Post Hair Loss Questions and Get Answers

Transplanting hair from the body to the balding scalp, typically referred to as Body Hair Transplantation or BHT for short, has become a subject of intense interest to many hair transplant patients (especially those who are endowed with the body hair of hairy back gorilla).

Some hair transplant physicians have been experimenting with and studying the viability of such body to scalp hair transplants, including Coalition member Dr. Bob True in New York City.

Dr. True made an excellent presentation on this subject at the recent annual ISHRS (International Society of Hair Restoration Surgery) meeting in San Diego this October. He was kind enough to provide me with his presentation so that I could share highlights of his findings on our community.

View the photos from this body hair transplant presentation.

According to Dr. True, there are up to 5 million hair follicles on the body. The follicles vary widely in hair character and behavior with the hairs on the torso generally most similar to scalp hair. Some races have very little torso hair. It is rare for a woman of any race to have much torso hair.

He finds that there is a wide variance among men who do have torso hair and that for men torso hair increases to the sixth decade of life.

Technorati Tags: Transplanting, Body Hair Transplantation, BHT, hair transplant, hair transplant physicians, body to scalp hair transplants, Hair Restoration Surgery

This insightful information was posted on our hair restoration forum by Dr. Alan Feller of Great Neck, NY who is a member of the Coalition of Independent Hair Restoration Physicians.

The number one limitation of Follicular Unit Extraction (FUE) / Follicular Isolation Technique (FIT) are the doctors themselves. Since its introduction to the world circa 2001, FUE has been shunned, ignored, or outright maligned by every strip hair transplant doctor who saw it as a threat. Very few embraced the challenge and did the hard work necessary to achieve any level of proficiency. When I was one of several FUE hair restoration physicians who gave a lecture at an ISHRS meeting in 2003 I could see the absolute hatred being beamed at us from most of the hair transplant doctors in the audience. They thought FUE would wreck their livelihood, but what they didn’t realize is that it could be an adjunct that would give them and their patients yet another option.

Even to this day most hair transplant doctors shun the procedure. Make no mistake about it, it’s not because of the procedure itself, but rather their aversion to learning how to do it. There are even hair transplant doctors who claim to perform FUE. It will say it right on their websites, but you will never see any before/after photos. This should be policed and stopped in my opinion because these doctors are engaging in a “bait and switch” scheme and it just confuses the general population and potential hair transplant patient.

Technorati Tags: FUE, Follicular Isolation Technique, FIT, hair transplant doctor, hair restoration physician, hair transplant patient

Having attended the annual International Society of Hair Restoration Surgery (ISHRS) meetings over the past ten years, while publishing the Hair Transplant Network, I now seem to know or be known by almost all of the prominent hair transplant physicians.

Those who have become famous online for doing outstanding work typically greet me warmly, while others who I have chosen not to recommend often stiffen up and scowl when they encounter me.  One hair restoration physician last week even took me aside in the hallway and threatened to sue me for having his recommendation discontinued.

But, like it or not, most physicians have come to realize that our patient based community and our open forum are here to stay and that we will continue to say when the “emperor has no clothing” even if it may be awkward or embarrassing. As the publisher of this community, I will continue to critique various techniques, treatments and those who perform them, while keeping an eye out for top-notch hair transplant physicians and clinics. I know the active members of this community will also continue to do the same.

In this report I’d like to share highlights from the 15th annual ISHRS scientific meeting that was held in Las Vegas from September 26th to the 30th.

I will focus on what may be of most interest to hair loss sufferers and patients such as presentations on the potential dangers of Dutasteride (Avodart), new advances such as hair multiplication (follicular cell implantation), the effectiveness of low light laser therapy (LLLT) in treating hair loss, the pros and cons of FUE (follicular unit extraction) and other topics.

Technorati Tags: Hair Restoration Surgery, hair transplant, hair restoration physician, hair transplant physicians, hair loss, Dutasteride, Avodart, hair multiplication, follicular cell implantation, low light laser therapy, LLLT, FUE, follicular unit extraction

This article was written by Dr. William Rassman, one of our well respected Coalition Hair Restoration Physicians.  Dr. Rassman has given me permission to post this article on our Hair Loss Q&A Blog in order to help educate fellow hair loss sufferers.  The original article can be found here.

