#1 How Hair Grows

 Hair growth starts before we're born and continues throughout our bodies and over the course of the entire lifetime. Before we're born, hair starts growing on our heads and bodies: at birth, many babies are covered with a fine, soft layer of hair called lanugo, which soon falls out, leaving the baby's skin smooth and practically hairless. As we age, the fine, soft hair of childhood is replaced by thicker hair, often of a darker color. At puberty, we start growing body hair along with acquiring other secondary sex characteristics. As we reach maturity, a majority of men will discover the hair on their heads thinning in the distinctive U-shape of male pattern baldness. Around one in four men will find they are losing their hair before the age of 30, and by the time men reach their forties, up to 75% of them will find they are suffering from hair loss. About 50% of women will also find they are losing their hair, but rather than baldness arriving in a particular pattern, women's hair tends to thin all over the head.

Normal hair growth takes place without our paying much attention to it. Hairs grow, rest, and eventually fall out in a continual cycle that goes practically unnoticed unless something starts going wrong. Hair usually grows at a rate of about a half an inch a month, although as we get older, the rate of hair growth may slow significantly. The lifespan of a single hair can be up to six years in length, but everything from hair care routines to illness or prescription medicines can affect hair growth and loss. With a healthy, normal scalp holding around 100,000 hairs, losing 50-100 hairs a day is the usual experience: we don't really notice them, but they come out on brushes, pillows and clothes and are replaced by new hair.

What is Hair?

Hair is made of a protein called keratin, which also builds our finger and toenails and the outer layer of our skin. There are two main kinds of hair; the fine, nearly invisible hair called vellus that covers most of our bodies, and what most of us think of as the "real hair", called terminal hair. Terminal hair is thicker and often dark-examples include the eyebrows, hair on the head and underarm hair.

Hair has three layers. Working from outside in, we have the cuticle, the cortex and the medulla. The cuticle protects the cortex. It is thin and has no color, but a healthy cuticle is glossy; it can be stripped off if you use harsh chemicals for permanents or coloring. Swimming in salt or chlorinated water can damage the cuticle, which opens up the other layers to the elements and may result in color change, fragility and breakage.

The cortex is where your hair color resides. It also determines the texture of your hair as well as its strength. Protecting the cuticle also protects the cortex, keeping your hair healthy and less liable to break.

The medulla is found in thick, terminal hairs. The body of your hair comes from the medulla.

But the hair shaft is only part of the picture. Underneath your skin is the root of the hair, which lies inside the hair follicle. At the bottom of each follicle is a structure called the dermal papilla. The dermal papilla accesses the blood stream so that new hair growth is fed, but it also has male hormone receptors on it that influence hair growth or hair loss. As hair grows, new cells are formed in the follicle, lengthening the individual hair from the scalp onward. Because hair grows from the roots, if you color your hair and wait for it to grow out, you'll find your natural color starting at the hair root, while the old color may be fading on the ends from repeated washing.

#2 Normal Hair Growth

There are three identified phases of hair growth. The active growth phase or "anagen" phase is the period during which individual hairs grow up to a half an inch a month. The anagen phase can be several years long; as few as three years or as many as ten. Nearly 90% of our hair is in this growth phase at any one time. 

When hair has stopped growing but has not yet been shed, it has entered the regressive or "catagen" phase. During the two week average span of this phase, the body is preparing to lose this hair and replace it with new hair. The hair follicle separates from the dermal papilla and the hair bulb disappears as its nutrition is withdrawn. Only 1-3% of hair is in the catagen phase at any time.

Ten to thirteen percent of our hair is in the resting, or "telogen" phase at any time. The telogen phase lasts from three to six months: hair falls out and new hair forms. An entire cycle of scalp hair growth lasts around four or five years.

Understanding how the hair cycle works can help you to understand how laser hair removal works.  You need several treatments before all the hair is finally eliminated. Because hair is only susceptible to laser treatment while in the active phase, you need multiple passes with the laser to eradicate the hair that may have been in the regressive or resting phase at other treatments.

#3 What Impacts Hair Growth and Hair Loss?   

Because hair relies on things like hormones and nutrition to keep operating correctly, changes in hair growth should be noticed as possible clues to your overall health. Thick, lustrous hair is often considered an indicator or good health, and hair that is thin, frizzy, breaking off or falling out can indicate health problems. Problems with the thyroid gland, diabetes, lupus, nutritional deficiencies, hormonal imbalances, stress and prescription drugs can cause your hair to weaken, lose its shine, change its color or even fall out. Some normal and reversible causes of hair loss include the body's reaction to some prescriptions, severe illness, childbirth and chemical hair treatments. Hormones can also cause excessive hair growth, usually noted in women who may begin experiencing increased facial or body hair.

