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This question, asked by a member of our Hair Loss Social Community and Discussion Forums, was answered by Coalition hair transplant surgeon Dr. Glenn Charles:

In my research, I have noticed that the hair restoration physicians who perform sagittal incisions do sessions averaging about 2500 grafts and then want you to come in later for further surgeries. Those who do lateral slit incisions average about 4,500 grafts in only one hair transplant surgery. What is everybody’s preference? Has anyone done both?

Both the sagittal and coronal slit have their place in hair transplantation. I often use combinations and have done very large cases using both methods. It should really depend on the individual factors of the case including, but not limited to, the type of hair the patient has, existing hair that the doctor needs to avoid damaging and the number of grafts per sq cm being placed.

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David (TakingThePlunge) Forum Co-Moderator and Editorial Assistant for the Hair Restoration Forum and Social Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

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Technorati Tags: Hair Loss, hair restoration, hair transplant, hair transplantation

Coalition member Dr. Jerry Wong of Vancouver, Canada is world renowned for innovating the lateral slit technique and for proving that large hair transplant megasessions exceeding 4000 follicular units when appropriate is not only possible, but can provide patients with world class results with minimal scarring. 

Given his outstanding achievements in the operating room and recognition both from his patients and his peers, it’s no surprise that Dr. Jerry Wong was awarded the Golden Follicle award at this year’s annual 2011 ISHRS (International Society of Hair Restoration Surgery) scientific meeting in Anchorage, Alaska.

Based on the outstanding reviews by patients on our hair loss forum and social community, there’s no question that Dr. Jerry Wong deserves this award.   Congratulations to Dr. Wong for his continued outstanding achievements.

The Golden follicle award is the highest honor given to a leading surgeon in hair restoration by the ISHRS at each meeting. This award recognizes outstanding achievement in clinically-related research in hair pathophysiology or anatomy as it relates to hair restoration.

View the official press release.

Bill Seemiller –  Managing Publisher of  the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum and Social Community

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Technorati Tags: lateral slit technique, hair transplant megasessions, Golden Follicle, ISHRS, International Society of Hair Restoration Surgery

Recommended hair restoration surgeon Dr. Parsa Mohebi recently announced the development of the new Laxometer to accurately measure scalp laxity during hair transplant surgery.

According to Dr. Mohebi, the new tool, aptly titled the “Laxometer II,” allows for an accurate measurement of donor region scalp laxity prior to the strip excision phase of a  Follicular Unit Transplantation (FUT) procedure. This tool, which will be officially unveiled at the 2011 Scientific Meeting of the International Society of Hair Restoration Surgery (ISHRS), precisely determines the amount removable donor tissue – maximizing the number of available follicular unit grafts while minimizing harmful transection and post-operative scarring.

In the official announcement, Dr, Mohebi states:

Thanks to this new advancement in hair restoration surgery, today, we can transplant a very large number of grafts and restore a person’s hair in simply one session, even if they are in the most advanced stages of baldness. Until recently, a procedure of this magnitude required two or more hair transplantations to achieve the desired coverage and hair density. This new ground breaking innovation will save time and money for both the patient and the surgeon.

More information about the Laxometer II will be available after the upcoming ISHRS meeting.
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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 restoration, balding, hair loss, hair transplant, hair transplants

This hair loss question  was answered by Dr. Paul Shapiro of Bloomington, MN who is a member of the Coalition of Independent Hair Restoration Physicians.  

The following question, asked by a member of our Hair Restoration Forum and Social Network, is related to patient results posted by Dr. Shapiro in the discussion thread, Dr. Paul Shapiro: 4400 FUT Grafts, 14 Days Post Op:

Can you tell me why you opted to go back into the crown? I ask because I hear of some hair restoration surgeons not wanting to touch the crown until a patient is much older and more progressed. This patient is a class 4 on the Norwood Scale at 28 but, theoretically, his crown could open up much further.

There is no set rule whether or not to put hair in the crown. What is important is that we take future balding into consideration so that, if the patient progresses, there is enough donor to make the hair transplant look natural.

In this case, the patient did not want his hairline very low and was happy with a mature frontal-temporal angle. I kept the front of his hairline high at 9 cm above the glabella and his frontal temporal angles mature. In these patients I will shrink the crown, but not completely cover it. It is usually safe to put hair at the top of the crown. Also the hair in the top of the crown is at a lesser density of around 25 to 30 FU/sq.cm to give it some coverage, but not very dense.

Recently, Dr. Jim Harris, who is recommended on the Hair Transplant Network became amongst the first hair restoration physicians to purchase the ARTAS Hair Restoration System, a hair transplant machine innovated by Restoration Robotics in an attempt to automate the follicular unit extraction (FUE) procedure.  But can ARTAS live up to its promise of increased extraction speeds, lower transection rates, increased session sizes, and optimal hair growth yield?

