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Where is Optimal Donor Incision for Hair Transplant?

June 23rd, 2006

Q: I have heard that the hair for a hair transplant is taken from the back and sides of the scalp. Where exactly is the best place to remove the hair from?

A: You are correct. The best place to put the donor incision is in the mid-part of the permanent zone located in the back of the scalp. As more hair is needed the incision is extended towards the sides.

The vertical position can be found by feeling for the bump in the mid-part of the back of the scalp, also called the occipital protuberance. The strip should lie over this point.

If hair is removed too low on the back of the scalp, there is a greater chance that the wound will heal with a stretched scar from the movement of the underlying muscles. If the incision is too high, the hair will be subject to the same genetic balding and may not be permanent.

Posted by Robert M. Bernstein M.D. at 2:24 pm

Does Hair Loss Treatment with Propecia Work in Older Patients?

June 22nd, 2006

Q: Hi. I am 52 years old and wish to know if Propecia will work for my age. I have started losing some hair a couple of years ago and it’s thinning out. Thank you very much for your help.

A: Propecia (Finasteride 1 mg) can hold on to hair at any age, but works best to re-grow hair in those who are younger. Occasionally we see patients in their 50s re-grow some hair with Propecia, but this is the exception rather than the rule.

Topic: Drugs (Medications)

Tags: Age / Finasteride / Hair Loss Treatment / Propecia / Propecia in Older Patients / Thinning Hair

Posted by Robert M. Bernstein M.D. at 2:40 pm

Why is Strip Harvesting in Hair Transplant Procedure Still Popular?

June 21st, 2006

Q: Why are strips used so much in a hair transplant when there is now Follicular Unit Extraction (FUE)?

A: Strip harvesting is used in the majority of hair transplant procedures because it allows the surgeon the ability to perform hair transplant sessions using large numbers of grafts while minimizing injury to the patient’s hair follicles.

This is possible because once a strip is removed from the back of the scalp, the tissue can be placed under a stereomicroscope where dissection is accomplished using direct visualization of the follicular units. This allows the grafts to be dissected with minimal trauma.

This degree of accuracy is not possible with other hair restoration techniques, such as FUE, where the separation of follicular unit grafts from the surrounding tissue is accomplished “in vivo” (directly from the scalp).

Topic: Donor Area

Tags: Dissection Phase of Hair Transplant / Donor Strip / Follicular Unit / Follicular Unit Extraction / FUE / Graft Dissection / Hair Transplant Procedure / Mechanical Trauma / Stereo-microscope / Strip Harvesting

Posted by Robert M. Bernstein M.D. at 10:57 am

Do Hair Loss Medications Propecia and Minoxidil Act Synergistically?

June 19th, 2006

Q: I have read on numerous websites that Propecia and Minoxidil work synergistically, and that a hair loss suffer will see better results using them together than either one alone. Do you believe this is the case, or do you think Propecia is enough treatment by itself for someone who just began to experience slight hair thinning and is too early for hair transplantation?

A: They may act synergistically since their mechanisms of action are different.

Rogaine (Minoxidil) stimulates the hair follicle directly, but Propecia (Finasteride 1 mg) permits hair growth by blocking the negative effects of DHT. Of the two, Propecia is far more effective. It is reasonable to use the two together as long as the medications are used regularly.

For patients contemplating surgical hair restoration, we generally have them continue Propecia only, since applying Minoxidil is too fussy and offers only incremental benefit.

Topic: Drugs (Medications)

Tags: DHT / DHT Blockers / Finasteride / Hair Loss / Hair Loss Medication / Hair Loss Treatment / Hair Restoration / Minoxidil / Propecia / Rogaine / Surgical Hair Restoration

Posted by Robert M. Bernstein M.D. at 6:23 am

Does Hair Transplant Donor Area Decrease in Size Over Time?

June 16th, 2006

Q: I am 22 and want to go for hair transplantation. I want hair restoration surgery now because I have a concern about my donor area that it might diminish if I postponed my transplantation. Could this be the case?

A: The logic is not correct. Having a hair transplant at an early age does not protect the donor supply.

If your donor area diminishes over time, then the transplanted grafts will fall out as well. Hair does not become permanent just because is moved in a hair transplant. It is never any better than the hair in the area where it came from.

The longer you wait – i.e. the older you are when a hair transplant is performed – the more information we will have about the stability of your donor area and this will allow for optimal planning of the hair restoration.