What is the current state of the art in hair restoration surgery?

Follicular unit grafting has revolutionized our approach to many forms of hair loss. With his method, many hundreds, or even thousands, of your tiny living grafts ("follicular units") containing only one, two, three or four hairs are inserted in closely spaced fashion (as close as 1/16" apart) over the entirety of your bald and thinning areas. These micrografts, which approximate the one to three hairs which naturally originate from each of your original follicles, result in a very natural, aesthetic appearance. Randomly-spaced single hairs can create an especially pleasing, feathered hairline.

In contrast, older or obsolete methods of hair transplantation practiced in the 1960's and 1970's nearly always resulted in a "clumped" or "bristle brush" appearance. The "Barbie Doll" appearance of hair transplant plugs (round grafts containing generally 9-10 or more hairs) is unfortunately nearly always quite conspicuous, and worse, permanent. During the 1980's minigrafts (smaller clumps containing 5-8 hairs) were an improvement, but only served to generate smaller "clumps". Indeed, approximately 1 out of 4 cases at our hair restoration surgery center involve the repair and/or hairline camouflage of these "plugs" or "minigrafts" placed at other clinics. Even more unfortunately, at some locations, these larger grafts are still utilized.

Unsightly "Barbie Doll" hairline from hair transplant surgeon who still uses round "plugs"

The benefit from follicular unit micrografting, versus plugs or minigrafts, can be visualized by viewing a group of tree trunks: even though the cross sectional area of each tree is large, one can clearly see space between the trees. In contrast, the tiny branches of a hedge, with a much smaller total cross sectional area, still create a much more dense visual barrier.

29 year-old male with receding hairline

Same patient, after only one session of 1-hair and 2-hair micrografts. Can you tell the difference between the grafts and his natural hair?

Why wait until you are completely bald?

The insertion of micrografts between your existing hairs, leaving them undisturbed, can systematically restore density to your scalp hair. Thus the grafted hairs may compensate for the loss of your natural hair. The successive placement of many of these micrografts over several sessions can even prevent the appearance of baldness in selected patients with remaining, but thinning, hair.

Marked thinning, on crown, in patient in 50's

Same patient, after 2 "hair-thickening" sessions of micrografts. An additional session would be add even more density

21 year-old white male with anterior crown thinning with very strong family history of baldness. This patient did not want to wait until he was completely bald

Same patient, after 3 "fill in" micrografting sessions with a beautiful result. Note that a mature hair line has been anticipated in preparation for the appearance that would be desirable during the patients middle-aged years

What about hair loss in females?

Most women, of course, never lose all of their hair, but in some instances the hair on top of the scalp can get quite thin. Heredity, hormonal situations, menopause, and certain medications can result in considerable hair loss. In these instances, in women with an intact hairline, the placement of micrografts between the existing follicles can restore a good deal of density to the crown of the scalp.

Improperly performed face lift surgery may permanently damage hair follicles along the temples and sideburns: browlifts (forehead lifts) may move the hairline back to an unacceptably high location, and scars along the hairline may be quite visible when the hair is parted or when the wind blows. In these instances, a new hairline must be created with 1-hair and 2-hair micrografts or follicular units. Of course, a normal, dense donor area must be present on the sides and back of your scalp in order for the surgeon to perform successful hair replacement.

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