Hair Restoration Blog

Q:

I read that some clinic’s use hair from the nap of the neck to help create a more natural hairline. Is this a technique that you practice or something you think is not necessary?

A:

The neck hair is not permanent in many people. This means it too can be susceptible to the adverse effects of DHT as a person goes through the process of balding by aging.

We do not use neck hair nor do we recommend it for hair transplants. If hair transplantation is done with the right design and standard techniques, it should not be detectable any way. It is not necessary to take hair from the areas with thinner hair to achieve a natural looking hairline.

Often times we at US Hair Restoration receive questions about the difference between the FUT Strip Method and the FUE procedure. Some will make claims that one option is superior, while the other is inferior. Both hair transplant techniques are done in US Hair Restoration and have their own adavntages and disadvantages.  Here is a list of reasons supporting both the strengths and weaknesses of the FUT Strip Method and the FUE:

The FUT Strip Method

• Allows the hair transplant surgeon to transplant a larger number of grafts in one session. Most people who have never had a hair transplant surgery can have maximum results in only one procedure.

• Allows the surgeon(s) to process and harvest the grafts under a microscope minimizing the level of damaged hair follicles.

•  Can be achieved at a more rapid speed than the FUE.

• What can be achieved in one FUT strip procedure can take 2-3 FUE surgeries.

• The number of damaged grafts might be greater for certain patients which undergo the FUE procedure because of their unique hair characteristics. People with wavy or   curly hair may have a higher risk of transection than patients with straight hair. A FOX test may be performed on patients with curly hair or wavy hair to determine whether or not they make good candidates for an FUE procedure. A FOX test is a small FUE procedure which helps to determine the level of damage to follicular graft before proceeding with a complete FUE transplantation procedure.

• The FUE requires more tedious labor and the cost for performing an FUE is usually more than a strip hair transplant.

• FUE procedures require a highly skilled operator and create a technical challenge for less experienced technicians who don’t have good hand-eye coordination.

The majority of the patients which receive a hair transplant with the strip method are going to have a linear scar on their donor area.  This scar can be minimized with certain surgical techniques such as the trichophytic closure, but it can never completely be eliminated. FUE hair transplant procedures offer unique advantages for differing patient circumstances.

FUE Procedure

• The scar visibility is slightly noticeable to completely non-existent with the FUE.  It may leave some miniature spots because of a lack of hair in that particular area or de-pigmentation, like a small dot which is lighter when seen close up.

• Hair can be kept short after the Hair Transplant surgery in front and back.  Any types of spots or de-pigmentation are not easily detectable.

• There is minimal pain for most patients and they don’t need pain killers after their hair transplantation.

• The surgeon can get donor hair from different parts of the body which the strip method has limited areas to take from. Areas such as the temples, beard and other body hair is included in this.

• The surgeon can choose the specific type of grafts to harvest.  When a special type of follicular unit is needed, this option is very good because the surgeon can choose the exact number of specific grafts to transplant. This is great for touch up work on the frontal hairline which needs single hair grafts, or for filling an isolated crown balding spot that does not require any singles.

• The contrast between high hair density and bald areas can be decreased by the FUE. Restoring hair in a scar only needs hair added to the scar, and the FUE would help to minimize the contrast between the scar and the surrounding areas more easily.

Despite of all above advantages and disadvantages about the two methods discussing them with a good hair transplant surgeon is a good starting point to find out what it the best option for you.

Using hair from other parts of the body for transplantation into scalp has been used for many years.  Unfortunately though, the change in the life cycle of body hair from different areas of the body has caused the body hair to stay as the last option for scalp hair restoration.  Body hair has long resting phase and short growth phase which means that most of the transplanted hair will stay in resting phase without having visible hair growth.

