• FUE – a new way of doing Follicular Unit Hair Transplantation

    FUE – a new way of doing Follicular Unit Hair Transplantation

    Follicular unit extraction is a minimally invasive procedure for performing follicular unit hair transplantation. However, unlike the predominant follicular unit transplant procedure, in which a strip of donor tissue is removed and dissected under magnification, the FUE procedure uses a small punch to extract each follicular unit one by one.

    Both the strip excision and FUE procedures create 1, 2, 3, and 4 hair follicular unit grafts that are then transplanted into the balding area in the same manner. The primary difference between these two procedures is the technique used to harvest the follicular unit grafts.

    Comparing the Strip Excision procedure to the Extraction (FUE) procedure

    The common strip excision method of performing follicular unit hair transplantation involves surgically excising a thin horizontal strip of bald resistant skin from the donor area.

    Strip Excision Procedure 

    Donor strip being excised
    Donor strip being excised

     

    Incision sutured together
    Incision sutured together

     

    Hair combed down after suturing
    Hair combed down after suturing

     

    This donor area is then sutured together. These sutures (either stitches or staples) are then typically removed about ten days after surgery. Some physicians use dissolvable sutures so that no removal is needed.

     

    Patient’s donor area 2 months after surgery
    Patient’s donor area 2 months after surgery

     

    Once this linear incision is fully healed the patient is left with a thin horizontal scar in the back of the head. This scar is typically hard to detect since the surrounding hair conceals it, even when the hair is cut short.

    To view a video of an actual strip excision surgery.

    How the FUE Procedure is performed

    With the Follicular Unit Extraction or FUE procedure 1, 2, 3, and 4 hair follicular unit grafts are carefully extracted one at a time using a tiny punch of one millimeter or less. Often the surgeon requires the patient to buzz cut a portion of their donor area so that they are able to see the patient’s scalp.

    The follicular units are extracted
    The follicular units are extracted

     

    The follicular units are extracted by placing the punch around a single follicular unit and cutting a small circle through the skin around that follicular unit. The follicular unit is then gently pulled up and away from the loose tissue underneath the skin.

    The small hole left behind after the follicle is extracted then heals over the following week. Normally this small round incision contracts as it heals making the resulting round scar smaller than the size of the 1mm punch that made the incision. The FUE patient ultimately ends up with hundreds of small round white scars, which are normally not detectable once the patient’s hair grows out.View a video of an actual FUE surgery.

    To Extract or to Excise, that is the question.

    Advocates for the relatively new FUE procedure claim that this procedure produces less noticeable scarring and no tightness or numbness in the donor area since no donor tissue has been pulled together and sutured. Many patients and physicians find the claim that FUE produces less visible scarring to be debatable.

    Some physicians and patients also have concerns about the relatively new FUE procedure, such as the lack of formal studies regarding the percentage of follicles that may or may not be transected during the sight unseen extraction process.

    In addition, since the physician must personally extract all follicles, one by one, the FUE procedure is very physician dependent and thus very expensive. The FUE procedure also requires considerably more time in surgery to move a given amount of hair to the balding area.

    The standard strip excision procedure has the advantage of utilizing a collaborative team to carefully create the grafts once the donor tissue is removed in a strip. This collaborative approach enables a well trained staff to do sessions of 2,000 to 3,000 all follicular unit grafts in a single day. This team approach enables a patient to get a much larger number of grafts/hairs in one sitting at a much lower cost per hair than with the FUE procedure.

    However, some believe that despite being relatively costly the FUE procedure may be appropriate for patients who have very limited elasticity in their donor area or who only need a small number of grafts.

  • Female Hair Loss and Birth Control Pills

    Female Hair Loss and Birth Control Pills

    Birth control pills can be a great way of preventing conception however;all medication comes with potential side effects. In addition to the many serious possible side effects associated with birth control pills, some come with a risk of female hair loss. By suppressing ovulation due to the combined actions of hormones progestin or estrogen, women who are predisposed to hormonal related hair loss may experience varying degrees of balding while on the pill, or even more likely, a few weeks to months after coming off of it.