Hormones: Androgens, Estrogens and Hair Loss

Hormones, for men and women, play a large part in the way hair grows once we reach maturity. Men and women both have estrogens (female hormones) and androgens (male hormones), but men have more androgens and women have more estrogens. Male pattern baldness is due to the effect of the male hormone testosterone on the dermal papillae, causing the shrinkage and eventual malfunction of the hair follicles. Because of the effect of the hormone, follicles eventually stop producing hair. This process is most often determined by genetic factors and every decade a certain percentage of men join the group of men with hair loss. 

Women too suffer from scalp hair loss due to hormones, particularly after the onset of menopause. At menopause, female hormones lessen and the effect of the androgens that occur naturally in everyone is more influential. This results in masculinization of the female body, in particular in the growth of darker, thicker facial hair and potentially, the thinning of hair on the scalp. Fine, unpigmented, vellus hairs can be transformed by the effect of androgens into terminal hairs, creating thick unwanted facial hair where there once was fine down or nearly invisible hair.

Pregnancy and childbirth sometimes cause hair loss in women. During pregnancy, the hair that is normally lost on a day-to-day basis may be kept by the body. This hair is then lost around three months after the baby is born, and when hormone levels are returning to pre-pregnancy levels. The good news is that the hair that is lost is replaced by new hair, so after a little panic at the amount of hair coming out in your brush, you'll see that your hair isn't thinning after all.

Unwanted hair growth in women is most often hereditary. Its medical name is "hypertrichosis", but it's not a disorder: it's just that some genetic backgrounds result in more or darker body hair than others. If you are of Latin, African, Indian, Middle Eastern or Mediterranean descent, if your ancestors roamed the moors of Scotland, or dark hair just runs in your family, you may find yourself with arms and legs that are hairier than you want them to be. Being naturally hairy is not a medical condition to be changed with hormones or drugs. Laser hair removal is the best option, being safe, permanent and practically painless. For more information on Laser Hair Removal

Unusual hormonal conditions can cause hair growth or hair loss, so if you notice you are  suddenly growing or losing hair on your face, body or head, and if you're pretty sure it's not related to issues of aging, you should check with your doctor. Ovarian problems, tumors or endocrine problems may affect the growth or loss of your hair, so if you're not sure what's going on with your hair, get a checkup. In the case of hirsutism in women, there is more body or facial hair than usual, and it may be because of excess male hormones.

#4  Checklist

Losing Your Hair? Use this checklist to look for potential causes.

Have you...

[  ] Suffered from an illness or hospitalization in the past 6 months?

[  ] Given birth?

[  ] Suffered major loss or trauma in your personal life?

Are you taking...

[  ] Blood thinners?

[  ] Medication for gout?

[  ] Vitamin A or E?

[  ] Birth control pills?

[  ] Antidepressants?

These drugs could be causing changes in your hair. Check with your doctor to explore your options.

 Are you...

[  ] Over 30, male with thinning hair ? You may have male pattern hair loss. If it bothers you, consider hair replacement or hair transplant as a hair loss treatment. No hair loss product on the market works more quickly, or permanently than hair restoration.  Remember, medications will halt the progress, but they will not replace

[  ] At menopause if female? Your hormone levels may be influencing hair loss and unwanted growth of facial hair. Check with your doctor.

[  ] Does hair loss run in your family? Male or female, if your parents, siblings or other close family members have suffered from hair loss, it may just be in your genetic makeup. Hair restoration or replacement is the best option for men or women experiencing hereditary hair loss.

#5 What is a Hair Transplant?

 What is a Hair Transplant? 

In order to emphasize that the newest procedures are vastly different from the past, Dr. Prasad prefers to call his procedures Hair Restoration. This term denotes that your hair will have coverage but that you will not have the pluggy look that advertises your surgery from a distance.

