• Female Hair Loss - Treatment and Restoration

    Female hair loss

    Female hair loss, otherwise known as Female Pattern Baldness (FPB), affects 1 out of every 4 women in the United States. Recent findings have found that the incidence of FPB has been reported to be as low as 8% and as high as 87%. And, it does appear to be as common for women as for men. Most often, menopause is the most frequent time for hair loss in women to become apparent.

    For a woman to lose her hair can be even more troubling than for men. A woman with thinning hair is not generally accepted as part of the normal aging process. Society has come to expect a thick, luxurious head of hair as part of the attractiveness in women.

    While males and females can both experience thinning hair, they typically do not lose their hair in the same order or appearance.

    Women with thinning hair compared to Men

    Typically men observe their hair loss earlier, whereas women will first notice it in their late 20's through their early 40's. Female Pattern Baldness (FPB) is often seen during hormonal changes. These include the use of birth control pills, following childbirth, or during or after the time of menopause.

    Top view of patient
    Top view of patient, showing excellent growth of transplanted hair.

    In addition, men typically have localized areas (patterns) of thinning, whilein women this usually occurs as thinning across the top, or over an even wider area. When women have very diffuse thinning over much of their scalp they are generally not good candidates for hair restoration surgery. However, women with localized hair loss, similar to the typical male pattern baldness, can successfully undergo hair restoration surgery.

    Thinning hair in females is also characterized by an increase in the combination of normal thick hairs mixed in with finer, smaller hairs. This results in decreased density, and not total hair loss.

    A woman's hair has also been proven to be more sensitive to the effects of stress than men's hair. Stress can result in hair loss in women and men. But this type of loss is not female pattern baldness. Rather, it is known as “telogen effluvium.” This type of hair loss is the shedding of hair in the resting phase when the body senses that it needs to divert its energies elsewhere. Therefore stress can temporarily changes the amount of hair that is shed. But the lost hair is likely to grow back.

    The production of the hair loss-inducing androgens is also different among men and women. A woman produces a small quantity of androgens in the adrenal glands and the ovaries. The ovaries also produce pre-hormones, which are then converted to androgens on the outside of the ovaries or adrenal glands.

    Generally speaking, a woman with hair loss will probably not experience total balding in a given area. But if there is total hair loss, this is most likely a sign of a previously hidden disease. For this reason, it’s important for females to have their hormone levels checked by a physician if they are experiencing heavy hair loss.

    Finally, men and women react differently to various hair loss treatment options. In men, hair loss may be halted or even reversed by finasteride (brand named "Propecia"). However, Propecia is not safe for females or children. Minoxidil (Rogaine) can be effective for both men and women in treating hair loss.

    However, for some women the causes of their hair loss are much more complex than the classic "male pattern baldness". Thus proper diagnosis of the underlying cause is vital before any hair loss treatments are attempted.

    The following physicians are nationally well known experts in female hair loss. Feel free to contact them.

    David Whiting in Dallas, Texas - 214 824-2087

    Vera Price in San Francisco, California 415 353-4163

    Maria Hordinsky in Minneapolis, Minnesota 612 625-1493

    Wilma Bergfeld in Cleveland, Ohio 216 444-5722

    For a web community that is dedicated to female hair loss visit HerAlopecia.com

  • Hair Transplant Cost

    Hair Transplant Cost

    Today hair transplant costs are vastly better value, than they did just a few years ago. Increased competition combined with the increased ability of a specialized clinic to produce large sessions of follicular units at reduced hair transplant costs and has resulted in patients getting vastly better results and increased density at lower prices.

    Just a few years ago it was not unusual for a clinic to charge as much as $15 US per graft, while providing patients with only small sessions of a few hundred grafts that achieved limited density and fullness.

    Today hair restoration clinics typically provide free no obligation consultations, with surgical sessions priced either per graft or by the session. Hair transplant costs typically cost between $3.00 to $8.00 per graft, with $5 to $6 per graft being about average.

