Post Hair Loss Questions and Get Answers

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 know that this will sound funny, and it is not a complaint, but it seems like the hair on top is much thicker than my hair on the side. I have been told I have good hair transplant donor hair, but the area that I see scalp when I part my donor region is much larger than, say, if I were to part my hair down the middle. Does this make sense?

My donor part may look like it is a half an inch wide or more, and my hair parted down the center may only be a quarter on an inch. I will see my hair restoration physician sometime this summer and talk to him about it but, until then, I was wondering if this is normal at all. It just seems like my donor is thinner than my non donor, or I could be OCD and over analyzing things? Any thoughts?

I’d guess that in 40% of the follicular unit transplant (FUT) strip cases we do that the hair is noticeably thinner on one or both of the sides than in the middle or up higher on the head. Then throw in a guy with salt and pepper hair and it can really get dicey as to how many grafts you’ll get from a typical strip.

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

One day, stem cell therapy may help the blind to see and the paralyzed to walk. It may regrow lost limbs and damaged organs, cure illness and even prolong life. Given this seemingly endless potential for medical miracles, it’s no wonder that balding men and women are anxiously anticipating news of a stem cell hair loss cure and the recent advent of a 3D stem cell printer just might bring that idea one step closer to reality.

Recently, researchers from Heriot-Watt University in Edinburgh, Scotland announced the development of a 3-D printer that uses “bio ink” (a material made from living cells that behaves much like a liquid, allowing people to “print” it in order to create a desired shape) to create living, human embryonic stem cells.

According to scientists,

“The cell printer was made from a modified CNC machine (a computer-controlled machining tool) outfitted with two ‘bio ink’ dispensers: one containing stem cells in a nutrient-rich soup called cell medium and another containing just the medium. These embryonic stem cells were dispensed through computer-operated valves, while a microscope mounted to the printer provided a close-up view of what was being printed. The two inks were then dispensed in layers, one on top of the other to create cell droplets of varying concentration. The smallest droplets were only two nanoliters, containing roughly five cells.”

About 99% of cells created through this process were alive and viable for replication. These cells then have the capacity to develop into any cell type from brain tissue to muscle, bone and even hair follicles. 

This insightful hair loss information was posted on our Hair Restoration Social Community and Discussion Forums: by Dr. Jerry Cooley of Charlotte, NC who is a member of the Coalition of Independent Hair Restoration Physicians.

How does ACell work? Are there any studies to show its effectiveness in hair restoration surgery?

Please see my recent update on ACell in the Hair Loss Q&A blog, “Updates on Hair Duplication (AutoCloning) and ACell: Hope For a Hair Loss Cure.

Performing full scale blinded, controlled studies on agents that might improve hair transplant results is exceedingly difficult if not impossible. To prove something is helping and that this result did not occur by chance, you need to study 50-100 patients with a split scalp design, and follow these patients carefully with good photographs and hair counts. Virtually no clinic could do this, and would you want to be one of these study patients where one half of your transplant came out looking different than the other half?

Nevertheless, we can adopt practices and techniques that are safe and scientifically sound and begin reporting our clinical observations. This is what I have done over the years with holding solutions like HypoThermosol, PRP, ACell, and liposomal ATP. Other hair restoration physicians who have also begun using these are reporting improvements similar to mine.

This question, asked by a member of the Hair Loss Discussion Forums, was answered by Coalition physician Dr. Bernardino Arocha

Restoring crown hair loss can use a lot of grafts. How do hair transplant surgeons design crown restorations while planning for future balding?

Crowns are said to be the “black hole of hair restoration“. They can put great demand on precious hair transplant donor hair so it is usually advisable to consider future hair loss progression, donor/demand ratio and contemplating the quandary of “robbing from Peter to pay Paul”. In other words, weather there will be enough available donor to complete the restoration completely as the Norwood pattern is fully expressed. Propecia (finasteride) use can help conserve donor by maintaining the crown.

In restoring crowns, it is important to anchor the transplant into the thinning areas that are furthest out: that is, to work from the outside in so the first area of hair loss is the last to be restored. This is to prevent hair islands from developing or the “halo effect”.

Dr. Bernardino Arocha

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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: balding, hair restoration, hair transplant, hair loss, Norwood, Propecia, finasteride

Whether or not hair duplication (formerly known as “autocloning“) may become a true cure for hair loss in the near future has been a hot topic of discussion since the topic was introduced by Coalition member Dr. Jerry Cooley at the 2010 Annual Scientific International Society of Hair Restoration Surgery (ISHRS) Scientific Meeting.  Dr. Cooley recently presented a brief presentation at last year’s 2012 ISHRS Meeting.  To view the highlights of his findings, visit the 2012 Annual Scientific ISHRS Meeting.

