Doctors on Hair Loss & Hair Transplant surgery.

I would like to know what is the CIT hair transplant? why is it better then the strip?

CIT or “The Cole Isolation Technique” (former known as FIT) is a hair transplant harvesting technique developed by Dr. John P. Cole in the early years of this century. It is similar, but not identical to, FUE, or follicular unit extraction. CIT uses proprietary technology and instruments to harvest intact follicular groups ranging from 1 to as many as 6 or more individual hairs along with their intact dermal elements. It must be stressed that these dermal elements are essential for the growth of new hairs in the recipient areas (these are the areas of thinning or balding that are being transplanted). Extracting hairs without the dermal elements is easy, but amounts to nothing more than a “pluck”; these hairs will not grow.
As with any other harvesting method, the hair transplant surgeon will first outline the donor areas to be harvested, as well as the areas which will be receiving the harvested grafts later on. Then, local anesthetic is infiltrated into the donor area to render the skin and deeper structures numb and insensitive to pain. Then, just before harvesting begins, the area is injected with a “tumescent” fluid consisting of saline, and often medications to minimize bleeding. This tumescent technique is fairly common in a number of cosmetic procedures. It is beneficial in a number of ways; it helps decrease bleeding with medications and also by virtue of the pressure of the fluid on blood vessels in the tissue; it brings the skin up and away from deeper structures; it provides a taut, firm surface on which to score the skin, and it slightly separates the follicular groups from each other so that they may be more easily isolated from one another.
Then, the skin around the follicular groups is scored with the special instruments; the surrounding tissues are teased away from the follicles and then the entire unit, that is, the hair shafts, the dermal elements surrounding the shafts, the sebaceous glands and a tiny ring of skin at the top is gently pulled out. The graft is perfect, and ready for placement in the recipient area. No trimming or preparation is generally needed. This is one of many benefits of CIT compared with the older style strip harvest method, which requires microscopic dissecting of all grafts prior to placement, necessitating a large team using stereo microscopes.
Healing of the tiny sites from which the grafts are pulled commences almost immediately. Usually by the second or third day, the tissue has grown in to cover the hole and there remains only a pale pink dot at the site. In some individuals, this may eventually appear as a slight “white dotting”, which is not strictly speaking a scar, but rather an area of hypopigmentation. This just means that the cells within the follicles that produce the dark pigment called melanin are gone, and the skin here is a slightly lighter shade than the adjacent skin. This phenomenon is relatively unpredictable; it is most common in darker complexioned people, but may manifest in pale-skinned folks. Likewise, it may occur after CIT with very small instruments, and not at all with larger-sized extractors (or vice versa!)
We feel that, compared to a linear, ear-to-ear strip scar, these tiny white dots have minimal negative cosmetic impact. With the hair only a few millimeters long, these dots are undetectable. A strip scar, on the other hand, may be visible with the hair considerably longer, and it may widen, sometimes for no apparent reason. In addition, the strip scar changes the direction of hair growth below it, relative to the direction above it. Unless a person desires to wet shave their hair down to the skin, these white dots, if they do occur, are invisible to the casual observer.
Now, once the grafts are extracted and ready for implantation, the process is quite similar to strip harvest hair transplant surgery. Tiny jeweler’s forceps are used to very gently grasp the hair-bearing grafts and place them into miniscule recipient sites. These sites are created by the hair transplant surgeon using various blades or needles; each site is made carefully and with a deliberately natural pattern. The angle relative to the axis of the head is extremely important, because the hair normally grows in specific patterns. These patterns have a general similarity in all people, but there are specific ways in which these patterns diverge in individuals. A “cowlick” at the frontal hairline is a good example, as is a unique “whorl” at the vertex or crown. It is often appropriate to closely mimic the existing pattern to obtain the most natural effect.
The so-called angle of emergence is of utmost importance as well. This is the angle at which the hair emerges from the scalp. This angle may be quite acute, that is, the hair may lie down very close to the plane of the scalp. If an inexperienced or minimally gifted surgeon makes these angles too high, then the look will be peculiar and unnatural. We have seen many cases such as this, and it is especially noticeable at the leading edge of the frontal hairline; follicles growing on the hairline at or close to a 90 degree angle are an aesthetic and cosmetic disaster.
Regional placement of various graft sizes is another challenge for inexperienced surgeons. One hair grafts ONLY should be placed at the leading edge of the hairline. Two hair grafts are then placed behind these “singles”; the “full-sized” three, four, or larger grafts are only placed further back behind the soft, feathered hairline. We commonly see repair cases with two, three, and even four hair grafts all over the frontal hairline! Fortunately, we can now remove these unsightly, inappropriately-placed grafts with the CIT technique and redistribute them further back where they rightly belong.
As with all hair transplants, the hair shafts themselves, which are essentially dead protein, will begin to shed at about 2 to 3 weeks. However, the follicular germinal elements are safely lying dormant beneath the skin. Usually at about 3 to 4 months, the first “new” hairs will begin to emerge. There will continue to be further growth for up to a year or more, but usually the full cosmetic effect will be evident at about 12 months.

Tags: bald pattern, balding, cit, dr. john p. cole, fit, follicular unit extraction, fue, hair loss, hair transplant, hair transplant surgeon, hair transplants, medications, physicians, punch size, saline, skin, stereo microscopes, the cole isolation technique, thinning

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what is the best possible treatment for baldness for a 23 years young male?

The best treatment for a 23 year old male with hair loss will vary somewhat depending on the degree of hair loss at this young age. If you have an advanced degree of hair loss, surgical solutions should not be considered. The reason for this is simply that hair loss is a lifelong process. Once it begins, it will continue the remainder of one’s life. Typically it will advance in stages. This means there will be periods when the loss is stable and periods when the loss accelerates quite rapidly. An advanced degree of loss usually means that one will lose an excessive amount of hair over their life time beyond the capacity of the donor area to keep up with the pace of loss. Eventually there will be a mismatch between supply and demand. This can result in an unnatural result later in life. One should avoid crown work when possible at this age or at least minimize the size of the grafts to one and two hair grafts that will appear more natural as the surrounding hair is lost later in life.

For the advanced degree of loss at an early age, medical and other non-surgical solutions would be the best options. These include DHT blockers such as Propecia and Avodart. It also includes minoxidil (Rogaine) along with Nizoral shampoo. We like Hair Cycle shampoo and conditioner too. One might also consider a hair piece.

Less aggressive degrees of loss should also be treated medically, but one might also consider a surgical solution. The surgical solution should never include a strip procedure. Rather one should have FUE or FIT when they are less than 30 years of age. It used to be that the only surgical option was a strip surgery that left a permanent strip scar. Today, this is not the case. Alternatives that avoid strip scars are available today and a much safer surgical solution.

It is a good idea to put off surgery as long as possible when you are young. The longer you wait, the more likely you are to know the bald pattern you are likely to develop into. In addition, you may find that you panicked as a 23 year old and solved the problem surgically. As men mature, sometimes they become comfortable with their hair loss. Once you begin surgery, you increase the probability that you may require additional procedures as you mature and your hair loss progresses. If you are certain that you want to maximize the hair on your head and you are not expected to have an advanced degree of loss, then surgery may be an option for you, however.

Tags: avodart, bald pattern, dht blockers, fit, fue, hair cycle, hair loss, hair piece, minoxidil, nizoral, non surgical solutions, Propecia, rogaine, strip, strip scar, young age

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