This hair transplant video shows how follicular unit grafts are created under microscopic dissection and then placed into tiny incisions in the balding areas. To learn more visit www.HairTransplantNetwork.com

www.hairtx.com FEMALE HAIR LOSS AND HAIR TRANSPLANT TESTIMONIAL – DALLAS PLASTIC SURGEON, DR. SAM LAM, HAS ONE OF HIS FEMALE HAIR TRANSPLANT PATIENTS TALK ABOUT HER HAIR LOSS AND HAIR RESTORATION BY DR. SAMUEL LAM 18 MONTHS FOLLOWING HER HAIR TRANSPLANT.

Many specific diagnoses and patterns of hair loss and/or thinning differentiate men and women’s candidacy for hair transplant surgery and its final outcome. Learn the difference!

Hair loss and thinning is much more straightforward to diagnose and predict in men than it is in women, agree doctors and surgical hair transplant experts.  And they all agree on one more thing:  The best result starts with the most thorough diagnosis of the hair loss or hair thinning issue to determine candidacy for a hair transplant surgery.

“While the majority of men are good hair transplant surgery candidates because they have a stable donor area on the back and sides of the scalp as well as predictable patterns of hereditary balding, women are prone to have diffuse thinning all over the head so there is no stable donor area.  For that reason, we find that only a minority of women are good candidates for a hair transplant,” explains Dr. Robert M. Bernstein M.D., F.A.A.D., Clinical Professor of Dermatology at Columbia University in New York and hair transplant surgeon and director of Bernstein Medical Hair Restoration in New York City.

“It’s extremely important to determine which women are good candidates for hair transplant surgery and which are not so we examine the donor areas using densitometry to measure and magnify follicles while we look for miniaturization of each hair, a change in its diameter, which is the hallmark of genetic hair loss. We make sure women have a stable, suitable donor area otherwise the transplanted hair will continue to fall out and will continue to degenerate in the new area.”   Bernstein also explains that women who present with diffuse hair loss and many diseases, hormonal abnormalities, medications and traumas can mimic thinning hair. “When a woman comes in with hair loss we do an extended evaluation to make sure they are a viable candidate for a surgery,” cautions Bernstein.   Some hair loss diagnoses that do make women good candidates for the surgery are Traction Alopecia or trauma, face lift scars and eyebrow restoration. “We tend to stay away from Alopecia Areata because if it recurs in a new patch, scars may become visible. We’ll wait until patches of loss are stable 3 to 5 years before we will consider a hair transplant.”

Once the diagnosis is determined and stable donor areas are identified, the technical aspects of removing the hair are very similar.  The only difference is that women’s scalps are thinner and tighter so the surgeon has to carefully control the depth of harvest. “If you’re a woman, be sure your doctor has experience working with a diagnosis and hair just like yours and ask for pictures and referrals you can call,” advises Bernstein.

The design most men are looking for is to replace the forelock or front, and receded temples, first. “We’ll place the hairs in a predominantly forward direction to accomplish this. Then, if we still have plenty of donor hair, we will try to fill up the thinning crown area on a man. But on a woman, we want to restore the frame – the rounded hairline around her face. So, if we don’t have enough hair to do everything, we concentrate on the frontal hairline, the temples and front part of the scalp that frames her face. Once we get enough density there, this new hair can be styled to camouflage hair loss or thinning just behind it, especially in Caucasian women,” explains Bernstein.  “Women’s hair transplants are also more difficult because women tend to have specialized swirls, directional changes and growth patterns around this front hair line that must be mimicked and can become very complicated.  Once completed, a woman can rely on styling techniques, perms, and color treatments to greatly enhance her hair transplant,” advises Bernstein.

The main complication to avoid is visible scarring, so in men, we will advise them never to buzz their hair short because scars can become visible.  In women, the biggest complication is stability of the donor area. Transplanting areas in transition can be tricky. “Sometimes,” cautions Bernstein, “because hair growth happens in cycles, the trauma of a transplant can cause a short-term shock and some fall-out even in healthy follicles.  We use techniques to minimize this effect but it is a risk that should be explained so women are not literally shocked by it!”

Hair loss may seem like a natural consequence of aging. You may even expect it to eventually happen to you after watching a family member go through it. But expecting hair loss and absorbing its effects can be dramatically different things with unexpected results. Just ask Lucas Rivner of Los Angeles, who eventually learned that hair transplant surgery can improve one’s life.