When you're experiencing hair loss, you may worry that there's nothing you can do about it, but you can. If you've spent time and money on hair loss products like medications, vitamins, shampoos or home remedies, you've probably been disappointed in the results. The only permanent hair loss treatment is a hair transplant or hair replacement procedure. Even people with significant hair loss can create a new, lower hairline and thicker, fuller-coverage of hair by having a hair transplant. Hair transplants have been around for decades, but until recently, they left patients with unnatural looking results. In older hair transplants, large clumps of hair follicles were taken from the existing hair and plugged into holes punched into the scalp with a needle. Unfortunately, the "hair plug" looked "pluggy";  patients returned from treatments with uniform rows of hair plugs marching across the scalp like an old-fashioned doll's head. And because the hairs were being transplanted in large groups, early hair transplants were more painful and more prone to infection. Other problems included long term issues: patients had patchy, uneven coverage. If you look at a celebrity hair transplant from 20 years ago, you can see the difference because you can see the unnatural hair pattern in the picture. With the newest techniques used by Dr. Prasad that incorporate follicular unit hair grafting (micro-hair graft), you can't tell if someone has a hair transplant.

Modern hair transplant surgery results in a natural looking hairline and better overall fullness and coverage. New surgical procedures enable Dr. Prasad to work with much smaller units of hair-between one and three strands at a time. Because the hair is transplanted in much smaller units, Dr. Prasad can place them closer together for fine, consistent coverage that looks completely natural. The approach to hair restoration is different for men and women. The difference lies in the method of the transplants that will give the best coverage. The main reason for this variation is that men and women generally lose hair in characteristic patterns. Generally speaking, men lose hair in a U- shape, whereas women lose hair more diffusely so that hair looks thin all over.

A hair transplant is the best hair loss solution for people who want to preserve their appearance. The most exciting part of hair restoration is that a natural hairline that is uneven and consistent with your youthful appearance can be achieved frequently.

Hair Transplant Cost

The hair transplant procedure begins with an initial consultation, where Dr. Prasad examines the pattern of hair loss and the quantity and quality of the existing hair. He will look at your hair density, which is the number of hairs per square centimeter that are currently growing on your scalp. People with high hair density have more follicles per square centimeter, and will require a smaller donor strip than people with low hair density. By observing your hair loss pattern and current hair density, Dr. Prasad can estimate the number of grafts that will be necessary to transplant in order to achieve a natural looking hairline and the best possible coverage. Unlike other hair restoration practices, Dr. Prasad, does not charge by the number of grafts but rather by the type of hair coverage a patient seeks. The cost of hair restoration is based on a customized treatment that takes into account the planned volume of transplantation, the complexity of the procedure and the time it takes to get the best results. Never choose a doctor on price alone. There is a limited supply of hair to transplant and every effort needs to be made to maximize the results. Hair transplant factories and low cost incentives by hair clinics base their work on high patient volume to keep up with advertising costs and high overhead.  In most cases, high patient volume surgery and quality surgery do not go together.

Do I have enough hair for a hair transplant?

Permanent hair on the scalp is usually found in a ring around the back of the head, so there is always some hair to be found. The good news is that you don't have to transplant all of the lost hair. A variety of factors that have to do with the quality of the hair such as  thickness of the individual hair, curl of the hair, contrast of hair color with color of the scalp means that in many cases, adding less hair than what was lost to any particular area can make it look like a full head of hair. This makes it possible for someone with significant hair loss to have some hair removed from one area and transplanted to another, where it will take root and grow. Since a large part of hair transplant success relies on where and how the hair is distributed, Dr. Prasad will carefully plan the sites of hair insertion and the number of follicular units needed to create the fullest head of hair. This new and very successful version of the hair transplant is called Micro-Hair restoration, and Dr. Prasad's experience in microsurgery and cosmetic surgery can not only help people experiencing hair loss for the first time, but can also correct old hair plugs for a natural look.

Male and female hair loss causes great distress to the men and women who experience it. While you will find pills, creams, lotions and home remedies for hair loss, they are generally ineffective. Propecia and Rogaine are medications that are useful in reducing the progression of hair loss but they will not replace the hair that has already been lost. Micro-hair restoration actually replaces the inactive follicles with live, growing hair from a zone where hair loss has not been a problem. The hair that grows is real hair that can be cut and styled as usual because it is your own hair.

#6 An In Depth Explanation of Hair Transplant Surgery

Hair transplants have minimal downtime such that most people can return to work within a week. Because the incisions are tiny, some patients choose to wear a baseball cap the next day so that people will not be able to see the transplant. The procedure is performed in state of the art operating facilities, under local anesthesia with sedation. The patient receives a tiny injection in the scalp, which numbs it and makes the procedure almost painless.

