Double board-certified Facial Plastic Surgeon Dr. Sang W. Kim of the Natural Face™ Clinics, specialize in hair transplant surgery for patients residing in the Syracuse metropolitan area and Central New York area including Ithaca, and Rochester.
More than half of men will experience some degree of hair loss by the age of 40. Some men will experience hereditary hair loss as early as in their late teens. The onset, pattern, and extent of the hair loss depend largely on their hereditary traits.
While there are numerous causes for hair loss in men, the most common cause of hair loss in men is the hereditary male pattern baldness, also called androgenetic alopecia. This type of hair loss presents with characteristic pattern of hair loss typically involving the front and the top of the scalp. Gradually the baldness at the front (frontal and frontotemporal recession) and the top (vertex) of the scalp will progress until a band at the back of the head is the only hair remaining.
This characteristic hair loss pattern is caused by male hormone called dihydrotestoterone (DHT). DHT is a naturally occuring by-product of testosterone, and while it has important function particularly during the male fetal development, one of its “side-effect” is its deleterious effect on scalp hair follicles in adults. We know that the hair follicles affected by DHT are found at the front and top of the scalp, while the back of the head is largely resistant to DHT-mediated hair loss.
Treatment options
For men with hereditary hair loss, several treatment options are available. Following the graduated approach, the simplest option is to hide the balding area. Some of the contemporary hair prosthesis is constructed with high quality natural hair material and can very effectively hide the appearance of hair loss. For more information, please go to Other non-medical / non-surgical options.
Numerous medications and supplements 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. Even patients who plan to or have undergone hair transplant surgery will benefit from being on these medical treatments. There are some side-effects associated with these medications, and one should discuss with a physician prior to starting on these treatments. For more information, click to the section Medical treatment for hair loss.
Characteristic male pattern baldness will likely progress throughout one’s lifetime.
Introduction to hair transplant surgery
Follicular unit transplantation is currently the gold standard for hair restoration surgery. In the past, hair transplant surgery consisted of implanting series of large punch grafts, which led to artificial results and the unappealing term “hair plugs”.
With the modern follicular unit transplantation, individual follicular units consisting of 1-4 individual hairs are transferred to provide a natural appearing result without the tell-tale signs of hair transplantation.
During hair restoration surgery, we are transferring the hair from the area of the scalp that are resistant to androgen-mediated hair loss to the areas that are affected by the androgen-mediated hair loss. The transplanted hair will retain their resistant property after they have been transferred to the new area of the head. With careful planning and meticulous execution, this can be performed to achieve a natural and lasting result.
Modern hair restoration surgery can be categorized into two techniques for harvesting the follicular unit hair grafts : the strip harvest technique and the follicular unit extraction technique. Since each technique has its advantages and disadvantages, patients should have a conversation with the surgeon to determine the right approach tailored to their needs.
During the follicular unit transplantation, the surgeon harvests and transplants 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.
Since hair loss is a life-long process, it is critical for the surgeon to anticipate the future pattern of hair loss, and determine a treatment plan that will allow a patient to look natural long after the surgery is finished. But the patients should also recognize that since hair loss is an ongoing process, they may consider another hair transplantation session down the road.
Our surgeons offer both types of hair restoration techniques
The Strip Harvest Technique
This is considered the traditional form of follicular unit hair transplantation. From the back of the head, a strip of hair-bearing scalp is removed. The horizontal strip is typically narrow (about 1 cm wide), but may extend from ear to ear depending on the amount of proposed hair transplantation. Following the removal of the strip, the wound is closed meticulously with special suturing technique to optimize healing with minimal scarring. The suture will be removed 10 days after the surgery. Once the area heals, some hair will grow through the linear scar while the surrounding hair will camouflage the linear scar rendering it nearly undetectable as long as the patient keeps an adequate length of hair in the back of the head (about an inch or longer). A key advantage of strip harvest technique, compared to the follicular unit extraction technique, is that same amount of hair can be transplanted at a lower cost to the patient.
Follicular Unit Extraction Technique
During the follicular unit extraction technique, instead of removing a strip of scalp, the individual hair follicle is removed from the back of the head and transplanted. In the past, the surgeons have used manual instruments (1mm or smaller punch grafts) to harvest these hair follicles resulting in prolonged and labor-intense process.
