First Quarter 2008, Volume 22, Number 2

Thinking about adding some hair?
What about subtracting or removing?


Medical advances in facial plastic surgery benefit all

Thinking about adding some hair?

Ask the Surgeon / Health Tip / What’s New

Don’t believe everything you read about facial plastic surgery

Perhaps you would like more hair in certain areas and less hair in others. Due to the advances in technology and techniques, both adding and subtracting hair is possible-and in a natural, minimally invasive way.

Scalp hair restoration
What causes hair loss? Heredity is the major factor for men losing hair. Hormone changes are responsible mainly for female thinning and loss. Disease, burns, accidents, and certain medications may also affect hair loss. You will not become bald by brushing your hair, wearing a hat, shampooing frequently, or having poor circulation. These are common misconceptions that are simply untrue. We naturally lose 40 to 100 hairs each day due to the growth cycle of the hair follicle. However, if you feel that you are well below the average 100,000 hairs on your head, you may want to talk to your facial plastic surgeon about options for restoring your hair.

The most common and successful surgical procedure for hair restoration is follicular unit transplantation. The first step is to determine the pattern of balding: frontal baldness only, front to crown, front and mid-scalp with no thinning at the crown, and crown only balding. This will allow the surgeon to plan the donor and recipient site effectively. Then, your facial plastic surgeon will remove a strip of hairbearing scalp, preserving the entire structure (blood vessels, sebaceous glands, surrounding adventitial sheath, and supportive nerve and blood tissue), and divide it into several hundred singular follicular grafts. Under microscopic magnification, the follicular units will be inserted into small needle-sized sites in the recipient area.

Since the technique uses small incisions in the recipient site, there is little damage or trauma to the area. This has a few important advantages. First, it allows the grafts to be placed very close to each other, which means a denser look and feel. Second, the small incisions allow a detailed mapping of the hairline; your facial plastic surgeon can define an irregular hairline with the highest degree of precision to give the most natural effect. Finally, little damage means that you can walk out of the surgery with no bandages. Note: While the results are immediate, it may take several sessions to produce the optimal result. Your facial plastic surgeon can provide you with more information on what specific procedure and plan might be right for you.

Eyelash restoration and enhancement
Did you know that the upper eyelid contains approximately 100 lashes, the lower eyelid about 60? Put away the fake eyelashes and glue, there is a permanent solution that creates length and density. You may be an excellent candidate for eyelash transplantation.

Your eyelashes are an important feature of the face; they frame your features and shield the eyes from dust and injury. Some candidates for eyelash transplantation are seeking reconstruction of the area due to physical trauma or injury, affects of medical treatments (e.g., radiotherapy or chemotherapy), or a congenital condition. Other potential patients are looking to enhance the aesthetic appeal of their eyelashes.

The procedure is similar to hair transplant surgery. A graft of living hairs and follicles is taken from a donor area– e.g., the nape of the neck or behind the ears-where the hair is fine. The graft is dissected into follicular units, which is the natural grouping of hair follicles. The surgery is performed under local anesthesia with the patient awake. A surgical needle is used to place the graft into the eyelid. The duration of surgery and the number of sessions will depend on the individual’s needs.

Transplanted hairs will grow soon after transplantation. Your physician will provide instructions on care and trimming.

Eyebrow restoration and enhancement
Are you self-conscious about your barely-there eyebrows? Whether you have over-plucked your brows or you have suffered from a medical condition or trauma, eyebrow hair restoration can recreate a fullness and natural contour line.

If you are interested in this surgery, discuss the desired outline and the natural symmetry of the brows with your surgeon. It may take several sessions depending on your unique needs.

The surgery begins by harvesting hair from an area on your scalp. The finer hair is a better match for eyebrow hair, rather than thick, coarser hair. The graft includes hair, tissue, and blood vessels; it is sectioned into micrografts of single hairs in order to place them meticulously into small incisions in the eyebrow.

Transplanted hairs will grow soon after transplantation. Your facial plastic surgeon will provide instructions on care and trimming.