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Hair Care

Hair Transplant Questions and Answers
By

Ziering Medical


May 25, 2004, 00:58

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The procedures involved with overcoming hair loss and hair transplants often lead to numerous questions including:
  • Why am I suffering from hair loss?
  • How do hair transplants work?
  • Are there other options for treating hair loss besides surgery?
  • Will the results look natural?
  • Is the hair replacement procedure painful?
  • Is my procedure kept confidential?
  • and many others.

Education is a big part of the hair replacement process. That's why we have compiled a list of common questions and answers for you to review in relation to hair loss and hair transplants. We want you to fully understand your hair replacement options, and to feel comfortable when working with Dr. Ziering and the staff at Ziering Medical.

Take some time to read the information below. If your questions aren't answered, please feel free to contact us for additional information. It would be our pleasure to help you better understand the details of hair replacement, and the methods that would work best for your specific circumstances.

Why am I losing my Hair?

There are a number of causes of hair loss. Androgenetic Alopecia (AA) is the most common cause of hair loss in men and women. It is genetic and can be inherited from the mother or father. In AA, DHT (a testosterone derivative) attacks hair follicles resulting in miniaturization and alopecia.

Hair loss is progressive throughout our lifetimes. In certain areas of the head the cells around the hair shafts have more 5-alpha reductase (the enzyme that makes DHT), as a result these areas have more DHT and generally demonstrate greater loss.



If Hair loss is progressive then why does hair transplant work?

The donor area is the strip of hair at the back of the head that is genetically programmed not to fall out. Even very bald individuals generally maintain their donor area. You can remove about half of the donor area before it becomes noticeable cosmetically. There is a limit to donor availability. Average available donor is 5,000 follicular units, not all of which can be harvested at one time.



Why cant you do all five thousand grafts at once?

The simple answer is that it would be difficult to get a good closure at the site of incision.



I see hair in the shower every day is that normal?

There are 100,000 hairs on the average head of hair. Hair cycles between growth and resting phases. In the normal head, 100-150 hairs enter a resting phase and fall out every day. The vast majority will begin to grow back in three to four months. This should not create anxiety as it is a normal function and is not noticeable. In fact your grafts will also cycle like all normal hair.



Is Hair Transplantation Painful?

The most uncomfortable part of transplantation is injection of the anesthetic. For individuals who have low tolerances for discomfort we use an anesthesia delivery machine that makes the discomfort very minimal.



Will it really look natural?

Yes, proper use of follicular units will be detectable only under a microscope or to a trained professional. The only people who know will be those you tell.



Can I just tell the surgeon where I want the hairline and have him do it?

We work very hard to meet the needs of the patients. However, there are some patients that have unrealistic goals, or do not understand how a transplant is going to look once it grows in. Our surgeons have a lot of experience designing hairlines that look natural for age, race, and gender. More importanty they understand how it will look grown in. We enjoy working with our patients on the custom surgical plan but if a patient insists on something that our surgeon believes would be cosmetically inappropriate, then the surgeon has the right not to perform the procedure.



Are there certain hair types or styles that make transplants look better?

Yes, light hair on light skin has minimal contrast and results in a very natural look. Dark thick hair on light skin is the most surgically challenging. Curly or wavy hair can also give the appearance of greater density. When styling it is better to part the hair to one side. This will create a layering effect and the appearance of greater density.



How thick will it be?

This is always a difficult question to answer. Density is a function of hair shaft thickness and number of hairs. 1,000 thin hairs do not appear as dense as 1,000 thick hairs. Your surgeon can help you understand this concept. The appearance of thickness or density will depend on how you style your hair, how much existing hair you have, how much hair you continue to lose, and how big the area is that you wish to transplant into.

Completely bald patients need to understand that when full, there were 60,000 hairs on the portion of the head into which we usually transplant, and 30,000 hairs when they began to notice they were thinning. If you transplant 2,500 follicular units you will get about 6,000 hairs. If you spread these out over the entire head you can imagine that it will not look as thick as when you had 60,000 hairs over the same area. Having said that the results of this type of procedure can make a dramatic and positive impact in ones appearance (see photo gallery).



