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Lateral Slit Technique
Over the past several years surgeons have used various techniques to perform follicular unit hair transplantation. One such technique is the Lateral Slit Technique, also known as Coronal or Perpendicular Grafting. This technique’s name is derived from the angle and direction in which the graft incisions are made.

While there are other techniques for performing densely packed and highly refined follicular unit transplantation, the lateral slit technique offers a high degree of control over the angle and direction in which the transplanted hairs will ultimately grow.

The lateral slit technique has been used both intuitively and systematically for years by hair restoration physicians. However, it has recently gained popularity as a systematic and precise way of performing follicular unit hair transplantation.

How our member physicians use the Lateral Slit Technique.

Many of our physician members use the Lateral Slit Technique exclusively or in combination with other techniques for creating graft incisions. The lateral slit technique enables a surgeon to create graft incisions at varying angles (ranging from 10 to 90 degrees to the scalp), including very acute angles that will make the transplanted hair grow out lying flatter to the scalp. The ability to create incisions at very acute angles is particularly useful in areas such as the front temples and sides where the hair normally grows out lying flat on the scalp.

The graft incision determines the direction of the hair growth

The lateral slit technique also helps enable a surgeon to determine the direction of the graft incisions. This then determines the ultimate direction of the transplanted hairs growth. Thus a surgeon can use this technique to control and vary both the direction and angle at which the transplanted hair will grow in order to mimic the subtle changes in hair direction that occur naturally.

Each graft incision is created by analyzing the neighboring hair so the surgeon can reproduce the correct hair pattern. As a result, as each transplanted hair emerges from the scalp it will grow and lay in a similar direction as its neighboring non-transplanted hairs.

Lateral slits can enable denser packing of grafts

Lateral slit incisions also tend to be more parallel to the scalp and thus more superficial and less invasive to the scalp’s underlying vascular structure. This parallel alignment also enables a physician to place more grafts per square centimeter with out the grafts compressing or popping up since the pressure exerted on the grafts does not push them upward from the scalp.

Using blades cut to the size of the grafts

Some of our members use custom blade cutters to create tiny blades to make incisions that match the size and depth of each follicular unit graft being transplanted. This enables a surgeon to safely dense pack more grafts into a given area during a surgical session. Healing time is also more rapid, with minimal scarring.

Typically most clinic’s blades range from 1.5mm to 2mm in size. However, by using the custom blade cutter our physicians can create blades as small as .7mm for a single hair graft and .9mm for a multi hair graft.

In addition, the blades created by the custom cutter are squared off to match the shape of the bulb end of a hair follicle. Non custom cut blades are typically spear pointed which requires them to be inserted deeper thus causing more trauma to the scalps vascular structure.

The ability to control the depth of the incision each blade makes is also critical. Each blade is placed in a blade holder that is set to not allow the blade to go any deeper than required for the graft to being placed in the incision. This minimizes unnecessary trauma to the deep vasculature of the scalp, thus enabling close tight incisions, minimal tissue swelling, and quick healing that leaves no visible scaring, pitting, or cobble stoning of the scalp.

Placing grafts to maximize their aesthetic result and coverage

The plane and direction in which each follicular unit graft is placed on the scalp can also impact the ultimate appearance of density that can be produced with a given number of grafts. This is because hairs within a follicular unit are typically next to each other inline.

Therefore by arranging each multiple hair graft on the scalp in a linear fashion to the line of sight, each follicular unit will provide the maximum appearance of fullness and scalp coverage. This also mimics how hair is normally aligned on the scalp.

Special thanks to Dr. DeYarman, Dr. Sharon Keene, Dr. Jerry Cooley, Dr. Alexander, and Dr. Glenn Charles for contributing their expertise and photos for this section.
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Dr. Bessam Farjo

Dr. Bessam Farjo

The Farjo Hair Institute is a family run clinic solely devoted to performing excellent follicular unit hair transplantation in Manchester and London.
The Future of Medical Hair Restoration
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.
- Read more about The Future of Medical Hair Restoration
Parsa Mohebi, M.D

Dr. Parsa Mohebi

Dr. Parsa Mohebi provides large sessions of high quality follicular unit transplantation with excellent results
Dr. Munib Ahmad MD

Dr. Munib Ahmad

Dr. Munib Ahmad in the Netherlands, performs every part of the hair transplant procedure to ensure his patients receive the highest quality. He is the first point of contact from the consultation to the aftercare. His results show aesthetic artistry with keen attention to detail.
Books - Your in-depth guide to hair restoration
Finding excellent in-depth information about hair restoration, beyond infomercials and brochures, can be difficult. We recommend the below books for those interested in-depth and reliable hair restoration information.

