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Dr. Thomas Nakatsui
Dr. Nakatsui performs large sessions of ultra refined follicular units using the lateral slit technique with extremely natural results. -
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
Incision sutured together
Hair combed down after suturingThis 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 surgeryOnce 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 extractedThe 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.
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H Rahal, MD
Dr. H. Rahal
Dr. H. Rahal and his staff perform large one pass sessions of ultra refined follicular unit hair transplantation with outstanding results. -
Jerry Wong, MD
Dr. Jerry Wong
Dr. Jerry Wong exclusively performs Ultra Refined Follicular Unit Hair Transplantation with outstanding results. -
The Coalition of Independent Hair Restoration Physicians
Chosen by Patients and Peers for meeting the highest standards.
This Learning Center is sponsored by the Coalition of Independent Hair Restoration Physicians.
This elite group of independent surgeons have been carefully selected by patients and leading physicians and are committed to providing Ultra Refined Follicular Unit Hair Transplantation.
This minimally invasive hair restoration procedure enables patients to achieve very natural and dense hair growth after only one surgical session.
Coalition members agree to have their results openly critiqued and reviewed on the world’s most respected online patient based community - the Hair Restoration Network. Learn more about the high standards Coalition physicians must meet for membership.
Find an an elite Coalition Physician in your area and consult for free about how to restore your own natural hair.
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COUVRé Alopecia Masking Lotion: Product Review
For many hair loss sufferers, scalp "tinting" solutions are the most effective type of topical concealer. Tinting solutions like COUVRé, also commonly referred to as "masking lotions" or "concealing lotions," eliminate the contrast between thinning hair and the bald scalp by naturally darkening the skin and matching the tone to one's existing hair. By matching bald scalp to an individual's natural hair color, the harsh contrast of thinning hair is eliminated, and a fuller, denser appearance is achieved.
Although several types of masking lotions currently exist, one of the most popular and trusted is COUVRé. However, what makes COUVRé distinct from other masking lotions, or different types of concealers in general? Is COUVRé a quality concealer for both hair loss suffering men and women? Most importantly, what are other concelears users saying, and where can balding individuals purchase their own supply of COUVRé masking lotion?
COUVRé: What is it, and how does it work?
Unlike comparable "shaker" application products (such as Toppik – a popular topical applicator product from the same makers as COUVRé), COUVRé is a tinted lotion, meant to minimize the contrast between dark, thinning hair and the balding scalp. According to the manufacturers, COUVRé is applied to the scalp using a specialized sponge applicator. Once the masking formula is on the scalp and providing sufficient camouflage, users are instructed to simply style hair normally and go about their day. The manufacturer of COUVRé assert that the application appears subtle, natural, will not appear "greasy or sticky," will not stain clothing or towels, and does not interfere with pores or affect natural hair growth.
The Benefits of COUVRé
According to both the manufacturers and satisfied users, COUVRé offers various benefits over comparable concealer products. First, because the makers of COUVRé are confident in the product, they ensure that, unlike some other concealers, COURVe will create a natural appearance without looking greasy or sticky, and does not clog scalp pores or interfere with existing hair shafts. Because of this, not only is COUVRé useful for those with thinning hair, but also for patients awaiting new growth from hair transplant surgery. What's more, COUVRé does not contain any harmful chemicals, can allegedly withstand perspiration, rain, wind, and even physical contact (such as touching the scalp). COUVRé comes in 8 different colors/tones (to match all hair types) and is equally effective in both male and female hair loss sufferers. Although COUVRé will withstand a variety of situations without smearing or smudging, it easily washes completely away with water and shampoo.
COUVRé Color Chart

Why COUVRé has Become Popular and Trusted within the Hair Restoration Community
While COUVRé does offer many benefits above other concealer products, its popularity and reputation within the hair restoration community is likely due to several important factors. First, unlike some other concealing products, COUVRé application is both simple and fast. For many individuals, the ability to naturally conceal thinning hair without spending an excessive amount of time "getting ready," is a huge benefit. Furthermore, because COUVRé contains natural ingredients and does not interfere with native or implanted hairs, it is safe to use with other proven hair loss medications (like Rogaine/minoxidil and Propecia/finasteride) and during the new growth phase of hair restoration surgery. Because of its ease of use, effective nature, and ability to conceal hair loss in a variety of situations, COUVRé has become a reputable hair loss treatment and remains popular within the hair restoration community.
What Real Hair Loss Sufferers are Saying About COUVRé
To read real reviews on COUVRé alopecia masking lotion from other hair loss suffering men and women, visit our hair loss forum and social community.
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Hair Transplant Cost
Today hair transplant costs are vastly better value, than they did just a few years ago. Increased competition combined with the increased ability of a specialized clinic to produce large sessions of follicular units at reduced hair transplant costs and has resulted in patients getting vastly better results and increased density at lower prices.
Just a few years ago it was not unusual for a clinic to charge as much as $15 US per graft, while providing patients with only small sessions of a few hundred grafts that achieved limited density and fullness.
Today hair restoration clinics typically provide free no obligation consultations, with surgical sessions priced either per graft or by the session. Hair transplant costs typically cost between $3.00 to $8.00 per graft, with $5 to $6 per graft being about average.
It is normal for the price per graft to drop as the size of the surgical session increases. Many clinics will offer a reduced rate per graft once a certain surgical session size (i.e. 1,000 or 2,000 grafts) is exceeded.
Comparing the costs of various hair loss treatments

