A Brief History of Hair Transplantation
Hair transplantation has come a long way since the late 1800s when "scalp flaps" were shifted to cover a bald or thinning area of the head. The primary hair transplantation process remained relatively obscure until the 1950s when Dr. Orentreich demonstrated how it was possible to successfully transfer free donor grafts to another location on the scalp; enabling the process to be recognized as a viable option in mainstream medicine. Eventually the rudimentary grafting was refined, leading to the use of "plugs" and then "micro-plugs" which became the predominate method of hair transplantation in the 1980s and early 1990s.

Significantly less noticeable than the former grafts, plugs became strongly associated with the rather unsightly "doll's head" phenomena where small tufts of hair were lined up and implanted in tidy little rows. The original Hair Restoration Surgery consisted of a 4mm standard round punch graft or plug with a very uniform appearance. Although hair was restored to formerly thinning or bare areas of the scalp, the overall effect left a lot to be desired due to the "doll's head" appearance.

Not Your Parents Hair Transplant
Fortunately, that has all changed. Today, hair transplantation results in nearly invisible integration with ones natural hairline thanks to the use of follicular unit hair transplantation. Modern day hair transplantation techniques use a wide variety of shapes (round, thin, fat, linear, rectangular etc.) combined with different hair or follicular units and incision or graft techniques (slot, slit and punch) to create natural-looking transplantation designed to mimic your own unique hair pattern.

Off the Top of Your Head
In addition to dramatically improved hair transplantation techniques, it is now possible to replace hair in areas other than the scalp including eyebrows, eyelashes or even facial hair such as the upper lip/mustache and beard. In fact, it is entirely possible to radically transform one's appearance with strategic surgery designed to enhance the hairline, thicken eyelashes or fill in sparse facial hair.

Why Try Transplantation?
Hair loss impacts nearly one of every two men (and roughly one of every ten women) by the age of fifty, so it should come as no surprise that hair transplants are among the top five most common cosmetic procedures in the United States.

Loss of hair may adversely impact self-esteem, job prospects and even one's social standing, making it more than a mere question of "vanity." Certain conditions or illnesses may cause or worsen hair loss including androgenic alopecia or scarring alopecia while still other influences such as genetic factors may result in sparse or thin hair. Whatever the reason, hair transplantation is a tried and true method to replace hair loss without resorting to uncomfortable hair pieces or wigs.

Other Options & Alternatives
While hair transplantation provides unique benefits that can be difficult to duplicate, there are other options and alternatives available to those persons who are either unable or uninterested in undergoing surgery. Some of the more popular options include:

• Hair Piece or Wigs One of the oldest options used to hide hair loss or add volume to thinning hair, hair pieces come in a wide variety of colors, styles and shapes ranging from complete wigs to simple enhancements.
• Minoxidell Approved by the Food and Drug Administration (FDA), this topical solution is designed to stimulate regrowth of hair on the scalp. Look for products like DS Laboratories Spectral.DNC - Breakthrough Hair Loss Treatment; not only does it contain the highest quality research grade, Minoxidil and ancillary compounds designed to complement and nourish the regenerative properties of the formula but it is encapsulated in DS Laboratories nonosomes for ultimate penetration.
• Bimatoprost An FDA-approved prescription created to promote eyelash growth, Bimatoprost is able to darken and lengthen eyelashes.
• Laser & LED Devices Low energy LED or laser devices such as HairMAX LaserComb Premium Edition promote hair growth via follicular stimulation in a convenient, easy-to-use and completely non-invasive manner. The LaserComb Premium by HairMAX provides ultimate performance with minimal effort. Clinical testing demonstrated some degree of hair regeneration in nearly all patients using the HairMax system.

How to Determine If Hair Transplantation is Right for You
The decision to undergo hair transplantation is highly individualized, but there are a few considerations to keep in mind when evaluating your options.

• Fine Hair v. Hair Loss The first step is to determine whether or not you are actually experiencing hair loss or thinning. Persons with very fine hair may benefit from the use of conditioners or agents designed to add volume to the actual hair shaft; for example, eyelashes are a common problem that typically respond well to products like Osmotics FNS Nutrilash Lash and Brow Enhancer or RevitaLash Eyelash Conditioner.
• Breakagev. Thinning Hair Another common culprit often mistaken for thinning hair is excessive breakage due to damaged hair. Never underestimate how much breakage can impact hair volume; products like Tricomin Revitalizing Shampoo are specifically designed to stimulate and restore hair to health through a combination of body building formulations, nutritional complex and essential amino acids.
• Limp Hair v. Volume A frequently overlooked problem associated with thinning hair is actually not a problem whatsoever; many people mistake limp hair with reduced volume when in fact, it is actually a build-up of oils, hard water elements and other chemicals. Switch to a nutrient rich solution like Tricomin Conditioning Shampoo to see how your hair responds before undergoing more intensive treatment.
• Temporary v. Permanent Hair Problems The final determination to be made before making a final decision on whether or not hair transplantation is right for you is whether or not your hair problem is temporary or permanent. Hormones, age related changes, excessive overprocessing, sun exposure, medications and more can negatively impact the health of hair. While overt examples such as chemotherapy are well known, many people fail to realize the dramatic impact day-to-day situations can have on hair quality. Men and women often benefit from Tricomin Deep Conditioning Treatment that revives damaged hair and restores those thick, luxurious locks.

