IS
HAIR TRANSPLANTATION PERMANENT?
Grafts
of skin containing hair follicles are taken from the
back of the scalp, where, even in balding men, hair
follicles are programmed to grow for life. These growth-programmed
grafts, when transplanted to bald areas of the scalp,
should grow naturally for the rest of the patient's
life.
ARE
HAIR TRANSPLANTATION PROCEDURES ALWAYS SUCCESSFUL?
Hair
transplantation, when performed by a talented and experienced
surgeon, is highly successful and virtually undetectable
in most patients.
IS
HAIR TRANSPLANTATION MAJOR SURGERY?
Hair
transplantation is topical surgery done under local
anesthesia. Though the operation is not complex in the
hands of a skilled surgeon and surgery team, any type
of surgery should be taken seriously. Before undergoing
hair transplantation surgery, each patient's medical
history, blood work and current health status is evaluated.
WILL
MY COMPLETED HAIR TRANSPLANT LOOK NATURAL?
While
experts agree that there is no perfect hair transplant,
with the development of minigrafts, micrografts and
single hair grafts, we can eliminate the Fuller Brush,
Barbie Doll appearance of conventional hair transplant
plugs. Most patients are very happy with their completed
hair transplant. Realistically, your hair will never
look as thick and full as it did when you were a teenager.
Yet transplanted hair is healthy, natural looking and
can cover bald areas of the scalp. Even men with substantial
receding hair lines and large bald areas can receive
satisfactory scalp coverage, in our opinion, with mini-,
micro- and or single hair grafts, as long as donor areas
are sufficient. Always remember, your expectations have
to be evaluated on an individual basis.
WHAT ARE THE MOST RECENT
HAIR SURGERY DEVELOPMENTS?
LaserDoc
CLINIC were pioneers in the mid '90s with the use of
mini-, micro-, and single hair grafts and various forms
of scalp reduction (Lateral Lift) to enhance the effects
of conventional hair transplants.
The
work done to perfect the DOUBLE AND TRIPLE BLADE SURGICAL
KNIFE has greatly aided harvesting techniques in donor
site areas. We are convinced that the multi-blade knife
makes punch harvesting techniques obsolete. In some
ways we think that the knife requires more skill by
the surgeon and his assistants than the punch. The knife
is much faster. The number of hair follicles destroyed
or lost in this process is greatly reduced. Since there
is less damage to the donor region and no lost space
between grafts, more grafts can be harvested. We feel
there is less trauma and healing is much better. The
critical sharpening of donor punches is eliminated (dull
punches make poor harvesting). As you can tell we are
enthused with the multi-blade technique. Remember, however,
just as you are different as a person, techniques from
one patient to another may differ. Nothing is set in
stone.
LASERS
overall are very controversial at this time. Many hair
transplant surgeons feel these are simply a marketing
tool and are being used prematurely. At the 1995 International
Society of Hair Restoration Surgery conference a leading
hair transplant surgeon was quoted as saying he is "worried
that the integrity of the hair replacement profession
will be called into question if we do not rapidly put
the interest of scalp biology ahead of marketing strategies"
The term LASER is an acronym for Light Amplification
by Stimulated Emission of Radiation. LASERS are instruments
that convert electrical energy into light. The vast
amount of heat generated by the light causes tissue
vaporization and hence incisions or holes. The heat
spreads and causes thermal or heat damage to the surrounding
tissue. The result may be that this damaged tissue is
less than optimal for further transplants or worse still,
it can affect the quality of hair growth from the initial
transplant.
The aim of present day research with LASERS is to reduce
the area of thermal damage to an absolute minimum. New
lasers are producing less thermal damage than before,
but the worry is that it may still be excessive.
Are lasers worth the risk? Not in Dr. Finkel opinion.
Another
breakthrough is the RADIOSURGICAL hair transplant harvesting
technique. With this method radio waves are used to
remove donor tissue in elliptical sections eliminating
old fashioned punch-plug techniques.
Radiosurgical harvesting does not use light as in laser
surgery, but modulated radio waves to separate the tissue,
causing less destruction of bulbs and resistant-free
cutting as compared to other harvesting methods.
With
these new technologies we routinely perform from 200
to 1000 graft sessions, with as many as 1500 to 2000
mega graft sessions on the horizon.
WHAT IS A LATERAL LIFT (scalp reduction)?
A
Lateral Lift is a surgical procedure for the top and
crown of the head that undermines the fatty tissue.
It enables the doctor to skillfully stretch permanent
fringe hair into the previously bald area. This can
be accomplished in as little as one hour with immediate,
permanent results. Candidacy for this exciting procedure
must be determined on an individual basis. This procedure
is used less frequently since the perfection of mini-,
micro-, and single hair grafts.