The hair transplant procedure begins with harvesting living hair follicles from the scalp. The doctor removes a small piece of scalp (the donor strip) where the hair is still growing. The actual size of the donor strip is determined by the hair density of the existing hair as well as the number of follicles it will take to do the transplant. You will already have some idea of this, as Dr. Prasad will have calculated the approximate size of the strip at your consultation. After the donor strip is removed, the scalp is sutured together. Dr. Prasad draws upon his cosmetic surgery experience to make the scar as small as possible. In addition, since the scalp is covered by existing hair, the small scar will be unnoticeable.

The hair transplant team takes the donor strip and removes the hairs from it in microscopically small groups called follicular units. In naturally growing hair, follicular units consist of one to three hairs growing together. The follicular units are separated from the tissue of the scalp, so the individual units can be transplanted closely together. Dr. Prasad will determine where on your scalp he will place single hairs versus two or more in a follicular unit, for the most natural hairline and the best coverage. A well designed hairline should match the shape of your face and flatter your appearance. Having an expert design your hair transplant is essential.

Dr. Prasad takes hair follicles harvested from the donor strip and inserts them into tiny incisions created in the area of hair loss. There may be several hundred to a few thousand grafts performed at the procedure, which may take four or five hours to complete. You may have more than one procedure over a period of months, depending on the amount of hair loss you want treated.

The hair follicles of the transplant are still healthy and alive, and won't be rejected by your body because they are your own cells. Within two to four weeks after the transplant, some of the transplanted hair will fall out, but don't worry! This is a natural process in living hair, which goes through a "sleeping phase" in the growth cycle. The hair will re-grow in its new location and replace the follicles that have stopped functioning. In three to four months, the transplanted hair follicles begin their new growth phase, and you can expect growth of around 1/2 inch per month but this varies in individual cases.

After the surgery, you will be able to wash your hair as instructed after 24 hours. Avoid strenuous activity and take it easy physically for at last five days after your hair restoration procedure. As the incisions heal, you will probably experience some itching, and there will be small scabs on the incisions that will go away in 4 to 7 days. Keeping the scalp moist will help the skin to heal faster and with less itching. Dr. Prasad advises that you take at least two days off work after the procedure. The sutures on the donor area will probably be difficult to see, since they'll be covered with hair in the area. Expect to have the stitches removed in about a week. While the sutures and scabs are healing, you may want to wear a baseball cap during the first few days before you return to work, to lessen any self-consciousness you may feel. Even if you have a job that is heavily service driven, you should not worry about going back to work since the healing grafts are usually difficult to see even without a cap.

Because hair restoration is simply relocating some of your own hair, the quality of your hair won't be changed. It will still look like it always did in terms of curliness, texture, color and how fast it grows. Since hair transplants no longer place large clumps of hair into the scalp, you'll find that the pattern of hair growth looks natural and even. The new grafting methods are precise and expertly applied. Your hair will behave normally, and you will be able to wash, brush, style or color it any way you like.

#7 What You Should Know about the Major Cause of Hair Loss

If you're suffering from hair loss, you're probably also wondering what causes it. Most people who are losing their hair spend a lot of time thinking about what they can do to reverse the situation, but there is no true method of hair loss prevention. Because hair loss has such an impact on one's self-esteem and confidence, nearly any hair loss product, no matter how impractical, will be bought by someone desperate to stop or prevent additional hair loss and get on with his or her life. Don't waste your money on treatments that don't work: hair transplants work, and are becoming more and more affordable. They can be accomplished in a short period of time, with permanent results.

It's only recently that the medical profession really began to understand the major causes of hair loss. We're all familiar with male pattern hair loss or baldness: many of our fathers lost a lot of their hair before we were grown. The typical pattern of male pattern hair loss is a heightening of the forehead as the hairline in front recedes, and a semi-circular area reaching back to the middle of the head where the hair becomes sparse, then stops growing completely.

The primary cause of hair loss is largely determined by genetics, so that those of us whose parents and grandparents suffered from hair loss are more likely to experience it ourselves. About 70% of men and 50% of women experience some significant hair loss, mostly related to the functioning of testosterone in the body. Women in menopause sometimes begin losing their hair because of reduced estrogen levels that result in increasing the effects of testosterone naturally present in women as well as men.

Male and female hair loss tends to be inherited, and is hormonally related. For either gender, hair loss brings up issues related to aging; it may even affect important aspects of life such as career advancement or dating and marriage in later life. People who suffer from hair loss often lose confidence in themselves easily and may experience depression over the seemingly uncontrollable nature of hair loss. But take heart: the modern approach to hair loss, which is more accurately referred to as a hair restoration procedure, is the best way to control and correct hair loss and restore your hair to its former attractiveness.

