Hair Restoration Treatments: Hope or Hype? (Part 3)

Surgical hair transplantation is the fastest growing cosmetic surgery today. There are currently a few surgical procedures available: the ‘donor strip' hair transplant, ‘follicle unit extraction', and scalp reduction.

The donor strip method is the most commonly used, provides the best results and is considered the only viable surgical treatment by over 95 percent of hair restoration surgeons in the United States. The surgeon first removes a section of hair-bearing skin from the back of the head, right around the base of the skull. The removal area is sutured together, leaving a thin scar blended into the hair in the back of the head. The follicular units are extracted and placed in cool saline solution. Then, small incisions are made in the areas of thinning and loss and one-by-one the follicular units are implanted.

Follicular Unit Extraction is just that; instead of making an incision in the back of the head, each individual follicular unit is removed with a punch blade and then relocated to the areas of thinning and loss, all in one step. Unfortunately, it isn't as simple as it sounds. First of all, hair follicles do not grow straight up and down beneath the skin; they grow at angles. Not only that, but each follicle can be at a dramatically different angle than the follicle next to it. Clinical studies have shown that 25-40 percent of all follicular units being extracted are destroyed, simply cut in half. In addition, the punch blade will leave multiple scars throughout the donor area. Bottom line: follicular unit extraction procedures cost more, result in less density and compromise the donor area. This is why few surgeons employ this technique, and respected names in hair restoration caution against it.

Scalp reduction surgery involves removing an area of the scalp, eliminating part of the area affected by hair loss. The result can be a reduced bald spot and greater coverage by surrounding hair-bearing skin as it is pulled towards the spot where the skin was removed. However, there are risks associated with this procedure. Stretching is a likely possibility since the resulting scar has a great deal of tension on it. Another possibility is traction alopecia, which is the permanent hair loss caused by great stress on hair follicles. Also, reduction in scalp elasticity from a scalp reduction can compromise future hair transplant procedures.

The cost for hair transplant surgery? The average procedure is about $5,200, and depending upon the procedure, could rise to $10,000 or more.
If you are experiencing hair loss, only you can judge the procedure that is right for you. Be sure to do your homework and keep in mind the relative risks and benefits of each procedure.