Beyond Hair Plugs: Modern Surgical Options For Hair Loss in Men
When medical treatments for hair loss fail to bring satisfactory results, some men turn to surgical treatments like hair transplantation ...

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Talk to me about the pattern of hair loss right there.

ROBERT V. CATTANI, MD: Here you see typical male hair loss, and we're pointing there to the frontal scalp. You can see the forehead lines of this young man. His hair's thinned out and it's receded, and he's probably, in that frontal area, lost 80-90% of the hairs compared to what he started off with. He's also a little thin on the top but he still has pretty adequate coverage up there. So he really needs work done on the front.

DAVID R. MARKS, MD: Of course, you have to have donor hair. How do you decide where to get the hair from?

ROBERT V. CATTANI, MD: Basically we have two types of hair on our head. I don't want to be overly technical here. But the hair that we have around the sides and the back is called terminal hair. It grows five to seven inches a year, each and every year of our life and for the rest of our lives. Basically. This is simplification. It is concentrated. Each shaft of the hair is thick. This is the donor hair. So when we harvest this donor hair and we transplant it, if you will, to the new balding site, that hair acts like it's never left the donor spot. So therefore it is permanent, it will prevail for a lifetime and will have concentration and density, certainly higher than what the balding area has right now. Never to the extent that the donor hair was. In other words, we can't make it as thick as where from whence it came.

DAVID R. MARKS, MD: We have picture of harvesting that they're running right now. So this is really in the back of the head.

ROBERT V. CATTANI, MD: That's correct.

DAVID R. MARKS, MD: What do you do? You clear out a strip of hair?

ROBERT V. CATTANI, MD: Yes. Let me just say this. First of all this is done in a doctor's office or surgical suite. It is not painful. It is monitored. We give the patients novocaine-type substances. Then by the use of a surgical blade we will remove a certain segment of the scalp.

DAVID R. MARKS, MD: Is that what's outlined there, the strip that will be removed?

ROBERT V. CATTANI, MD: Yes, it is. From this harvesting we'll be able to create several hundreds of grafts. Thousands of hairs sometimes. I think it's safe to say, and I want Dr. Reed to give comment on this. I like to move approximately 2,000 hairs per procedure. Dr. Reed would like to comment on that I'm sure.

MICHAEL L. REED, MD: Yes, I think the new definition of what's called a megasession, which is the largest session that can be safely be done to make a lot of progress in just one procedure, is to move somewhere between 2,000-3,000 hairs, which, in the follicular unit world is anywhere from maybe 1,000-1,200 follicular units, which are these clusterings containing two or three hairs per unit. We take out the strip of tissue and under a dissecting microscope, it's first microdissected into little tiny slivers which are a few millimeters thick and then it's subsequently dissected into smaller grafts containing anywhere from one, or maybe two or maybe three follicular units at the most. So anywhere from one to maybe eight hairs per graft. Then those grafts are put very closely together in surgically produced sites in the new home, in the recipient site, in a pattern that resembles that found in mother nature.

DAVID R. MARKS, MD: We're going to look at that in a minute. But it looks like a very large strip that's taken out. How is the healing? Is there any scaring?

MICHAEL L. REED, MD: Any time that there's surgery there can be a scar.

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