Hair Restoration is a procedure that moves your naturally growing hair to an area which is thinning and or balding. The use of follicular Unit Grafts, micro and mini grafts allow for a natural hairline, which in many cases is almost undetectable. The Hair Restoration process is safe and convenient. Simply stated it means that, each individual person, male or female, has a unique problem and needs an individual plan to help them meet their Hair Restoration goal. Implementing the most current techniques will enhance your hairline giving you the greatest amount of follicular grafts to create a fuller and natural hairline.
The process starts with research by the individual patient. The more relevant information you have about the techniques used and the practitioner providing the hair restoration procedure the more confident you will be that this option can benefit you.
The search for treatment leads patients to a Hair Restoration specialist. In determining the best person to help you with your Hair Loss problems, understanding the background of the professional whom you are consulting is essential. Considerations when choosing your Hair Restoration specialist.
- Choose a Board Certified Surgeon
- Inquire about his/her experience with Hair Restoration
- Seek references, patients that you can contact or view before and after photographs of patients that have had the procedure
- Meet the staff and walk through the facility to ease anxiety
- Ask questions. Understand the process.
Williams Center Plastic Surgery Specialists goal is to educate in the treatment of male-pattern baldness, female-pattern hair loss, hairline advancement and eyebrow transplantation.
Male: The most widely used classification for male pattern baldness, or “androgenic alopecia”, is the Norwood Classification. This system was published by Dr. Norwood in 1974 and defines the most common type of hair loss in men, as well as a less common pattern (The ‘A’ Variant).
Class I: Minimal recession along the frontal hairline and frontotemporal regions. This represents the typical hairline of an adolescent or young man. At this early stage no treatment or intervention is warranted.
Class II: The frontal hairline is beginning to recede with a deepening of the frontotemporal triangles. This stage is not yet considered true balding and is best managed with topical (RogaineT) and/or oral (PropeciaT) medications.
Class III: This stage represents the minimal extent of hair loss considered sufficient to represent true balding. The characteristic feature of this stage is a deepening of the frontotemporal recessions. Class III patients are typically best managed with follicular unit grafting and/or topical (RogaineT) and oral (PropeciaT) medications.
Class III Vertex: This classification refers to hair loss chiefly on the vertex (crown) of the head. Treatment includes follicular unit grafting and topical (RogaineT) and/or oral (PropeciaT) medications.
Class IV: The frontal hairline and frontotemporal triangles are further regressed and the vertex is enlarged in this stage, however, a solid bridge of hair remains separating the frontal recession from the vertex. Class IV should not be confused with Class III Vertex in which the hair loss is primarily on the vertex (crown). Treatment for this stage includes both follicular unit grafting and topical (RogaineT) and/or oral (PropeciaT) medications.
Class V: This stage represents further recession of the frontal and frontotemporal regions and enlargement of the vertex balding. The band of hair separating the two areas is becoming narrower and sparser. Treatment is typically follicular unit grafting and topical (RogaineT) and/or oral (PropeciaT) medications.
Class VI: The bridge of hair separating the frontal and frontotemporal region from the vertex is now gone leaving one large area of baldness on the front and top of the scalp. Treatment is follicular unit grafting and topical (RogaineT) and/or oral (PropeciaT) medications.
Class VII: These patients have severe hair loss. All that remains is a narrow horse-shoe shaped band of hair along the sides and back of the scalp. Treatment includes follicular unit grafting and/or a hairpiece.
Class A patients are less common than the regular classification patients (<10%), but are important because they lose the majority of their hair in the front and tend to look more bald at an earlier stage. The posterior migration of the hairline without concomitant vertex hair loss results in a loss of the facial framing effect the hairline normally provides and therefore the impression that a patient is more bald than they actually may be. Fortunately, these patients make excellent candidates for hair transplantation surgery.
Female: Hair loss in women can be an especially emotionally devastating problem. It is estimated that over 25 million American women suffer from hair loss. Any significant hair loss seen in a woman should be evaluated by a physician with a thorough medical exam. The most common type of hair loss seen in women is referred to as female pattern hair loss. This is the type of hair loss without any apparent cause other than hereditary factors. Additionally, some women suffer from temporary hair loss from severe physical or emotional stress. This includes crash dieting, physical illness and pregnancy. This type of hair loss is typically reversible once the stressor is alleviated.