    It is normal for the price per graft to drop as the size of the surgical session increases. Many clinics will offer a reduced rate per graft once a certain surgical session size (i.e. 1,000 or 2,000 grafts) is exceeded.

    Comparing the costs of various hair loss treatments

    Price options

    Although hair transplant surgery is not inexpensive, it can be the best hair restoration value given that the results are natural and last a life time. The cost of non surgical solutions like a hair system or hair loss medications can exceed the cost of hair restoration surgery when the long term costs are compared.

    For example – A quality custom hair replacement system on average costs $1,200 and needs to be replaced about once a year. In addition, a hair replacement system requires regular upkeep and reattachment each every 5 to 6 weeks at about $75 per visit or $675 per year.

    Hair Piece, or Surgery

     

    Thus the cost of buying and maintaining quality hair replacement systems over 15 years is approximately $28,125.00 ($1,200 plus $675 in annual upkeep = $1,875 x 15 years = $28,125.00). This total cost well exceeds the typical cost of surgical hair restoration.

    Note - Of course the cheapest option is shaving your head with an actual net saving due to no expense for shampoos, conditioners, combs, brushes, or hair stylist.

    Consult a physician for an estimate

    Our member physicians price their procedures independently. So your final cost will depend on who you select and how much hair restoration you will need to be satisfied.

    To do a free consult with one of our quality member physicians to get an estimated cost of restoring your hair visit our member physicians’ area.

  • Ultra Refined Follicular Unit Hair Transplantation

    Ultra Refined Follicular Unit Hair Transplantation

    The Ultimate in fullness and naturalness in one surgery session.

    We’ve all seen the “pluggy” hair transplants of the past. But we don’t see today’s state of the art hair transplants because they go unnoticed.

    Corn RowsMini MicroFollicular units
    Plugs Mini Micros Follicular Units

    Follicular Evolution - from plugs to micro grafts to ultra refined grafts

    Surgical hair restoration has dramatically evolved from the big round “plug” grafts of the 1960 ’s and 70’s, to the “mini micrografts” of the 80’s and early 90’s, to modern hair transplant procedures using entirely follicular unit grafts .

    Now hair restoration surgery is going through another important evolution that is improving both the naturalness and fullness that can be achieved from any one surgical hair transplant session.

    Ultra Refined Grafting - Smaller Blades, Incisions and Grafts

    Today ’s micro surgical blades, like the size of hair grafts, have become ever smaller and now enable hair transplant surgeons to safely make more tiny graft incisions in a given area then ever before. Surgeons are then able to “dense pack” select areas with as many as 40 to 60 follicular unit grafts per square centimeter. This graft density is as much as twice that of the standard follicular unit hair transplant procedure.

    FUT result

    FUT Result

    Such high densities of transplanted hair typically produce the appearance of fullness even after only one surgical session. Patients also experience rapid healing and no visible skin distortions due to the tiny size of these incisions.

    Ultra Refined Follicular Unit Grafting - Hard on the clinic but easy on the patient.

    Ultra refined follicular unit grafting raises the bar for physicians and their staff. This delicate and demanding hair transplant procedure requires more skill and careful attention to be performed properly. The smaller and more tightly packed incisions require more closely dissected follicular unit grafts that are carefully trimmed under microscopes. These small and densely packed incisions are also more difficult to place the grafts into.

    This procedure also requires more careful patient selection, as “dense packing” of grafts is not appropriate for all patients.

    Ultra Refined Follicular Unit Transplantation – the new “Gold Standard”

    Natural hair hair transplant hair line

    In the hands of a highly skilled physician and staff the Ultra refined follicular unit hair transplant procedure can achieve excellent new hair growth that is so natural that it is undetectable even under close scrutiny.

    While the standard micro “follicular unit” hair transplant does produce natural looking results, its ability to achieve high density in only one surgical session is limited. Thus patients may have to do subsequent surgical sessions in a transplanted area to achieve a full look.