    Yasmin is a birth control pill that combine sethinyl estradiol and drospirenone Because Yasmin may induce hair follicles into the telogen phase (hair shedding) of the hair growth cycle, hair loss is a reported side effect

    We recommend women to use only low-androgenindex birth control pills. For women with a strong predisposition for genetic hair lossin their family, we recommend use of other non-hormonal birth control pills or other forms of contraceptives for the prevention of conception.

    For your reference, here is a list of birth control pills ranging from the lowest androgen index to the highest: Desogen,Ortho-Cept, Ortho-Cyclen, Ortho Tri-Cyclen, Micronor, Nor-Q D, Ovcon-35,Brevicon/Modicon, Ortho Norvum 7/7/7, Ortho Novum 10-11, Tri-Norinyl, Norinyland Ortho 1/35, Demulen 1/35, Triphasil/Tri-Levien, Nordette, Lo/Ovral,Ovrette, Ovral, Loestrin1/20, Loestrin 1.5/30.

  • Rogaine 2% Liquid for Women

    Rogaine for womenRogaine for women is the most recommended treatment for hair loss on the market for women today, and the only FDA approved and clinically proven treatment available for female hair loss sufferers.

    Note: Despite what the insert says, Rogaine works just as well for frontal hair loss, recession, and thinning hair.

    This product includes the original 2% minoxidil solution manufactured over 15 years ago. While it only reports a 46% success rate as opposed to the 5% liquid solution's 64% and the foam's impressive 85%, Rogaine for women reduces the possibility of unwanted side effects, including the unpopular unwanted facial and body hair growth.

    How It Works:

    Rogaine works by stimulating the hair follicles and revitalizing them. This sometimes stimulates the regrowth of miniaturizing hairs, promoting a thicker and fuller appearance of hair.

    Developing Realistic Expectations:

    Rogaine for women is a good starting point for women with thinning hair. While it's not as effective as the 5% liquid solution or Rogaine foam, the possibility of side effects are reduced. Thus, women may want to start small and work their way up to the more advanced Rogaine solutions.

    Don't expect immediate results. Just as hair loss is a slow process, regrowing it is too. Thus, it's recommended to use Rogaine for approximately 6 to 12 months before determining its effectiveness. Documenting your progress with bi-monthly photos can help you better evaluate the results.

    Hair shedding is a common symptom the first few months and a sign that the medication may be working for you. It's crucial to push past this stage with continued use for the recommended period of time.

    To date, only surgical hair restoration is proven to grow hair in completely bald areas. You are invited to have a free virtual consultationwith one of our prescreened hair restoration physicians.

  • Hair Loss Shampoos & Conditioners

    Hair Loss shampoos and conditioners

    There are a variety of shampoos and conditioners that can be used to slow down the progression of male and female pattern baldness. It should be noted that no shampoo nor conditioner is proven to regrow hair.  Thus, for best results, any shampoo and conditioner product should be used in conjunction with other proven hair loss treatments such as Propecia (finasteride)and Rogaine (minoxidil).

    Shampoo and conditioner can also help to "volumize" the hair, making hair appear thicker and fuller.  Ingredients found in many of these treatments are designed to promote healthy hair growth and nourish the follicles.  Thus, for a healthy scalp and hair, using one or more of these dedicated shampoos and conditioners can be the perfect addition to any hair loss treatment regimen.  To learn more about each product, click a link below:

    Nioxin
    Nizoral 2% Shampoo - Extra Strength
    Nizoral Shampoo - Regular
    Revita Shampoo
    Revivogen
    Tricomin

    To date, only surgical hair restoration is proven to grow hair in completely bald areas. You are invited to have a free virtual consultation with one of our prescreened hair restoration physicians.