Lucas was in his early thirties when his hair began falling out. Before that, his life had been pretty good. He worked as a software technician with a great job and had his fair share of dates. He’d put off settling down, thinking he’d get to it in another year or two. But then his hair began to fall out. His hair loss happened it in front, along his hairline and before long saw the crown of his hair thinning out, too.  Like so many people who eventually decide to get hair transplant surgery, Lucas first noticed his hair on his pillow in the morning and rinsing down the shower drain.

Lucas would spend an hour each morning in front of the mirror trying to cover the hair loss. He tried shampoos, over-the-counter hair loss products and even tried restyling his hair to hide his hair loss. But nothing really worked.  He went into denial, never believing that the loss of his hair would progress far enough to merit a solution like hair transplant surgery.  Lucas began hiding in his job, spending less and less time out in the world and particularly in the dating scene. His dating fell off to practically nothing and maybe it was his imagination, but he felt like he’d suddenly become invisible to women. They seemed to look right through him and his rapidly thinning hair.

Lucas lost the easy confidence he’d once had around women and the more invisible he felt, the worse became his bumbling efforts to connect with women who would have once found him attractive. He felt older than his years and not like himself at all.  He was on the verge of swearing off dating altogether one day when a female co-worker and friend sat him down for a little pep talk.  “Lucas,” she said, “it’s not your lack of hair that’s interfering with your love life, it’s your lack of confidence. Women like a man with confidence.  It makes them feel safe.”

For a few days, he thought about this. Then he realized she was right. His perception that he’d become invisible was his own.  Somehow, he had to find himself again because it had begun to affect all areas of his life. So, how exactly was he going to get his confidence back? On the Internet, he Googled “hair loss solutions” and found quite a few sites talking about advances in hair transplant surgery. After performing his due diligence he chose hair transplant doctor with a great reputation and made an appointment to go in and talk to him.

His first appointment convinced him that he was heading in the right direction. The hair transplant doctor told him about the high success rates they had achieved with hair transplant surgery and he showed Lucas photos. He explained to Lucas that he was an excellent candidate because he had good donor hair at the back of his head. Plus, she explained, despite the admittedly expensive price of hair transplants, because of his age, he could expect to spend less over his lifetime doing hair transplant surgery than if he went with nonsurgical hair systems that would always require maintenance and updating.  Hair transplants, once done are permanent and becomes your own real growing hair. The hair transplants will not fall out because it’s not hair that’s genetically predisposed to do so.

Lucas went ahead with the hair transplant surgery, financed it with credit and went back to his life. Within six months, his hairline and crown began to regrow. Like a miracle, he began to look, and more importantly, feel like himself again. No one seemed to notice it, or if they did, they assumed he’d lost weight or had begun working out. But the biggest change was how he felt when he approached dating again. He knew now, it wasn’t about how he looked, but how he felt about himself that had held him back. Within a few months, he’d met Carly, the woman he would marry a year later.  Lucas has never looked back on his decision to undergo hair transplant surgery. Hands down, it’s the best money he’s ever spent.

Looking good and feeling good go hand in hand. Hair loss can have a devastating impact on your self-esteem whether you’re a man or a woman. There are dozens of options out there to help you. If you’re not ready for hair transplant surgery, or think you can’t afford it, you owe it to yourself to take the time to go into a hair transplant surgery doctor’s office and ask him if hair transplants will work for you. So, what are you waiting for? Give them a call. Make an appointment. Find yourself again.

Depending on a number of critically important factors, hair transplant surgery can either be one of the best decisions you will ever make or among the worst. Today we’re going to discuss the pros and cons of surgical hair restoration, euphemistically called hair plugs or transplantation. In fact, the more accurate description is “autologous hair bearing skin transplantation”. This is because the actual procedure involves harvesting sections of skin from a hairy part of one’s scalp (donor) and moving it to a bald area (recipient) of the same person. Skin transplantation between anyone other than genetically-identical twins does not work.

The technique of moving hair bearing skin tissue grafts from one part of the scalp to another dates back at least 50 years. In the 1950’s a pioneering surgeon by the name of Dr. Norman Orentreich began to experiment with the idea on willing patients. Orentreich’s groundbreaking work demonstrated a concept that became known as donor dependance, or donor identity, that is to say that hair bearing skin grafts harvested from the zone of the scalp outside the pattern of loss continued to produce viable hair even though the grafts had been relocated into areas that had previously gone bald.

