Doctors on Hair Loss & Hair Transplant surgery.

What is the importance of hair characteristics in hair transplant surgery?

These characteristics are significant in that they determine to a great degree how much coverage of the scalp there is, in order to block light. When light is not blocked and penetrates through to the scalp, the appearance is of thinning or balding.

The other big factor here is the density, which is another topic unto itself. The density is the number of hairs or follicular units per unit area (square centimeters or square inches or whatever unit you prefer; the centimeter is the standard for physicians). Although this density usually gets most of the attention when discussing hair loss, hair characteristics are equally, if not more, important.

First let’s look at color. At first, one might think that the darker the hair, the better the coverage. This is generally not correct. Lighter hair usually goes with lighter skin, and the tow together tend to mask thinning very well. Darker hair can cover well, but in the case of poor hair transplant work (pluggy looking, or larger graft on frontal hairline) they may stand out much worse than lighter hair. We will discuss color in more detail when we discuss contrast.

Curl is another very important factor in coverage. Generally speaking, curly hair provides coverage in proportion to the degree of curl (i.e., wavy hair gives better coverage than straight hair, curly hair better than wavy, very curly better than slightly curly, etc.). This has to do with light blockage as well. The curlier the hair is, the more it creates a meshwork of sorts (kind of like a thatched roof) which “stands up” a little bit off the scalp and keeps the light from penetrating to the scalp.

Contrast has to do with the difference between hair color and skin color. The closer to each other the hair and scalp are, the better the coverage. In a way, this “fools” the eye of the observer into not noticing the decrease in density. If a person with blonde hair and light skin loses 50% or his or her density, they may appear much less affected than a person with equally light skin and jet black hair. In this case the dark hairs of the second example are highlighted against the light skin and it shows the sparseness of the hair. The person with the blonde hair reveals very little difference between the hair and scalp, in other words, the observer cannot detect where the hair leaves off and the scalp begins.

Last, let’s consider caliber. Thicker strands of hair provide more “hair mass”, which is a term doctors use to describe the total effect of length times caliber. The more hair mass in a given area, the better the coverage. This makes intuitive sense. Imagine covering a hut with logs. If you place 20 logs as a roof, which will give better coverage, skinny logs or big round ones with large diameters? Of course, the bigger ones, so the thicker hairs do the same over the scalp. And remember, what appears as thinning or balding is simply the appearance of light shining through to the scalp.

1 Comment | Ask a Question |  Email This Post  Print This Post

I’m told by various strip physicians that the strip scar is a thin as a pencil mark. Is this true?

This is completely dishonest. The average strip scar is 2 to 3 mm wide and it can stretch from ear to ear. If you plan to cut your hair short, this can be a problem for you as it is obviously a man made scar. It is an obvious sign that you had a hair transplant. No one wants anyone to know they’ve had a hair transplant, however. No one wants anyone to know they had hair loss or that they ever considered hair restoration surgery. Even shorter hair styles can expose the strip hair transplant scar. Frequently we are told that a hair cut of a number 3 or shorter exposes the strip scar form a strip hair transplant.

There is a new fallacy you are hearing from strip surgeons, as well. They claim that their new trichophytic closure technique produces pencil thin scars that are invisible. We’ve seen 5mm wide scars produced by this technique. Five millimeters is ¼ inch wide. It is a huge gap with no hair in it. When the trichophytic closure works, it rarely works in the rear of the scalp. You will not see an advantage along the sides of the scalp usually. Furthermore, the tighter you make the scalp by performing successive strip procedures, the more likely it is that your scar will widen and stretch out. Furthermore, these strip scars can turn whiter than the surrounding skin or bright pink. This produces further contrast to the scars should they be exposed by a short hair cut or by a medical illness that causes thinning or loss of your hair.

One other problem you will never hear about from your strip surgeon is that strip procedure causes irreversible changes in your donor area hair growth angles. A strip is nothing more than a scalp reduction in the donor area. It alters hair growth angles for the rest of your life.

There is no reason to have a strip procedure. It really is up to the patient to demand the alternative, which is far better. Patients should begin to demand CIT, which is an advancement over our older FIT procedure. There is CIT and no quite CIT. Many physicians will tell you they perform FUE. This FUE procedure does not meet the quality of CIT. CIT is a proprietary procedure with quality instrumentation. Only CIT has proven results day in and day out with all types of hair including wiry, kinky hair seen in men of African decent.