Topical medication, such as minoxidil (RogaineT) may be used in women, however, women may not take the medication finasteride (PropeciaT). Hair transplantation is good treatment option for women if there is not severe thinning in the donor area on the back of the head. However, it should be emphasized that surgical treatment of hair loss in women can not recreate thick hair, although it can certainly create thicker hair and the look of increased density.
Hairline advancement is a procedure for women who have a high forehead. By utilizing densely packed follicular unit grafting the hairline is brought forward and the size of the forehead is reduced. This procedure is indicated for anyone concerned about the aesthetic appearance of a high forehead whether this is an inherited trait or due to previous plastic surgery.
Many women suffer from sparse, uneven or even absent eyebrows. This is usually due to overplucking, electrolysis or previous surgery. The eyebrow transplant procedure involves obtaining fine, single-hair follicular unit grafts that are precisely placed to recreate the desired eyebrow contour. Your ideal eyebrow shape is discussed with the doctor and a template is created in which the grafts are placed. This is typically accomplished in a single procedure.
The state-of-the-art method of hair transplantation is follicular unit grafting. This is the procedure where “donor” hair is taken from the back part of your scalp. Hair for transplantation is taken from the back of the scalp because this hair is not affected by the hormones that cause hair loss on the crown and frontal scalp. Once these “immune” hairs are transplanted they maintain their inability to be affected by hormones and should remain on your head for the rest of your life. A strip of hair is taken from the donor area and is immediately given to the technicians to begin preparing for the transplant. The strip of hair is composed of thousands of follicular units. Follicular unit is the term to describe how the hair naturally grows from the scalp. Hairs exit the scalp in one-, two-, three- or even four-hair groupings, therefore a follicular unit can contain anywhere from 1-4 hairs. We maintain this natural growth pattern in the transplant in order to create the most natural result possible. The one-hair follicular units are utilized in the most anterior part of the hairline and the larger follicular units are placed behind these to give the appearance of a natural hairline with increased density just behind the hairline. While the follicular unit grafts are being removed from the donor strip, the doctor begins creating the recipient sites. Prior to the beginning of the procedure, your new hairline is drawn in collaboration between yourself and the doctor. Remember, this is the hairline you will have for the rest of your life so it needs to be a compromise between your hairline in adolescence and your potential hairline if no transplant was done. Therefore, the goal of the hairline design is to frame your face and reflect a natural, mature male hairline. This is different than in women where the goal is to preserve their natural hairline, but increase the density of the hair behind it. Following the creation of the recipient sites, the follicular units are carefully transplanted into each of these sites. Session may range from 500 to over 2000 follicular units, therefore expect to spend approximately 5-6 hours with us. During the procedure a light sedative and local anesthesia is used to keep you comfortable and relaxed for the duration of the procedure.
Other less commonly employed techniques for hair transplantation include scalp reduction and the Juri flap. In the occasional patient these more invasive procedures may be utilized. Scalp reductions can often reduce the size of crown balding prior to follicular unit transplantation and Juri flaps create a dense anterior hairline. The pros and cons of these procedures can be discussed in your consultation.
Immediately following the procedure antibiotic ointment and a light dressing is placed over the graft sites. A surgeon’s cap or bandana is then placed over the dressing to conceal any evidence of having a procedure. For the remainder of the day you should rest and relax. The following morning the dressing may be removed. At that time you may gently start cleansing the graft sites and the donor site. You may resume your normal activities, such as work, as early as the first postoperative day. However, you should refrain from heavy activity, such as weight lifting or swimming, until your stitches are removed on the 10th postoperative day. On the third day you may gently shampoo the hair. Expect the small crusts around the graft sites to remain for 8-10 days.
When the sutures are removed on the 10th post-operative day most patients are placed on nightly minoxidil (RogaineT). This works to increase the growth rate of the transplanted hair. Additionally, most male patients should be taking finasteride (PropeciaT) to prevent further hair loss, especially the hair on the crown of the head. To decrease any unwanted side effects we advise most patients to take the medication every other day. You should begin to see hair growth by 3-4 months following the transplant. Some patients will return for a second transplant between 6-10 months following the first, if indicated and desired. However, even a single procedure should “stand alone” and look natural and complete regardless if one chooses to have future transplants.