Comparison of scalp (left) vs. facial (right) hair: Note the difference in density of hair per surface area and the average number of hair in each follicular unit. Scalp hair is denser with more hair per grafts (over 2hair/graft) while beard hair is less dense with fewer hair per grafts (1-2 hair/graft)

Facial hair such as beard and mustache hair on the other hand has a longer growth phase and shorter resting phase.  That is why men can grow their facial hair to become really long.  Facial hair is also thicker than scalp hair in most people.  Thicker hair could be translated as more bulk of hair after hair transplantation.  Both longer growth phase and thicker hair shafts make beard hair a better option for scalp hair restoration in comparison to body hair transplant from other areas.

There are two problems with with beard hair restoration.  One is that they are very sparse and removing hair only needs to be done through a strip procedure.  The other problem with using facial hair for scalp transplant is that the facial follicular units are having fewer number of hair per unit that means less hair per grafts removed with FUE techniques.

Beard transplants are gaining popularity recently with newer techniques for extraction of hair (FUE) and it can be a great alternative to scalp hair for transplanting to the balding area in people who do not have good quality scalp hair.

Q:

I am a 23 year old medical student with about 4 years of hair loss history. I have diffuse thinning with very aggressive frontal hairline loss. I would be looking to do 2-3 procedures at 2000 grafts each FUE style from my beard and chest area. But my body hair and beard hair seem to be just fine. I have had all of my bloodwork done to rule out any systemic problems thats causing this odd pattern diffuse hairloss (autoimmune alopecia is also ruled out by 3 dermatologists).

A:

Before proceeding with a hair restoration surgery, we have to properly determine your type of hair loss and candidacy for a hair transplant based on your history and diffuse hair loss.  Many people who have diffuse hair loss including the hair on the sides and back of their scalp may have a condition called Diffuse Unpatterned Alopecia (DUPA).  This condition can be mistaken with hair loss as a result of other systemic medical conditions like iron deficiency or possibly due to thyroid or other hormonal imbalances.  Body hair transplants through FUE harvesting techniques can be considered for those patients who do not have the option of scalp to scalp hair transplant, but it certainly comes as the last option considering the very short growth phase in hair cycle for body hair as opposed to scalp hair. Beard hair may be a better option in some patients, but all individual options need to be considered after a complete evaluation of patient’s supply and demand of hair.

* More information on body hair transplants and its results in contrast to that of scalp hair transplants, please visit Hair Restoration Blog.

Q:

My hair loss is ruining both my life and my family’s lives. I go to the XXX school of medicine in XXX and would be flying over to get the procedure done. I wanted to see if we could discuss a large FUE treatment from my body and beard area for transplantation into the balding areas of the scalp to end my hair loss for good.

I look forward to hearing from you,

Cheers

A:

As I have previously stated before here in my blog, body hair can be considered as an alternative method for hair restoration as long as you, the patient, understands that the end result is not going to be comparable with a scalp hair transplant due to smaller final length of hair and short growth phase (Anagen) as opposed to long resting phase (Telogen) that are characteristics of body hair.  In other words, you may only see a portion of transplanted hair follicles in growth phase while the remainder stay in resting phase without maintaining a visible hair shaft.

Beard hair transplantation could also be another option, which is typically closer to scalp hair in many patients and has a longer growth phase (which is why it grows to become longer in comparison to body hair).  However, any of these options have their own pros and cons and patients should be evaluated for each treatment plan based on their needs and only after a complete evaluation by a hair transplant surgeon is performed.

Q:

I am a 27 yr old male and have very low growth facial hair in the mustache area. Please advise, are hair transplants for mustaches possible? How many grafts are needed? What is the going cost of a hair transplant like this?  What about time taken for growth?