What is Shock?

Shock can occur when placing grafted hair between growing hair. Trauma from the procedure can cause some additional hair shedding. The strong hairs will grow back, the weak hairs that were destined to fall out may or may not return.



Will the transplanted hair be curly?

Transplanted hair does tend to have a slight wave but if your donor hair is straight it will not become curly.



Can someone else donate their hair to my cause?

Sorry, your body would reject someone else’s hair just like a heart or kidney transplant.



Can you clone my hair?

This technology is being explored but it is a long way from being available to the consumer. Best estimate is 10 years before this is a real option.



Does a transplant prevent hair loss?

No a transplant will not prevent further loss. We consider this when planning a surgery. You can decrease the rate at which you loose hair by taking adjunctive medical therapy.



I am currently using a hair System can I wear it while my transplant grows in?

Yes you can but it should be clipped on and not glued or adheased. Tape can be used in the front but only so long as it is lower than the level of the grafts. There are a variety of ways to transition out of a hairpiece and we can help you work through these scenarios.



What kind of training does my doctor have, did they learn hair transplant at a weekend clinic?

Medical training and education can be very confusing to people outside of the medical profession. There are DO’s, MD’s and a variety of board certifications. For those of you who aren’t sure what all of that means, here is how it works.

There are only two degrees of medicine in the United States of America that give an individual the right to apply for a state license (each state has a their own licenses) to practice surgery (cut and suture) or medicine (prescribe FDA and DEA regulated medications) unsupervised. These are the “allopathic” MD (medical doctor) degree and the “osteopathic” DO (Doctor of osteopathic medicine) degree. Any individual who graduates from one of these 4 year programs have earned the title “doctor” of medicine (as opposed to history or chemistry).

It is exceedingly rare for new doctors begin practicing medicine right out of medical school. 99% of new doctors enter into a residency to learn a specific field of medicine (Dermatology, Emergency Medicine, Plastic Surgery etc). Residencies are at least 3 years in length and can be as long as 7 years. The goal of the residency is to prepare a Doctor to practice their specialty and to pass that specialty’s “Board” Examination. Successfully completing a residency entitles a physician to sit for a Specialty Board and if passed become “Board Certified.”

Beyond the residency, doctors wishing to “sub-specialize” can receive additional training in a “fellowship.” A fellowship is highly specific field of study. There are fellowships in sports medicine, hand surgery, hair transplantation, Toxicology, Invasive Cardiology etc. Fellowships are important because they allow physicians to exclusively focus their time on a concentrated field of medicine, and typically teach physicians to do a limited number of procedures very well. This is especially important in hair transplantation, which is often minimally covered or excluded altogether from residencies. Even plastic surgery, and dermatology residencies do not generally require their surgeons to have performed or even seen one hair transplantation.

We believe that physicians who have dedicated a year of their life to a fellowship focusing exclusively on hair transplantation and hair loss will have a better understanding of the artistic and surgical intricacies of hair transplantation. As part of our commitment to quality, all of the surgeons at Ziering Medical have completed a residency and are board certified in that specialty, in addition they have all completed a minimum one year fellowship in Hair Transplantation Surgery and are board certified or eligible to take the Board Exam offered by the American Board of Hair Restoration Surgery. Every Ziering Medical surgeon has a minimum of 8 years of medical and surgical education with at least a one year fellowship specifically in Hair Transplantation.

Dr. Ziering is board certified in Dermatology, by the American Osteopathic Board of Dermatology, and in Hair Transplantation Surgery by the American Board of Hair Restoration Surgery. In addition he has over 13 years of hair transplantation surgery experience.

This article is taken from Ziering Medical Website, used with permission.




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The medical information provided in this site is for educational purposes only.  Any topic discussed in this article is not intended as medical advice. It is not intended nor implied to be a substitute for professional medical advice and shall not create a physician - patient relationship. Consult a dermatologist, if you have a specific question or concern about a skin lesion or disease.
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