IS HAIR TRANSPLANTATION SURGERY PAINFUL &
WHEN WILL I SEE HAIR GROWTH?
Now,
new advances have made the hair transplant procedure
virtually painless.
Hair growth can be seen from the transplanted grafts
anywhere from 6 to 26 weeks, depending in part on how
quickly the capillaries form around the newly relocated
bulbs.
HOW
IS THE HAIR TRANSPLANT PROCEDURE PERFORMED?
Male
pattern baldness is a condition that comes from a genetic
response to the male hormone, testosterone. This results
in a negative effect on the growth of hair in the U-shaped
area (horse-shoe shaped area) of the scalp from the
top-crown area to the frontal hairline. When performing
hair transplants, strips of tissue are removed from
the back and sides of the head, where the hair bulbs
are not effected by male pattern baldness because they
lack the negative genetic programming described above.
This tissue is then dissected into mini-, micro-, and
single hair grafts and then artistically placed into
the balding or thinning area.
The transplanted hair should generally start to grow
in 6 to 26 weeks. As discussed above it should continue
to grow for a lifetime because these transplanted bulbs
are different genetically in their response to testosterone
from previously existing hair in balding areas.
Over a series of sessions, averaging from 2 to 4 sessions,
(a session is a particular time that the patient comes
in to have a procedure performed) the patient should
have a completed hair transplant. The numbers of sessions
that are performed on an individual patient vary dependent
upon individual patients' circumstances and desire.
A minimum of 7 to 10 days before surgery the patient
will have bloodwork done. Approximately 7-10 days prior
to surgery the patient should discontinue the use of
aspirin, aspirin-related products and vitamin E as these
products may cause thinning of blood. Also, if marijuana
or other illicit drugs have been used, these should
be discontinued two weeks before surgery and up to four
weeks after surgery, as they may severely constrict
blood circulation, decreasing yield of hair or even
endangering survival of grafts.
The day of surgery the patient is to eat a good full
meal shortly before arriving at the surgical center.
Upon arrival, the planned procedure is reviewed with
the patient by Dr.Finkel. Subsequent to this, and only
after a thorough discussion with the patient, the procedure
will begin. The most critical portion of the operation
occurs right at the beginning -- the decision as to
the placement of the hairline (when there is no longer
one present). This decision involves a unique combination
of surgical experience, artistic talent and communication
with and understanding of the patient's desires, moderated
by amount of donor hair available.
Once the hairline is agreed upon and drawn in on the
scalp and photographed, the patient is then given Valium.
This is done to relax the patient and to counter-act
the possibility of jitteriness from the local anesthetic.
The first area to be worked is the donor area. Let's
define the donor area. Take a point over the left ear,
now, draw an imaginary line around the back of the head,
to an equal point over the right ear. Anything in the
general vicinity below that line is considered donor
area in most patients. Outside this field the hair bulbs
are more likely to be negatively affected by the male
hormone, testosterone, in a patient experiencing pattern
baldness. The hair shafts toward the upper edge of that
imaginary line are then flipped up and pinned up with
hair clips or surgical tape.
The area about 1/2 inch wide below the line described
above is shaved down to about 1/8 inch in length in
preparation for harvesting the healthy bulbs.
This also gives Dr.Finkel a clear visual evaluation
of the angle of the bulbs underneath the scalp. Next,
saline solution is introduced to puff up the donor site
area, which lessens tissue shifting during harvesting,
and by increasing tissue turgor, results in a sharper
more exact cut, avoiding excess injury to the bulbs.
To remove strips of donor tissue from this location,
Dr. Finkel uses a multi-blade surgical scalpel. We feel
that this technique of harvesting in the hands of a
skilled surgeon gives the best yield.
Once the donor strips are cut horizontally, they are
then trimmed away from the scalp, at a depth just below
the bulbs in the fatty tissue. The harvested strips
are then placed into a Petri dish containing a saline
solution, which preserves the healthy tissue. Then they
are taken into our lab area where they are dissected
into mini-, micro-, and single hair grafts by expertly
trained surgical assistants. At this time Dr. Finkel
sutures the donor area closed. After closure the area
is washed and cleaned. Then the hair clips are removed
from the unshaved region above the donor site, allowing
the hair here to cover the sutured donor area below.
Now we are ready to move into the recipient area where
the healthy hair-bearing grafts will be relocated.
First the recipient area is anesthetized and a saline
solution is introduced here in a fashion similar to
the donor area. This prepares the area for receiving
the mini-, micro-, and single hair grafts.