Hair Duplication (autocloning) works on the principle that a hair, when plucked properly, will emerge with its epithelial cells and follicular stem cells intact.  According to Dr. Cooley, applying ACell (a natural agent regularly used in optimal wound healing) to the plucked hair and implanting it into the scalp stimulates the body’s natural regenerative potential to create new hair follicles.  Since plucked hairs also regrow in the original site, a potentially limitless donor supply is created, providing hair loss sufferers with the possibility of restoring a full head of hair.

Below, world renowned hair transplant surgeon Dr. Cooley  presents his ongoing research on the use of ACell MatriStem for wound healing and the promising hair duplication technique.   While the below, preliminary data gives hope to hair loss sufferers waiting for hair multiplication technology to provide a cure for baldness, much more research and testing is required.

To view the entire power point presentation, click here.

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What is ACell?

This question, from a member of our Hair Loss Social Community and Discussion Forums, was answered by recommended hair transplant surgeon Dr. Richard Mejia:

Looking at getting my third hair transplant. Both transplants have been via follicular unit transplantation (strip). The thought of a 3rd strip is daunting to me so I am considering follicular unit extraction (FUE). Should I continue to exhaust strip before moving on to FUE?

It all depends on the clinical look of your donor area, the scalp laxity and the ability to do another strip while replacing the old line and leaving a similar or better result.

If you are going to do a small case like 800 grafts, generally this is easily done with strip while removing the old scars and doing trichophytic closure to improve the result. However, a proper clinical exam and consult would be the only way to assure you got an accurate response based on your hair restoration goals, quality of hair etc.

The advantage of doing a strip is I can generally extract more grafts and give you more hair in one day, provided the donor exists to do so without significant tension.

Dr. Ricardo Mejia MD, FAAD

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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 forumand social community

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

Recently, I started researching hair transplant surgery, and I’ve become nervous about the possibility of scalp necrosis from the procedure. Is this a common problem? What exactly is necrosis? What causes scalp necrosis from hair transplantation?

Necrosis simply refers to tissue death caused by insufficient blood supply to an area of tissue.

In hair transplant surgery, I can think of several different scenarios where scalp necrosis specifically (and not necrosis or death of the newly implanted grafts) could occur:

The most prevalent causes are likely an infection due to a subpar donor closure during  Follicular Unit Transplantation (FUT), graft removal during the Follicular Unit Extraction (FUE) procedure, and “over packing” of follicular units in the recipient area.

Each of the above scenarios would require very specific situations that actually lead to scalp necrosis.

In the FUT example, the strip excision site would need to be closed tightly enough to actually “clamp off” blood vessels and suffocate certain areas of the donor region. This excessive strangulation of the critical blood supply would cause progressive damage and eventual tissue death (necrosis). In the FUE scenario, excessive graft extraction would need to damage enough superficial blood vessels to destroy blood supply to the non-extracted donor tissue. In the “over packing” example, follicular unit grafts would need to be implanted at such a high density that they overwhelm the blood supply and suffocate the rest of the scalp.

This question, from a member of our Hair Loss Social Community and Discussion Forums, was answered by recommended hair transplant surgeon Dr. Richard Mejia:

What is the advancement in hair restoration technology if one can’t get enough hair on head? What about taking hair from the body? I heard it has helped many people like me.

I had a hair transplant 4 months ago and I have better than expected hair growth at this point. I had 2300 grafts in the front of my head. The surgeon said he put more grafts on the right side as I had less hair there. My only issue is that my left side is growing great but my right, although it has hair growing, there is not as much and there is a small spot where it look a little patchy (no hair).

My question is, should my hair on the right side even out as it is on my left and is it possible to still have small patches with no growth and this just fill in by themselves? As I said, I am happy but hope that right side fills in more.

After hair restoration surgery, it’s not uncommon for hair to begin filling in thicker on one side of the hairline. You are still quite early in the hair growth phase and I suggest waiting a few more months before trying to assess your hair transplant. In all likelihood, your hair will eventually even out on both sides.

In the meantime, I recommend discussing your concerns with your hair restoration physician in order to find out what his or her policy is, in the event that you require a small touch up. Most ethical hair transplant surgeons will offer free or greatly reduced touch up procedures to address areas of low growth.

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