Hair Transplant & Hair Loss Interview with an Expert – Part 2

This is Part 2 of our in-depth interview on hair transplants, hair loss and male pattern baldness with an expert on the subject. A must read for all men, whether balding or not!

 

INTERVIEW – PART 2

Now, onto the hair transplants. I must say that one of the things that got my attention on your forum was how good your hair looked, Bill. You are an illustration of how good hair transplants can work wonders. Tell us why you decided to take this extra step (a hair transplant) instead of leaving it to the minoxidil/finasteride alone as the majority of men do.

I appreciate the compliment. My hair restoration journey was a long one but was one that could never have been accomplished by non-surgical treatments alone. By the time I was 27 years of age, I was experiencing significant hair loss and was very insecure about the way I looked. I wore a hat almost everywhere I went and felt ashamed to take off my hat in front of others. I know that most of my problem was not really to do with my hair but how I felt others were interpreting the way I looked without it. This significantly affected my self confidence and I decided to start researching my options.

After seeing a late night infomercial for Bosley and doing a simple search for “hair transplant” online, I found Patrick Hennessey’s (publisher of the Hair Transplant Network) personal website sharing his own hair restoration journey, experience and photos. It was only then when I felt confident that hair transplantation was the “real deal” and I began researching local doctors who performed the procedure on the Hair Transplant Network website.

While I’m very happy with my hair transplant results, looking back, I do wonder whether or not I would have ever needed hair transplant surgery if I started taking finasteride right away in conjunction with ongoing Rogaine treatment. But then again, if I didn’t go through the journey, I wouldn’t know what I know today nor would I be able to dedicate my time in helping countless others get past the hype and find real information and treatments that best suit them.

 

Another photograph of Bill before he went on his hair transplant journey

A before picture from a successful hair transplant

 

Bill’s end results from his successful hair restoration approach

After photograph from a successful hair transplant for male pattern baldness

 

Could you describe to us the actual hair transplanting process? I have seen some incredible images of the process itself with needles and surgical threads all over the place, I assume they use local anesthesia? How long does the HT process last? What about the days after the HT?

Hair transplantation is a relatively pain-free outpatient procedure performed under local anesthetic, however, it takes virtually all day to perform. The procedure works on a principle known as “donor dominance” in which DHT resistant hair taken from the sides and back of the scalp (the donor area) will retain its DHT resistant properties even after it’s moved to balding areas of the scalp (the recipient area).

A typically hair transplant procedure starts with a brief consult with your surgeon to discuss and decide on the surgical plan including hairline design. You are also given a few pills (these drugs vary and should be discussed with your surgeon) to take prior to the procedure to prevent infection and to help you relax.

The first step in the surgical procedure is to numb the scalp under a local anesthetic and remove the donor hair (either by the strip harvesting technique or via follicular unit extraction). While nurses and technicians are trimming follicular units under microscopes to prepare them for transplanting, the surgeon is artistically making tiny recipient incisions in the balding areas that will eventually hold the grafts. A skilled surgeon will create an artistic, precise pattern and control the direction of hair growth by creating incisions at an angle in order to mimic nature. Once this process is complete, the technicians/nurses (and sometimes the surgeon too) will spend the rest of the day inserting your new hair into the balding areas. Meanwhile, the hair transplant patient can sit back, relax and enjoy in-house movie entertainment or interesting conversations with the technicians/surgeon.

While a hair transplant procedure lasts almost an entire day (or sometimes longer), the final results aren’t seen until 12 to 18 months after the procedure. The scalp takes a couple of weeks to heal although the donor area can take longer if the strip harvesting technique was used. The new transplanted hair will shed within the first month and only after 3 to 5 months will new, healthy follicles transplanted beneath the surface of the scalp begin producing new hair. These hairs often grow in thin, fine and colorless and take up to a year plus to fully darken, thicken and mature.

 

You mention above several hair transplanting techniques, could you tell us the current HT options available to men suffering male pattern baldness?

