Follicular Unit Extraction and Scalp Micropigmentation

 Most men will suffer hair loss to some degree in their life. This is because of DHT a male hormone that negatively affects the hair follicles of the scalp; most aggressively at the temples, crown and top of the head. So men bear this change or maturation of male pattern baldness (MPB) well; but many experience the well documented ‘psychological effects’ which culminate in low self image, esteem and confidence.

It is no wonder that hair restoration through hair transplant surgery is  one of the leading medical cosmetic concerns among men.  Today’s follicular unit transplant (FUT) surgery is providing the undetectable and natural solution that patients’ seek.

Nevertheless, some people with advanced hair loss and limited donor hair for the surgery have fewer choices. Follicular Unit Extraction (FUE) surgery combined with scalp micropigmentation (SMP) offers and innovative approach for men with advanced male pattern baldness (MPB).

A combination of these less invasive procedures can provide excellent results under the skills of today’s leading hair transplant surgeons.  A combined FUE and SMP procedure means:

• Individual follicular units (FUs) will be transplanted for balanced and even coverage
• Individual FUs will be transplanted to created an attractive age appropriate hairline

• will include selection of dermal pigment to match your hair color
• micro injections of dermal pigment to simulate ‘stubble hair’

• to support the development of transplanted hair a short term prescription of Propecia may be prescribed

 These two advanced hair restoration procedures can provide a patient with the option of having a shaved or ‘military type hair style that is attractive and a safe medical solution to their hair loss. s where the entire scalp and hairline frames the face with closely cropped ‘stubble’ hair. A person with limited donor hair can be a prime candidate for this safe and less invasive hair transplant procedure.

Skilled hair restoration surgeons can take individual follicular units (FUs) and create the maximum balanced coverage over the scalp. They can then create further ‘look of density’ by simulating hair stubble with scalp micro-pigmentation (SMP). Los Angeles hair transplant centers are innovative leaders in hair restoration procedures.

SMP is a procedure where special surgical needles are used to inject dermal pigments into the scalp or other areas such as eyebrows into the skin.  The color of pigment selected is close to that of the patient’s hair resulting in a cosmetic hair shadow.  SMP is a safe and very non invasive procedure.

Combining FUE and SMP to resolve the challenge of hair loss for people with little alternatives and represents an advancement in modern hair restoration.  This solution is not for everyone but is a welcome choice for some people who previously had limited alternatives to resolve their hair loss problem.

Follicular Unit Extraction (FUE) for Scar Revision

FUE hair transplant procedure is used for completely restoring hair to balding areas of scalp. The nature of this surgery makes it more time consuming because each follicular unit (FU) is extracted singularly. The FUs can have one, two, three or even four hair shafts. This type of procedure on like ‘Strip Method’ hair transplant procedures allows for a limited number of grafts to be extracted.

Since the extraction of individual follicular units (FUs) is done individually it is perfect for the small procedure of revisioning a hair transplant scar from a previous hair transplant. The surgeon can extract a small number of grafts from the permanent zone and artistically and strategically place them in the scar. This process of using FUE uses hair to obscure and blend the margins of the scar to the surrounding scalp.

 The Cause and Problem of  Hair Loss

Dihydrotestosterone (5α-Dihydrotestosterone), [DHT] is a male sex hormone, an androgen. Male and female adults can lose hair as a consequence of changes in the metabolism of androgen in the body – men far more commonly than women. Most men experience hair loss from the effects throughout their life. The incidence increase with age; however, some men can experience it even in their adolescent years.

Male pattern baldness, [MBP] is also known as androgenic alopecia or androgenetic alopecia, is caused by the hair follicle’s sensitivity to DHT. The follicles miniaturize [shrink], reducing the lifespan of the follicle resulting in abnormal production of hair. Hair loss is considered to be a legitimate medical problem that in some individuals leads to serious depression.  DHT plays a major role in hair loss.

Female Pattern Baldness, [FPB] also has an androgenic component but can also have some other contributing factors.  The best hair restoration surgeons will order additional tests to isolate that the cause is androgenic. In patients where this is accurate than hair transplant is a natural, proven and permanent solution.

