Hair Today, Gone Tomorrow, Hair Again
Jan. 4, 2000 (Atlanta) -- According to the American Academy of Facial
Plastic and Reconstructive Surgery, hair loss affects two out of three men, and
one in five women. But that doesn't have to be the end of it, thanks to the
evolution of hair replacement techniques.
In a study in the recent issue of the Archives of Facial Plastic
Surgery, Stephen C. Adler, MD, and Daniel Rousso, MD, compared
aesthetic improvement, effectiveness, amount of postoperative pain, and
complications of past and present techniques. According to their results, hair
restoration procedures overall just keep getting better.
The main objective of the study was to actually prove that newer techniques
are better than older techniques, Adler tells WebMD, and also to give patients
a voice. "It's important, because as doctors we can always have an opinion
of our own work and, yes, we can see that we have improved the hairline, the
density, the scars by the new techniques. But basically its our own subjective
opinion, and this is actually the first time that the patient's opinion based
on an objective evaluation is actually performed and sufficiently proven,"
According to Adler, this type of study is not only important for hair
restoration, but also for other procedures like facelifts and laser peels. He
predicts the research will generate a wave of similar studies.
The researchers sent out 300 surveys to patients who had undergone hair
replacement over the last three decades. Of that group, 66 responded, with an
average age of about 44. The patients were grouped into three segments
depending on when the surgery was done: before 1980, 1981-1990, and
First, definitions of some terms and techniques are in order. For any hair
replacement to occur, some hair is needed from a donor site. A totally bald
person is out of luck. According to the authors, the science of hair grafting
reaches back to the early 1800s. But the procedures commonly associated with
hair replacement didn't begin in the U.S. until the next century.
Adler and Rousso focused on standard grafts (8-10 hairs per follicle),
minigrafts (about 4 hairs per follicle), and micrografts (1-2 hairs per
follicle). They also focused on scalp reduction, in which a piece of scalp is
removed and the parts with hair are stretched over it; flaps, in which a
section of hair-bearing scalp is partially disconnected to replace a bald part;
strip harvesting, in which a strip of the scalp is entirely disconnected and
moved to a bald spot, or punch harvesting. The "punch" method is the
oldest method, wherein pencil eraser-sized plugs are removed and placed where
needed, giving a person, as Adler describes it, a "doll's head"
Patients surveyed said that they had fewer complications and the best
results with the micrografts, which the respondents did not even begin to
receive until 1991, and they said that the results were better with minigrafts
than standard grafts, apparently an increasingly outdated mode of