No one likes losing their hair or going bald as they age; nonetheless, it happens and is happening to men and women alike every day. The medical community has made great strides in understanding the basic science behind balding and male pattern hair loss (aka androgenic alopecia). We now have a FDA-approved medicine (finasteride) that directly blocks the formation of DHT (dihydrotestesterone, a byproduct of testosterone metabolism) that is so toxic to predisposed hair follicles. Though research is ongoing, the same progress has not been made with female pattern hair loss and its basic physiology.
The good news is for those that are losing hair is that the procedures done to replace the hair an individual has lost or is destined to lose have become not only highly technical and precise but are yielding amazing results. The history of hair restoration surgery is littered by previous failures and unnatural results. Now gone are the days of “hair plugs” and large scalp flaps for the perspective hair restoration surgery patient.
The reason hair replacement surgery in the past had looked so artificial or “pluggy” related to the size of the grafts that were placed in the scalp. The old 4 mm punch grafts were just too big to yield a natural result; furthermore, hair surgeons started to realize the placement of those grafts must be in a natural position on the scalp. The solution came in the 1990s when several prominent and expert hair surgeons began using the microscope to dissect their grafts into individual follicular units. This technique produced tiny grafts known as microfollicular units or MFUs that could then be precisely placed into a patient’s scalp to recreate a natural hair line. Over the ensuing years and decades, their techniques became disseminated across the world and now are considered standard of care for modern hair restoration surgery.
An issue that arose related to the method of harvesting those MFUs destined for hair transplantation. At the current time there are two main and proven ways to harvest hair from the donor area (the posterior-occipital scalp) for use in hair transplantation. The more common way to harvest the donor area is a “strip technique”. In this technique, the surgeon removes a strip of donor hair from the posterior scalp and sews the area together. The harvested strip is then divided using microscopic dissection to yield a large quantity of MFUs. The other technique is known as “follicular unit extraction” or FUE. This restoration method removes individual follicular units from the posterior scalp using small punches. This technique has become more common place in recent years due to innovation in the instruments used to perform FUE (i.e. neograft ©).
It suffices to say, there are benefits to either method and both methods can yield excellent results with minimal complications in experienced hands. Today, those individuals worried about their hair loss have viable medical and surgical options. One needs to simply seek out those individuals and physicians experienced in the art of hair restoration.