Dr. Phillip Chang is a Board Certified Plastic Surgeon with offices in Loudoun ( Ashburn and Leesburg ) and Fairfax ( Reston ) Virginia. In addition to hair transplant or hair restoration surgery, Dr. Chang specializes in surgical and nonsurgical cosmetic enhancements including breast augmentation, facelifts, tummy tucks, and other face and body improvements.
Overview of the Hair Transplantation Process (Follicur Unit Micro-transplantation)
There is no doubt that hair loss for men and women can be devastating to your self-esteem and self-image. Despite the advent of some medical treatments such as Rogaine and Propecia, more and more patients are turning to more permanent solutions such as hair transplantation. Hair Transplantation procedures have been revolutionized by the introduction of the Follicular Unit Micro-Hair Transplantation procedure. By using a surgical microscope to separate each hair follicle, hair transplantation is not only permanent but it no longer has the appearance of plugs that gave hair transplantation a bad name in the 70s and 80s. This procedure is based on the following principles.
- Hair loss is the result of the abnormal sensitivity of hair follicles to the hormone dihydrotestosterone (DHT) after it is converted from testosterone
- The hair follicles in the posterior scalp and the side of the head appear to be immune to the effects of DHT
- Follicular unit hair transplantation uses this principle and the principle of Donor Site Dominance to move or transplant the hair from the back of the scalp to the areas of hair loss
- About 2000 hair follicular units can be moved in each session. Depending on the degree of hair loss, some patients may benefit from 1 or more sessions.
Natural History of Hair Loss and Potential Treatments
Premature hair loss can be devastating to the self-image and self-confidence of both men and women. Most of us have experienced some temporary hair loss that we have worried about. There are many reasons for temporary hair loss. These can include
- Medical Illness ( hypothyroidism, cancer, viral syndromes )
- Poor diet ( Iron or vitamin deficiency )
- Direct Trauma
- Hormonal Imbalance ( pregnancy, perimenopause )
Temporary hair loss is fortunately… temporary. There is often a direct identifiable cause that we can find and treat. I often identify these problems during your initial consultation and the consultation often ends without having to proceed to a more involved hair restoration procedure.
More permanent causes of hair loss can also affect both men and women. Permanent hair loss in both men and women are most often due to hormonal influences initiated by a genetic predisposition. Specifically, hair loss is usually due to elevated levels of dihydrotestosterone (DHT). DHT is a male hormone that is also found in women in smaller amounts. Because hair follicles are ultra-sensitive to DHT, an excess of the hormone often causes the hair to fall out.
Hair loss or baldness is a genetic trait—but unlike what you may have been told, it’s not necessarily passed down from your maternal grandfather. Medical science has come to learn that baldness genes are actually passed down from both sides of the family—and they affect hair loss in women as well as men. Baldness genes may also skip generations and are utterly random in terms of which siblings (male or female) they will affect. They may even have very different effects on siblings in the same family.
Hair Loss in Men
Baldness is a medical condition that affects some 25% of men in their 20’s and an astounding 2/3 of all men after the age of 60. Male-pattern hair loss and baldness does not have any intrinsic side effect aside from hair loss so many consider it a cosmetic medical condition, but for those who suffer from it, its effects it can be devastating with social and psychological consequences.
Androgenetic Alopecia, or “male pattern baldness,” occurs in me whose hair follicles are sensitive or over-exposed to the hormone dihydrotestosterone (DHT). In men, testosterone is converted to DHT. Over time, DHT-sensitive hair (usually found on the top and front of the head) becomes weaker, finer, and eventually stops growing. However, even men who experience advanced baldness have healthy hair follicles mostly around the sides and the back of the head that last a lifetime. Even though these healthy hairs are exposed to DHT, they are resistant to this hormone and survive for a lifetime. The usual life of a hair follicle is 5 years, 4 of those spent growing and the last year being stagnant, but follicles that are damaged fall out and are not replaced by new follicles. This is why male pattern baldness is gradual but irreversible in its later stages.
Hair Loss in Women
Hair loss in women can be particularly devastating. Women will often pay hundreds of dollars to stop by their local hair salon to receive a stylish cut and color. Her hair style often defines and frames her image. Now imagine the perceived affect on her self esteem when her hair prematurely and inexplicably begins to thin.
In most cases, hair loss in women is a normal condition dictated by heredity. Hair loss is relatively common in women, more common than one would imagine. Almost 30 million American women, or one in four, experience thinning hair due to androgenic alopecia – female-pattern-baldness. All women have both estrogen (female) and testosterone (male) hormones in their systems. The loss or depletion of the protective estrogen and/or the over-production of testosterone permits the invasive testosterone to exert its effect on the hair follicles, resulting in a thinning of the hair.
In women, hair loss usually begins at menopause. Before this time, DHT is counteracted by estrogen, but when estrogen levels drop, women’s hair follicles may also become prone to the effects of DHT. Unlike men, hair loss patterns in women are marked by thinning throughout the scalp; fully bald spots at the crown are rare.
The onset of hair loss in women can begin anytime after the teenage years, but most commonly occurs during perimenopause or menopause when a woman’s estrogen levels fluctuate at first and then gradually decrease to a new, much lower level – culminating in the loss of the protective effects of estrogen. Anything, from drugs to a traumatic event, that alters the protective levels of estrogen could lead to a premature development of female pattern hair loss.
Women may experience temporary hair loss following pregnancy. The reason for this is because during the pregnancy term, the hormones of a woman’s body changes. Because pregnant women have elevated levels of progesterone and reduced levels of estrogen, hair will begin to fall into its resting stage too early. After childbirth, new hair will then begin to grow, causing the hair that is in its resting phase to shed. This typically occurs between three and six months post childbirth, and women will attain normal hair growth patterns following this temporary situation.
Follicular Unit Transplantation is the scientific and permanent solution to hair loss, not only for men, but also for women.