Hair Transplant Surgery is a Great Solution (watch video)

The method of using hair from other parts of the body to be placed into the scalp has been used for several years now. The Unfortunate thing is the change which occurs in the life cycle of body hair makes body hair the last option for scalp hair restoration. Body hair tends to have a long resting phase and short growth phase, meaning the majority of the hair which was transplanted will stay in the resting phase and have no visible hair growth.

 
When seeing a side-by-side comparison of the scalp hair (left) vs. the facial hair (right), there is an obvious difference in the density of hair on the surface area and the average number of hairs in each follicular unit. Scalp hair is denser with more hair per grafts (over 2-4 hair/graft) while beard hair has less density with fewer hair per grafts (1-2 hair/graft)

On the other hand, mustache and beard hair has a shorter resting phase and longer growth phase. Because of this, men can grow their facial hair very long. For most people, facial hair is much thicker than scalp hair. Thicker hair could be translated as more bulk of hair after hair transplantation. Both thicker hair shafts and longer growth phase make beard hair a better option for scalp hair restoration in comparison to body hair transplant from other areas.

Unfortunately, there are two issues with beard hair restoration. The first is the fact they are very sparse, and removing hair only needs to be done through a strip procedure. The second regarding using facial hair for scalp transplant is follicular units found on the face have a fewer number of hairs per unit, which means there is less hair per grafts removed with FUE techniques.

Beard transplants are gaining popularity annually, and the newest technology in hair transplantation allows for hair loss doctors to use scalp hair for transplanting to the balding area in people which do not have good quality facial hair. Modern technology continues to advance the art and science of hair restoration further into new realms of possibilities, with an large annual growth reported yearly.

There are times when patients suffering from the more advanced stages of balding require a second hair transplantation surgery to complete the process. The question many of these particular patients have is what the time lapse is between the first and second surgeries.

This depends on if there is density which needs to be added to the already transplanted areas. If so, there needs to be at least six months which has passed since the original surgery. This is because after six months there is more complete growth from the first hair transplantation, and a touch up in the already transplanted areas will bring more complete results. The amount of hairs transplanted in the second surgery is typically less than the first since the scar from the first surgery is removed a second time. Overall, the greater the density in the transplanted areas, the better the hair restoration will look long term.

There are times when I receive inquiries as to why professionals such as hair stylists and dermatologists do not recommend hair restoration surgery to their clients or patients. I have scratched my head to this quandary as to why this is, since hair restoration surgery is the only method which is proven, permanent, and natural! The fact is, when it is done by a skilled hair restoration surgeon, the final product looks GREAT!!!

In the past twenty years, hair restoration surgery has progressed significantly, but with the most noticeable changes happening in only the past five years. The most profound breakthrough in this time is the current method of dissecting hair grafts to maximize accuracy for long-term growth as well as the ability to transplant larger quantities of hair grafts (up to 5,000 in one sitting) which is known as a giga-session.

Unfortunately many stylists, and shockingly physicians as well, are not up to speed with modern hair transplantation techniques or the positive effects a surgery can have on their clients or patients. It is our goal at US Hair Restoration to continue to educate physicians, hair stylists, and the public about the science and art of current hair transplantation techniques.

We are intentional about inviting professionals such as physicians and hair stylists to hear about our services, witness a live surgery, and see life changing results just months after an operation. This knowledge helps them to be more informed of how to better direct their clients and patients. When it comes to hair and hair loss in general, hair stylists are seen as having great credibility for making suggestions. At US Hair Restoration we have a progressive campaign for educating them called the “LA’s Top Style List” and we believe our message will be made known.

A patient once asked me why his surgery of 2850 grafts did not bear the same results after three years as some who have had the exact same number of grafts. I informed him to never compare other patients results simply based on the number of grafts alone.

Whenever I meet with a patient before hair transplant surgery, I intentionally educate them of what they personally should expect after their procedure. At times I do give big promises to certain patients with better quality donor hair (denser, wavier, and thicker), and some I encourage to get more than one surgery for maximum results. The overall results will be determined by donor hair quality, number of grafts, and hair to skin color contrast.

