Doctors on Hair Loss & Hair Transplant surgery.

My mother had esophageal band surgery a couple of years ago due to her excessive weight problem. Following this she has noted progressive hair loss and a change in her personality. I’ve read that band surgery and stomach stapling can cause hair loss. Is this true?

Bariatric (Weight Loss) Surgery: Metabolic, nutritional, psychological and physiological Consequences Bariatric or weight loss surgeries have become commonplace in the USA and in other countries, in part due to an ever increasing incidence of obesity in the context of a societal standard of beauty that emphasizes a thin, shapely physique. Lobbying by various organizations, as well as medical studies detailing the present and future consequences of untreated obesity, has led to insurance coverage for these surgeries, which were previously deemed “cosmetic”. This article will detail some of the physical and mental aspects of the often rapid weight loss which occurs after bariatric surgery.
The bariatric surgery community utilizes a number of procedures to promote rapid and hopefully permanent weight loss. Some of the earlier methods have been abandoned or modified due to unacceptable morbidity in the post-operative period, both immediate and long-term. Currently used techniques most often decrease absorption of calories or promote early satiety (feeling of fullness), or some combination of the two.

Unfortunately, the decreased absorption of calories is accompanied by decreased absorption of macro- and micro-nutrients. This often leads to nutritional deficiencies of varying degrees of severity. Sometimes these deficiencies may go undetected for some time, until they have had a profound effect on the patient. Many of these deficiencies can be very difficult to treat (refractory) once established. They may cause significant derangement in the patient’s physical, mental and emotional health.

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Tags: anxieties, bariatric surgery, calcium, caloric, calories, cosmetic surgery, depression, emotional distress, endocrine system, hair follicles, hair loss, hyperparathyroidism, iron, magnesium, medical therapy, metabolic, nutritional, obesity, patients, physiological, protein, psychological, psychotherapy, surgery, vitamin, weight loss, zinc

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Now that there is a genetic test to predict your hair loss, is it possible to simply wipe out this gene and thus put a halt to hair loss?

The genetic test is a test for a marker on the X chromosome that predicts hair loss. We do not know if this gene has anything to do with the cause of hair loss. Hair loss is multifactorial. This is probably why you see a few people who respond favorably to certain topical or oral medications while others don’t seem to respond at all. It is more probable that hair loss results from the interaction of multiple genes. It remain unknown what would happen should we alter a single gene. The consequences might actually be negative.

Tags: future, genes, hair loss, hair loss pattern, hair loss solutions, predict, x-chromosome

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I see on your website that you offer a Hairdx test, what is it and how is it helpful to prevent hair loss?

Hairdx is a genetic marker test to determine your risk for hair loss and to determine whether you might not loose your hair. The test evaluates a specific marker on the X chromosome. As you know, the X chromosome arises from the mother of the male. The marker is on the androgen receptor gene located on the X chromosome. Men who carry this gene variant are at a 60% risk of loosing their hair by age 40. Men with the less common genetic variant have a greater than 85% probability of not going bald before age 40. Ninety-five percent of bald men have the high risk androgen receptor variant.

It is known, however that androgenetic hair loss is polygenic in inheritance. One receives genes from both the mother and the father and it is felt that hair loss is not sex linked. This means that you can receive the risk for hair loss from either the mother or the father, but the specifics are still poorly understood. To date there are 4 major genes that determine your risk for hair loss, age of onset, eventual hair loss pattern, and rate of hair loss progression.

This test is only a prediction of future hair loss. It does not rule in or rule out the probability of future hair loss entirely. If you test positive, you should be evaluated for other signs of hair loss. These include miniaturization of the hair follicles and loss of hair shaft pigment. If you show signs at any point after testing positive for the marker, you might want to consider medical therapy such as Propecia or Minoxidil. You might also want to begin using Haircycle shampoo and conditioner to prolong the anagen duration, which is known to slow down the rate of hair loss progression. Instituting medical therapy at an earlier stage in life may limit the rate of your progression and the ultimate degree of loss you will suffer from.

We are happy to send a test kit to you if you like. The cost of the test is 149.00. This is the first diagnostic test to help you determine if hair loss may be in your future.

Tags: genes, hair follicles, hair loss, hair loss pattern, hairdx, medical therapy, minoxidil, pigment, Propecia, x-chromosome

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What are the common used hair transplant techniques and how are they different from CIT?

Hair transplant surgery can be done using several different techniques, including old-style plugs, strip harvest, The Cole Isolation technique (CIT), and body hair transplantation (BHT). Plug harvesting is only mentioned for historical reasons; it is a very poor technique and should not be used in the modern era. Strip harvest using only two incisions became popular during the 1990’s, and is still widely used today. CIT is very new, having been used only the past 5 or 6 years, but is beginning to challenge strip surgery in some areas as a procedure with much less scarring. BHT is used mostly for adding hair to scalp hair surgeries, and in patients who have had much of their scalp donor hair removed. Scalp hair is always better, and BHT is seen as a complement to scalp hair.
Hair grows on the scalp in separate units, which are known as follicular groups or follicular units. They contain 1, 2, 3, 4, or rarely 5 or more hairs. During the CIT procedure, a special tool is used to take these hair groups out one at a time. The advantage is that no long incision or wound is made in the scalp, and therefore no long scar results. Also, there is very little pain after the surgery, and the hair grafts come out ready to place in the balding areas, with no trimming needed. Sometimes there are tiny white dots left where the hair s were taken out; these are very small and if the hair is more than ¼ inch long or so, the dots are invisible.
These hair grafts are then placed into tiny slits or holes made by the surgeon into the balding or thinning hair areas; in about 3 or 4 months the first of the “new” hairs begin to sprout and by the end of a year, the full result of the transplant will be seen!

Tags: balding, bht, cit, follicular groups, Grafts, hair transplant surgeon, hair transplant surgery, incisions, patients, plugs, scalp, scarring, slits, strip, the cole isolation technique, thinning hair

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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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