(Read The full Article » » » »)

Add a Comment | Ask a Question |  Email This Post  Print This Post

What is Maximum Medical therapy for hair loss?

People with hair loss, and certainly anyone even CONSIDERING hair transplant, may want to use a regimen of maximum medical therapy. This just means using a number of different medications that have different mechanisms of action to try to “cover all the bases”, so to speak. Attacking hair loss by targeting different aspects of the process is a way of using the synergy between various agents to maximize the effects.

Finasteride (Propecia and Proscar) is an agent that blocks the formation of dihydrotestosterone (DHT), a hormone that has been implicated in male pattern baldness (androgenic alopecia). This is a first line drug for men with thinning hair or balding. It is not beneficial for women; in fact, it can cause birth defects if a woman is exposed to the drug and gets pregnant. It has few side effects in men and has been used for about 25 years with a good safety record.

Minoxidil (Rogaine and many generic versions) is topical, or placed directly on the scalp. Side effects are few, and it has a synergy when used with finasteride. This may be used in men and women, and is considered by many to be the drug of choice in women with hair loss.

There is some evidence that an anti-fungal shampoo containing ketoconozol (Nizoral) may help slow hair loss. It can be used twice a week and has the added effect of decreasing dandruff and itching of the scalp. There are also a variety of over the counter preparations (Hair Cycle products) and internet-marketed preparations that are available. Many of these contain minoxidil and other ingredients. Some of these are topical androgen (male hormone) blockers; there is little scientific proof of their effectiveness, but many men swear by them, and they may work for some.

The most important thing one can do with these latter agents is read and read some more. Information from sources other than the manufacturers is likely to be more objective and may help one with informed decisions.

Add a Comment | Ask a Question |  Email This Post  Print This Post

This video demonstration was taken during live hair transplant surgery with one of Dr. Cole’s patients.  With strip harvesting or traditional FUE, the patients are very limited in their personal appearance and have difficulties getting back to normal daily activities because they are asked to shave their head.
Shaving the head allows the physician to have high visibility of the donor area which is necessary for donor hair extraction. With the new C2G technique, the patients are able to keep their normal hair style before and after the CIT technique!
Now patients can have the best of both worlds. They no longer have to put up with the pain associated with strip scars and they can still maintain their normal hair style.

 

 Online Video [2:00m]: Play Now | Play in Popup | Download (51)

Add a Comment | Ask a Question |  Email This Post  Print This Post

It is really unknown what causes shock loss.  Shock loss is hair loss resulting from a hair transplant procedure.  There are many theories, however.  Shock loss most likely is due to an inflammatory response as a result of physical trauma.  It is really quite uncommon in the donor area.  It is more common in the recipient area.  The density of incision sites may play a role as high density incision sites tend to produce shock loss more commonly.  Shock loss will occur only in the area where the incisions are made.  It will not occur in adjacent regions.

Shock loss begins about 2 to 3 weeks after a procedure and it will continue over a period of a few weeks.  If you experience hair loss months after a procedure, it is not due to shock loss, but rather due to progression of hair loss or some other factor unrelated to the hair transplant procedure.

Some feel it is due to the injection of epinephrine, which is commonly added to the anesthetic.  This is most likely untrue as you will not see shock loss in areas where anesthesia is given, but rather only in areas where the incision sites were made.  You also more commonly see it in the recipient area while epinephrine is also given in the anesthetic given in the donor area during a hair transplant surgery.  Even though the same anesthetic with epinephrine is given in the donor area, you do not see shock loss in the donor area when it occurs in the recipient area.

The inflammation might result from physical trauma, but it also might be due to the free radicals that accumulate in tissue that continues to metabolize outside the body in an anaerobic state.  Free radical scavengers in the storage fluid along with cooling of the tissue outside the body might help reduce the amount of free radicals produced by the grafts.  One might also limit the free radical load by limiting the recipient area density during a hair transplant.

Shock loss is uncommon in the donor area with both strip harvesting and with FUE or FIT.

When shock loss occurs, the hair will generally begin to grow back after a hiatus of 3 months.  It is only the fine wispy baby like hair that seems most prone to remain dormant following shock loss.  This sort of baby fine, short, lightly pigmented hair produces the least amount of coverage, however, so it will not be missed as coarser, darker, longer terminal hairs will take their place when the hair transplantation produces new hair growth beginning three months after the hair transplant.

Add a Comment | Ask a Question |  Email This Post  Print This Post