There are a few other reasons some people lose their hair, but generally speaking, the genetic factor is far and away the most important influence in most hair loss.

Other Causes of Hair Loss

If you have experienced a severe illness or malnutrition, you may also have hair loss, and it may be permanent. Anorexic patients often lose the hair on their heads as their bodies shut down due to lack of nutrition. If you have often colored your hair or used harsh chemical relaxers, you may experience hair loss from damage to the hair follicles. Sometimes, the damage is permanent. If you frequently color your hair and find you are losing more than the 50-100 hairs a day we all shed and replace normally, you may want to stop coloring your hair. It's possible that, rather than having damaged the follicles, your hair has become thin and brittle and is breaking off near the scalp.

Things that do not cause hair loss include wearing hats or shampooing too often. Years ago, it was believed that clogged pores or insufficient blood flow to the scalp could cause hair loss, and barbers sold treatments that included vigorous scalp massage and topical ointments. Today it's understood that hair loss occurs when follicles either turn off hair production due to the influence of testosterone, or when the follicles become damaged.

#8 Hair Restoration for Men

At some point in their lives, most men suffer some hair loss which tends to increase over time, often resulting in significant baldness. In fact, 70% of men and 50% of women suffer some hair loss as they advance in years, but in men, hair loss can start in their 20's and increase with each passing year. Although baldness is neither a disease nor an indication of any physical abnormality, it can cause problems in life, work and even love. Your hair is one of the things people notice first about you: we are often described to others by the color and style of our hair. When you're losing your hair, people tend to see you as older; maybe quite a bit older than you really are. At work, conscious or unconscious ageism causes some men to be passed over for promotions or for the exciting and challenging projects that senior managers may deem fit for "younger, more dynamic"  personnel. Men may hit a "glass ceiling" based on their apparent age and the modern culture's near-worship of a youthful appearance. Looking younger can significantly and positively impact one's income and sense of self.

Norwood Classification

Hair loss drastically affects the appearance because it reshapes the hairline and thus affects the apparent shape of the face. The classic, U-shaped Male Pattern Baldness exposes the forehead and often affects the temples as well. Some men opt for shaving their heads completely when the horseshoe baldness starts to grow, and a few men look wonderful with shaved heads. The shape of the head, the facial type and the appearance of the eyes contribute to a look of elegance without hair. There are dyes and even paints sold that claim to give the appearance of thicker hair, but they usually look fake, and don't solve the problem. Darker hair can look somewhat thicker, but it should be colored professionally if it's going to have an even, natural tone. The downside of having your hair colored is that hair color itself can cause hair to become thinner and more brittle: the harsh chemicals in hair color have even been known to cause hair loss in people who use color frequently!

Most men simply face their hair loss like their fathers did: with  philosophical resignation. If they think about it too much, it becomes upsetting, so they shrug their shoulders and get on with other things. But it's no fun to lose your looks, and when family or friends comment or tease, it may be tempting to start wearing baseball caps. Single men may find losing their hair especially difficult, as many women, particularly younger ones, prefer to date men who have full heads of hair. That glass ceiling may operate socially as well as in their career.

For these reasons, men may suffer from lost confidence and low self-esteem when they lose their hair. Some experts have even hypothesized that hair loss may be the most important factor behind the male midlife crisis. Hair loss can make you feel insecure about your appearance, especially in sexual matters. People who feel unattractive may become depressed or may overcompensate by spending lots of money on obvious status symbols. Hair restoration is much less costly, and by creating a new hairline and a full head of hair in one procedure, it gets right to the "root" of the  problem!

#9 Hair Restoration in Women

 With new technologies and terrific results creating more interest in and understanding of permanent hair replacement, women are making up an increasing number of hair transplant patients. Although men still account for around 90% of hair replacement surgeries, women are discovering that hair transplants can solve problems that once could only be dealt with by using hairpieces.

 There are a number of potential causes in hair loss in women: hormonal changes dues to pregnancy or menopause; nutritional deficiencies such as lack of iron; traction alopecia from tightly pulled weaves or other hair systems and certain medical conditions are some common factors that contribute to hair loss. If you see your doctor because of thinning hair, you should expect to be tested for conditions such as  hypothyroidism, lupus, or unusual levels of testosterone and dihydroepiandrosterone sulfate (DHEAS) levels: it's most important to rule out certain conditions as a potential cause before dealing with the aesthetics of hair loss. You doctor may discuss your diet, any hair products or systems you use, and whether there is a family history of hair loss. If you have experienced sudden, dramatic hair loss, it may be that your body has undergone severe stress. In this case, hair usually grows back in a few months and requires no intervention. However, in medical conditions such as hypothyroidism, hair re-growth is unusual and hair restoration may be necessary to replace the lost hair.

