Follicular Unit Hair Transplantation is a medical procedure which redistributes your naturally growing hair. Hair which is growing in great density on the back of your head can be moved to areas where there is a shortage or thinning of the hair, such as the balding areas in front or on top of the scalp. Because of the abundance of hair on the back of the scalp, removing some hair from this area does not cause any cosmetic problems. Additionally, these hairs are genetically programmed to grow throughout your lifetime, thus transplanting them to the balding area permits them to grow permanently.
- Permanent
- Natural
- Undetectable
- 1-3 hair micrografts avoid the old pluggy, dolls head appearance
- Avoids the needs for temporary solutions such as wigs, hair pieces
- Improves male and female pattern loss of hair
- Thicker hair
- Reduction of bald spots
- For both men and women
- Affordable
- Artistically-designed hairlines
Propecia, Rogaine, Hair Pieces, Wigs, and Hair Extensions
The following will lead you through a typical hair transplantation procedure.
While the patient watches a video, your surgeon anesthetizes the back of the
scalp and harvests a strip of hair-bearing skin. The strip is meticulously
dissected down to individual grafts; some grafts containing 1 hair follicle
each (one hair follicular unit), while others contain 2 or 3 hair follicles
each (two or three hair follicular units).
Next, the surgeon follows the pre-designed graft placement, planting the
smallest single-hair grafts into the frontal hairline to give a purposeful,
somewhat random and natural distribution of hair. The 2-to-3 hair grafts are
placed behind this hairline to fill in and enhance hair density. The surgeon
takes into consideration the pattern of expected change of hairline and
future hair loss, so that the transplanted hairs, now permanent, will sit
naturally as the pre-destined baldness pattern of the non-transplanted hair
evolves.
Further, in an attempt to create the desired distribution of future gray
hairs, the surgeon will assess present day coloration and mix or separate
follicles that may gray in order to preserve the desired, natural appearance
as the patient ages. Our surgeons have published articles on hair
transplantation in medical journals and remains acutely aware of the subtle
nuances that go into the "good transplant."
Not everyone is a candidate for hair transplantation. At your initial consultation, your surgeon will examine the density of hair on the back of the scalp in order to determine if there is enough hair for transplantation to the balding area. Multiple sessions may be required for optimal benefit, and patients should have realistic expectations prior to undergoing hair transplantation, or any other cosmetic procedure.
Hair transplantation can naturally and permanently correct thinning hair. Though hair transplantation has been performed since the 1950's, technological advances in recent years have substantially enhanced cosmetic outcomes. Recent advances have transformed hair transplantation into the most commonly performed cosmetic procedures for men in the United States.
One may not be aware of the staggering number of people who have had a hair transplant, as a good hair transplant is not noticeable. Certainly, most everyone has seen a bad transplant, perhaps one that was done with large plugs, resulting in a pluggy, dolls head, or corn stalk effect. These poor outcomes were due to older techniques using large, round punch devices to remove 15-20 hairs per graft.
Today, Dr. Berman and his staff move only one to three hairs at a time, placing them each in tiny slits in the skin, eliminating any possibility of creating a pluggy appearance. Because these results are superior to the older techniques, Dr. Berman exclusively relies on this "Follicular Unit" approach, as opposed to the old punch graft technique, still used by others. Today, our well trained team can move thousands of hairs per session, creating natural results.
The specific risks and the suitability of these procedures for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.
Patients can shampoo new hair one day following the procedure. Sutures from back of head are removed in seven days. Transplanted hairs will fall out within two months, followed by regrowth of new hair. The final appearance may not be noted for up to one year.
Most patients are awake during the procedure and may infrequently feel some slight discomfort.
Wash hair; avoid blood thinners such as aspirin, Motrin, ibuprofen, etc.
Most patients can shampoo their hair in 24 hours. Avoid strenuous exercise and blood thinners after the procedure for about 1 week.
Our physicians are assisted by registered nurses, physician assistants and medical assistants when performing this procedure.
The most common form of balding is male pattern hair loss, representing close to 95% of all hair loss cases. Mild to moderate male pattern hair loss affects about half of men by age 50. This type of hair loss results in a receding hairline and/or balding at the crown. It is due to heredity, from either the mother's or father's side of the family, and is dependent on hormones. Propecia is the first and only FDA-approved pill proven to treat male pattern hair loss on the vertex (top of head) and anterior mid-scalp area in men.