    The many patient benefits of this new procedure are significant and include:

    • The ability to get excellent hair density in only one surgical session.
    • Minimal trauma in the graft recipient area with rapid post surgical healing.
    • Little or no visible pitting or distortions in the transplanted areas.
    • More natural direction and angulation of the transplanted hair.

    Coalition of Independent Hair Restoration Physicians All members of the Coalition of Independent Hair Restoration Physiciansare required to perform ultra refined grafting with excellent results. Learn more about the membership standards.

  • Revivogen Scalp Therapy, Shampoo and Conditioner for Hair Loss

    Revivogen Kit

    Revivogen hair loss treatment is a "3 in 1" all inclusive product that comes with scalp therapy, one eyedropper, one shampoo and one conditioner.

    This topical scalp therapy treatment, equally effective for both men and women, claims to be very successful at inhibiting the 5-alpha reductase enzyme, which converts testosterone into DHT (dihydrotestosterone). The makers of Revivogen claim that it is even more effective than Propecia in reducing DHT in the scalp without the unwanted side effects. It's also potentially the most potent topical antiandrogen on the market. Antiandrogen hair loss treatments like Revivogen inhibit the production of the male hormone DHT. The makers of Revivogen claim that it is even more effective than Propecia in reducing DHT in the scalp without the unwanted side effects.  This product however, has not been approved for hair loss by the FDA.

    Revivogen all natural medicated shampoo is one of the few shampoos that includes ingredients scientifically supported to help inhibit the production of DHT and its binding to hair follicles. A 12oz bottle should last just under 2 months.

    Revivogen shampoo has ingredients that complement the Scalp Therapy solution, increases scalp circulation, opens pores, and produces a cooling and refreshing menthol feeling on the scalp.

    Revivogen Thickening Conditioner revives limp and thinning hair in men and women by moisturizing and strengthening the hair shaft. Natural proteins add natural volume, shine and create the appearance of thicker and fuller hair. For best use, we recommend using this conditioner with Revivogen Shampoo. Or, get the discounted Revivogen Shampoo and Conditioner combination instead to save money.

    We strongly recommend using Nizoral shampoo every 2 or 3 days in conjunction with these treatments. Its active ingredient ketoconazolehas proven to be a moderate DHT inhibitor and has growth properties approximately as effective as Rogaine 2%.

    How It Works:

    Revivogen contains scientifically backed ingredients including Azelaic Acid, Vitamin B6, Zinc, Saw Palmetto, GLA and ALA which are fatty acids proven to inhibit the production of DHT. Reducing the amount of DHT in the body and scalp reduces the risk of vulnerable hair follicles dying and falling out.

    For proper treatment, Revivogen should be applied at least once a day to the scalp's affected areas as well as the surrounding areas.  Once you've used the medication, you should not wash your hair for at least three hours.  This allows the active ingredients to be absorbed into your scalp  The effects of Revivogen may take some time to work.  Most users claim to experience their desired results after about 6 months of use.

    Revivogen contains no reported side effects.

    Developing Realistic Expectations:

    Men and women sometimes suffer from hair loss for different reasons. Thus, diagnosing its cause is necessary to facilitate and promote proper treatment. Revivogen is not clinically proven or approved by the FDA.

    Revivogen and other antiandrogens (such as Propecia, Crinagen, Nizoral, Revita, etc.) may provide marginal benefit to men and women trying to maintain existing hair due to androgenic alopecia. Propecia by far is the most effective and only proven antiandrogen. For the best chance at regrowing hair non-surgically, adding a hair growth stimulant such as Rogaineor Tricomin is crucial.

    Don't expect immediate results. It's recommended to use Revivogen for at least 6 to 12 months before determining its effectiveness. Documenting your progress with bi-monthly photos can help you determine whether or not Revivogen has been successful in helping you maintain existing hair.

