Modern Hair Restoration
	By Dr. Mark J. Korman M.D., F.R.C.S.C. www.kormanmedical.com View Dr. Korman's profile

For both men and women, appearance is an important determinant of success in business and social spheres. Baldness or thinning hair influences others' perceptions of you and affects your own attitude and self confidence.

Today’s patients have numerous proven and effective surgical and non-surgical options available to prevent and treat hair loss. Prescription treatments can stop or even reverse hair loss and unlike the sometimes unnatural results of the past, modern hair transplantation can now yield results that are truly undetectable.

What causes hair loss?

Numerous medical conditions can cause temporary or permanent hair loss however the cause of the problem in the vast majority patients seeking hair restoration is what is known as male or female pattern hair loss. Predisposition to pattern baldness is thought to be largely inherited however the genetic process is complex and poorly understood.

Can hair loss be prevented?

Medical treatment can slow or stop pattern hair loss in a large proportion of patients. Some patients will even experience re-growth of hair. The key to medical prevention of hair loss is to start as soon as possible and preserve existing hair.

The mainstays of modern medical treatment include Propecia (finasteride) and Rogaine (minoxidil). Propecia is a pill that is taken every day and will stabilize hair loss in approximately 90% of men who take it. It is generally not prescribed for women. Minoxidil must be applied to the scalp twice per day and has been shown to be effective in both men and women.

It is important to remember that if left untreated, pattern baldness will progress relentlessly. While some patients experience re-growth, the primary goal of medical treatment is to prevent additional hair loss, not to restore hair.

When should I consider treatment?

It is critical to appreciate that your hair is a non-renewable resource and treatment to stop ongoing hair loss should be considered at the soonest possible time even if surgical treatment is not currently and option for you. By the time an area has a thinned appearance, 50% of the hair in that area has already been lost. Halting your hair loss will conserve valuable donor hair and prevent progressive baldness, possibly reducing the extent or even eliminating the need for future surgery.

What treatments are available?

There are both medical and surgical options available. Propecia and Minoxidil are the mainstays of medical treatment and hair transplantation is the backbone of hair replacement techniques.

What is a hair transplant?

A hair transplant is an operation in which hair follicles that are not susceptible to pattern hair loss (usually from the permanent fringe of hair at the back and sides of the head) are relocated to areas of the scalp that are bald, or destined to become bald. Hair can also be transplanted to other areas including the eyebrows, eyelashes, moustache, beard and body.

With modern techniques of mini, micro and follicular unit grafting, pluggy, unnatural "doll’s hair" results are a thing of the past.

In a modern hair transplant, an area of hair is removed from the back or sides of the scalp and microscopic surgical dissection is used to divide the donor tissue into its individual follicular units. Follicular units are naturally occurring groupings of one, two, three and sometimes four or five hairs. Depending on your goals and individual characteristics, under some circumstances slightly larger grafts known as multi-follicular unit grafts (MUG’s) can be created to help achieve additional density behind the hairline.

The donor area on the back or sides of the scalp is meticulously sutured using a cosmetic surgical technique known as "trichophytic closure" which usually renders the scar virtually undetectable.

Precise instruments are then used to create tiny recipient sites in areas of the scalp that are bald (or destined to become bald). The creation of the recipient sites requires surgical skill and artistry in order to achieve a long-term result that will continue to look totally natural even as the patient ages.

Once the recipient sites have been created, the grafts are individually inserted into place. The transplanted hair is your own and will continue to grow for the rest of your life, just as it did in its original location. It can be washed, brushed, cut and styled just like any naturally occurring hair. Modern techniques and instrumentation allow for the delivery of natural results with the hairline, density and coverage that are appropriate for each individual patient.

Hair transplantation is performed as a day surgery procedure under local freezing with mild sedation in a comfortable office setting.

Does it hurt to have a hair transplant? What are the side effects?

Hair transplantation should be a comfortable and virtually pain-free experience. With the use of light sedation, local anesthetic and gentle and meticulous techniques, the vast majority of patients report that they experience little or no pain. Many actually enjoy the experience, asking questions, listening to music, or watching a movie as the procedure progresses.

The side-effects of hair transplantation surgery are relatively minor and serious complications are extremely rare. Modern hair transplantation surgery is comfortable, predictable, and produces pleasing results.

What if I don’t want to look like I’ve had a hair transplant?

Many potential patients state that the only thing worse than baldness would be a bad hair transplant. The sight of unacceptable, obvious, pluggy, and embarrassing results produced by older, outdated techniques would give anyone second thoughts.

The field of transplantation has come a long way from the days of "corn-rows" of hair plugs. Grafts have gotten smaller, hairline design more sophisticated, and technology more advanced. The advent of follicular unit transplantation with microscopic single-hair graft preparation has enabled surgeons to deliver results that are predictable and undetectable. Often, patients’ hair stylists are not able to tell that a transplant has been performed.

How many procedures will I require?

The number of procedures required depends on several factors including treatment goals, the degree of hair loss, and the availability of donor reserves. Some people are satisfied after only a single procedure, while others will desire further treatment in order to add density, refine the hairline, temples or crown, or to keep up with progressive hair loss over the years.

Regardless of the number of transplant sessions that are ultimately carried out each operation should be designed as a "stand-alone procedure." This means that each transplant will be specifically designed to look natural throughout your entire lifetime regardless of the extent of future hair loss or future surgery.

Can women with thinning hair undergo transplantation?

Absolutely. Like men, women are subject to hair loss and while this can be particularly upsetting and can have a devastating impact on self-esteem, in most cases it can be effectively treated. As in men, the most common cause of hair loss in women is inherited pattern baldness however some basic tests may be needed to rule out an underlying medical problem such as thyroid dysfunction or low iron.

Unlike what is generally seen in men, female pattern hair loss is more frequently associated with a diffuse thinning effect over the entire scalp sparing the frontal hairline. Many women complain that the part in their hair seems to get wider. While female pattern hair loss is extremely common, many women do not realize that treatment is available and effective and so continue to suffer with the embarrassment and anxiety that frequently accompany thinning hair. Fortunately, more and more women are availing themselves of the excellent treatment options that are available including hair transplantation.

What can I expect after my hair transplant?

Hair transplantation is done as a day surgery procedure with patients able to go home on the same day. In general, no bandages or dressings are required. Most patients have only mild discomfort following a hair transplant and hair can be gently washed on the first day following surgery. Most people choose to take a few days off work but some people resume their normal schedule within 1-2 days. Heavy lifting and vigorous exercise are discouraged for one to two weeks following surgery.

Following a hair transplant, new growth will commence within about 3 months and the transplanted hair then grows at the normal rate of about 1cm per month and continues to thicken over time.