Hair Restoration Blog

Reframing the Face With Hair Transplant Surgery – Webinar by Dr. Mohebi

Join us, yet again, with US Hair Restoration Medical Director Parsa Mohebi, MD as he discusses popular hair loss topics. So often we receive phone calls and email inquiries regarding common questions people have about the art and science of hair restoration and how it can affect them and their personal situations. Here are the most recent topics discussed by Dr. Mohebi at our recent webinar:

Most people are not aware of the rule of thirds and how facial symmetry affects ones appearance. In this lecture, Dr. Mohebi discusses the importance of choosing a good hair line to achieve the proper facial symmetry.

Other webinars at this session:

Female Hair Loss Treatment

Male Patterned Hair Loss Treatment

We often get questions here at US Hair Restoration as to why there is little talk of women getting hair transplantations?

This question and others about female hair loss treatment options are commonly asked about.  The answer is found in the differences between common male hair loss and that of women.  Some of the differences between male and female hair loss are:

1. When looking at female hair loss in its most common type, it is not nearly as common as typical male hair loss, also known as male patterned baldness.
2.  Women’s hair loss rarely leads to complete baldness.  It often presents itself merely as thinning.
3.  FPB, or Female Patterned Baldness, usually touches the entire scalp with no donor hair protected in the back, unlike men with Male Patterned Baldness (MPB).
4. Women suffering from hair loss are much less accepted than men. MPB hair loss is known as a normal variation among men rather than a disease because most men have some degrees of hair loss after the age of 50.

Many women may benefit from hair restoration surgeries by restoring their hair in the balding areas.  The most important factor that determines a woman’s ability to receive a hair transplant is their donor recipient area.  That is to say, women whose hair loss is more similar to male patterned hair loss are far better candidates for a hair restoration procedure.

When considering their candidacy we need to keep in mind the common differences of balding between men and women.   A hair transplantation surgeon should be intentional in setting realistic expectations.  A man suffering class VI hair loss, having no hair on top of his head, might be thrilled about having a mere 40% of his original density on the bald areas after a procedure.  For a women, having only 40% density, will probably not be acceptable.

Women who desire close to 100% density in the bald areas should be told the truth which is they might need more than one hair transplant surgery.  Although women hair restorations can help most female patients, the candidacy for hair restoration in women should be carefully calculated before planning a hair transplant surgery.

These are the factors which should be met for determining proper candidacy for women regarding hair restoration surgery and before finalizing the surgical plan for female hair restoration:

1. Donor/Recipient mismatch: This means the donor hair on the back and sides of the woman’s head should be better quality than balding areas
2. Limited balding area: This means the area suffering balding or thinning must be limited.  Women with diffused hair loss wanting increased density everywhere are generally not good candidates for female hair restoration surgery.
3. Realistic Expectations:  The reality is hair transplant surgery only moves hair from one area to the other.  It is not about creating new hair.  Because of this, women need to understand hair restoration helps them to redistribute hair to cover the areas that are more important to them.  Creating 100% original density requires more than one hair transplant surgery.

A final important factor for women who are looking into a hair loss procedure is to consider finding the right hair transplant surgeon who has experience handling hair restoration procedures in women.  Female hair restoration is an art in itself and should be considered properly.

Female hair restoration is not simply another version of the common hair transplantation done in men.  The common size of a woman’s skull, the dynamics of the scalp skin, and the precision of making sites for the new grafts are important skills for a surgeon to understand. A good, well knowledgeable, and experienced surgeon will be on top of these things and do the best job possible to help reach the desired goals.

Dihydrotestosterone (DHT) is a byproduct of the hormone testosterone, which is formed in different areas such as the prostate gland and hair follicles.  Hair follicles which are susceptible to genetic male patterned baldness contain DHT receptors.  Over time as males produce more and more DHT the molecules affect hair follicles and cause them to become decrease in size, and eventually fall out permanently.

DHT and having the gene of male pattern baldness are the primary contributing factors for male pattern baldness. Women with female-pattern baldness, unlike men with male-pattern baldness, are usually not characterized by increased production rates of DHT due to their low levels of testosterone.  However if for any reason a woman has increased testosterone, she may develop female patterned baldness just like a man does with the same mechanism.

Hair in the areas that are prone to male patterned baldness such as corners, top and crown areas are loaded with DHT receptors in men with Androgenetic Alopecia.  However, the hair on donor areas such as back and sides do not have as much DHT receptors.  This is why hair is more permanent on the sides and back as opposed to the top and front.

The distinction in hair quality on different areas (donor vs. recipient) allows a hair transplant surgeon to remove hair from one area and transplant it to the balding portions of the scalp.  These transplanted hairs are permanent and won’t be affected by circulating DHT. Finasteride (Propecia) is a drug that blocks the conversion of testosterone to DHT by blocking the enzyme alpha reductase.  DHT levels in hair loss patients decrease when they are on Propecia and this helps maintain healthy hair, and this helps some of the miniaturized hair become stronger.

We recommend medical treatment with DHT blockers in many of our patients who undergo a hair transplant procedure to help maintaining their own hair in addition to restoring the balding areas with hair restoration surgery.