    To date, only surgical hair restoration is proven to grow hair in completely bald areas. You are invited to have a free virtual consultation with one of our prescreened hair restoration physicians.

  • Jerry Wong, MD

    Dr. Jerry Wong
    Dr. Jerry Wong
    Dr. Jerry Wong exclusively performs Ultra Refined Follicular Unit Hair Transplantation with outstanding results.
  • Jerry E. Cooley, MD

    Dr. Jerry Cooley
    Dr. Jerry Cooley
    Dr. Jerry Cooley and his staff were early adapters of using microscopes to do excellent all follicular unit hair transplantation.
  • How hair loss medication can inhibit DHT and Alopecia Areata

    Propecia or Avodart

    If you are going bald you should seriously consider hair loss medication treatments to halt or even reverse your hair loss. While there is no “Hair Loss Cure”, hair loss drugs like finasteride (Propecia) and dutasteride (Avodart) can often stop or even reverse alopecia areata in most people.

    However, just like any other drug, Propecia is accompanied by a list of potential side effects, some of which have been more recently reported as potentially long term.  You can read more about this in the "What About Side Effects" section further down this page.

    Studies have shown that 80% of men using Propecia stopped or even reversed their hair loss to some degree. Preliminary clinical trials for Avodart appear even more effective than Propecia.

    However, neither Propecia nor Avodart has been proven to restore hair in the frontal areas. For reasons yet unknown these drugs, along with Rogaine, only generally work in regrowing thinning hair in crown area of the scalp. Only hair transplant surgery has been successful in restoring hair in the frontal hairline area once it has been lost.

    Propecia and Avodart are also less effective in growing hair in older men. These hair loss drugs work best for men who have been balding for less than five years.

    Women must NOT USE Propecia

    Both Propecia and Avodart are not recommended for use by women or children.

    It’s been found that these drugs can cause birth defects. More specifically, these birth defects may occur when large amounts of the drug are absorbed into the body during the period of foetal development.

    Physicians advise pregnant women to not handle Propecia tablets, as this may harm male foetuses. But as of yet, there has not been a single reported case of birth defects caused by handling these tablets.

    Furthermore, there’s also no evidence that pregnant women exposed to the semen of Propecia or Avodart patients will risk any birth defects.

    Propecia and Avodart are also not advisable for men with liver disease or prostate cancer.

    Get a Prescription for Propecia or Avodart.

    Often our member physicians will prescribe Propecia or Avodart to halt a patient’s hair loss and then restore the hair already lost with hair transplant surgery. These treatments in combination can work synergistically. The drugs work to halt the hair loss, while hair restoration surgery restores what was lost.

    To get a prescription for Propecia or Avodart schedule a free no obligation consultation with any of our quality hair restoration physicians. Find a physician in your area.

    Propecia and Avodart should be taken once a day. It has been found that after two years of treatment, Propecia effectively grows hair in about 66% of patients. Also, about 83% of the subjects receiving this treatment continue to maintain their existing hair after two years.

    Propecia (Finasteride) was originally a drug called Proscar, which was used to treat and reduce men's prostate conditions such as benign prostatic hyperplasia (BPH).

    Its parent company, Merck & Co., soon realized that the drug had a unique side effect - it grew hair on bald men's heads.

    In December 22, 1997 the FDA approved Propecia as a hair loss pill. Merck & Co. then marketed the drug as a hair loss treatment under the trade name of Propecia.

    More recently Dutasteride, sold as Avodart, has generated interest as a promising new hair loss medication. Like finasteride (Propecia) it inhibits the creation of DHT and was originally developed as a treatment for men’s prostate condition.

    However, unlike Propecia, Avodart inhibits the creation of both type one and type two 5 alpha reductase enzymes. Dutasteride has been shown to decrease levels of DHT by 90% after only two weeks, making it a more powerful and faster acting weapon against hair loss than Propecia (Finasteride).