A:

People may have facial hair loss due to: scaring and other scar conditions, or they may just not have the ability to grow their mustache or beard genetically.  In most cases, facial hair can be successfully restored with a hair transplant using scalp hair through follicular unit transplantation.  Beard hair can also be used for transplantation into the mustache area if there is a mismatch between the thickness of scalp and beard hair shafts. In this process, we use either strip follicular unit transplants or FUE (Follicular Unit Extractions) to harvest hair for mustache hair restoration. If we have to remove hair from the beard area, FUE is usually preferred to avoid scarring on the hair growing area of the face. The number of needed grafts is determined by the width of the upper lip as well as the shape that looks appropriate and proportional with the other facial features.  The cost of facial hair transplantation for mustaches and beards generally follows the same per graft cost as scalp hair transplantation.  As for the final outcome, results of a mustache hair transplant can be seen as early as 4-6 months following the hair transplant and may continue improving during the first year after that.

Q:

I have heard of FUE transplants with relatively high-quality hair coming from the neck area, and from the beard. It seems like this could dramatically increase the number of grafts available for patients, at least for the hairline and front.  Then, body-hair (chest, back…), which I think are lower quality (but very abundant on me!), could possibly be used for the crown area. I would like to take as few hair from the back of the head as possible, and as much as possible from other areas.
Doctor, what do you think of this plan? Would it be a good strategy to pull from other sources rather then the scalp for donor hairs? What would be the costs involved?

A:

Follicular Unit Extraction (FUE) can remove hair from anywhere in the body as long as you are tested positive for FOX for those areas.  Neck hair is not the best option for hair transplantation because those hairs may fall out at higher ages of some patients. We can use body hair for hairline, and front or even the crown, but you may need multiple surgeries to obtain adequate density from those areas with body hair.  As we discussed before, body hair has a long resting phase in relation to its growth phase.  So you will have more follicles in resting phase (telogen phase) that do not have any visible hair in comparison to the ones in growth phase (anagen phase) that provide you with actual hair and give you coverage. We do FUE transplants in our California hair transplant centers on a regular basis.  FUE procedures are more labor intense and more time consuming so the cost of them are almost double in comparison to regular strip hair transplant procedures.

(more…)

Follicular Unit Extraction (FUE) – Advantages or disadvantages

My patients always ask about advantages and disadvantages of Follicular Unit Extraction so I thought this topic makes a good post for the blog. Before going over these points I have to say, although we at US Hair Restoration offer the most advanced techniques of FUE nationwide, most of our patients are still being transplanted by strip technique and I don’t recommend FUE to everyone and select my FUE patients very meticulously. Here are the main reasons why we do recommend FUE to some people and not to everyone.

Advantages

• FUE does not leave a linear scar, which is great for those who want to wear their hair very short on the back or the ones who may need to shave their head in the future (like actors).
• FUE has a more comfortable healing process with decreased healing time.
• No restrictions in physical activities for those who want to do strenuous exercise right after FUE procedure.
• FUE is a viable alternative for those who have tight scalp that makes strip surgery risky or impossible.
• Follicular unit extraction makes it possible to harvest hair from body, beard or almost everywhere else.
• FUE is very useful when we need limited number of grafts like for restoration of eyebrow hair.

Disadvantages

• The biggest disadvantage of follicular unit extraction is that the maximum follicular unit graft yield is lower than when it is done with strip technique due to higher rate of follicular transection compared to the strip technique.
• Although linear scar is not present after FUE, small punctuate scars will be there that may make future FUE hair transplant surgeries more difficult or impossible.
• Not everyone is a candidate for FUE and patients need to be tested with FOX before proceeding with the surgery.
• FUE procedure takes much longer to perform compared with strip FUT procedure.
• FUE is more laborious thus it cost more compared with strip technique hair transplants.
• In FUE, we have more chance of burying grafts that increases the risk of having folliculitis (tiny inflamed cysts under the skin) on the donor area.

Q:

Is Hair cloning or multiplication being done anywhere yet?