- Propecia can slow the loss of hair in men
- Propecia can increase hair growth in men
Follicular Unit Hair Transplantation
Rogaine Solution
The causes of hair loss are not well defined; however, researchers have found that men with male pattern hair loss have increased levels of DHT in the balding area of their scalps. DHT is one of many male hormones in the body. DHT is developmentally important early in a man's life; however, it appears to be a cause of hair loss as men get older. DHT shrinks the hair follicle until it no longer produces visible hair.
Human hair normally follows a cycle of growth, falling out, and new growth. But increased levels of DHT are believed to contribute to the shortening of the growth phase, and a shortening of the time it takes for the hair to fall out. This results in thinning of the hair on the scalp.
Science has found a way to affect DHT with a prescription taken once a day in tablet form: Propecia. Finasteride, the active ingredient in Propecia blocks the formation of DHT and, in this way, appears to interrupt a key factor in the development of inherited male pattern hair loss in men. Propecia has been proven to effectively lower DHT in the scalp.
Men with male pattern baldness may be candidates. Women and children are not candidates for Propecia.
The fact is, for most men, Propecia works. Most men reported an increase in the amount of hair, a decrease in hair loss, and an improvement in appearance. The results of two years of clinical testing* showed favorable results for the vast majority of men on Propecia.
- 5 of 6 men kept the amount of hair they had (vs. 28% with a sugar pill)
- 2 of 3 men regrew some hair (vs. 7% with a sugar pill)
- 80% were rated improved by doctors (vs. 47% with sugar pill)
*Based on vertex studies at two years of men aged 18 to 41 with mild to moderate hair loss. There is no evidence that Propecia works for receding hairlines at the temples. Take Propecia daily and you could see results in as little as three months. If you stop taking Propecia, however, your results will gradually go away over 12 months. And if it has not worked in 12 months, it is unlikely to be of benefit. Propecia is available by prescription only, so the best thing to do is talk to our medical staff for more information.
Clinical tests showed Propecia was very well tolerated. Only a very small number of men had sexual side effects, with each occurring in less than 2% of men. They included less desire for sex, difficulty in achieving an erection, and a decrease in the amount of semen. When the men who had these side effects stopped taking Propecia, the side effects went away. Propecia is for men only. Women who are or may potentially be pregnant must not use Propecia because of the risk that the active ingredient may cause a specific kind of birth defect. Likewise, women should avoid handling tablets that are crushed or broken. Propecia tablets are coated to prevent contact with the active ingredient during normal handling.
None.
No. This is a medication take orally.
See prescribing provider for more information.
See prescribing provider for more information.
Our physicians and Physician Assistants
Dr. David A. Berman is conducting an FDA clinical trial for robotic harvesting of follicular units (tiny hair grafts containing 1-3 hairs each), sponsored by Restoration Robotics, Inc., Mountain View, CA, USA. Dr. Berman is recognized for his work in hair transplant surgical innovations, and is a frequent speaker to physicians at international meetings. He will present his latest research findings at the 68th Annual Meeting of The American Academy of Dermatology in Miami, Florida in 2010.
Robotic surgery is commonly performed in prostate surgery, cardiology and gynecologic procedures, among other specialties. Dr. Berman has been testing robotic devices to automate the harvesting and implantation of hair for over three years. Follicular unit extraction (FUE), a technique where hair is moved as individual naturally occurring groups of 1-3 hairs, is a very labor-intensive, tedious and difficult procedure to perform by hand. The need for the surgeon to repeat this motion thousands of times in a few hours makes this nearly impossible for most practitioners of hair transplant surgery, and indeed lends itself perfectly to the use of robotics for the FUE technique. The prototype robotic device that Dr. Berman is testing has a robotic arm that moves in 6 degrees of freedom and is directed by 4 stereoscopic cameras which permit real time 3D video image-guidance, a needle punch mechanism, disposable proprietary dermal punches, disposable cartridges, and a user interface. The extraction technique consists of a double needle punch arrangement with an inner (1mm) punch and outer (1.37mm) punch. The inner punch has cutting capabilities and the outer punch has a blunt edge used for dissection. The blunt edge on the outer need helps reduce the incidence of transecting follicles. Vacuum and tweezer forceps are applied to further facilitate the extraction of follicular units.