During the next two decades hair transplantation gradually evolved from a curiosity into a popular cosmetic procedure, primarily among balding men of late middle years. In the 1960’s and 1970’s practitioners including Dr. Emanuel Marritt in Colorado, Dr. Otar Norwood, Dr. Walter Unger showed that hair restoration could be feasible and cost effective. A standard of care was developed that, in experienced hands, allowed for reasonably consistent results.

At the time the most common technique involved the use of relatively large grafts (4mm — 5mm in diameter) that were removed individually from the donor site by round punches. This tended to leave the occipital scalp resembling a field of Swiss cheese and significantly limited the yield that was available for movement to the bald zones on top and in front of the patient’s scalp.

Over the course of multiple surgical sessions, grafts were placed into defects that had been created in the recipient zone (bald area) using slightly smaller punch tools. After healing the patient returned for follow up sessions where grafts were placed in and amongst the previous transplants. Because of the relative crudity of this technique, results were often quite apparent and the patient was left to walk around with a dolls hair like appearance, particularly noticeable at the frontal hair line, and especially on windy days. Such patients were usually quite limited in the manner they could style their hair and, because of the wasteful donor extraction method, many persons ran out of donor hair long before the process could be completed.

In the 1980’s hair restoration surgery gradually began to evolve from the use of larger punch grafts to smaller and smaller mini and micrografts. Minigrafts were used behind the hair line, while one and two hair micrografts were used to approximate a natural transition from forehead to hair. Donor site management also evolved from round punch extraction to strip harvesting — a far more efficient technique. Pioneers in this area were skilled surgical practitioners such as Dr. Dan Didocha, Dr. Martin Tessler, Dr. Robert Bernstein and others. The concept of creating a more natural appearance evolved still further in the 1990’s with the advent of follicular unit extraction (FUE), first proposed by the highly gifted Dr. Robert Bernstein, and described in the 1995 Bernstein and Rassman publication “Follicular Transplantation.”

The 1990’s also brought new tools into the mix, such as the introduction of binocular or ’stereoscopic’ microdissection. Stereoscopic microdissection allowed the surgeon to clearly see where one hair follicle begins and another ends. As the 1990’s progressed, many transplant surgeons shifted away from the use of larger grafts in favor of one, two and three hair follicular units.

While highly useful in the hairline region, such ‘micrografts’ were not always optimal in recreating density behind the hairline. So even after multiple sessions, the final outcome of micrograft-only transplanted scalps tended to look thin and rather wispy. Perhaps of even greater concern, the dissection of a donor strip entirely into micrografts risked a significantly reduced conversion yield. Here’s why.

Let’s assume we are starting with two donor strips of hair bearing tissue from two similar patients. Two surgeons are each dissecting a single donor strip, but the first surgeon aims to dissect down into one and two hair micrografts alone, while the second surgeon dissects only enough micrografts to place in the hairline, leaving larger three, four, five and six hair grafts available for placement behind the hairline. At the beginning each donor strip contains 1,000 hairs. Both surgeons should theoretically end up with 1,000 viable hairs available for transplantation regardless of how the tissue was dissected. Unfortunately, the reality doesn’t quite work out that way.

Every time the donor tissue is cut the risk of transecting a follicle occurs. Transected hair follicles are known colloquially in the industry as Christmas trees — because they are hairs that lack viable roots. Basically, from a previously robust terminal structure, they either produce thin fine hair or none at all.

This is a problem for several reasons, but first and foremost, it is a problem because the act of hair transplantation does not ‘create’ new hair. The process simply relocates viable hair from the back of the scalp to the front.

And since there is a fixed supply of permanent donor hair which may not be sufficient to fill the area of demand, it is intrinsically counterproductive to reduce this limited supply via a technique know to engender relatively poor yield. The problem is solved by the careful use of FUE/micrografts in the recreated hairline and somewhat larger grafts behind the hairline. Refinement is thus achieved at the hairline with appropriate density behind the hairline zone. If either of these factors are missing from the equation the result is a dysaesthetic hair restoration. Either the outcome looks thin and fuzzy (micrografts only) or it looks doll-hair like (large grafts only). So now we can now begin to see why the size and strategic placement of each graft becomes a critically important consideration in hair transplant surgery.

