Gone Yesterday, Hair today
An Innovative Solution to Hair Replacement
By Paul Kelly, M.D., F.A.C.S.

Hair loss is very likely the leading killer of self-esteem in men. Those of the male gender know that hearing those 3 little words - "you're losing hair" - resonates not only a sense of dread, but a sense of aging. We send our kudos to those who can embrace this change in appearance, but more importantly, we send to those that elect to fight this losing situation the most current information on how to fight hair loss effectively.

Hair loss has been documented through out the ages - from the days of those who rode the Roman chariots to the present. While the future of your hair retention is most dependent on genetic factors, there does exist some credence in the theory that going green, diminishing the stressors in our lives, and eating a healthy diet lend themselves to keeping the hair you have. Studies have shown that those who live in a less polluted environment have less complaints of hair loss than those who don't. Similar studies suggest that less stress and healthy eating help as well.

The largest myth that should be debunked is that your maternal grandfather has the most influence on the prognosis of you keeping your hair as you age. Genetic predisposition is just that - and the disposition is a combination of maternal and paternal influence.

Women are showing an increasing interest in permanent hair replacement, and while restricted to just the Rogaine products for hair retention, the operative options remain viable options. Unlike men, women tend to lose hair just behind the established hairline. This creates a loss that is very noticeable, since the visible scalp is relatively obvious. It doesn't help that the average woman is shorter than the average man and the typical point of view of the female head is from a slightly higher vantage point. Procedure protocol for women is similar with the primary difference in the required number of hair follicles transplanted and the design of the hairline itself.

Hair loss treatments have evolved over the last 10 years to include medical options such as Rogaine and Propecia (for men only) and surgical options such as scalp reduction and micro-follicular hair transplantation. The most recent alternative to hair transplantation is the use of the laser comb. This product is thought to stimulate follicular activation and growth. Directions for use vary between 1-3 times per day. While not an unreasonable option, the verdict clinically and academically is not yet supported. The most appropriate candidate for use of the laser comb is the patient who early on sees loss of hair and has intolerance of Propecia.

Medical treatment of hair loss is for the most part innocuous, but occasional side effects can serve as a deterrent for continued use. Continued use is also not without its expense, and cost benefit may sway some patients to the only permanent solution - micro follicular hair transplantation.

The ideal patient for this surgical correction of hair loss has often times tried medical therapy and his or her hair loss is progressing despite the use of Propecia and Rogaine. The patient's desire for natural, permanent and low maintenance hair furthers the desire for surgical correction.

Micro follicular hair transplantation is done in the office under local anesthesia with oral sedation. A small strip of hair is taken from the back area of the scalp; this is an area that does not recede or fall out, so moving it, along with its pre-disposition to grow forever, to the front part of the scalp makes great sense. The site from where hair is harvested heals with an almost imperceptible fine line scar.

Hairline design is hi-tech these days, taking into account a need for the natural look as well as the requirement that the hair line look natural even as the patient continues on that aging escalator. Gone are the days of the plugged look or the rows of hair plugs like that found on a doll. State of the art transplantation involves placing 700-1000 or more hair follicles into the areas of loss in an irregular and random pattern. The front hairline is first reconstituted to reframe the face. The temporal areas are filled next, and then mid scalp and the vertex of the scalp (that famous bald spot) are filled last. The end result is one of a natural re-framing of the face with the hair that you once enjoyed as a younger person. The result will look natural now and in 20 years - all these considerations are important.

Deciding that hair transplantation is right for you is a personal decision - getting the information to make that decision is your personal responsibility. Do your homework, feel comfortable and confident with your physician, and remember that surgical correction performed today yields hair 9-12 months later. If there was ever the "patient person's game" - having hair transplantation is the model. IMAGE