Treating Hair Loss
I always had an interest in hair restoration and treating hair loss early in my practice. The reason is that hair loss affects about 35 million men and 21 million women in the United States alone. Over 40% of men will have noticeable hair loss by age 35, and 65% of women will have significant hair loss by age 60.
Originally, however, hair transplants were with “plugs” with 10-12 hairs per plug. The result was quite unnatural and the appearance was similar to a toy doll. In the 1990’s, FUE (follicular unit extraction) was developed, which was manually extracting 1 mm grafts containing 1-4 hair follicles, and thus hairs. The result was very natural, and actually undetectable as a transplant, if done with skill.
NeoGraft, an automated method of FUE, was developed about 10 years ago. I was first exposed to the NeoGraft at a plastic surgery meeting and purchased one and haven’t looked back. Still, skill is as important or even more important that the equipment, as with any surgery. A better scalpel doesn’t make for a better surgeon.
Treating Hair Loss with Neograft
Treating hair loss with NeoGraft, we must keep in mind that only a maximum of 2500 grafts can be performed in one sitting, and this takes about 4 hours under local anesthesia and mild sedation. We also offer nitrous oxide to help reduce any anxiety and discomfort. There are no sutures or staples needed, and recovery in 7-8 days before it cannot be noticed that a procedure was done in most cases. Some of the hair will start growing from the grafted follicles in 3 months, some in 4 months and some even up to a year. By 6 months about 50% of the hairs are growing.
For any FUE procedure, the hair must be cut in the back of the scalp–the donor area. Because of this, those with long hair that wish a minimal amount of hair to be cut, we recommend the strip excision. The grafts are the same, and the scar is covered with their own hair, so it is imperceptible. For men who wear their hair short, the scarless NeoGraft is the recommended procedure.
The price is per graft and depends upon the number of grafts needed to meet the patient’s goals. For the hairline, single hair graft must be used to appear natural. Behind the hairline, multiple hair grafts (up to 4 hairs per graft) are used for maximum density. Importantly, the hairs must be placed in the proper direction for the most natural appearance and to make the hair manageable as well.
After 7 years of NeoGraft and strip hair transplants, they are among the best procedures we perform and most appreciated by the patients. The grafted hairs will grow no matter what, but the original hairs in the balding areas must be maintained to prevent loss. We recommend minoxidil foam topically and in some patients, finasteride tablets to prevent further hair loss. A recent addition is Vivascal, a nutrient to be taken by mouth that retards hair loss.
Additionally, in many patients, we recommend PRP (platelet rich plasma) injections as directed by your physician. PRP contains growth factors and can be very effective in stimulating hair growth and preventing hair loss.
E. Ronald Finger, MD, FACS
Savannah, GA and Bluffton, S.C.