Once you are certain thathair loss or thinning hair cannot be adequately addressed with less invasive or cost effective means, it may be time to consider surgical options. Your prospective hair transplant specialist will review each of the following criteria to determine the best method for your specific situation:

• Prior transplantation history and outcome.
• Expectations and social implications of the surgery.
• Existing hair health and availability.
• Current medical conditions and overall health status.
• Chemical sensitivities and allergies.
• Medications including both prescribed and over-the-counter (OTC) drugs.

Cost, Complications and Other Considerations
Cost is often the first question that comes to mind when people initially research the feasibility of hair transplantation. However, the actual cost involved in hair transplantation is highly individualized and determined by a multitude of factors including time required to perform the procedure, location and type of surgery performed, extent of transplantation required and other variables. Nationwide, the typical price ranges from roughly $3,000 to in excess of $15,000.

The next most common concern related to hair transplantation involves complications such as pain, bleeding or scars. Although relatively rare, infection and scars occasionally take place and may require the use of antibiotics or corticosteroids. More common post-operative complaints tend to center on pain and bleeding issues; most resolve with little to no intervention other than a mild oral narcotic or OTC pain reliever. Numbness, skin discoloration and dimpling are typically temporary but bothersome side effects experienced by some hair transplant patients which typically resolve over time. Finally, hair transplant candidates should always be aware of allergies or adverse reactions related to anesthesia or other medications used before, during and after the procedure.

Although follicular hair transplant procedures have dramatically improved the outcome for most recipients, there are disadvantages that should be carefully considered. In addition to higher costs related to intensive labor and time required to prepare and transplant up to 3,000 follicular units, the final result is highly contingent upon the actual skill of the surgeon involved. It is important to carefully evaluate the credentials and reputation of the hair transplant doctor prior to making a final decision.

How to Select the Right Hair Transplant Specialist
The final results of your hair transplant surgery will be directly related to the skill and expertise of the surgeon selected. Learn how to pick the best possible hair transplant specialist with these quick considerations:

Board Certified. One of the most important decisions you will make when selecting a hair transplant specialist is whether to choose a Board Certified Plastic Surgeon. This designation typically indicates a level of proficiency and expertise above and beyond standard training; however, it is still a good idea to check credentials to make sure they are in good standing with the state without pending complaints.

Testimonials. Ask how long the physician has practiced this procedure and view before and after photographs of prior patients. If possible, take time to speak with others that have worked with this physician or facility in the past. Just remember, prior results do not guarantee future performance.

Right Fit. Not only should you feel comfortable with the hair restoration specialists, but make sure they perform the type of transplant best suited for your needs and specialize in hair transplantation. Always opt for a physician that is patient-focused and takes the time to answer questions and concerns in a relaxed manner without making you feel rushed or pressured.

Pre- & Post-Care Products
Once you have made the decision to undergo a hair transplantation process there are several things you can do to maximize results and minimize complications both before and after the actual surgery.

Preparation
Your physician will provide a complete list of pre-surgical instructions detailing specific actions and medications to be avoided. However, long before the big day arrives, many people find it valuable to condition their scalp and hair. In fact, many surgeons require patients to use specialized shampoos designed to treat common scalp conditions and thoroughly clean hair. Tricomin Follicle Therapy Spray and Shampoo are popular options designed to maximize healthy hair without leaving an oily residue while DS Laboratories Dandrene helps eliminate dandruff.

Post-Op Planning
Once again, your physician will provide detailed post-operative instructionsthat must be followed to reduce the risk of complications. For example, most people are advised to rest and relax for several days following a hair transplantation procedure. Antibiotics or topical medications may be prescribed to prevent edema and risk of infection.

Patients often complain about post-operative scabbing or crusting which usually resolves within two weeks but may result in a slight itchiness in the interim. Likewise, dont be alarmed if the transplanted hair stubble falls out; it can take 12 to 18 months for full growth to occur, but once it does, the results are there to stay!

Karmen B. Saran
DERMAdoctor Staff Writer

(Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.)

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