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I am a hair loss sufferer considering hair transplantation but I am confused.  I have been reading this hair restoration forum for some time and don’t understand what makes some hair transplant clinics better than others.  Hair replacement surgery seems like a simple process.  Why are some hair transplant surgeons better than others?

There are many ways to answer this question.

Firstly, I don’t think it’s fair to call hair transplantation a “simple” procedure.  It’s in fact a very delicate process and damaging the follicular unit grafts without the necessary and proper care is sadly more commonplace than not in the world of hair transplantation.

Keep in mind also that not all hair transplant doctors in the world utilize the latest techniques and technologies.  In fact, the majority of them are still using out of date techniques which is why only a handful of hair transplant clinics are recommended on the Hair Transplant Network.  Many hair restoration clinics, believe it or not, still refuse to use microscopes when slivering the follicular unit grafts from the strip.  Many clinics still use minigrafts.  Read more about the history of hair transplantation.  And even still, many hair replacement surgeons still use a triple + blade to harvest the strip, which significantly increases hair follicle transection rate.

Keep in mind also that there are variations in even the latest of techniques and technologies. 

Some hair transplant physicians prefer making recipient incisions with needles, some with precut flat blades, some with custom cut flat blades, etc.  I have personally heard of cases made for each of these hair transplant tools.

Technorati Tags: hair loss, hair transplantation, hair restoration, hair transplant clinic, Hair replacement, hair transplant surgeon, follicular unit grafts, hair transplant doctor, hair restoration clinics, hair follicle transection, hair transplant physician

This insightful article was written by well respected hair restoration forum member “Janna” who is also the lead hair transplant technician for Shapiro Medical Group of who is a well respected member of the Coalition of Independent Hair Restoration Physicians.

Two types of incisions one great hair restoration result at nine months.

A while ago Pat Hennessy, the Publisher of the Hair Transplant Network, the Hair Loss Learning Center, and the Hair Loss Q&A Blog inquired about hair transplant photos where Dr. Jerry Wong and Dr. Ron Shapiro were asked to perform a live hair transplant surgery demonstration at the 2006 ISHRS (International Society of Hair Restoration Surgeons) Live Surgery Workshop. Pat asked if I could aid in getting some postoperative hair transplant photos of this particular hair transplant patient. The main objective of the live hair transplant procedure was to showcase a side by side demonstration of sagital and coronal (lateral) incisions while dense packing the hairline. The demonstration went extremely well, so well in fact that both hair transplant surgeons were asked repeat this educational demonstration again at the 2007 European Conference in Paris last May.

Since Dr. Shapiro went through the trouble of putting the hair transplant pictures together for great side by side comparison, I thought there may be seeking hair loss sufferers interested in seeing if they can tell a difference between sides. Most of the hair restoration physicians that have seen the photo as well as Dr. Wong and Dr. Shapiro feel that both sides look very good. I think it demonstrates that as long as fine follicular unit grafts and tiny incision are used properly, the great majority of hair transplant clinical results are due to the skill of the hair transplant physicians rather than a specific incision type. All parties have consented to showing the pictures on the hair restoration forum.

Technorati Tags: hair transplant, hair restoration, hair transplant photos, hair transplant surgery, ISHRS, International Society of Hair Restoration Surgeons, hair transplant patient, hair transplant procedure, dense pack, hair transplant pictures, hair restoration physician, Dr. Wong, Dr. Shapiro, follicular unit grafts, hair transplant clinic

How long after the first hair transplant should I wait to have another one?

Though there are varying answers on this, I have revervations about going for a second hair restoration procedure too early especially if hair is to be transplanted in the same area as previously transplanted hair.  This also depends on whether or not the hair transplant procedure is follicular unit hair transplantation / follicular unit strip surgery (FUT/FUSS) or follicular unit extraction / follicular isolation technique (FUE/FIT).

In my opinion, undergoing follicular unit hair transplantion too early does not give the scalp enough time to restore normal elasticity.  This means a lesser amount of follicular unit grafts can be excised from the donor area safe zone the second time around.  Scalp exercises are only encouraged 6 months after the first hair transplant procedure anyway which ultimately suggests that the donor area can be a bit sensitive before that point.  Personally, my donor laxity started to really increase dramatically after about 8 months from each hair replacement surgery.

Whether referring to follicular unit transplantation or follicular unit extraction, in the recipient area, new hair growth can occur up to 12-18 months after hair replacement surgery.  In the latter months however, new hair growth will be minimal.  Due to the projected new hair growth even in later months, it is possible that some may be transected and therefore damaged before they actually grow, preventing them from growing.  Additionally, it may be more difficult to determine the proper direction of a hair if that hair has only started to grow.

Technorati Tags: hair transplant, hair restoration, transplanted hair, follicular unit strip surgery, FUT, FUSS, follicular isolation technique, FUE, FIT, follicular unit hair transplantion, follicular unit grafts, donor area, Scalp exercises, hair transplant procedure, hair replacement, follicular unit transplantation, hair growth

This question was posed by a hair loss sufferer on our hair restoration forum and answered by Dr. Michael Beehner of Saratoga Springs, NY who is one of our recommended hair restoration physicians. His professional answer is below.

Most of the factors that we think have to do with “shock loss” of native hair following a hair transplant procedure all take place at the time of hair restoration surgery. The two most important things are: one, the VULNERABILITY of the hairs that exist on top, and two, the AGGRESSIVENESS with which the recipient sites are made. If a large percentage of those remaining native hairs are “miniaturized” (limited length and decreased diameter; ie: “wispy”) they are much more likely to be shocked than a strong terminal hair is. When recipient sites are aggressively made, whether it is the closeness with which they are made or the width, depth, or length of the individual sites, native hairs can be lost either by taking a “direct hit” by the instrument used or simply as a “shock” reaction to having all these cumulative injuries occurring so close to them.