    Dutasteride is not yet FDA approved for the treatment of hair loss. However, some hair restoration physicians also prescribe it for the treatment of hair loss. Like Propecia, Avodart is not safe for women and children.

    Sticking with the program to see results

    Losing your hair took time. So too will regrowing your hair using Propecia or Avodart. These drugs require patients to take the drug daily for at least three months before any obvious changes will be noticeable. Most physicians advise taking these drugs for a year before evaluating their effectiveness.

    At this time, Propecia and Avodart are only available by prescription. Our member physicians are available to discuss these hair loss drugs with you and prescribe them if appropriate. To find a quality hair restoration physician in your area.

    Other DHT Blockers

    Aside from Propecia and Dutasteride, there are other treatment options (all topical) that may or may not work to block the effects of DHT on vulnerable hair follicles. These include Revivogen, Crinagen, Progesterone Creams, and Xandrox (a type of minoxidil). Other DHT Blockers

    To learn more about these treatments, as well as all other topical options, visit our Topical Hair Loss Products and Treatments section.

    How hair loss drugs inhibit DHT and Alopecia Areata

    Baldness is largely the result of dihydrotestosterone (DHT) interacting with those hair follicles that are genetically vulnerable to their effects.

    DHT is essentially the active ingredient or catalyst for the hair loss process. DHT binds with the receptor sites of genetically vulnerable follicles and gradually degrades the follicles ability to produce healthy hair. This eventually results in baldness in the affected areas.

    Hair loss drugs like Propecia or Avodart work by inhibiting the conversion of testosterone into dihydrotestosterone (DHT). By reducing the amount of DHT present in the scalp the hair loss process is slowed and in some cases even reversed.

    What about side effects?

    Up until a couple of years ago, side effects when taking Propecia or Avodart were only considered temporary. However, over the last several years, many me have reported ongoing side effects from Propecia even after stopping treatment.  This more permanent condition has become known as "Post Finasteride Syndrome" or (PFS). Side effects included but aren't limited to reduced semen production, a reduced libido and softer erections.

    As a result, in April of 2012, the FDA mandated labeling changes to finasteride related products.  Labeling changes to Propecia include "libido disorders, ejaculation disorders, and orgasm disorders that continued after discontinuation of the drug".  Labeling changes to Proscar include "decreased libido that continued after discontinuation of the drug".  Labeling changes to both Propecia and Proscar include "reports of male infertility and/or poor semen quality that normalized or improved after drug discontinuation".

    While most men don't experience any side effects at all, it should be known that a small percentage of men may experience persistent side effects even after stopping treatment.  Most men who experience side effects however, only experience them temporarily and stopping treatment makes them go away.

    For a list of potential side effects and more information on Post Finasteride Syndrome", visit http://www.pfsfoundation.org/.

  • Rogaine Foam for Men and Women

    The exciting new Rogaine foam has undergone its own extensive FDA trials and can rightfully boast an impressive 85% hair regrowth success rate in people who use it twice daily. This is more than 20% higher than the liquid 5% minoxidil solution at 64%. Rogaine foam also comes without the inconveniences of its liquid counterpart such as scalp irritation, flaking, and messy application. The foam dries almost instantly as opposed to the liquid's 15 minute waiting period.

    Note: Despite what the insert says, Rogaine works just as well for frontal hair loss, recession, and thinning hair.

    How It Works:

    Rogaine foam uses versafoam technology to aid the delivery of the minoxidil to the hair follicles. As the minoxidil absorbs into the scalp, it stimulates follicles, revitalizing them, promoting thicker and healthier hair growth. This promotes a thicker and fuller appearance of hair.

    Developing Realistic Expectations:

    While Rogaine foam is supreme in many ways, it's unlikely to regrow thick terminal hair in completely bald areas. For best results, men ought to consider combining Rogaine with Propecia (finasteride), the only FDA approved and clinically proven DHT inhibitor to stop hair loss. See the "recommended treatments" section below for more details.