I’ve mentioned the two gold standard techniques above, but more specifically, the two primary hair transplant techniques are follicular unit hair transplantation via strip harvesting (FUT) and follicular unit extraction (FUE). There are many variations of these techniques and some surgeons use their own marketing words for them, but the fundamentals of their techniques are the same as the two I’ve mentioned above.

The two techniques FUT and FUE are similar in how the follicular units (hair groupings as they occur naturally typically in groups of 1, 2, 3 or 4 hairs) are transplanted however, how follicular units are removed from the donor area differs significantly.

During the strip harvesting technique (FUT), the surgeon removes a linear strip of tissue with a cutting device (typically a single bladed scalpel) from the sides and back of the scalp containing the donor hair. The surgeon then closes the wound by pulling the two ends of the scalp together using sutures or staples. In the hands of an experienced and skilled hair restoration surgeon, scarring is typically minimal and hair can even grow through the scar using the trichophytic closure technique. Meanwhile, nurses and hair technicians sliver the strip and trim follicular units to size using microscopic dissection. An experienced staff trained by the surgeon can produce beautiful, healthy hairs for transplanting with a minimal transection (irreparable damage) rate.

During follicular unit extraction (FUE), the surgeon uses his/her FUE tool (typically motorized or manual) of choice to extract follicular units one by one from the donor region. Varying tools come with their own set of advantages and disadvantages, but without getting too technical, all of them score and punch through the skin deep enough in order to harvest an entire follicular unit and its roots. Unlike the strip harvesting technique, the surgeon cannot see the hair roots and thus must use what’s referred to as “blind dissection” to extract the follicle. A surgeon must rely on his or her skill, experience and tool of choice in order to minimize transection and extract healthy follicles without damaging them. Surgeons dedicated to follicular unit extraction (FUE) have helped to improve and evolve the technique significantly over the last several years. The appeal of this technique to hair loss suffering men is that it doesn’t produce a linear scar and it’s sometimes easier to wear the hair on the sides and back of their scalp cropped extremely short without showing a scar.

Both techniques comes with a long list of advantages and disadvantages and I always advise those considering hair transplant surgery to spend a lot of time researching the varying views on both of these techniques.

 

Wow, as I’ve said before, I am a bit of a hair geek and I must say I am impressed by your description of the techniques, great explanation. Back to your story, your first hair transplant was in September 2004. Now, the internet is full of scammers and snake oil gurus, how was the availability of good and trusted information on hair loss and hair transplants back then? 

The internet is still full of gimmicks, snake oils and promotional propaganda today. Separating fact from fiction is no easy task for a newbie either. Many corporations prey on suffering individuals and use their emotional discomfort to make a profit. It’s honestly very disturbing.

The good news is, legitimate information is much easier to find today more than ever since the dawning of patient driven discussion forums and social communities. Similar to consumer report magazines, patient driven hair loss forums like the Hair Transplant Network enable real patients to share their genuine hair restoration experiences, photos and opinions online regardless of the physician, good or bad. While not all content on discussion forums is 100% accurate, one can find a lot of invaluable information, especially when researching credible treatments, hair transplant surgery and physicians.

I was personally drawn to the Hair Transplant Network back in 2004 before I became affiliated with the community after finding its publisher Pat and his own online hair transplant success story. I got to know Pat personally in a short period of time and felt he was truly genuine.

Pat started the Hair Transplant Network over 12 years ago in order to “pay it forward” and help other hair loss sufferers like him find quality hair restoration physicians after successfully restoring his own hair through hair transplant surgery. In 2004 and onward, I became a regular participant by sharing my own personal experiences and opinions. Helping other hair loss suffering men and women like me became a personal hobby and ambition of mine. Thus, I began to pay it forward myself by spending countless hours in the evening researching hair loss related topics and posting responses to other members’ questions on the Hair Transplant Network forum. In 2007, Pat hired me and thus, my career as the associate and then managing publisher began and I am now able to help other hair loss sufferers find the best solution for them full time.

 

Bill, presently

Bill showing his successful hair restoration program

 

You are a great example of how educating oneself as a consumer is imperative for great results, especially when it comes to something as life-changing as a hair transplant can be. What is your take on the pros and cons on a hair transplant? Do the hairs that are transplanted fade away with time or are they spared from the progressing male pattern baldness? Do you have to keep getting more and more hair transplants as time goes by?