Female Pattern Baldness

The major cause of hair loss in women is similar to that of men: Female Pattern Baldness (FPB) is genetically determined and cannot be prevented. In Female pattern Baldness, there are two general scenarios: unlike men, women do not lose their hair in the distinctive horseshoe pattern; rather, most FPB results in hair loss diffused throughout the hair from the forehead, across the top of the head and on the frontal sides. The scalp begins to be visible, and places in the front where the hair is usually parted become most noticeably thin. This is the most usual pattern for women's hereditary hair loss. The second pattern occurs less frequently: the center of the hairline begins to bald, extending in a triangular area towards the back of the head.

The good news is that, unless hair loss is very great indeed, most women with Female Pattern Baldness can achieve excellent and permanent results with surgical hair restoration. In the procedure, healthy hair follicles from the back of the head are removed in a strip, dissected into naturally occurring bundles and transplanted into predetermined areas in the region of hair loss. The back of the head usually contains hair follicles that remain impervious to the hormones that cause pattern hair loss, and "donor dominance" results in 90% of transplanted hairs continuing to grow naturally in their transplanted sites.

Since, hair restoration does not need to replace all of the lost hair, it's possible to effectively recreate hair density and a natural hairline while still leaving plenty of hair on the back of the head. In Male and Female Pattern Baldness, hair loss will continue over the subsequent years: people who are experiencing genetically determined hair loss should expect to have more than one procedure as the balding continues in new areas. However, because most people never go entirely bald, it's possible to continue hair replacement over time with great looking results.

One of the most effective ways of combating Female Pattern Baldness is to transplant hairs along the part and on the hairline. Many hair transplant doctors favor using larger numbers of hairs in a single graft along the part-3 to 6 as opposed to the 1 or 2 used along the hairline. Using more hairs in a graft maximizes density in what should be a dense region while also minimizing trauma to surrounding hair follicles. An important concern in dealing with female pattern baldness is in creating transplants that fit in between the natural hair without impacting healthy follicles. 

Cosmetic Surgery

Another major cause of hair loss in women comes as a result of having had facial cosmetic surgeries such as brow lifts and facelifts. Because the incisions are usually made vertically behind the ears or above the forehead, either the hairline is noticeably lifted or the sideburns are affected. The sideburns( known as temporal tufts) are necessary for a natural-appearing hair style, and when they disappear, they can cause a startling change in the overall appearance. Restoring sideburns is more than surgery; it's artistry. The temporal tufts contain the most delicate, feathery hairs; they are slanted in a particular direction, and they grow in a special shape. To ignore even one aspect of restoring the sideburns can result in unnatural-appearing hair growth. Sideburns are usually restored using the smallest follicular unit grafts to create the delicate line needed along the sides of the face.

Restoring the hairline after cosmetic surgery is an exciting and exacting procedure that recreates a perfectly natural and beautiful look. When hair loss occurs due to plastic surgery, it's from scarring that inhibits hair growth.. In some scarring, particularly above the ears, using larger grafts helps create denser coverage while also controlling for the fact that hair replacement in scarred areas has only 50% efficacy in terms of re-growth. Scar tissue doesn't have the normal amount of blood flow of normal tissue, which can cause about half the hair transplanted to die, so surgeons tend to place more hairs in the area to minimize the loss of the new transplants. Other techniques designed to work with transplanting hair into areas of scarring (or "alopecic scarring") include making the incisions deeper and wider to give the follicles the best chance of contacting a healthy blood supply.

Some women experience the "double whammy" of Female Pattern Baldness coming on the heels of surgical scarring. In these cases, as long as there is sufficient hair for donor purposes, the hairline can be modified by transplants both to cover scars and to bring the forehead back to where it should be. When you are being evaluated for hair restoration, Dr. Prasad will tell you if you have enough hair density to create a satisfying hair transplant. In some cases, pattern baldness has gone too far and can't be remedied with a hair restoration procedure. These patients may consider a hair system for better results. 

Hair loss for women can be depressing and traumatic. A natural hairline and full, thick hair is a sign of health and vitality, so it's no wonder that women are thrilled with hair transplant surgery. After a hair transplant, your hair style and facial harmony are restored and within a few months, new hair growth is evident. By the end of a year you can see the permanent, attractive results of your hair restoration.