Our practice has incorporated the NeoGraft® technology which is a minimally invasive, machine-assisted hair restoration procedure. We are the first and the exclusive hair restoration practice in Syracuse / Central New York area to provide this technology. NeoGraft® system allows safer, effective, and more efficient way to perform follicular unit extraction. Compared to the traditional strip harvest technique, there is no risk for a linear scar on the back of one’s head. Since no incision is made in the scalp, we do not need to use sutures or staples during the procedure resulting in quicker recovery time.
What is involved in hair transplantation?
Anesthesia for the procedure
Our 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 need a breathing tube during the procedure. We provide as much local anesthetic to achieve comfortable setting for the patient throughout the day. Typically, a patient will take a nap or two during the procedure.
Harvesting the donor hair
During the initial phase of the surgery, 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 about 1 cm in width, the wound is closed meticulously with a special technique to hide the 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. 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.
Harvesting follicular unit hair graft using NeoGraft® system
Recipient Site Creation
This is perhaps the most important step of the surgery. The surgeon designs and creates an individual site where the hair grafts will be placed in. The surgeon must consider the angles, direction, pattern, and patient’s goal when designing and creating a natural appearing hairline and the density. 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 or have a small snack.
AT THE END OF THE DAY
At the end of the day, patient’s head will be wrapped in a dressing. Patients may bring a loosely fit hair gear or scarf to wear over the head dressing as long as it does not touch the area where grafts were placed. Because the patients were under mild sedative during the procedure, they cannot drive home on their own. Most procedures typically take the morning and part of the afternoon and patients will be discharged either home or to the hotel via shuttle (our office can arrange the hotel stay at a special rate). Patients will return to our office the following morning for removal of the dressing, and we will review thepost-operativee instruction together.
Even though local anesthesia and only mild sedation are necessary, patients are closely monitored throughout the procedure.
Follicular unit graft ready for transplant. At the top, notice that individual follicular unit graft is naturally found in a bundle of one, two, or three hair follicles.
Meticulous slit creation incorporates the hair density, the angle of the hair departure, and pattern of the hairline to recreate the
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 or have a small snack.
AT THE END OF THE DAY
At the end of the day, patient’s head will be wrapped in a dressing. Patients may bring a loosely fit hair gear or scarf to wear over the head dressing as long as it does not touch the area where grafts were placed. Because the patients were under mild sedative during the procedure, they cannot drive home on their own. Most procedures typically take the morning and part of the afternoon and patients will be discharged either home or to the hotel via shuttle (our office can arrange the hotel stay at a special rate). Patients will return to our office the following morning for removal of the dressing, and we will review thepost-operativee instruction together.
How long does it take to recover from follicular unit transplant surgery?
AT DONOR SITE (BACK OF THE HEAD)
If you had the traditional strip harvest procedure, you would have a horizontal wound on the back of the head with suture closure. The suture will be removed 10 days after the surgery. If you have long hair (>1 inch in length), the hair above the wound should rest over and essentially make it imperceptible immediately after the surgery.
Donor site 10 days after the strip harvest procedure. Patient just had the sutures removed at the back of the head. Patient had 1,600 graft transplantation.
If you had a NeoGraft® (follicular unit extraction) procedure, the only visible signs at the donor site are the shortly trimmed hair-cut with numerous small dots where grafts have been taken from. The donor site heals quickly and should be almost imperceptible within 1-2 weeks once the trimmed hair grows back.
The hair at the donor site is shaved in preparation for the procedure
Donor site 1 day after the procedure. Notice that surrounding hair camouflage the donor site.
Donor site 5 days after the procedure.
AT THE RECIPIENT SITE (WHERE GRAFTS WERE PLACED)
The patient may resume normal activity and work as early as the day after the procedure. Expect some crusting and scabbing where the grafts were placed for the first few days, but the patient may cover that with a hat or scarf. Some patient may notice swelling around their forehead or brow area. 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. Hair coloring can resume 4 weeks after the surgery. It takes about three to six months before one can notice an appreciable new hair growth.
Patient wishes to increase the hair density and restore the front hair line.
One day after the procedure. Notice the small crustings at the transplanted site.
Five days after the procedure. Minimal residual crustings seen.
What is the cost of hair transplant surgery in Syracuse?
The cost of hair transplantation starts at around $5,000 for a small session. The actual cost will depend on the type of procedure, characteristics of patient’s hair, and the amount of hair that the patient elects to restore.
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.
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