Although hair transplant surgery is not inexpensive, it can be the best hair restoration value given that the results are natural and last a life time. The cost of non surgical solutions like a hair system or hair loss medications can exceed the cost of hair restoration surgery when the long term costs are compared.
For example – A quality custom hair replacement system on average costs $1,200 and needs to be replaced about once a year. In addition, a hair replacement system requires regular upkeep and reattachment each every 5 to 6 weeks at about $75 per visit or $675 per year.

Thus the cost of buying and maintaining quality hair replacement systems over 15 years is approximately $28,125.00 ($1,200 plus $675 in annual upkeep = $1,875 x 15 years = $28,125.00). This total cost well exceeds the typical cost of surgical hair restoration.
Note - Of course the cheapest option is shaving your head with an actual net saving due to no expense for shampoos, conditioners, combs, brushes, or hair stylist.
Consult a physician for an estimate
Our member physicians price their procedures independently. So your final cost will depend on who you select and how much hair restoration you will need to be satisfied.
To do a free consult with one of our quality member physicians to get an estimated cost of restoring your hair visit our member physicians’ area.
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Find the Hair Loss Treatment Right For You
Today hair loss sufferers have several legitimate and proven treatments for restoring their hair.
Over the past decade in particular, treatments for hair loss have made huge advances. Hair loss medication like Propecia (finasteride), Avodart (dutasteride), and to a lesser degree topical treatments like Rogaine often can stop or even reverse hair loss in most people.
However, neither Propecia nor Rogaine has been proven to restore hair in the frontal areas. Only hair restoration surgery has been successful in restoring hair in the frontal hairline area once it has been lost.
Done right, hair transplants are so natural that even a hair stylist cannot detect that a person has had a hair transplant. The days of the “corn row” or “Barbie doll” hair transplant are long gone.
Hair replacement systems or “hair systems” have also improved and become more refined. Those who are extensively bald and want to restore a full looking head of hair may find a hair replacement system to be appropriate.
There are also topicals, such as sprays and applications, which can do a surprisingly effective job of giving a person the appearance of having a much fuller head of hair.
Future hair loss treatments also hold the promise of making baldness a disease of the past.
Despite attempts by the FDA to regulate the promotion of hair loss products, balding men and women still need to be wary of the many questionable treatments that are often heavily advertised.Each hair loss treatment has its advantages and disadvantages. We believe in empowering you with the tools and assistance to explore and evaluate all your treatment options. Ultimately the best hair loss treatment is the one that works best for you.
We encourage you to take your time and explore all your options before committing to any hair loss treatment.
Explore this and other web sites and compare notes with other hair loss sufferers about what does or does not work.
Our hair restoration discussion forum has over 180,000 searchable postings by other hair loss sufferers.
If you post your question or concern, typically several people will reply with helpful advice and suggestions.
To get expert medical advice and review all your hair loss treatment options, consider doing a free consultation with one of our quality member physicians.
To learn about our physicians, or to arrange a consultation, visit our physician finder.
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Hair transplants - Are they right for you?
Most hair loss sufferers can benefit from hair transplants. However, some are better candidates than others and will achieve more dramatic results.
Different Patients Achieve Different End Results
Two Hair Transplant Sessions one totaling 1860 grafts the other 2995 graftsIt is important to have realistic expectations and to find a hair transplant surgeon who can meet or exceed your expectations.
Surgical hair restoration is largely a matter of "Supply and Demand".

The look you can and will achieve with hair transplants is determined by several factors. But the most critical factor is really a question of "supply and demand".
The supply of hair is how much viable bald resistant donor hair you have. The demand is how much bald area you want to cover and to what degree of thickness.
Your “Donor Hair” determines what you can achieve.
For virtually all hair loss sufferers, even those with severe baldness, there is typically hair that grows for life on the sides and back of the head. This is because the hair in this "donor area" is genetically different from the hair on the top of the head in people who go bald.
The hair follicles in the "donor area" are genetically resistant to the effects of such baldness causing hormones as (DHT) dihydrotestosterone. That's why they continue to grow, while the hair on the top (in the male pattern baldness area) thins and goes bald over time.
How much viable donor hair you have will largely determine how much you can accomplish with hair transplants. Most people have enough viable donor hair to do at least one or two hair transplant procedures.
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Dr. Ted Miln
Dr. Ted Miln
Dr. Ted Miln is performing refined follicular unit grafting with incredible density, with results that are undetectable from his patient's native hair.
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