Contrary to popular belief hair loss is a condition that occurs in both men and women although it is certainly much more common in men. In men it has come to be known as male pattern baldness. The most modern techniques of hair restoration are used in at Newport Beach Center for Surgery, which include scalp reduction as well as hair transplantation which is a surgical method where by hair is removed from the back of the scalp and transferred to the front of the scalp. It should be noted that male pattern baldness is like trying to hit a moving target because some men at age 20 show a significant loss of hair especially in the forehead area and in the crown area. Hair loss is based primarily on heredity or genetics so it is very difficult to prognosticate how much hair loss a person at age 20 is going to have, for example, at age 50. The idea is that for patients to understand that once they lose their hair, that it is permanent and that whatever hair that they have remaining, is used to obtain hair re-distribution.
In cases where there are significant areas of baldness, for example, in the crown, an ideal technique to be used is what’s called scalp reduction where significant portions of bald scalp are removed and the bald areas are reduced significantly. We then are able to use the remaining hair, which is primarily along the side and back of the scalp as a donor tissue to transfer to the front of the scalp to create a new hairline. This technique basically is a redistribution of wealth. Patients have to understand that there’s no way for them to regain their 17 year old hair pattern, but remarkable improvements can be achieved in patients by first doing scalp reduction and then transferring the remaining hair to the front of the scalp.
A patient typically comes into the out patient center, has a mild sedation. The area in question is then injected with a medicine that both eliminates pain, as well as minimizes bleeding. Typically a strip of hair-bearing skin is removed from the back of the scalp and that wound is then closed in such a way as to make it very inconspicuous. The hair bearing skin that has been removed becomes the donor tissue for replacement for the loss of hair at the front hair line. A team of assistants are used and under magnification the donor tissue is very carefully dissected into, what are called microfalicular units. These units might contain one, two, three, or four shafts of hair so that literally thousands of, what we call micro-grafts are produced under magnification so that they can be transplanted to the front of the scalp. Special surgical instruments are used to create a regular, irregular pattern by creating several hundred slits in the scalp that is to receive the micro-grafts. Using fine jeweler forceps, the micro-follicle units are then inserted into the slits that have been created into the front of the hairline.
This entire procedure is very tedious, but results in near miraculous transfer of hair bearing skin to the bald areas. On completion of this painless and relatively bloodless procedure, a very very light dressing is applied and the patient is allowed to leave the facility and is capable to literally walk out to the vehicle. The patient, being that they have had sedation, are not allowed to drive. They are seen the very next day when the light dressing is removed and at that point they can resume all of their normal activities, including daily hygiene, activities, diet, and sleep habits. The patient has to be educated to realize that they micro-follicular units that have been transplanted will not start growing hair for approximately three months. This is a very difficult period for the hair transplant patient, as it creates the expected anxiety of the hair growing. Almost miraculously in three months the patient begins to feel “stubble” or a “beard-like” sensation to the areas that have been transplanted, and those follicles begin growing so that in six months from the time of the original surgery, the patient has three months of hair growth. The photographs show examples of improvement in the hair pattern of a patient who is just an ideal candidate for hair restoration. It not only develops a better hair line, but it creates a more youthful appearance. Psychologically this has tremendous positive dynamic impact on the patient as it is a well-known fact that baldness is extremely damaging to the male patient.
| In men the two basic techniques used to reduce baldness are scalp reduction, where larger portions of bald skin are removed to diminish the area that requires hair transplants. | |
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At times we see female patients who have a very high hairline that is a hereditary in nature. There is a very safe, simple, surgical procedure which can be performed under a sedation type anesthesia in which an incision is made at the hairline and the scalp is mobilized and brought down to a more ideal and attractive level and the bald scalp of the forehead is removed and the patient ends up with a much lower hairline. In other areas of this website, we discuss what are known as tenets of beauty, which dictate that the nose occupies the middle third of the face. We can see clearly that the example below (insert pg. 54 of book) is a very very dramatic improvement in lowering this woman’s hairline in restoring one of the cardinal signs of facial beauty where the nose, in fact, does occupy the middle third of the face. This procedure is also performed under a light anesthesia. The patient is able to walk out to her car. She may not drive, having had sedation, but leaves the clinic alert and awake, and then returns the following morning for removal of the dressings. That patient, the day after surgery, is encouraged to resume all normal activities including personal hygiene, including shampooing the hair and to resume normal physical activities, regular diet and regular sleep habits. This procedure is a very permanent procedure and the patient benefits of a lower hairline for the rest of her life.
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