Hair Restoration Blog

FUE Research Committee

International Society of Hair Restoration Surgery established a FUE Research Committee at its latest annual scientific meeting in the Bahamas.  The new committee is solely focused on Follicular Unit Extraction (FUE) hair transplant procedures and the techniques that could be utilized to improve the quality of the FUE procedures. The FUE committee will examine the modern methods of FUE procedures and also conduct comparison studies with other current procedures and hair restoration techniques. ISHRS’s FUE Committee is comprised of several internationally known figures in hair restoration with distinguished background in research and medical innovations.

Chairman of this committee (Dr. Parsa Mohebi) is in charge of orchestrating this significant effort in setting up studies and multi-center research projects to achieve the goal of this society.

Learn more about the ISHRS FUE Committee aims >>>

Learn more about FUE Hair transplant surgery in this video.

FUE Transplant on the Rise

FUE Transplant Surgery has been transformed in the last few years with emergence of the new techniques of FUE transplantation. These  include automated and robotic extraction devices.  The goal of most these innovative techniques is focused on improving the quality of FUE hair transplantation while minimizing the invasiveness of the procedures. There are new studies that elucidate how FUE grafts should be handled for maximum survival and improved overall results.

We look forward to keeping you updated on the new FUE committee activities.

Report of ISHRS 20th Annual Scientific Meeting

OCT 17-20 2012– Atlantic City, Bahamas

The annual meeting of International Society of Hair Restoration Surgery is the most significant hair restoration meeting worldwide.  This year’s meeting was one of the best in terms of the content of the information discussed.  The meeting was held in Atlantic City, Bahamas.

Hair Restoration Surgery is evolving rapidly with newer technologies that enhance our understanding of hair growth and the tools that help us expect better growth. This year’s conference hot topics had five areas of focus. These topics are reviewed below:

Robotic hair restoration

ARTIS or Robotic Hair Transplantation was actively promoting its robotic arm that helps the surgeon to extract the FUE Grafts for hair transplantation.  The Robotic hair transplant update for 2012 was not as significant as many attending physicians anticipated.  Considering that the robotic hair transplant is being promoted and used in several offices actively for over a year, most surgeons expected to learn more about the scientific evaluations that can differentiate robotic procedures with other techniques of hair restoration.

The doctors who used robot in their offices in the last year discussed their personal experience with robotic hair restoration.  Some discussed that the numbers of grafts have been improved, but there was not a significant evaluation on the quality of grafts to other methods of FUE hair harvesting or to compare the robotic grafts with grafts from strip hair transplants.

Stem Cell and hair multiplication

We have had a few discussions about new advancements in Stem Cell research in 2012.  Some of the familiar faces gave lectures about the status of hair stem cell research and where we are standing on hair multiplication.  At present it appears  that no one has started the phase III level of research.  In practicality this means we are unlikely to be able to have a way to multiply hair in the next 8 or 10 years. Until we hear the phase III level of hair multiplication studies are successfully completed our patience and our practices will be reliant on our present hair restoration methods.

FUE transplantation

Many doctors discussed the increased rate of FUE hair transplantations worldwide.  However, comparing different countries, it is apparent presently FUE is being used mostly in Asia and Europe in comparison to the United States.  I (Parsa Mohebi, MD) presented result of the study of the effects of delay in extracting follicular units on viability of FUE grafts.  I have discussed the conclusion of our study on 3 patients in which FUE grafts were initially punched and then removed in 5, 30, 60 minutes and 4 hours.

This study was the only study conducted  to compare the in-situ viability of the follicular unit grafts.  The study showed that keeping the punched grafts in scalp longer than a few minutes may decrease the survival of the grafts. The results of this study may help the design of the next generation of FUE devices and robotic surgery to try to be more efficient with the time that grafts are punched and before they could be removed from the scalp.

Methods for improving the aesthetics of hair restorations

I had another presentation on the advantages and disadvantages of extracting hair from temporal areas.  I have brought up the “Mad Scientist Phenomenon” which refers to the situations that hair transplant surgeons harvest maximum number of grafts from the donor area on the back and not take any hair from temporal areas in patients who have a high density of hair on the temporal areas. The thickness of hair on the temporal areas may undermine the drastic changes that a hair transplant may have on restoration on the front and top areas.

Finasteride Controversies

Dr. Washenik from Bosley discussed the controversies around finasteride (Propecia).  He discussed the persistent sexual dysfunction controversy and a Canadian lawsuit that could not link the side effects to the medication.   Dr. Sharon Keen discussed that the studies that reviewed the permanent side effects of finasteride did not have adequate objective evaluation of health status in those patients.  There were also some discussions about other side effects of finasteride such as the DHT blocking effects on increased production of testosterone and estrogen that may lead to gynecomastia (enlargement of breast tissue in men).