MODERN HAIR RESTORATION

Hair Restoration has made great progress over the last several years with new techniques that have helped improve the quality and efficiency of hair transplants. Dr. Parsa Mohebi, one of the premier hair restoration surgeons, describes these groundbreaking methods, which include new, surgical techniques, hair loss medications, and non-invasive treatments in his book.

Hair loss can have a devastating effect on our self-image and can impact our personal and professional lives in innumerable ways. Dr. Mohebi assures those who are suffering with this condition that there are many medical and surgical treatments available today to help treat patients with different types of hair loss, including specific treatments for male and female patterned baldness. Dr. Mohebi gives his readers tips that can help them evaluate their current hair loss situation in order to find the best treatment available.

Modern Hair Restoration is a one of a kind A-Z guide for most types of hair loss sufferers. It is based on the latest advancements in treating male and female patterned baldness and the newest techniques of hair restoration. The medical breakthroughs described in this book have successfully treated thousands of patients and should continue to help the lives of many more hair loss sufferers for years to come.

Buy MODERN HAIR RESTORATION - A Complete Hair Loss Guide For Men And Women

The Hair Replacement Revolution

"The Hair Replacement Revolution" offers hair loss suffers atruly expert and comprehensive guide to all legitimate hair loss treatments.

This guidebook is written by two credible and respected physicians, Dr.Emmanuel Marrit and Dr. JamesHarris. It alsooffers suggestions for excellent hair restoration surgeons, which are NOTdetermined by financial contributions. This book can be purchased at Amazonfor $12.00 and is truly a "Must Read"!

Read exerpts from this great book.

Hair Restoration Surgery in Asians

Hair Restoration is in demand worldwide, but because Asian hair tends to be more sparse and coarse than Caucasian hair, transplantation procedures need to be adapted to Asian patients. This book, exclusively devoted to Asian hair, is a complete and comprehensive text written by a group of authors sharing their experience in their specialized fields of hair restoration. Included are many practical tips as well as chapters on regional transplantation such as eyebrows, eyelashes, sideburns, beards, and mustaches, in addition to the usual scalp hair restoration.

With its many illustrations, the book gives readers a complete knowledge of hair restoration surgery and provides a quick, easy-to-use reference on Asian hair and the differences in patients' demands. With an influx of new physicians in this challenging field of medicine, further education and training are imperative and must be available to provide a high standard of medical practice. This compilation meets that objective and ultimately makes the valuable contribution of restoring patients' self-confidence.

Buy Hair Restoration Surgery in Asians

To Bald or Not to Bald

Although it is usually an unwanted sign of ageing, hair loss may no longer be inevitable. Hopefully, by the time you finish this book you will understand the proven, effective treatment options that have become so popular. In subsequent chapters you will realize that hair loss is a problem that can be solved with new and exciting methods that will be explained in detail as we move along. We live in a new era of medical innovation and possibilities. Advances in medical research, technology and surgical techniques have restored patient's faith in the field of medical and surgical hair restoration. This books explains the entire process of hair restoration today.

Buy To Bald or Not to Baldon Amazon.

Hair Loss and Replacement For Dummies

What are the causes of hair loss? Can you prevent it? Can lost hair be restored? Hair Loss & Replacement For Dummies helps you understand why men and women lose their hair and offers thorough, objective reviews of a wide array of hair replacement options, including hair replacement surgery, prescription and over-the-counter medicinal treatments, hairpieces, natural remedies, and a variety of other options.

This authoritative, user-friendly guide explains the pros and cons of hairpieces, fibers, foundations, and hair thickening techniques. You’ll learn about pharmaceutical, laser, and topical treatments, and you’ll find out how to determine whether you’re good candidate for hair restoration surgery. You’ll even find help in assessing costs, controlling expectations, avoiding hair replacement scams, and determining which option truly is best for you. You’ll discover:
- What you need to know about hair and hair loss
- How to take better care of your hair
- Ways to prevent or reduce hair loss
- Creative techniques for concealing hair loss
- Shopping tips for hair-replacement systems
- How finesteride, minoxidil, and other medications might help
- Advice about low level laser treatments
- The low-down on hair restoration surgery
Complete with helpful myth-busting information about the causes of hair loss and the benefits of FDA-approved treatments, and helpful comparisons of the advantages of non-surgical and surgical hair replacement, Hair Loss & Replacement For Dummies is the resource to consult before you decide on any hair replacement treatment.

