What should I look for when selecting a hair transplant physician?

Selecting the right physician is a very big decision because the quality of work being done today varies widely. Consider what consumer advocate and the author of "The Bald Truth" says about hair transplant physicians today:

In his book Kobren warns readers that although the "Follicular Unit Hair Transplant" procedure is widely considered to be the "Gold Standard," it is unfortunately performed well by only a small handful of hair transplant surgeons.

Ask your self these important questions before you consider before making a final decision:

• Can the surgeon provide at least one dozen sets of clinical "before" and "after" case photos for your review? Be sure the photos offer good clarity and detail, and include "before" views as well as "after" views that allow for critical evaluation of the hairline, midline and crown areas.
• What is the physician's reputation among his or her peers?
• Does the physician lecture or teach other physicians?
• Have the surgeon's techniques been documented in leading medical journals? Such publishing credits help ensure credibility and the authenticity of a surgeon's work, having passed stringent medical review processes.
• Can the surgeon provide a list of names and phone numbers of patients willing to discuss their personal experiences? Patient testimonials will say a lot.
• Is the surgeon performing procedures in a fully-equipped and sterile outpatient surgical facility designed exclusively for hair restoration?
• How many procedures does the surgeon perform in one day? Ideally the physician will be dedicated to working on you all day if you are doing a large mega session procedure.
• Does the physician perform hair restoration surgery full time?

What causes baldness?

The cause of male pattern baldness is no longer a mystery. Research has shown that when the male hormone - testosterone is exposed to 5-alpha-reductase, an enzyme in the hair follicle, it produces another hormone called dihydrotestosterone (DHT), which causes permanent hair loss. This hormone (DHT) causes the hair follicle to shrink and grow a finer hair that is lighter in color, shorter and less deeply rooted than its predecessor. Most often, the hair in the balding region will continue to grow at an increasingly slower rate until hair growth ceases completely.

The pattern of progression, and the extent and speed of male pattern baldness, is largely dictated by genetics, hormones and age. For men, this permanent type of baldness generally follows specific patterns. Even in the most extensive cases, a horseshoe shaped fringe of hair remains. This donor fringe is insensitive to the balding process and will last a lifetime. This is because this hair is genetically programmed in the root, or hair follicle, to be resistant to the effects of DHT.

The hair in this donor area provides the basis for surgical hair restoration. These hairs, when transplanted into thinning or balding areas, will take root and grow, and continue to grow for the rest of a person's life.

Are hair transplants permanent?

Since the hair used in hair restoration surgery comes from the donor area, which is not sensitive to the balding process, it will be permanent. This hair will retain its genetic characteristics even after relocation. It will grow and continue to grow for the rest of your life.

What is "follicular unit hair transplantation"?

This procedure has been called the logical end point of 30 years of evolution in hair transplantation beginning with traditional larger plugs and culminating in the move to one, two, and 3 hair follicular unit hair grafts, which mirror the way hair grows in nature. (Hair Transplant Forum Feb. 1997).

The key to follicular unit transplantation is to identify the patient's "natural hair groupings" and use them intact to create from "micro follicular unit hair grafts" that are composed of naturally occurring 1, 2, and 3 hair grafts.

These follicular unit micrografts are much smaller than traditional untrimmed micrografts that contain equivalent amounts of hairs. Their size enables larger numbers of them to be placed in tinier, less traumatic incisions closer together.

Using this advanced technique a surgeon can move more hair in a totally natural way - creating a natural look at every stage of hair restoration.

Why are so few physicians performing all micro"follicular unit hair transplantation?

It's known that using small follicular unit grafts of 1 to 3 hairs and large sessions of 1200-2000 grafts is the ideal procedure for a patient who wants to achieve the most natural result with the least number of sessions.

As beneficial as it is for the patient, it is equally unappealing for the physician performing the procedure. This procedure requires the physician to be more detailed and exact, both in the cutting and placing of the graft. Using smaller grafts results in the need for more of them, thus it is more labor intensive. It necessitates a larger staff and longer time commitment to achieve the desired result.

