last International Society of Hair Restoration Surgery (ISHRS) meeting in Las Vegas (2007) by Maria A Muricy, MD, confirms increase in hair shaft diameter, fullness, and overall quality with laser hair treatment alone. Additionally, some statistically significant evidence reveals that low level laser therapy when combined with 5% minoxidil (the active ingredient in FDA approved Rogaine) provided noticeable cosmetic benefits for women in particular. However, this study also showed that laser hair loss treatment alone produced no statistically significant new hair growth in both men and women.

Laser Hair Therapy and FDA Approval

Another important issue to consider is the significance and meaning of the FDA clearance (not approval) of the Hairmax laser comb. Though some have proposed the Hairmax laser comb was only approved for safety, apparently the FDA did require Lexington International (who funded the study) to provide it with a study on its efficacy (effectiveness) in treating baldness. But this study and its results have not been released to the public since Lexington International had the option of submitting the study to the FDA privately. The obvious question then is – why would Lexington hide their study from the public if it proved the efficacy of laser hair regrowth?

While the Hairmax laser comb device was found by the FDA to be safe based on its “substantial equivalence” to previously approved laser light therapy devices and thus “cleared” (not “approved”), it was unclear to what extend the FDA reviewed or cleared it based on its effectiveness in treating hair loss. To learn more about the FDA standards for “approving” food and drugs and for “clearing” medical devices visit www.fda.gov

It appears that much of the laser hair treatment industry is now promoting their devices as “FDA Approved for Hair Loss” as if they are on par with the two only FDA approved hair loss solutions Propecia (finasteride) and Rogaine (minoxidil). However, until laser hair treatment provides compelling public evidence of its effectiveness in treating hair loss, it is quite possible that the effectiveness of low level laser therapy may be oversold by some companies. We expect that time will tell.