The THICKNESS OF THE SCALP is another key factor. The plexus of key arterial vessels that network to supply blood supply to the scalp lay deep in the scalp over the “galea” layer (the thick gristle at the bottom) deep in the subcutaneous fatty layer. It this subcut layer is nonexistent, then it is hard for the doctor to avoid injuring those deeper vessels, even with tumescence.

Technorati Tags: hair loss, shock loss, native hair, hair transplant, hair restoration, terminal hair, recipient sites

I recently had the opportunity to visit Dr. Williams and his staff as they performed a truly ultra refined hair transplant procedure in their Henderson office in the Las Vegas area. I found the high quality and refinement of their work very reassuring. After speaking extensively with the clinical staff it was obvious that they had extensive experience and took great pride in the quality of their work and patient results.

All grafts are trimmed under microscopes. Graft quality that I observed was excellent. The staff does not sub divide the naturally occurring 1, 2, 3 and 4 hair follicular units when creating grafts. Dr. William and his staff focus on one patient a day and have the capability to do 3,000 graft sessions.

Dr. Williams has a strong surgical background and has been performing follicular unit hair transplantation exclusively for the past seven years. He has a very good bedside manner and is very candid with his patients.

Patients are also provided with free post op low light laser therapy (LLLT). Dr. Williams and his staff have no doubt that this post op treatment has accelerated both the healing and growth for their patients.

Like many other leading hair transplant physicians, Dr. Williams often uses both perpendicular (lateral) and parallel (sagital) graft incisions depending on the area he is transplanting and whether the area has pre-existing hair. He never requires his patients to shave their hair.

Technorati Tags: Dr. Williams, ultra refined hair transplant, follicular units, follicular unit hair transplantation, light laser therapy, hair transplant

The question of shaving the recipient area (the balding area where hair is to be transplanted) for a hair transplant is a hot issue. Below you will find Dr. Hasson’s comments on why he feels shaving the recipient area is important for optimal results.

This insightful article was written by Dr. Hasson, a member of the Coalition of Independent Hair Restoration Surgeons.

There are multiple technical factors that come into play during the creation of recipient sites and the subsequent follicular unit graft placement. These include:

1. When thinning areas are shaved down the “thinning process” takes on a different meaning. With the use of magnification it will be seen that some follicular bundles are absent (and there are wider spaces between remaining bundles) and that some bundles are significantly miniaturized. It will then be possible to place new recipient sites in the place of absent bundles and alongside miniaturized bundles to recreate the density. This can also be done in a uniform manner so that if the pre-existing hair eventually disappears, due to progression of hair loss, the hair transplant can still look reasonably natural. If the recipient site is not shaved the hair restoration surgeon must part through the hair again and again looking for any empty spaces and trying to fill the spaces as best as possible. This is not really as exact a process but much more hit or miss.

Technorati Tags: balding, hair transplant, follicular unit, hair loss, hair restoration

This insightful article has been written by Pat Hennessy, the Publisher of the Hair Transplant Network, the Hair Loss Learning Center, and the Hair Loss Q&A Blog.  Some of the material has been edited by Bill (aka Falceros), the Associate Publisher. 

Follicular unit extraction (FUE) also known as follicular isolation technique (FIT) is a hair transplant technique different from Follicular Unit Transplantation in which a small round punch instrument is used to extract follicular unit grafts from a patient’s bald resistant donor areas. These 1, 2, 3 and 4 hair follicular unit grafts are then transplanted into a patient’s balding areas.

Given the time consuming and tedious nature of this procedure a hair restoration physician is often limited to transplanting 500 to 1000 follicular unit grafts in one day. The cost per graft of FUE has significantly gone down in the last few years but is still typically a few more dollars per graft than the cost of the standard follicular unit hair transplantationDuring the Follicular Unit Extraction or FUE procedure individual follicular unit grafts are excised one at a time using a tiny one millimeter or less sized punch. Typically the hair transplant patient’s hair in the donor area where these grafts are being removed is cut short so that the physician is able to see the patient’s scalp.The follicular units are extracted using a multiple step process. First a small sharp punch scores the skin around a follicular unit. Then a small dull punch is used to go deeper into the soft tissue surrounding the follicular unit.Since the direction and angle of the follicular unit beneath the skin can’t be seen and can often differ from the direction of the hair on the surface, a sharp punch if used below the surface of the skin might transect or severe the underlying follicular unit. However, the dull punch tends to envelope the follicular unit, while separating it from the surrounding soft tissues. This process is typically referred to as “blunt dissection”.Once the underlying follicular unit is separated from the surrounding tissues it can then be extracted, often by a forceps gripping the hair above the surface.

Technorati Tags: Follicular unit extraction, FUE, follicular isolation technique, FIT, hair transplant, follicular unit, bald, balding, hair restoration, hair transplantation, follicular unit graft, hair transplant patient

On Monday I had the privilege of watching Dr. Victor Hasson of Hasson and Wong and his staff perform a large 5,119 graft session of Ultra Refined Follicular Unit Grafting from 8 am until 8 pm in Vancouver, Canada. I also met and viewed two patients of Dr. Hasson and one patient of Dr. Wong while they were in the office having their staples removed. Another patient who posts on our forum as Qwert also came by the office and I examined his impressive results from one huge session of 6,544 grafts.

To view the photo album containing photos documenting this visit, click here.

It was a very full and interesting day, which confirmed much of what I had come to believe about Hasson and Wong over the past seven years.

Technorati Tags: Dr. Victor Hasson, Hasson and Wong, Ultra Refined Follicular Unit Grafting