Seoul, South Korea was the host of the second Annual Meeting of Asian Association of Hair Restoration Surgery (AAHRS), which was held in May 2012. The president of AAHRS, Dr. Sungioo “Tommy” Hwang did an exceptionally commendable job organizing the meeting along with the president of Korean Society of Hair Restoration Surgery Dr. Jung-chul Kim. The meeting was well planned with many well researched and presented lectures including presentations on the advanced techniques of hair restoration surgery such as FUE transplants with new automated devices and hair multiplications methods.

I had the privilege to be one of a select group of medical professionals invited to serve as faculty from the United States. This provided me an opportunity to give two presentations. The first discussed the safe method of hair transplantations and secondly the use of Laxometer and its benefits to patients and the advancement provides in increasing the safety of hair transplant procedures.

Some of the other interesting topics were on the characteristics of patterned hair loss in Asians by Dr. Won-Soo Lee from Korea and female alopecia by Dr. Seok-Jong Lee. The topics related to the ethnic hair loss and the ethnic hair restorations were among my favorite subjects since at US Hair Restoration we have a diverse group of patients in our California Centers including patients of Asian and Middle Eastern ethnicity.

Dr. Parsa Mohebi was one of the invited faculties from U.S. for 2012 AAHRS meeting in Seoul, South Korea..

Another interesting topic that was presented was the “Baldness Gene”. It has been hot subject in the field of hair restoration in last few years. Many people have been focused on the gene therapy techniques in hair restoration or the use of stem cell research in hair multiplications in last decade.

Dr. Moon-Kyu Kim had a very elaborate lecture on “Baldness Gene” in which he discussed the paradoxical effects of androgen hormones on hair growth. Dr. Kim and his group compared the gene expression difference between frontal and beard Dermal Papilla after stimulation with DHT. They proved that the protein DKK-1 is being regulated differently in different area that can be one of the pathways involved in male patterned baldness.

Faculty of AAHRS Annual meeting, Seoul, South Korea, May 2012

Dr. William Rassman was another USA hair transplant surgeon invitee to the AAHRS Annual Meeting. Dr. Rassman discussed his innovative method of Scalp Micropigmentation (SMP) as a useful method to hide baldness in particular patients. He discussed the advantages and disadvantages of the techniques and presented several before and after pictures of the patients with hair loss who were treated with scalp micropigmentation.

Dr. Ali Abbasi, one of the pioneers of hair restoration surgery in Iran, presented the safe methods of removing strip in hair transplant surgeries including the techniques of measuring scalp laxity and the use of the Laxometer. Dr. Jerry Wong who is one of the leading hair transplant surgeons who performs gigasessions also stressed the importance of proper measuring of scalp laxity before performing the surgeries to increase the number of grafts while enhancing the safety of hair transplantations.

Dr. Jack Min Yu from China discussed the intricacies of beard FUE Transplant and the do’s and don’ts of such a procedure. I found this particularly interesting and his research was mostly aligned with what we discovered in our practice.

I would like to express my appreciation to the organizers from Asian hair transplant surgeons for their great hospitality and in particular to our Korean host surgeons who were involved in organizing the session. During my stay in Seoul, I had a chance to see a few historical locations in the city and become more familiar with this beautiful country and its great history. I look forward to the following meetings of the Asian Association of Hair Restoration Surgery in the future.

At the 2011 International Society of Hair Restoration Surgery (ISHRS) Scientific Meeting, the updated statistics for the Hair Restoration industry were released. Hair Restoration continues to be a growing branch in the cosmetic surgery field for decades now.  The new data shows that it continues to be emerging exponentially and in 2010 there was an estimated 279,381 surgical hair restoration procedures, an 11% increase over the 2008 census. The United States alone reported 101,252 surgical procedures in 2010 as well.

The ratio between male to female hair transplantation patients in 2010 was 85.9% to 14.1%.  Since 2004, the number of female hair restoration patients has increased 24% which might be due to the better techniques of evaluation of female hair loss and better methods of determining the eligibility of the women with hair loss for hair transplantation.  Since 2008, eyelash, eyebrow, and face hair restorations procedures increased 14.2%. In the US alone, mustache and beard procedures nearly doubled (1,369 to 2,382).