If two different patients were to be compared who have the same hair characteristics, but one is twice the thickness than the other, a microscope would be used to reveal the cross section of hair. This would reveal the one patients hair is four times thicker (A= r2) and the final result is expected to have a volume of 4 times thicker.

Many factors can contribute to poorer results from a hair transplantation surgery. Some factors may be from the patient themselves, while others situation may be due to the technique of the surgery and how well the follicles maintain post-surgery.

Here are a few frequently asked questions we have for your general inquiry:

How do you relocate hair grafts once broken down into follicular units?

The hair grafts (or follicular units) are transplanted based on the individual needs of the patient. The doctor will draw the hairline at your initial consult and right before the procedure and discuss it in detail with the patient. Designing the hairline has to do with the degree of baldness in each area of the scalp and the patients’ preference.

How are the hair grafts placed?

The follicular units must be immersed in a special solution in cold temperature once they are taken from body. When the sites are completed by the surgeon, the hair technician will gently insert the grafts one at a time. This is a very meticulous process and typically takes a few hours.

Does Dr. Mohebi perform the hair transplant surgery himself?

All surgeries are performed by Dr. Mohebi. He will get assistance from a surgical team of hair technicians during dissection and implantation of the follicular unit grafts.

Am I put under sedation while I get the procedure?

You will be put under sedation during the procedure but you will still be conscious. You will become more alert and aware as the surgery goes on, in which you will be sitting in an upright position in a surgical chair most of the time. You can watch a movie, read a book, listen to music or you can sleep (if you choose to) during your hair transplant surgery.

How long before the transplanted area doesn’t look like a procedure has been done?

Redness and swelling after hair restoration surgery is not uncommon and may last a few days following the procedure. Most patients generally recover from surgical swelling and redness after day 4 or 5. A loose fitting hat can be worn to prevent direct sunlight, which will protect the grafts and also keep your swelling or redness from being seen by others, if that is your concern.

Where can I find before and after photos of Dr. Mohebis’ work?

Before and after photos as well as video testimonials of previous hair transplant patients can be found at our facebook page: http://www.facebook.com/home.php#!/pages/US-Hair-Restoration/148987321796051, which we will keep updated as much as possible on a regular basis.

Good day all,

I recently had a case that I found very interesting and I thought you might as well. A patient was experiencing hair loss and was very unhappy to the point that it had a negative effect on his and his family’s lives. He was attending a school of medicine in another state and was willing to fly to our US Hair Restoration offices in Encino, California for the possibility of receiving a large FUE transplant from his body and beard into the balding areas of his scalp. He was hoping that this would help to end his hair loss once and for all.

Body hair can be used as an alternative method for hair restoration, as long as the patient understands that the end result will not be comparable to a scalp hair transplant due to a shorter growth phase (Anagen), as opposed to a long resting phase (Telogen), and a smaller final length of the hair, which are the characteristics of body hair. Thus, you may only see a portion of transplanted hair follicles in growth phase while the remaining hair stays in resting phase without maintaining a visible hair shaft.

Another option for hair transplantation is the possibility of using beard hair. Beard hair (for many patients) is closer to scalp hair and has a longer growth phase which allows it to grow to be much longer in comparison to body hair.  Both of these options have pros and cons and patients should weigh all of their options, after a full evaluation with a certified hair restoration surgeon. By speaking one-on-one with a qualified hair transplant surgeon, patients are able to find a treatment plan that best fits their needs.

To determine what option is best for you, attend a free consultation with a qualified hair restoration physician. If (like the patient above) traveling to one of our offices is inconvenient for you, then please feel free to fill out an online consultation request and our office staff will follow up with you as soon as possible to begin scheduling for a internet/phone consultation.

Following popular demand, we have now decided to post all of our patients success stories on this blog.  I love having the opportunity to see my patient’s post operative results and personally witnessing their life transformations. Here is one example of a patient who’s life was changed following his hair transplant procedure:

We will be sure to keep you posted with all future video testimonials at US Hair Restoration.

Best,

Parsa Mohebi, MD