  • Hair loss - Race, Age, and Gender Considerations

    Hair loss - Race, Age, and Gender Considerations

    Hair loss is a universal condition, affecting all ages, races, genders and nationalities. It’s estimated that “androgenetic alopecia,” or male and female pattern baldness affects 35 million men and 21 million women in the United States alone. This section examines how race, age and gender affect hair loss.

    Race and Hair Loss

    In physiological terms, human beings are all composed of the same bones, muscles, and everything else down to the cellular level. But there are specific differences.

    Hair, in all of its variations, is one area in which human beings display their differences. Hair follicles can widely vary in terms of color, length, shape, thickness, strength and various other factors.

    There are many ethnic groups to consider. But we will focus on the special considerations of Asians, Blacks (of African descent) and Caucasians.

    Asian Hair Loss Considerations

    Asian people typically have very straight hair. Their scalps contain fewer hairs per square centimeter, they actually have a lower hair density than that of Caucasian hair follicles. But because the individual hair follicles of East Asians are thicker, this gives the look and impression of greater hair density.

    For these reasons, hair restoration techniques for East Asians, much like other races, must be sensitive to a variety of anatomic and cultural differences. For instance, East Asian females often have an increased likelihood of developing “diffuse alopecia,” or hair that thins evenly over the entire head than Caucasian females.

    Even though it’s not a definite requirement, it’s very helpful for Asian patients to seek out doctors with experience in Asian hair.

    Another consideration for East Asians considering hair restoration surgery is the increased chance of developing keloid scars. A keloid is a thick, irregularly shaped and elevated scar with uncontrolled growth that results from excess fibrous skin tissue. East Asians typically have a greater likelihood of keloid development than Caucasians, but less than that of people of African descent. Therefore, before undergoing surgery, East Asians may want to consider being medically evaluated for keloids.

    African Hair Loss Considerations

    People of African descent usually possess naturally curly hair. This curly hair gives the visual impression of increased hair density for a given amount of hair, which is beneficial in hair restoration surgery.

    The hair follicles beneath the skin of people of African decent also typically curve more than Caucasians. This can make harvesting the donor hairs, without severing or transecting the hair follicles beneath the scalp, more difficult. A hair restoration physician needs to be very aware of this difference and adjust to its requirements.

    As in the case of East Asians, people of African descent possess some unique hair and skin characteristics. Some of these medical conditions are more common in black skin than in white skin. This may increase the risk for post-surgical complications.

    Those of African descent have a higher chance of developing keloid scarring when injured. This in turn leads to a greater chance of noticeable donor scars. Keloids aren’t a widespread problem. But those with a history of them are carefully evaluated in regard to their existing scars. The evaluation usually involves a small "test procedure" to determine if there’s a normal healing rate.

    Another issue is that of postoperative skin discoloration. With darker skin, there’s often a greater risk of both increased and decreased skin color after injury or surgery. These risks can be determined by the patient’s medical and family history.

    Ingrown hairs are also a more common problem in darker skin. If a patient has a history of ingrown hairs or other minor skin infections, this may signal a higher risk for ingrown hairs post-hair restoration surgery. Again, this risk can be determined by a small test procedure.

    Caucasian Hair Considerations

    Caucasians (white people) may have a wide range of hair and skin types. However, if someone has dense and or coarse hair, as well as skin color similar to their hair color, they will generally achieve the best results for a given amount of restored hair.

    Learn more about aging and gender hair loss

     

  • Dr. Ron Shapiro

    Dr. Ron Shapiro
    Dr. Ron Shapiro
    A true pioneer, with a worldwide reputation for outstanding follicular unit hair transplantations among both colleagues and patients.

  • Parsa Mohebi, M.D

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

  • What is Rogaine and how does it 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

  • Jerry Wong, MD

    Dr. Jerry Wong
    Dr. Jerry Wong
    Dr. Jerry Wong exclusively performs Ultra Refined Follicular Unit Hair Transplantation with outstanding results.

  • Traction Alopecia Hair Loss

    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: