Post Hair Loss Questions and Get Answers

This question, from a member of our hair loss social community and discussion forums, was answered by Coalition hair transplant surgeons Dr. Ron Shapiro and Dr. Glenn Charles:

During a recent hair transplantation consult, the physician told me that he will create an “irregular hairline” during my hair restoration procedure. However, I’m wondering why he would chose to do that? Wouldn’t a straight hairline look better? Why create an irregular hairline during hair transplant surgery?

The goal of any hair transplant procedure is creating natural, realistic results. A very important aspect of achieving subtle, realistic results is recreating a natural hairline. Though many individuals assume that hairlines unaffected by hair loss are straight and regularly shaped, this is not the case. In fact, in order to create a realistic hairline, hair restoration surgeons must utilize an irregular, “zig zag” design.

In fact, according to Dr. Glenn Charles:

The term we often use to describe the hairline approach is creating a “regular irregularity.” Meaning there has to be a certain degree of randomness to give a natural appearance. However, there also has to be some method to the madness. You could also call this “Zig Zag” hairline design.

Dr. Ron Shapiro agrees, and said the following:

This comment, from a member of our Hair Loss Social Community and Discussion Forums, was answered by Coalition hair transplant surgeon Dr. William Lindsey:

I’m planning on going for a hair transplant and recently consulted two top hair restoration physicians: both highly recommended on this forum. One recommended follicular unit extraction (FUE) and the other a strip. Both recommended between 1500-2000 grafts.

I’m trying to consider worst case scenarios for both options and am wondering if the scar is poor with the strip, how well does FUE into donor scar work to cover it up if I want to keep a short hairstyle as an option in the future? Has anyone done it successfully?

Follicular unit hair transplantation via strip is much more consistent at providing good results and unless you are planning on really short hair, our office would strongly suggest strip. Plus, if you are likely to need more hair later on, strip limits the quantity of scar tissue in the donor area.

You can wind up with a bad strip scar from even the best of surgeons, but it’s not common. Just yesterday I saw another 30ish year old with Norwood Class 5 hair loss who’d had 600 FUE’s (more likely 2mm punches) to attempt to rebuild his frontal hairline.  Now he presents for repair of that plus addressing some of the “further back” loss he’s had since that procedure. Well his donor area is all full of scar and we’ll be lucky to get 2500 grafts out of him and more likely 2200 at one setting since there is so much scar tissue in his donor region.

From May 24th through May 26th, 2013 the International Society of Hair Restoration Surgery (ISHRS) is hosting the second annual Mediterranean Follicular Unit Extraction (FUE) Workshop in Madrid, Spain. The workshop consists of a series of lectures about important topics in Follicular Unit Extraction, FUE question and answer sessions, FUE discussions and debates, and a series of live Follicular Unit Extraction operations.

Because we recommend a number of FUE innovators and experts, several of our recommended and Coalition hair transplant surgeons are participating in the FUE workshop. According to the official program, our hair restoration physicians are participating in the following activities:

During the first day of the workshop, Dr. Jean Devroye, Dr. James Harris, and Dr. Bijan Feriduni are participating in a debate about the anatomy of FUE grafts. Dr. James Harris is also lecturing about motorized FUE procedures and performing a live, 1,000 graft FUE case on the first day of the conference (and hosting a “Q&A” session after the procedure). On the second day of the workshop, Dr. Devroye is presenting a lecture about motorized FUE and Dr. Feriduni is lecturing about manual Follicular Unit Extraction procedures; both physicians are also performing live, 1,000 graft FUE operations at the end of the day. On the third and final day of the workshop, Dr. James Harris is giving a presentation on automated FUE procedures and the ARTAS Hair Restoration System for automating FUE hair transplant surgery.

Due to its less invasive nature and modern approach, Follicular Unit Extraction (FUE) hair transplant surgery continues increasing in popularity. As patients continue requesting FUE procedures in large numbers, hair restoration physicians have begun explaining their FUE philosophy and describing how they practice the procedure.

Recently, Coalition hair transplant surgeon Dr. James Vogel decided to take part in this ongoing trend and shared his Follicular Unit Extraction philosophy with our hair restoration community. According to Dr. Vogel:

I have been  performing FUE donor harvest technique for the past three and a half years.  My  philosophy has been never to be the first on the block to try new techniques on my patients; however when a new technique or procedure is proven safe and effective I embrace all new technology in a comprehensive manner.  The development and refinement of FUE is a perfect example. 

My  approach to FUE donor harvest is identical to the way I  manage all aspects of the transplant.  I am  extremely “hands on” and  intimately involved with every aspect of the procedure.  I have  tried numerous methods for FUE harvesting over the past several years. The current FUE device I  prefers to use is the Alpha Graft Unit. This is a simple FUE device that offers easy angulation and  adjustment to enable alignment with the  plane of the follicular unit as they exit the scalp.  Tumescent saline is used in the donor scalp to “straighten” the follicular units to maximize extraction and minimize transection of grafts.  Click here to see a video of my FUE extraction. 

Several months ago, we started a new feature at our hair loss community: the Hair Transplant Patient of the Week.

Each week, we review hair transplant cases posted by patients on our Hair Restoration Discussion Forums and select one particularly excellent result as our Hair Transplant Patient of the Week.

In April, we selected three community members as our patients of the week:

First, was Hypox, who received 2,500 grafts via Follicular Unit Transplantation (FUT) from Dr. Victor Hasson. After years of trying hair loss medications, traditional Chinese treatments, and Low Level Laser Therapy (LLLT), Hypox underwent surgical hair restoration in 2009 with a different physician. Ultimately, Hypox decided he required additional grafts, and sought a second procedure with Dr. Hasson in 2011. Recently, Hypox shared a 6 month update with our community, and the results are excellent! To see Hypox’s restored hairline, frontal scalp, and (partial) midscalp, please review the following: 6 Month Update – 2,500 Grafts from Dr. Victor Hasson.

Next was Levrais, who received 5,700 grafts via Follicular Unit Extraction (FUE) from Dr. Christian Bisanga.  During a total of 3 procedures, Dr. Bisanga used an impressive 5,700 grafts to restore Levrais’ hairline, frontal scalp, temple points, and part of his vertex. Recently, Levrais shared a 5 month update of his 5,700 graft FUE procedure with Dr. Bisanga, and the results are impressive! To review the procedure, please see the following: Levrais – 5,700 Graft FUE with Dr. Bisanga.

I’m interested in the hair transplant surgery without a rear scar. Please tell me what the next step is. Is it possible to do the procedure with long hair? Please note that I am not completely bald and I use Toppik hair loss concealer.

It’s important to note that there is simply no such thing as completely scar-less surgery. However, it seems that you are referring to Follicular unit extraction (FUE) hair transplantation.  This procedure avoids the strip scar associated with Follicular unit transplantation (FUT) via strip excision and can, under the right conditions, result very minimal scarring, allowing the patient to wear a closely cropped hairstyle without detection.

Unfortunately, FUE will require you to shave your donor area and, in some cases, your entire head. To learn more about these techniques, click the links above and also research on our hair restoration forum.

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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
To share ideas with other hair loss sufferers visit the hair loss forum and social community

Get Proven Treatments at the Best Prices by visiting our new online hair loss treatment shop.

Technorati Tags: hair transplant, bald, Toppik, hair loss, Follicular unit extraction, FUE, hair transplantation, Follicular unit transplantation, FUT, hair restoration

Several months ago, we started a new feature at our hair loss community: the Hair Transplant Patient of the Week.

Each week, we review hair transplant cases posted by patients on our Hair Restoration Discussion Forums and select one particularly excellent result as our Hair Transplant Patient of the Week.

In March, we selected three community members are our patients of the week:

First, was Djjr1, who received 2,500 grafts via Follicular Unit Transplantation (FUT) from Coalition hair restoration surgeon Dr. Alan Feller. Four years ago, Djjr1 grew tired of his hair loss and decided to seek surgical restoration with Dr. Feller. Recently, Djjr1 proved that quality hair transplantation truly “stands the test of time” by updating the community with his 4 year results. To review Djjr1′s excellent 4 year post-operative update, please see the following: Dr. Alan Feller – Four Years After 2,500 Grafts.  