——

Lasers in Surgery and Medicine, Volume 19, Number 2, 1996, Pages 233-235

There has been a recent surge of interest in “laser hair transplantation” that has paralleled the increased use of lasers for a wide variety of cosmetic surgical procedures. Lasers generate great enthusiasm on the part of both physician and patient, but this has sometimes exceeded the actual value of the laser as a surgical tool. An obvious example has been the use of the CO2 laser as a nonselective, destructive modality to remove tattoos which left scarring and a cosmetic deformity worse than the tattoo itself. This has been subsequently replaced by pulsed lasers with specific pigment absorption (such as the Nd:YAG, Ruby, and Alexandrite lasers) operating on the principle of selective photothermolysis that truly offers benefit in the treatment of these lesions. Super- and ultra-pulsed CO2 lasers are now being used to replace “cold steel” in generating hair transplant sites. However, before we rush to use lasers in hair restoration surgery, we should first apply logic and reason to this application, and then proceed cautiously with carefully controlled studies so our patients will only benefit from its use. The following discussion will address various aspects of current laser technology in the specific context of the most recent advances in hair transplantation techniques. The intent will be to challenge the theoretical basis for the use of existing lasers, to question some dubious claims regarding their benefits, and to suggest future areas of laser research.

Technorati Tags: laser hair transplantation, cosmetic surgical procedures, hair transplant, hair restoration, laser technology, hair transplantation

Recently I’ve been getting a number of emails from patients who are asking just what is the difference between standard follicular unit hair transplantation and the more recent “Ultra Refined Follicular Unit Hair Transplantation”. While the differences are subtle they can be important to patients.

Since I first became a hair transplant patient (see my blog) and began learning and sharing hair transplant information online over ten years ago, I’ve seen hair transplantation evolve from small sessions of large grafts and incisions (”mini/micro grafts” containing up to 7 or 8 hairs) to much larger sessions of ultra refined follicular unit grafts that are placed into tiny minimally invasive incisions.

This evolution - while improving the naturalness, fullness and healing time for patients - made the procedure more challenging and even less profitable for many clinics. Some clinics embraced these patient friendly evolutions while many resisted them and argued against having to implement these changes.

Those physicians who rose to the challenge of successfully providing their patients with true follicular unit hair transplantation came to be recommended on the Hair Transplant Network (View list of recommended hair transplant physicians).

Patients have been getting positive life changing follicular hair transplantation from these physicians for several years. When patient results and care have proven to not be top notch these physician/clinics have been promptly removed.

Follicular Unit Hair Transplantation 2.0

Technorati Tags: hair transplant, hair transplantation, Follicular Unit Hair Transplantation

I had the honor to visit the world renowned Limmer clinic in San Antonio, Texas on Tuesday, March 20th of 2007. In many respects the Limmer clinic is the birth place of “follicular unit grafting” since it was Dr. Bobby Limmer and his staff who first began using microscopes to visualize and trim naturally occurring follicular units into follicular unit grafts.

Dr. Bobby Limmer’s significant contributions to the refinement and advancement of follicular unit hair transplantation are well documented, including in the “History of Hair Transplantation” section of the Coalition Hair Loss Learning Center.

Dr. Bobby Limmer shared his techniques and findings with his peers and was a persuasive advocate for the follicular unit procedure. For his part in pioneering this excellent surgical procedure Dr. Bobby Limmer was awarded the “Platinum Follicle Award” by the International Society of Hair Restoration Surgery in 1996.

Over 14 years ago Dr. Bobby Limmer was joined by his son Dr. Brad Limmer who also has a strong background in dermatology. By joining his father’s hair transplant practice Brad was able to study under his renowned father and learn what would later become accepted as the “Gold Standard” in hair transplantation. He also learned his father’s emphasis upon honest and upfront education with all patients.

The Limmer clinic has continued to refine their follicular unit technique and today create minimally invasive incisions that are as small as 0.7 mm for the one hair grafts. These tiny incisions enable them to place more grafts closer together when appropriate for the patient. Patients now experience more rapid healing.

Technorati Tags: “History of Hair Transplantation”, hair transplant

Meeting Report by Pat Hennessey – Publisher of the Hair Transplant Network and the Coalition Hair Loss Learning Center

Each year the International Society of Hair Restoration Surgery (ISHRS) hosts a four day meeting that is attended by ISHRS members from around the world. I have attended several of these international meeting as both a guest and as a member of the press. The highlights that I thought would be of interest to hair loss sufferers are presented in this report.

This years annual ISHRS meeting was held in San Diego, California from October 18th to the 22nd. Over four hundred hair restoration physicians from around the world attended this international meeting along with over 100 medical technicians and staff members. It was impressive to see so many hair transplant physicians sharing and debating the fine points of hair restoration. I found it interesting that many of the issues that have been discussed on our forum over the past couple of years were the hot topics at the meeting. These topics included - optimal session and graft sizes, ultra dense “super” mega sessions vs traditional density mega sessions, sub follicular unit grafting vs follicular unit grafting, growth rates, hair multiplication, FUE, and trichophytic closure techniques.