Like previous FUE extraction machines, the ARTAS Hair Restoration System attempts to increase the speed of extraction (allowing for larger single sessions) while automating the surgical process.  Claims that very little skill is needed to use automated devices has  led some marketing giants to mass market their machine to the neophyte hair transplant surgeon and untrained medical professionals.  Since no automated device or machine can adapt or make critical decisions during an FUE procedure, many hair loss practitioners and veteran patients have expressed concerns that many who undergo surgery with a neophyte surgeon using the ARTAS or any automated hair transplant equipment will eventually come forward with less than satisfactory results.

While the concept of automating the FUE hair transplant procedure is impressive, putting such advanced equipment in novice hands may be disastrous.  However, innovative machines like the ARTAS Hair Restoration System in skilled and experienced hands could significantly aid quality physicians and their staff in providing patients with the best results.

According to Dr. Harris:

I acquired the system because it produces great follicular unit grafts at an efficient rate and it will help leverage my resources.

Although hair transplantation is not an exact science (in fact, most physicians state that medicine, in general, is as much an art as a science), when it comes to hair transplant surgery many patients desire an accurate, objective outline of the procedure.

One of the areas hair restoration patients desire precise data is in graft count verification. Specifically, patients desire a way to verify that they receive (roughly) the number of follicular unit grafts estimated during the hair transplant consultation and paid for during the time of the operation.

However, in various cases, hair transplant procedures can range from 3,000 – 5,000 grafts, and it’s difficult to keep track of each follicular unit as it’s harvested, prepared, and implanted. So, how are hair loss patients supposed to “keep track” of the number of implanted grafts, and ensure that they receive the correct, quoted number of follicular units?

In a recent thread on our Hair Loss Discussion Forums, a group of patients asked themselves the exact same question and came to some innovative and creative conclusions.

Several patients stated that a final count was provided at the end of the procedure, and since they visited a trusted hair transplant surgeon, they safely assumed the graft count was accurate. Another member explained how he used a “clicker” to keep track of the incisions made in the scalp; a different member used a similar method, but simply counted the number of incisions instead of keeping track with a clicker device.

This hair loss question was posted directly to Dr. Raymond Konior of Chicago, IL,  who is a member of the Coalition of Independent Hair Restoration Physicians.   See his professional answer below.

At what age and degree of hair loss is it appropriate to transplant a patient’s crown?

The crown has been described as the “black hole” of the scalp. Based on that, I believe a very large percentage of patients seeking hair restoration should avoid grafting into the crown region, especially young men in whom it is often impossible to determine how far the pattern will progress. This recommendation is based on the finite nature of donor supply and on the progressive nature of male pattern balding, i.e. there is an imbalance between supply and demand. The fact of the matter, however, is that despite prolonged and detailed consultative discussion relating to the risks and limitations of grafting the crown, many men are still adamant about obtaining some crown coverage. Although it is difficult to predict with absolute certainty everyone who is a rock solid candidate, it is possible to weed out the majority of poor candidates and to institute a safe grafting strategy which will avoid future problems for most patients

While today’s state of the art ultra refined hair transplant procedures can provide many hair loss sufferers with a full and natural looking head of hair, each patient is unique and what can be realistically achieved with hair restoration surgery will vary. All balding men and women want to restore a full head of hair. But is this realistically achievable for everyone?

The discussion of large megasessions exceeding 3000 grafts and dense packing on our popular hair restoration forum has many hair loss sufferers hopeful and rightfully so. But while this ultra refined follicular unit grafting procedure is coveted by the vast majority of patients, not everyone is a candidate for it. Thus, working with a quality hair restoration physician to determine what you need to meet your goals is critical, even if it doesn’t evenly align with what you want. So how can you determine whether or not what you want matches what you need?

In the discussion topic, “Hair Restoration Needs Verses Wants – Buyer Beware“, forum member “Spex” cautions prospective hair transplant patients and helps them align their desire for a full head of hair with what can be realistically achieved for them. View this discussion topic to read what our members are saying and to contribute your own experience.
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David – aka TakingThePlunge
Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

This question comes from a member of  our Hair Restoration Social Community and Discussion Forums:

I’m looking to undergo a moderately sized follicular unit extraction (FUE) procedure, but I’m having trouble finding information on the actual growth rate/yield I can expect from FUE. What kind of growth rate can I expect from a follicular unit extraction (FUE) procedure?

I think there are two things to consider with regard to follicular unit extraction (FUE) and yield/growth rate: 1. any damage to follicular unit grafts during the extraction phase (which would damage the follicle and result in a graft that didn’t grow) and 2. a graft extracted from outside the universal extraction zone, which would be susceptible to future hair loss (as the graft wouldn’t be as resistant to dihydrotestosterone – DHT).

The first variable is dependent on the skill of the hair restoration surgeon and, to a much lesser extent, the tool used. If you visit an experienced FUE surgeon, my guess is that the ’90 – 95%’ number often quoted (which is comparable to the 95% growth rate experienced with traditional follicular unit transplantation) would be accurate. If the practitioner has less experience with extracting follicular units, than issues with transection become apparent and the ‘yield rate’ will suffer as a result.

The second variable is really up to the hair transplant surgeon, how many grafts he/she is trying to extract, and whether or not they feel like the follicles in these extraction areas (outside of the universal safe zone) are susceptible to future loss or not.