When you're looking for a hair restoration doctor, you should look for someone with experience dealing with women's hair replacement issues. Some surgeons have only dealt with male hair loss and may not have the experience to redesign women's hairlines or sideburns, or replace hair in female balding patterns. The thickness and color of your hair is also a consideration, especially when the region being transplanted is naturally fine and delicate.   Since Dr. Prasad has a background in other cosmetic procedures, he has the necessary experience to balance the shape of your face, previous hairline and hair style, with the appropriate hairline when your hair restoration is planned. 

#10 Eyebrow and Eyelash Restoration

It might seem nearly impossible to believe that structures as unique as your eyebrows can be surgically replaced, but with modern surgical techniques and today's understanding of hair growth and re-growth, the procedure is done on a regular basis. It is fine work, with hairs being transplanted individually or in pairs, using needles less than 2mm in diameter. Eyebrow and even more delicate eyelash transplants can transform a face that has lost brows or lashes due to illness or injury.

Eyebrow transplants are most often needed when eyebrows have been eradicated from the effects of fire or injury or repeated plucking. Tattoos and body piercings have also contributed to the loss of eyebrows because of scarring or infection.. Hypothyroidism can cause the eyebrows to disappear, and people with congenital hair loss may also lose their eyebrows.

While we don't usually think of eyebrows and lashes as vital parts of the anatomy, seeing a face without these hairy appendages is something of a shock. Lost eyebrows creates an empty space between the eyes and forehead that is exceedingly noticeable: besides that, facial expressions are seriously affected by a lack of eyebrows. The muscles that move our eyebrows up in surprise or down in anger or confusion still operate, but without the brows, the face takes on a curiously blank look. Eyebrows help us interpret each others' feelings. They also provide a natural shade: when we squint in bright light, the eyebrows help filter out some of that light so we can see. And in hot weather, they prevent sweat from dripping from the forehead into the eyes. 

Eyelashes define the eyes and add to the attractiveness of the face. When you blink or close your eyes, your eyelashes form a beautiful crescent that rests on the lower lid. But on a more practical note, eyelashes keep out dust and dirt. When a gnat flies towards you and you blink, the reflex shuts your eyes while the lashes create a line of defense before the lids.

As in any hair restoration, consultation focuses on determining the cause of loss before the surgical planning begins. It's important to know whether eyebrows have been lost from medical conditions that need to be addressed separately, such as hypothyroidism, or psychiatric illness such as trichotillomania, where patients pull out their own hair. Medical conditions need to be evaluated and treated. 

Some hair restoration procedures are performed to remedy earlier surgeries in which the technology wasn't as advanced. Many recipients of the early "hair plug" transplants return for follicular unit grafts, in which much smaller transplants consisting of one or two hairs each are placed at the leading edge of the hairline for a softer, more natural look. In some countries, it has been a practice to create artificial hair replacements using nylon threads instead of the patient's own hair (this practice is illegal in the U.S.). Because the body is always trying to rejects what it rightly sees as a foreign body, people who have had nylon "transplanted" into their heads or eyebrows or lashes suffer from ongoing infections and associated scarring. In the case of eyebrows, the surgeon first has to remove the nylon threads, clear up any infections and then deal with the scarring in planning the eyebrow restoration with the patient's own hair.

#11 Designing the Eyebrow

 

Because eyebrows are made up of a relatively small number of hairs, the donor strip is usually much smaller than strips used for hair replacement on the head. Most eyebrow replacements take around 100-200 grafts, with one or two hairs in each follicular unit. The hair can be taken from anywhere on the patient's head. When placed in the eyebrow region, hair will sometimes grow back slightly finer. When it comes to eyebrows, it's important that the surgeon place the grafts in the correct pattern and direction to create a natural looking eyebrow. Ideally, the eyebrow follows a smooth, mostly horizontal path for men. For women, it should contain an arch just above the center point of the eye. To help the hairs to grow in the right direction, Dr. Prasad forms the recipient sites so that the hair will grow lying close to the skin in the correct direction to form a nice eyebrow. Patients may use gel for the first few months to train the hair in place. Because the hair is taken from the head, it continues to grow in length as it would on the scalp: eyebrow transplant patients trim the brow hairs once or twice a month.

Eyebrows grow in a particular pattern. On the inner corner of the eye, the hair tends to grow more vertically, but soon turns in the direction of the outer eye. Hair should be close to the skin, and the amount of hair naturally tapers as it reaches the end of the brow. When you consult with Dr. Prasad, he will design the placement of the grafts to create the most natural looking and attractive eyebrow possible.