At this time small punctures are made into the recipient
area and small slivers of bald tissue is removed. This
technique eliminates graft compression and uneven growth.
The sizes of the punctures vary, starting at about the
size of a pin in the frontal zone, which will accommodate
one to two hair placements. Moving gradually back on
the head behind the frontal hairline zone, the puncture
is increased in size to accommodate a 2 to 4 hair placement.
In some cases, a little larger recipient area sliver
is removed to allow for the placement of the 3 to 4
hair graft. We try not to exceed 3 to 4 hair placements,
as any larger size grafts have a tendency to create
a clumpy, Barbie-doll kind of appearance. Spacing between
each placement is about a graft's distance apart. This
allows proper blood circulation to reach the new hair
bearing tissue. Grafts placed too closely together in
a session may result in insufficient blood circulation
to these new placements, resulting in decreased hair
yield. The recipient puncture sites also have to be
angled properly, taking into account the patient's facial
shape and the direction of pre-existing hair. This is
critically important. What subsequent sessions accomplish
is additional hair density between previously placed
grafts. The number of sessions an individual patient
will need varies. Two to four sessions in an area is
the average to accomplish a natural appearing result.
Subsequent sessions can be performed at approximately
8 to 12 week intervals, so as not to interfere with
blood supply to the previously placed grafts.
After completion of a session, no-bandages are applied.
Patients are typically instructed to take additional
Valium to sleep and to counteract the residual effects
of the local anesthetic.
Medication is also prescribed to eliminate discomfort,
although, with Dr. Finkel advanced techniques this is
usually minimal.
Because medication can cause drowsiness, it is best
if patients do not drive, and make arrangements to be
dropped off at and be picked up from the clinic. If
this is a problem, we will try to make special arrangements.
Patients are instructed to sleep with their head elevated
and to use an ice pack on the donor site overnight.
If the patient needs any question answered or situation
handled there is 24 hour direct phone
accessibility to a trained senior staff member.
If individual circumstances allow, it is recommended
for our trained staff to clean surgical areas for several
days following surgery. This eliminates the need for
a patient, who is untrained, to be responsible for properly
cleaning surgical sites. This is done as a courtesy.
The next day after surgery, the patient should be able
to discontinue use of Valium and medication for discomfort,
if these were necessary at all. After the first night
the use of extra-strength Tylenol is normally sufficient
for any soreness.
It is our firm belief, after over 25 years experience,
that care after surgery is just as important as the
surgery procedure itself.
Medrol dose packs are given to lessen inflammation,
and to decrease post operative puffiness. Antibiotics
are given as a precaution to avoid infection. A patient
may occasionally experience some hair thinning after
surgery. This is usually minimal and temporary.
Two to four weeks after surgery the hair in grafts will
shed because of blood flow interruption that occurred
during the procedure. Approximately 6 to 26 weeks from
the day of surgery hair will start to grow. This hair
should continue to grow for a lifetime. This is how
hair transplants are able to CORRECT baldness permanently,
with your own healthy hair. When all is said and done,
patients usually say, "I wish I had done this sooner!"
HOW MANY HAIR TRANSPLANT SESSIONS WILL BE NECESSARY
BEFORE MY HAIR TRANSPLANT IS COMPLETE?
That
depends on the size of the balding area, donor yield,
and the goals of the individual patient. While some
patients are satisfied with minimal coverage, most enjoy
a thicker look. As few as one (1) or two (2) sessions
for one patient, or as many as three (3) or four (4)
sessions in another may be needed.
HOW DO I CARE FOR MY TRANSPLANTED
HAIR?
The
day following surgery the patient is cleaning the surgical
areas. We at LaserDoc CLINIC feel that follow-up care
with surgery is just as important as surgery itself.
No additional cost is incurred by patients undergoing
the hair transplant procedures for these cleaning sessions,
so as to leave that care to trained professionals. Any
special instructions will be given to you at the time
of surgery.
The cost for hair replacement far exceeds the cost of
a hair transplant. In hair transplants the "new
hair" is real and should grow with pleasing appearance
for a lifetime, once completed. It usually does not
require any more attention than your normal hair cut.
ARE MOST PATIENTS GENUINELY HAPPY WITH THEIR
HAIR TRANSPLANT?
Most
patients are happy with their new look and enjoy increased
self-confidence. Remember, there is no perfect hair
transplant. The most significant benefit of hair transplant
surgery is the renewed self-esteem that comes with the
knowledge that one looks better. With the natural look
of single hair and micro-mini grafts hair transplants
today can look natural and virtually undetectable. The
most common complaint is "Why didn't I have this
done sooner?"
