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Surgical Hair Restoration

It has been known for centuries that many men lose the hair on the top of their heads and usually retain the hair on the sides and in the back. It has been a relatively recent discovery that DHT receptors are the root of the problem in male pattern baldness. We now know that balding men usually have an abundance of DHT receptors on the follicles atop their heads, but few, if any, DHT receptors on the follicles on the sides and back of the head. These follicles can be taken from their original areas and the hair transplants can be relocated to the balding areas of the head to replenish the lost hairs in these regions. This technique of hair restoration surgery is called hair transplantation, and in the United States is elected by roughly 250,000 men per year. The transplanted follicles normally continue to grow hair forever because they retain the characteristics from their original location (i.e. they are unaffected by DHT even when they are moved to the new areas).

The concept of moving hair from one location to another is not new. Hair transplants, in various forms, have been around since the 1950's. Original hair transplants involved harvesting 20-30 large 4mm "plugs" from areas in the back and sides of the head and implanting them on the top. Unfortunately, these "plugs" were just that. They gave the appearance of "cornrows" or "doll's hair" as they created very dense areas of 35-40 hairs surrounded by the balding areas. Over the next several decades, these "plugs" got smaller in size, but nevertheless, were still "plugs" and still were cosmetically noticeable. By the late 1980s and early 1990s, micro grafting and mini grafting began to replace the larger grafting techniques. In these hair loss restoration procedures, grafts of 1-5 hair follicles (2-12 hairs) are transplanted. These hair restoration surgery methods create a vastly improved cosmetic appearance over the prior methods. Unfortunately, these grafts are still noticeable to the naked eye upon close inspection, as they are denser than the surrounding areas. The only way to truly recreate the hairline in an undetectable fashion is to transplant individual follicles, as they naturally grow. Thus was the birth of follicular unit hair transplants, or follicular unit grafting.

In the late 1990s, the follicular unit hair transplant procedure emerged to become the most cosmetically appealing method of hair restoration surgery. Using this method, the donor hair from the back and sides of the head is dissected into its simplest form- single follicles. This allows individual follicles (each consisting of 1-5 hairs) to be transplanted to the balding areas with a much more natural appearance than the older methods of surgery. The merits of follicular unit grafting are obvious by examination of the improved cosmetic results. Unfortunately, there are still many physicians who continue to rely upon micro grafting and mini grafting hair loss restoration techniques.

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