Buy Hair Loss and Replacement For Dummies on Amazon
- Read more about Books - Your in-depth guide to hair restoration
Azelaic Acid
An Active Ingredient in Several Topical Hair Loss Treatments

Azelaic acid is a naturally occurring substance found in whole grains that contains a mild antibiotic designed to “clean” skin. It is also said to be a potential inhibitor of 5-alpha-reductase in human skin. A reduction of this enzyme may reduce the amount DHT (dihydrotestosterone) in the body and therefore, have a similar effect to finasteride; the active ingredient in FDA approved oral hair loss solution Propecia (finasteride). In theory, applying azelaic acid to the scalp may prevent or eliminate the binding of DHT to the hair follicle receptor, preventing hair loss and potentially stimulating hair regrowth. Azelaic acid can be found in many prescription acne medication and topical hair loss products like Xandrox and Provillus.

Combining azelaic acid with FDA approved hair regrowth solution minoxidil in a single topical product in theory, may prove to be a more powerful hair loss treatment for androgenic alopecia than minoxidil alone. This is why some conjecture that Xandrox may be a more effective treatment than Rogaine (minoxidil).

Azelaic acid has not been clinically proven effective as a standalone treatment for treating genetic female hair loss and male pattern baldness. It has also been known to irritate the scalp when applied topically. Though there is a low percentage, azelaic acid may interact with other medications. Be sure to consult your physician before using azelaic acid while on other medications.
- Read more about Azelaic Acid
Robert J. Dorin, DO, ABHRS

Dr. Robert Dorin

Robert J. Dorin, DO has been a specialist in hair restoration since 2002 and a member of our network since 2006. He offers advanced FUE and FUT procedures as well as PRP therapy. Prospective patients seek out Dr. Dorin for his personalized care and ultra-refined results.
Traction Alopecia Hair Loss
What is Traction Alopecia?

Traction alopecia is a form of hair loss resulting from the repeated yet unintentional pulling, twisting or rubbing of the hair. Traction alopecia can affect both men and women, though it's more commonly seen in women. Though it can be temporary, balding from traction alopecia may become permanent if these traumatic forces are applied to the hair and scalp repeatedly and for prolonged periods, resulting in scarring.

What Causes Traction Alopecia?

Practices that may result in traction alopecia include; wearing tight braids, ponytails or cornrows and extended use of hair extensions. Due to the popularity of these hairstyles, traction alopecia has become one of the leading causes of hair loss among African America women.

Balding from traction alopecia can also occur from repeatedly wearing tight-fitting hats, helmets or other headgear.This is likely where the popular hair loss myth about hats causing hair loss derived, but it is important to note that, under normal circumstances, wearing a properly fitted hat will not negatively impact hair growth.

Treating Traction Alopecia

The first step in treating traction alopeciais to change the habits leading to the condition. This may mean adopting a new hairstyle or altering your wardrobe. Finally, applying a vaso dilator like Rogaine(minoxidil) to the affected area can increase blood flow to the damaged follicles and effectively speed up new hair growth. Assuming the hair follicles have not been permanently damaged, new hair growth will likely occur though it may take several months.

In cases of severe and permanent tractional opecia, the only effective method of restoring hair to the bald areas is surgical hair restoration. State of the art, ultra-refined follicular unit hair transplantation allows quality surgeons to harvest DHT resistant hair from the donor region at the rear and sides of the head. These hairs are then implanted into the balding areas of the scalp, resulting in a natural and undetectable appearance. To see which physicians we recommend and for a free virtual consult, visit the Coalition of Independent Hair Restoration Physicians.

To learn more about how surgical hair restoration can be used to treat traction alopecia hair loss, view the following results from our hair loss forum and social community:
- Dr.Robert Dorin - 1909 Grafts on a Traction Alopecia Patient
- Dr.Victor Hasson / 3560 Grafts / One Session / Traction Alopecia / One Year
- Read more about Traction Alopecia Hair Loss
Dr. Manish Mittal

Dr. Mani Mittal

Dr. Mani Mittal provides customized hair restoration plans for each patient. He's involved in every step of the procedure and consistently provides high-quality results with high growth rates. His ability to recreate hairlines with artistry and finesse makes him an optimal choice.