For more information, check out the ISHRS Practice Census located at: www.ishrs.org/mediacenter/media-statistics.htm

The 19th Annual ISHRS meeting for 2011 was held in Anchorage, Alaska. It was my first trip to Alaska and I was looking forward to seeing the beauties of the largest state in America.  Being very busy with many different activities, it made my time for sightseeing nearly impossible. I was required to be available one day prior to the opening day of the conference to get prepared for the many different events which were to come.

Hair Transplant Workshop

Dr. Mohebi and other faculties teach Hair Transplantation Techniques in ISHRS Meeting Anchorage, Alaska

I was one of the faculties for the surgical workshop. There were many new hair transplant surgeons who came from around the world to this annual scientific meeting to learn more about the art and science of hair restoration. The workshops included topics such as hair line design, cutting, placing, anesthesia, and donor harvesting and I was there to teach the latter course. There was great interaction between the faculties and students as they got the chance to learn the hands on techniques of surgical hair restoration.

Latest techniques of Hair Transplantation

The main thrust of the conference was the lecture series which gave a forum to many lecturers covering multiple topics regarding the many different areas of hair restoration. Since hair transplant surgery is still a relatively new field in the medical world, the greatest emphasis was on new technologies in hair transplantation, the latest techniques of hair transplant surgeries, devices, tools and methods of diagnosis and the treatment of hair loss.

ISHRS 19 Meeting: New Hair Transplant Surgical Instruments and Techniques Panel, Drs. Parsa Mohebi, Alan Bauman, Sara Wasserbauer and Kongkiat Laorwong

This year I was the moderator for the Giga-Session Hair Transplantation Panel. The panel included 2011 Golden Follicle Award winner Dr. Jerry Wong and Doctors Sharon Keene, Arthur Tykocinski, and Akaki Tsilosane. The discussions included properly choosing the best candidates for large number of grafts hair transplant surgeries (Giga Session Hair Transplants), planning for surgeries, as well as the full spectrum of Giga-Session Hair Restoration.

The Laxometer II was one of the newest innovative technology devices presented by me. The Laxometer was developed as a response to the need within the hair restoration industry for a measuring device for calculating the scalp laxity or skin mobility before hair transplantation surgeries. The Laxometer precisely measures the mobility of the scalp giving greater accuracy for larger surgeries or if a patient has a tight scalp. This device was introduced to the market for increasing the safety, precision, and efficiency of the hair transplantation.

Another device presented at the 19th Annual ISHRS Scientific Meeting was the upgraded Restoration Robotics, now called ARTAS System. This machine is now FDA approved for use in the United States and several lectures were presented about this new hair transplant technology. ARTAS was developed to help meet the need for increased precision and speed for scoring the follicular grafts in Follicular Unit Extraction (FUE) hair transplants. This is considered a very new technique in hair transplantation, but the robot currently only assists in one step of hair restoration. That is scoring the follicular grafts.  We still do not have a perfect automated system to extract and transplant the hair grafts. This device will need more time for testing and post-operation, long-term patient results.

Other New Technologies for Hair Restoration

In last few years, we have witnessed emergence of several new tools in hair transplantation that carried the claim to be the latest technologies and ground breaking tools for the field.  A lot of devices claimed they could change the way hair transplantation was done. However, many of those new tools did not deliver on their promise.  This has been a trend which has continued to be repeated for several years now. One of these devices was the NeoGraft that was sold to many non-hair transplant doctors with the promise of the simplicity of use and the minimal need for a surgeon’s involvement. The company has stated that the technicians can run the machine for the most part. One major issue the NeoGraft company forget to point out to these new costumers is the fact that hair transplant surgery requires experience and proper training in order to deliver great result. No machine, especially in the wrong hands, can substitute for lack of experience and expertise.

There were a number of lectures presented regarding the problems involved in hair multiplication, auto-cloning, hair stem cell research, and others important topics. Like years previous, there were several debates about Strip FUT vs. FUE,  manual FUE vs. automated FUE, also sharp vs. blunt punches for Follicular Unit Extractions.

Controversies in Hair Restoration

This year we had many controversial lectures such as lasers for hair restoration and growth factors, as well as mesotherapy and PRP (Platelet Rich Plasma).  The ISHRS allows for an open forum for hair transplant surgeons to share their innovative ideas, work, and theories that they can be giving constructive criticism and analysis by other experts in the field. This has been effective in keeping members of the society updated with new ideas and methods for hair restoration. It is unanimously agreed by members of ISHRS that hair restoration surgery is a progressing science and art which is rapidly growing into more advanced technologies and cellular level manipulations. It is well accepted that greater research is needed in order to thrust the industry forward in these new innovative areas for the art and science of hair restoration