Hair loss, or alopecia, is a very common condition that can affect both men and women. There are many causes for alopecia, but the most common cause is the male pattern hair loss, also called androgenetic alopecia. It is an inherited and progressive condition that may start as early as your teens or later in life.
Diagnosis of androgenetic alopecia in men is made through careful history and examination. Common features of androgenetic alopecia are the characteristic pattern of hair loss, family history of hair loss and the characteristic thinning of the hair (miniaturization).
Many women, like men, are also affected by androgenetic alopecia. However, the female pattern hair loss typically presents as thinning of hair at the front or the top of the scalp.
For women with hair loss, the physician may consider and rule out other potential causes. Various medical conditions such as pregnancy or hormonal changes, thyroid conditions, anemia, and some medications are known to cause hair loss. Psychological stress or autoimmune conditions may also lead to hair loss. Once the cause has been identified, medical treatment should be directed toward correcting that medical problem. Frequently, that may lead to resolution and recovery of hair loss.
Management of Hair Loss
Numerous options are available for patients with androgenetic alopecia. Following the graduated approach, the simplest option is to use hair prosthesis to camouflage the hair loss. There are three types of hair prosthesis: hairpieces (also known as toupees), wigs, and weaved hair-extenders. Although contemporary hair prosthesis is constructed with high-quality natural hair material, it may not always be the right solution for everyone. Many people simply prefer to have restoration of their own natural hair.
There are many medications and supplements that promise to help grow and prevent further loss of hair. Currently, finasteride pill (Propecia®), and minoxidil topical agent (Rogaine®) are the only two FDA-approved medical treatments for androgenetic alopecia in the United States. Independent clinical trials have shown that both medications are effective at preventing further hair loss and improving growth of new hair in some patients. Because these two medications work under different mechanisms, patients may combine the two treatments to optimize their outcome. There are some side-effects associated with these medications, and one should discuss with a physician prior to starting on these treatments.
There are various types of hair restoration procedures including scalp reduction, scalp expansion, scalp flap procedures, and the hair transplantation procedure. Over the past 20 years, there has been a spike in the public interest in hair transplantation procedures. This is due to the technical advancements utilizing the follicular unit transplantation technique, which allows seamless and natural appearing result, unlike the “pluggy” results of the past.
The follicular unit transplantation is the gold standard of hair restoration surgery. In hair transplantation surgery, the hair follicles from the area of the scalp that are resistant to androgenetic alopecia are transferred to the areas that are affected by the condition. With careful planning and meticulous execution, this can be performed to achieve natural appearing restoration at the affected area with minimal changes at the donor site.
There are two types of techniques for harvesting the follicular unit hair grafts: the strip harvest method and the follicular unit extraction method. Because each technique has its advantages and disadvantages, prospective patients should have a conversation with their hair restoration surgeon to determine the ideal method specifically tailored to their need.
The Hair Transplantation Surgery
Follicular unit hair transplantation – Current state of the art in hair restoration surgery
Many patients are concerned about the “doll’s head”, or “pluggy” appearance seen in some people who have undergone hair transplant surgery. Such artificial results were due to surgery performed from the past when the punch graft hair transplantation was a series of round punches of the hair-bearing scalp (hair plugs) that were harvested and transplanted to the bald area.
Over the past decades, hair restoration surgery has evolved to the follicular unit transplantation era. During the follicular unit transplantation, we harvest and transplant the follicular units consisting of 1-4 hairs that are bundled naturally as a group. This is the smallest unit of hair follicles that can be transferred to another site without compromising its survival. The harvest, preparation, and implantation of the hair follicular units are the technical aspect of the procedure. The artistic aspect of the procedure involves the surgeon’s ability to interpret and design an individualized and natural hairline and density that will last a lifetime. Because hair loss is a life-long process, it is critical for the surgeon to recognize that the goal of hair restoration should consider how the patient will look 10 or 20 years after the surgery, and not just one to two years ahead.
What Does The Surgery Involve?
Typically, the hair transplantation surgery is performed under local anesthesia and mild sedation. This means that the patient is not put to deep sleep and does not use a breathing tube during the procedure.
Harvesting the donor hair
During the harvest, donor hair is carefully harvested from the back and the side areas of the head. The hairs from these areas have fundamentally different characteristics than the hairs of the rest of the scalp. They are resistant to the androgen-mediated hair loss, and when these hairs are transferred to the areas that are affected by the androgen-mediated hair loss, they will retain their innate tendency to resist the hair loss.
Following the harvest of the donor hair in a narrow strip just over ½ inch in width, the wound is closed meticulously with a special technique to hide the resultant scar. The goal is to allow surrounding hair to grow through the scar so that hair will camouflage the scar and render it essentially invisible to observers. The harvest and closure of the donor hair should take no more than an hour.
Preparation of the follicular unit grafts:
From the donor hair strip, thousands of individual follicular units are meticulously isolated with microscope-assisted dissection. Typically an experienced and well-coordinated team is needed to perform this task.
Recipient Site Creation
This is perhaps one of the most-important steps of the surgery. The surgeon must consider the angles, directions, pattern, density, and patient’s goal when designing and creating the natural appearing hairline. Finely modified hypodermic syringes are utilized to create the sites where hair grafts will be placed.
Hair Graft Placement
The prepared follicular unit grafts are gently inserted into the recipient sites. This is the most time-consuming part of the procedure. Throughout the procedure, while the patient is comfortable, he/she is not under deep sedation. Frequently, we will pause as needed to allow the patient to go to the bathroom break or have a small snack.
After the surgery:
The patient may go home or to a hotel nearby the clinic for the night after the surgery. The patient returns to the clinic the following morning to be examined by the surgeon to ensure everything is appropriate. The next scheduled visit will be on the tenth day to remove the sutures at the back of the head.
The patient may resume normal activity and work as early as the day after the procedure. Expect some crust and scabbing on the head and swelling at the forehead for up to a week, but he/she may cover that with a hat. One should avoid rigorous exercise for two weeks. Starting the day after the surgery, the patient begins gentle hair wash. Rogaine and regular shampoo can be resumed 10 days after the surgery. It takes about three to six months before one can notice an appreciable new hair growth.
How Much Does Hair Restoration Cost in Syracuse?
The cost of routine hair transplantation surgery may range from 4,000 to 9,000 dollars or more. The actual cost depends on the size of the transplantation needed for each patient. Having our own private on-site surgical facility allows our patients to save money by including all the before and after care, operating room costs and the local anesthetic fees together. Natural Face™ Clinics accepts all major credit cards. We can also assist if you need financing through CareCredit®. Please call and ask for our concierge services for assistance with financing.
Double board-certified Facial Plastic Surgeon Dr. Sang W. Kim at Natural Face Clinics specialize in aesthetic enhancement of the face, head, and neck, exclusively. Patients come to see us from the Syracuse metropolitan area and Central New York area including Ithaca, and Rochester. At Natural Face Clinics, we specialize in restoring the youthful neck contour, tired appearance of the brows and eyes, and skin laxity. We offer customized treatment, both surgical and non-surgical, including facelift, eyelid surgery (blepharoplasty), nose surgery (rhinoplasty), brow lift, neck lift, and skin resurfacing. Find out more by scheduling your personal consultation today.