I appreciate the compliments and your interest in my story. Because of the principle I mentioned above (donor dominance), hair transplantation is relatively permanent in the hands of a skilled and experienced physician. I say “relatively” because as the aging process continues, it’s possible for a person’s overall hair to thin out. This includes men and women who’ve never suffered the effects of genetic hair loss. Thankfully, this is typically minimal and doesn’t create any visual or noticeable change in the appearance of one’s hair.

Moreover, most men (and even women) suffering from the effects of hereditary baldness require more than one hair transplant to meet their goals. For starters, hair loss is progressive. Thus, even if men and women undergo surgery during the early stages of hair loss; recession, thinning hair and balding will most likely continue, especially in those patients who’ve decided against coupling their hair transplant procedure(s) with proven non-surgical treatments. Secondly, most men and women with advanced degrees of balding will require more than one hair transplant to achieve any kind of density or fullness.

Hair transplantation is really a matter of supply versus demand and in many cases, men and women who undergo surgery must understand that while naturalness should always be expected, what can be realistically achieved is only an “illusion” of density. Mathematically, there’s simply not enough donor hair available to recreate a head of full, thick and lustrous locks like the days before any signs of hair loss. However, a skilled and experienced hair transplant surgeon is quite good at strategically and artistically transplanting the available donor hair into balding areas and giving men and women a relatively full and natural looking appearance.

Your readers may be wondering how transplanting less hair in balding areas than what was naturally there before hair loss began can appear full and dense. This is because realistically, visual signs of hair loss are only noticeable after a 50% loss. As much as we’d all like to restore 100% of our hair, frankly, we really had more than we needed to begin with. Thus, transplanting 50% of a person’s original density can still produce a very natural and full looking appearance that can fool most into thinking they’ve never experienced any hair loss in the first place. But be aware, many patients with advanced degrees of balding may still show signs of thinning/balding if the demand (balding area) is too much greater than the supply (donor area). This includes me.

Not all men and women are candidates for hair transplant surgery. In fact, men and women with early onset of genetic pattern baldness are much better off trying proven non-surgical treatments for a couple of years prior to considering surgery. Furthermore, young men and women in their early to mid twenties (or even earlier) are typically not good candidates for surgery because:

1) If they’re experiencing hair loss at such a young age they’re most likely in store for a lot more. These individuals should consider trying proven non-surgical treatments and wait to see how their hair loss pattern develops before undergoing surgery.

2) A young person’s expectations of what can be achieved with hair transplant surgery is typically unrealistic. I remember how I felt in my early twenties when I first noticed my bald spot. I was very emotional and would have done anything to fill in that little spot of baldness. Had I found a surgeon willing to work on me and densely pack every area of balding as it progressed, I’d have a very unnatural looking head of hair today and I’d be miserable.

Likewise, anyone with unrealistic expectations is not a candidate for hair transplant surgery.

There are also rare anomalies that can occur, often referred to as the X factor that may hinder growth or even rarer, cause transplanted hair to fall out. I’ve only heard of a few instances of the latter and even when surgery was performed by a reputable surgeon with a proven record of producing excellent results, no reason or explanation was ever provided as to why this had occurred.

Typically however, hair transplantation works wonders on the vast majority of educated patients with realistic expectations in the hands of a skilled and experienced surgeon with a proven history of producing excellent results.

 

Editor’s note: Guys, I will post Part 3 of this interview very soon so stay tuned as Bill talks next about the monetary investment and expectations to have from hair transplants. In the meantime, Like/Tweet/+1 and share the word online! You can also check Part 1 here.

All the best. Rogelio.

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Rogelio

Rogelio is the go-to guy when it comes to men's hair. Having embraced his natural curly hair for over a decade while living in 5 countries, Rogelio has learnt a thing or two along the way. Rogelio is the author of the two bestselling men's books "The Curly Hair Book" and "The Men's Hair Book", and his motto when it comes to hair is, "Gentlemen, having a good head of hair should not cost us our testosterone".

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