A:

Hair cloning or multiplication has been in the news in the last few years. I prefer to use the term hair multiplication, rather than cloning because cloning refers to production of genetically identical organisms. Dolly the most celebrated sheep was the product of first cloning. When it comes to hair, we do not really clone the cells, but we culture them and try to get a whole organism from cultured cells. Unfortunately the process of culturing hair follicle cells has not been as simple as some other tissues in human body. The complexity of hair physiology is due to participation of many different stem cells in development of each hair follicle. In this process, we do not multiply genetic material or DNA of cells.

Hair cloning news

Hair multiplication if become a reality could bring about a great opportunity for bald people with violated donor scalp who cannot be good candidates for hair transplantation with current techniques. Despite our enthusiasm about hair multiplication, hair cloning news in last few years has not been filled with many success stories.

Hair cloning 2007

Year 2006 intercytex company announced that they are going to start phase 3 of hair multiplication study soon. Hair cloning has been in the news and many people are eagerly following that news to see when and how they can get a full head of hair using hair cloning techniques. Unfortunately, cloning hair has not been going that well and in last few years we only had limited research results on hair multiplication in animal models and in human. Here is the question that people usually ask me: Is hair cloning being done anywhere yet? And my answer usually is: Not except on experimental levels. Several investigations are in process on hair multiplication field and hair stem cell research.

Hair cloning 2008

Hair multiplication or as people call it hair cloning is a method that allows us to culture hair follicles and multiply it so we can increase the final number of hairs. So far, we know that it is doable on animals, and there are some reports of its feasibility on human volunteers. Safety has been one of the biggest questions on any research involved with stem cells. Stimulating growth of stem cells has always raised the flag for possible tumor formation. In year 2008, we should witness some results of the phase 3 studies on the procedure. During this year or in next few years, we should have a better understanding of the effectiveness and safety of hair multiplication. I know many of my patients are following hair cloning news carefully. Unfortunately, hair multiplication news has not been very fruitful in last year, but the process is complex and one way or another it will become clear in next few years that we can or cannot use hair multiplication methods in hair restoration surgeries.

Searching for the best Los Angeles hair transplant surgeon may not be an easy task, but Los Angeles has always been a referral center for most cosmetic surgeries, even though hair transplant surgery is one of the newer branches of cosmetic surgery. You can find a wide variety in style and levels of Los Angeles and Beverly Hills hair transplant surgeons. Some of the most updated hair transplant surgeons practice in Los Angeles and San Diego, California, but you can also see lousy surgeries done by some hair transplant surgeons. Overall, hair restoration surgery like any other cosmetic surgery is a buyer‚Äôs beware market, and one must be careful not to fall into the trap of signs such as “Number one Beverly Hills hair transplant surgeon” or “the most experienced Los Angeles hair transplant surgeon”. You can see similar advertisements and a lot more like Extreme make over hair transplant surgeon or doctor 90210.

The good news is that today, most hair transplant surgeons offer free initial consultation. It is importantto take advantage of this situation and shop around. It is your look and your desire to live with it for the rest of your life after all. It is not enough to visit several hair transplant doctors; you also need to educate yourself on hair transplantation process, surgical techniques and hair transplant surgeon’s background before visiting the doctor. This way, you can appreciate a good technique and knowledgeable doctor when you see one while you can find the most affordable hair transplant. US Hair Restoration – a Los Angeles hair transplant surgery center offers free physician consultation for everyone. We offer state-of-the-art hair transplant surgery with exclusive follicular unit transplants (FUT), mega sessions for people with extensive hair loss and follicular unit extractions (FUE) or noninvasive hair transplants that does not leave an scar in the donor area.

Los Angeles is Hollywood and in Hollywood “appearance” is everything. Modern hair transplant surgery with undetectable results has become a demanding field in Southern California in last few years both because of the number of people looking for hair restoration surgery and the ones looking for the best hair transplant surgeon in Los Angeles, Beverly Hills and Southern California over all. Many people travel the world to get their hair transplant surgery done in Los Angeles or Beverly Hills. Los Angeles is and will probably always be the Mecca of hair transplant surgery for people who cannot accept anything but the best.