Next, was Aj29, who received 1,301 grafts via Follicular Unit Extraction (FUE) from Dr. Christian Bisanga. Aj29 chose Dr. Bisanga to treat his temporal regions and hairline because of his experience with FUE and his expert use of a manual FUE punch tool. Recently, Aj29 shared a 9 month update on the community, and his decision to seek FUE with Dr. Bisanga clearly paid off! To view Aj29′s 9 month post-operative update, please see the following: Dr. Bisanga – 1,301 Grafts to Hairline.

Only hair restoration physicians who persistently produce the best results are approved for recommendation on the Hair Transplant Network. Thus, we are pleased to announce that Dr. Mike Vories of Mount Pleasant, South Carolina has been approved for recommendation by our online community. To learn how we prescreen and recommend hair transplant surgeons, click here.

Dr. Vories has been performing hair transplant procedures since 2002 and now performs high quality follicular unit extraction (FUE) exclusively at his clinic in Mount Pleasant, South Carolina. As a hair transplant patient himself, Dr. Mike Vories is compassionate and empathetic to the needs of balding men and thinning women worldwide.

Dr. Mike Vories, his technique and results were carefully reviewed by our patient community. Visit the “Potential Recommendation of Dr. Mike Vories of Mount Pleasant, South Carolina” to see what our members are saying.

After carefully reviewing his technique, results and all the private and public feedback we received, we’ve decided to approve Dr. Vories for recommendation on the Hair Transplant Network for his dedication to high quality follicular unit extraction (FUE) in South Carolina. To congratulate Dr. Vories on his recent achievement, visit his potential inclusion forum topic above.

For hair loss sufferers considering high quality FUE hair transplantation in South Carolina and beyond, you are encouraged to consider Dr. Vories for your next hair transplant procedure. To learn more about Dr. Vories, his technique and to view his patient results, visit his recommendation profile.

Onwards and Upwards,

Just wondering; if balding is a progressive condition, why would patients opt for surgery (be it strip/extraction)? Won’t we have to deal with it once the hair falls out?

You are correct. Androgenic alopecia is a progressive condition and there is no hair loss cure. This is the very reason why hair transplants are not recommended for very young balding men and also why most hair restoration surgeons highly recommend medically stabilizing hair loss with Propecia (finasteride) and Rogaine (minoxidil).

The older we become, the easier it is to more accurately judge just how far on the Norwood Scale our hair loss will progress. This helps doctors and patients agree on a long-term plan that will make the best use of grafts in order provide for adequate donor hair to address future balding. Medical treatments can prolong the life of existing hair and, in some cases, even regrow hair. The right patient with the right plan can achieve a natural and aesthetically pleasing result that will last a lifetime.

It’s important to remember that not everyone is a candidate for surgical hair restoration. Patients have to find a skilled and ethical hair transplant surgeon that they trust to give them the best advice.

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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
To share ideas with other hair loss sufferers visit the hair loss forum and social community

This question comes from a member of our hair loss social community and discussion forums: 

I’m undergoing hair transplant surgery, and want to make sure the new hairline is created at an appropriate height. Anatomically, what is the proper distance between the eyebrows and the hairline? Are hairlines always placed at normal proportions during hair transplant surgery?

Normal hairline height is relative to the patient. Most hair restoration physicians like to refer to Leonardo da Vinci’s “rule of thirds” when determining natural hairline height. The rule of third refers to the idea that the face is split into three equal parts: the section between the chin and the bottom of the nose, the bottom of the nose to the glabella (space between the eyebrows), and the section between the glabella and hairline.

Obviously, this doesn’t always hold true in hair restoration surgery (as hairlines are sometimes not lowered to anatomic position), but it’s a good rule of thumb for “normal” hairline height. However, if you’re looking for approximate figures, most natural hairlines are around 6.5 – 7.5 cm (roughly) from the glabella.

_________
Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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Technorati Tags: hair loss, hair transplant surgery, hair restoration