While it is more labor intensive and therefore more costly to the clinic, the belief is that the doctors should bear this added financial burden. This is because they're not moving that much more hair, they're just moving it in a better manner.

Some physicians say there is not sufficient circulation in the recipients site to place 1000-1500 grafts and ensure successful growth.

This may be the case with sessions of 1000 to 1500 grafts if grafts larger than four hairs are used. And it's usually physicians using grafts of this size that make this statement.

However, mega sessions of 1000-2000 grafts with grafts of 1-4 hairs are completely successful. Performing sessions any smaller would be counter productive as it would not maximize the procedures potential.

How much work will I need?

How much work you will need depends on various factors - such as, how much hair loss you have now, the amount of hair loss you will have in time, and your goals and expectations - or how thick you need it to be.

What does Hair Transplantation Cost?

Generally hair transplantation has become a dramatically better value over the past several years. The cost of hair grafts have gone from a typical $25 per graft charge for the old large pluggy grafts, to prices ranging from $4 to $10 for today's mini, micro, and all micro follicular unit grafts. The price per graft tends to be lower as the size (number of grafts) of the transplant session increases. Therefore larger sessions not only produce more dramatic and rapid progress but better cost efficiencies.

The Shapiro Medical Group's pricing is very moderate by industry standards. And that's not even taking into account the vastly superior results that are achieved by them. For a mega session of 1500 or more all micro grafts the cost per graft can be as low as $4.00 per graft. Financing is also available.

Of course the cost of hair transplantation will ultimately depend on how much work you need to be satisfied.

Since Propecia is now available, will hair transplantation be a thing of the past?

While Propecia and Rogaine have been proven to regrow hair, they will not grow all your hair back. Both products have not been proven to grow any significant hair in the frontal temple area, which is the main area of concern for most people.

Their greatest benefit seems to be in slowing down hair loss. Propecia and Rogaine can be part of an effective hair restoration plan. We prescribe Propecia in order to help maintain some of the hair which may be lost over time.

What about "Scalp Reductions"?

Scalp reductions were first introduced in the mid-1970s as a way of treating an individual with a midline bald spot. Although several design approaches can be used, an elliptical approach is generally the most common. With this procedure, an ellipse of bald skin is removed centrally in the crown area and the hair-bearing scalp on the sides of the head is stretched toward the middle to obtain closure.

Because scalp reductions do not allow for an upward and forward advancement of the entire scalp, they are not effective in treating patients who possess or have the potential for more extensive baldness. Due to this inherent surgical limitation, as well as the aesthetic drawbacks, which include an excessive stretching back of the bald area and increased receding at the temples, the scalp reduction procedure is considered outdated for the treatment of moderate to extensive baldness. Newer procedures offer more predictable and better aesthetic results, and often require fewer surgical sessions.

Does removing hair from the donor area on the back of my head leave a gap?

The scalp is very elastic. When the donor strip of hair is removed, the scalp on both sides is just pulled together and sutured. The only evidence of surgery is a thin line hidden under the hair that grows vertically on the back of the head.

Are there risks involved?

Elective surgery to improve physical appearance is universally accepted and is being performed successfully everywhere there are qualified specialists. Hair restoration procedures differ from general surgery, however, in that they involve only the outer layers of the body. You should not worry excessively about risks or complications, because they are rare.

Is hair restoration surgery painful?

The discomfort associated with hair restoration surgery is usually comparable to that of dental surgery. Pain medication is always offered, though its use is limited generally to the first 24 hours after surgery.

Will my transplanted hair require special care?

Your newly restored hair will grow and require the same maintenance as your original head of hair. It's your hair and can be colored, permanently waved or styled in a variety of ways suitable to your lifestyle.

Can I wear a hairpiece until my surgery is completed?

Hair pieces can be worn between surgical visits if you want, as long as proper hygiene and ventilation of the scalp are maintained.