Technorati Tags: Hair Restoration Surgery, hair loss, hair transplant, hair restoration, ISHRS, hair restoration physicians, hair transplant physicians

Why are some doctors recommended on the Hair Transplant Network but not members of the Coalition of Independent Hair Restoration Physicians? Are there two different standards?

I would like to clarify the distinction between a physician only recommended on the Hair Transplant Network and that of a physician who is both recommended on the Hair Transplant Network and also a member of the Coalition of Independent Hair Restoration Physicians.

This distinction is written on the page entitled “How we select the physicians recommended on this site”. But I think that many have not seen this page. In any case, a fuller explanation, with background may be even better. The Hair Transplant Network has existed since 1999. When it began “Follicular Unit Hair Transplantation” was the new “gold standard”. 

The Hair Transplant Network led the way in helping people learn about it and the few hair restoration physicians who at that time performed it. As patients demanded this more patient friendly procedure more and more physicians moved away from mini/micro grafting and embraced the new gold standard procedure. Those who did this procedure successfully were recommended on this site.

Six years ago a “mega session” was 1,500 grafts and hair transplant sessions bigger than 2,000 grafts were rare. Hair transplant surgeons also typically used blades to create incisions that were 1.5 mm (versus incisions as small as 0.6 or 0.7 that are now created with Ultra Refined Follicular Unit grafting). With such big incisions and bulky follicular unit grafts, dense packing was not really possible. Thus to achieve decent cosmetic density patients needed to do two or more sessions in a given area.

Technorati Tags: Hair Transplant Network, Coalition of Independent Hair Restoration Physicians, Hair Transplant, hair restoration physicians, hair transplant, Hair transplant surgeons

The most recent September/October issue of the Hair Transplant Forum (a professional journal distributed amongst hair restoration physicians) featured an article entitled “A super megassession of 2,800 to 4,000 follicular units packed to 40-50 FUs/cm2: Are you prepared?”. The article was written by Coalition member Dr. Arthur Tykocinski of Sao Paulo, Brazil.

In this article he raises the big question of the day – “Do we really want to realize that we have to move on, changing again and again the procedure, to get to the new gold standard? Are we up to this challenge?” Dr. Tykocinski then went on to detail his truly optimal ultra refined procedure from A to Z.

Educated patients online have known for the past two or three years - that the “gold standard” in hair transplantation has moved from standard follicular units to bigger sessions of ultra refined follicular units.

But which physicians have risen to the new standard? Those few who have met this new and ultra high standard are eligible for membership in the Coalition. Mastery of the new “Gold Standard” Ultra Refined Follicular Unit Hair Transplantation has been a requirement for Coalition members for over a year and a half.

Dr. Tykocinski has given me his permission to present his article, which I think really spells out the new Gold Standard. The article also does an excellent job of detailing his truly optimal ultra refined procedure from A to Z.

Technorati Tags: Hair Transplant, hair restoration physicians, hair transplantation, Ultra Refined Follicular Unit Hair Transplantation, Tykocinski

Hi Patrick,

I am 24 and I have been slowly thinning in my frontal areas for the last 5 years or so. I have tried many things over the years like minoxidil and finasteride but nothing could stop the inevitable. I was wondering if it is a good idea for me to have my thinning areas in the front filled in with a hair transplant. Are hair transplants a good option for someone my age? -Joe

Joe,
 
Both Propecia (finasteride) and Rogaine (minoxidil), as you’ve discovered over time, are not as effective at stopping or reversing hair loss in the hairline as they are in the top mid scalp and crown areas.
 
Ultimately hair transplantation will probably be your only viable option for restoring your hairline. Fortunately the new ultra refined hair transplant techniques use smaller incisions that are less disruptive to the surrounding existing hair and thus “shock fallout” (post surgical effluvium) of existing hair is less of an issue than it was a few years ago.
 
However, some of your existing hair in the front could shed, especially the thinning hair that has already become miniaturized. Typically most of the hair that you may loose in the grafted area regrows within a few months. So sometimes doing a hair transplant into existing hair that is thinning is like going two steps back initially to eventually go several steps forward.
 
I suggest you consult with a Coalition hair restoration physician since they all perform ultra refined follicular unit hair transplantation with proven results. Since you are 24 years old it still be too early for you to do surgery. But when the time comes you will be that much more prepared if you have done your research and consulted with a top notch hair transplant surgeon.
 
Feel free to post your current photos on our hair restoration discussion forum to get feedback from me and other members. Getting multiple opinions from experienced patients can be very useful.
 
Best wishes for restoring your hairline.
 
Pat - pulisher of the Hair Transplant Network and the Coalition Hair Loss Learning Center  

Technorati Tags: minoxidil, finasteride, hair transplant, hair transplants, Propecia, Rogaine, hair loss, hairline, hair transplantation, hair transplant surgeon