Several other potential caveats to hair transplant surgery are graft compression, misdirection, misangulation, mishandled grafts and donor site damage. Graft compression occurs by trying to insert too large of a donor graft into too small of a recipient hole. If the donor graft is not carefully fitted to the recipient hole then the tissue and hair can literally get ’squeezed together’.

To see how this works, extend the fingers from your left hand open and wrap the fingers from your right hand around the middle portion of your left hand. Just as your fingers get squeezed closer together, the hairs in a compressed graft end up closer together then they were intended by nature. This tufting lends an odd or unnatural appearance to the hair.

Misdirected grafts produce hair that ends up growing in a direction contrary to that which was intended. Again, this problem causes a weird, unnatural — and difficult to style — head of hair. Misangulation, somewhat similar to misdirection describes a misplaced graft that produces hair at an angle which does not correspond to the way scalp hair is supposed to grow. Again, the result is hair that just doesn’t look right no matter how it is combed.

Mishandling of grafts usually involves either transsecting a follicle (cutting off the root) or dessicating (allowing to dry out) the tissue. Graft mishandling typically occurs primarily in less than experienced surgical hands.

Donor site damage is metaphorically tantamount to decimating the entire Amazon rain forest in order to harvest a few dozen plants to use for decorating a neighborhood street. There are few things more aesthetically demoralizing then walking around with a partially-completed hair transplant — knowing that there isn’t enough donor hair available to finish the job because your donor site is exhausted.

Your donor hair is a precious resource. Treat it like solid gold. It’s all you’ve got and everything you’ve got to complete a process of surgical hair restoration. Don’t waste a single follicle.

So from all of this we can begin to appreciate some of the key pitfalls and risks of transplant surgery. As we see, the risks are principally aesthetic — meaning that the potential for damage is generally cosmetic, not medical. The scalp of most healthy people is extremely well vascularized and, in the setting of transplant surgery, scalp infection and/or other medically-relevant scalp complication is quite rare.

For those individuals considering transplant surgery it is crucial to equip oneself with good solid information. The internet is a good place to start. Visit trusted online resources. An excellent start would be a visit to the International Society of Hair Restoration Surgeons. Another reasonably objective resource is the hair transplant network. David Tse runs a highly educational website called Hairsite. There is always Medline which acts as a clearinghouse for all medical research, including surgical hair restoration. Those who publish on pubmed.com are often the highest caliber in their field.

Once you’ve gathered information from online resources you can move next to contacting the surgeon’s office itself. Take your time. Don’t let anyone talk you into surgery until you’re ready. Keep your money in your wallet and your donor hair behind your ears until you’re really prepared to commit both to the task at hand.

Talk to actual patients. If possible, visit with a restored patient or two in person. Many finished patients will not mind visiting with you if they’re happy with their outcome. Plan to have at least one personal consultation with each surgeon you’re considering. Don’t be afraid to travel. You needn’t go outside the United States for hair restoration. But if you live on the West Coast or East Coast you shouldn’t be limited to hair surgeons in your immediate vicinity. It’s your hair for goodness sake! Don’t let geography be a factor in the decision.

Ask each candidate surgeon pointed questions, such as: Can you show me pictures from patients who started with my degree of hair loss? How close to a full head of hair can I come? What will be the total cost for me to get there? Not just price per graft, or price per procedure, but the cost to get me from where I am now to where I want to be. How many surgeries are we talking about, and spread over what period of time? What is your policy for touch up work? What portion of your practice do you devote to corrective surgeries? Can I see photos of patients that you’ve corrected? These last two questions are highly useful because hair surgeons who are adept at correcting other people’s mistakes are generally less likely to blunder themselves.

There is a crucial take-home lesson from all of this. The single most important criterion in predicting a good outcome for hair transplant surgery is not the patient, but the surgeon. In surgical hair restoration, art is at least as important as science. You’ve access to genuine excellence in the hands of experts like Dr. Dan Didocha, Dr. Robert Bernstein, Dr. Bradley Wolf, Dr. Martin Tessler, Dr. Leonard Aronovitz and others. So for those seriously thinking about undergoing transplant surgery, the key is to arm yourself with knowledge first. Take your time. Be ‘patient’ before becoming anyone’s “patient”. Follow this advice and the odds are you will end up happier after your hair restoration then you are today.