The Procedure

 Eyebrow procedures are done using a combination of local anesthesia and mild sedation. Patients may take antibiotics before and after the surgery. When the surgery begins, the donor strip is removed and the individual hairs are dissected from it by the Dr. Prasad's technicians, and the area from which the strip was excised is sutured closed. A donor strip for eyebrow restoration is usually around 1 by 3 centimeters, containing around 250 follicular grafts, which are usually more than enough to restore both eyebrows. The recipient sites are created by the use of a tiny needle or a microblade less than 1 mm in width. The sites are cut in such a way that the hair will lie parallel to the natural direction of growth. The hairs are laid into the recipient sites, and there is no bandage or dressing. Patients may decide to wear sunglasses after the surgery, and they can carefully wash the face within a couple of days. Ice reduces swelling, and patients may take mild pain medications. The first night, some patients sleep with the area patched for added protection. Around 80% of transplanted eyebrow hairs will survive and grow. Surgeons take the success rate in any particular region into account when planning hair restoration procedures, and may transplant more hair to make up the difference. In eyebrow restorations, it's impossible to tell which hair will grow and which will fail, and there isn't much room to place additional hair anyway: it may be necessary to have a second procedure some months after the first has shown results.

#12 Eyelash Restoration

Because of the proximity of the lashes to the eyes, eyelash restoration is a more delicate matter. The cornea is protected during the surgery, and a topical anesthetic is used on the eyes. Ophthalmic ointment is used until the scabs heal, to prevent infection, and antibiotics are prescribed.

The grafts for eyelashes are stripped away from surrounding donor skin, often leaving only the follicle and the hair to be inserted. It may be the additional handling or the removal of extra tissue that makes lashes more vulnerable to loss after transplant. Although hair replacements are usually 90% retained and eyebrows 80%, only around 50% of transplanted eyelashes are expected to grow after transplant. Additional grafts may be required to fully fill the lashes.

There are three different procedures for restoring eyelashes: in one, the hairs are inserted the same way they are for eyebrow and hair restoration, by being placed into sites prepared with a small needle in the appropriate area. In another version of the surgery, a strip of hair about as wide as a hair follicle is taken from the sideburn region and sutured into an incision made along the border of the eyelid. In the third method, the surgeon uses a French needle to make both the recipient site and to insert the hair follicle into the site. Threaded as you would a sewing needle, the hair is pulled into the site and left there to grow.

After an eyelash transplant, patients may sleep in glasses or with a patch over the eyes the first night, and may carefully wash their faces in a day or two. Transplanted lashes and eyebrows often grow right away, unlike other hair, which can take some months.

While it's possible to transplant lower lashes, there is a risk of a condition called "trichiasis", in which eyelashes turn inwards. When this occurs naturally, patients have to undergo surgery or the lashes irritate the eye and cause infection and eventual blindness. Patients who wish to have their lower lashes restored are counseled about the greater risk and the need for caution.

Like other hair moved from the head to the face, eyelashes will grow much longer than normally. They will need to be trimmed once or twice a month, and to train them upwards, we recommend an eyelash curler.

#13 Revision of hair plugs

Many early hair transplant techniques used hair “plugs” which are grafts that are larger than grafts that are aesthetically acceptable by today’s standards. These older hair transplant techniques can be significantly improved by using today’s very refined hair restoration techniques. After a modern hair transplant repair, patients can typically achieve a natural look that they can style in any manner.
In certain situations, the surgeon can mask the old plug grafts by surrounding them with today’s smaller and more refined micrografts. This is only effective if the older grafts are not too close to the hairline. A patient must also have a sufficient number of micrografts available to surround and mask these larger grafts.

However, if a patient’s large grafts are too low on the hairline or if there are not sufficient micrografts available to mask them, they should be carefully removed.

Often a patient’s previous hair transplant grafts cannot simply be masked by surrounding them with smaller and more refined micrografts. In this case, the surgeon has to surgically remove and recycle the large grafts into small micrografts that can then be re-transplanted. The hair plug is removed and is then carefully dissected into tiny micrografts that contain one, two, three, and sometimes four hair follicular units. These micro units are used to create the distinctly irregular border that natural hairlines have.

Hair loss is a very sensitive matter. We understand that many patients may have had a painful and negative experience with hair transplant surgery and are reluctant to have any further procedures performed. However, once patients realize that they can achieve a natural hairline and go back to a more “normal lifestyle” they are eager to have a micro follicular graft procedure.