Restoration Robotics, Inc. and Dr. Moll’s other robotics companies
Restoration Robotics was founded by Frederick H. Moll, M.D. Dr. Moll is considered a leader in the field of surgical robotic technology. He founded Intuitive Surgical, Inc (NASDAQ: ISRG). Today, Intuitive Surgical is the global leader in the rapidly emerging field of robotic-assisted minimally invasive surgery. Since its inception, the company has consistently provided surgeons and hospitals with the tools needed to improve clinical outcomes and to help patients return to active and productive lives. Intuitive Surgical serves customers throughout the United States and internationally, providing technology and procedural innovation across cardiac, urology, gynecologic, pediatric and general surgical disciplines. Dr. Moll is also President and Chief Executive Officer of Hansen Medical, Inc. (NASDAQ: HNSN) a publicly traded surgical robotics company that produces the Sensei® X Robotic Catheter System. This system is the world’s next-generation purely robotic flexible platform, combining advanced levels of 3D catheter control and 3D visualization to bring accuracy and stability during catheter-based electrophysiology procedures of the heart. By translating a surgeons hand motions at the workstation to the control catheter inside the patient’s heart, the Sensei X System’s proprietary instinctive motion control technology empowers accurate and deliberate catheter placement.
- No linear incision
- No linear scar
- Increased accuracy of graft placement at proper angles and orientation
- Increased graft survival
- Less labor/medical staff requirements
- Potentially reduced cost of the procedure
- Increased accuracy of graft harvesting
- Faster healing time
- Expanding the donor area to include areas remote from the scalp, such as the chest or back
- Reduced duration of the procedure
- Reduced recovery time
Follicular Unit Transplantation
Follicular Unit Extraction, by manual technique
Targeting Follicular Units: The medical staff sees a magnified stereo-view of the scalp. The software digitizes this view. Complex imaging algorithms compute angles, orientation, location of follicular units on the scalp as well as follicular unit type (1,2,3) – this is the basis for accurate targeting. Additionally, stereoscopic video images guide the movement of the needle mechanism and robotic arm. This function is known as visual servoing.
Two punches, an inner and outer, arranged concentrically: The inner punch is sharp and has a 1mm internal diameter castellated edge that makes a shallow incision in skin of 1-3mm. The outer punch is blunt, with an internal diameter of 1.37mm. The Outer punch enters the scalp through the incision made by the inner punch. It spins or oscillates into the scalp while bluntly dissecting 7-8mm into the skin around the follicle. Donor area hair is cropped to 1mm length. Lidocaine is injected into the skin of the scalp to numb the area. Tension is applied to scalp using a specially designed retractor. Patient is in the semi-prone position in our specialized chair. Camera system scans the patient’s scalp and identifies groups of 1-3 hairs (follicular units, FUs). System automatically targets FUs for harvesting based on medical staff input. The process is semi-automated: it can automatically target 5, 10, 15, or more follicular units sequentially; additionally, the system periodically prompts the medical staff user for input.
This is an investigational device not yet available for commercial purposes. Thus, patients must be prescreened for this FDA clinical study. Participants receive a fee from Restoration Robotics, Inc. to be part of our study. Our current studies require significant balding of the scalp and are only performed on male subjects at this time. The robotic 3D video imaging system works best in patients with dark hair color.
We will follow study participants for nine months after their procedure, performing hair counts and other measurements so that we can gain an accurate assessment of the success of this novel hair transplantation approach.
- Inherently safe design: Stereo cameras measure the distance between the needle and the scalp at every frame, and the robot moves based on the camera measurements
- Redundant safety devices: Hard stops, Force Sensor, Emergency stop buttons, and medical staff overrides
- The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. New medical devices used in research certainly do have some degree of risk which will be discussed prior to the procedure.
Patients go back to work the next day. Since there are no stitches needed, patients may even return to vigorous athletic activity within a few days.
A local injection of topical anesthetics makes this procedure safe and comfortable without the need for sedative medications.
Wash hair; avoid blood thinners such as aspirin, Motrin, ibuprofen, etc.
Apply polysporin antibiotic ointment to the donor area twice a day. Patients may shampoo the scalp within one to two days, but avoid rubbing the recipient area for about one week.
Our physicians are assisted by registered nurses, physician assistants and medical assistants when performing this procedure.
