Innovations in Hair Restoration Surgery
There is medication on the market today that is effective in slowing hair loss for both men and women. It has long been known that testosterone levels in men contribute to male pattern baldness. The medical term for the testosterone in question is dihydrotestosterone, or DHT. It causes balding in men who carry male pattern baldness genes.
Medication to Halt Balding
A drug called finasteride which has been effective in fighting prostate cancer is also effective in halting hair loss in men because it reduces the DHT level by 65%. Finasteride is marketed under several names including Proscar, Propecia, Fincar, Finpecia, Finax, Finast, Finara and others. It has proven to be effective in stopping hair loss in 85% of men. Propecia, in particular, has been approved by the FDA for usage in halting male pattern baldness and is used by dermatologists.
While dermatologists have clear pharmaceutical options for halting baldness, there are also techniques now in use for hair restoration that new technologies have made effective as well. The notion of transplanting hair from other areas of the body to the scalp has been a reality since it was first attempted by a Japanese physician in the 1930s. However surgical practices today have made it possible to transplant single follicles or groups of follicles in a seemingly random pattern and in a manner that ensures their continued health.
Punch Grafts Become the Surgical Standard
Fifty years ago a Dr. Norman Orentreich of New York City introduced the use of “punch grafts,” which in his case meant 4mm wide grafts containing hair follicles being transplanted to the scalp. In 1992, Dr. Bob Limmer developed a method of dissecting follicles (follicular units) from a donor strip of scalp taken from the back of the head. His method is the standard for hair transplant today, referred to as a follicular unit transplant or FUT. Dr. Limmer captured follicular units containing up to ten hairs that were transplanted in 4mm grafts into a 3.5mm “punch graft” site on the scalp. Both skin and fat were transplanted; the whole process took 3-4 sessions of 50-100 grafts each, separated by two to three months healing time. It was a year’s procedure.
Follicle Grafting Becomes Microsurgery
Today technology has advanced the grafting process to the point that 95% of the follicles transferred survive and grow into healthy hair. The state of the art hair restoration graft today is actually microsurgery that can include one thousand to three thousand FUTs during a four to eight hour surgical procedure. The grafts heal in four to five days and are difficult to detect in a few weeks.
This technique requires surgical assistants working next to the doctor preparing grafts by identifying follicle clusters, preserving them and cutting away scalp tissue around them. The FUTs are then placed into tiny slits made in the scalp using a miniature scalpel, which cuts a slit 0.8-mm to 1-mm wide. Those micro-incisions are staggered to provide a random appearance. The grafts themselves are taken from a strip of scalp tissue a centimeter wide and long enough to provide sufficient grafts.
A method called the trichophytic closure has made it possible to hide the incisions for the donor strip almost completely. A tiny, shallow wedge is cut from one side of the incision. When the incision heals hair grows through the scar tissue, effectively hiding it.
And, a new practice for harvesting hair follicles called follicular unit extraction (FUE) makes it possible to take.75-mm to 1-mm-diameter skin punches to remove one follicular unit from anywhere on the body. Due to this technique body hair is now being transferred to the scalp by surgeons specializing in hair restoration and there is no need for a strip of donor scalp.