    Don't expect immediate results. Just as hair loss is a slow process, regrowing it is too. Thus, it's recommended to use Rogaine for approximately 6 to 12 months before determining its effectiveness. Documenting your progress with bi-monthly photos can help you better evaluate the results.

    Hair shedding is a common symptom the first few months and a sign that the medication may be working for you. It's crucial to push past this stage with continued use for the recommended period of time.

    To date, only surgical hair restoration is proven to grow hair in completely bald areas. You are invited to have a free virtual consultation with one of our prescreened hair restoration physicians.

  • Nettle Root Extract

    Nettle Root Extract

    Contained in Several Popular Hair Loss Treatments for Men

    Nettle root extract can be found in a number of popular hair loss treatments, such as Provillus and Procerin, and at your local health food store as a standalone product. Conjectured to effectively inhibit the production of DHT, below we examine whether or not nettles are as effective as Propecia (finasteride) in blocking DHT and stopping the progression of male or female pattern hair loss.

    DescriptionNettle Root

    “Nettles” is the common name for Urtica Dioica, an herbal plant also known as the Stinging Nettle. This perennial herb is often eaten in many parts of the world and is often added to soups, salads or cooked as greens, though less frequently. Nettle leaves are long and pointy, but only the shoots and top of the plant are eaten. Nettle plants have dark green leaves and typically grow about 2 or 3 feet tall and its flowers are covered with tiny stinging hairs that contain an irritant. Allergic reactions are common if they come in contact with human skin.

    Use of Nettles

    Nettle root extract was found to partially block 2 enzymes by researchers such as R. Hartmann.  The first is 5-alpha-reductase that when combined with testosterone, produces DHT (dihydrotestosterone). DHT is the hormone responsible for androgenic alopecia hair loss. The second enzyme is aromatase, which makes estrogen.  Combining nettle root extract with another herbal agent pygeum has been found to inhibit these two enzymes more effectively than either one alon It was shown that nettle root extract had to be used at high dosages in order to effective whereas lower doses of pygeum worked well.  Prostatonin, the combination product of nettles and pygeum have been used to treat BPH (benign prostatic hypertrophy).

    Studies by researchers JJ Lichius and others have shown a reduction in prostate growth in mice when large doses of nettle extract were taken orally. Combining nettle root extracts with saw palmetto berries in BPH patients reduced the amount of testosterone and estrogen. Conversely, it has been conjectured that nettles can block testosterone from binding to the sex hormone globulin, a carrier protein that binds testosterone and limits its bioavailability in the body. As a result, nettles have been called an aphrodisiac since it may help maintain testosterone levels.

    Other uses of Nettles include treatment for arthritis, asthma, kidney, urinary tract infections, and last but not least, baldness.

    Nettle Root ExtractNettle Root as a Hair Loss Treatment

    Like many other herbal supplements with some clinical evidence suggesting efficacy in treating enlarged prostates (BPH), some have claimed that nettle root extract may stop hair loss and maybe even aid hair regrowth.  Because Propecia (finasteride) works to stop the progression of male pattern baldness by inhibiting the production of DHT, it is conjectured that nettle root extract may be of similar benefit.

    Nettle root is a popular ingredient taken orally in a couple big name hair loss products such as Provillus and Procerin.  Some have also conjectured that applying nettle root extract topically to the scalp may also facilitate new hair growth. Because many topical irritant type products are used to treat alopecia areata hair loss, some suggest nettle root extract applied topically may be effective in treating it. Those who conjecture its efficacy to treat baldness recommend doses of 500mg or more daily.

    Though some have declared that nettle root extract may be an effective hair loss treatment, no clinical controlled studies have been performed proving its efficacy for androgenic alopecia (genetic female hair loss and male pattern baldness) or alopecia areata. 

    Possible Side Effects of Nettles

    Despite claims made that “all natural” herbal supplements are free from side effects, nettle root has its share of warnings. When topically applied, irritation of the scalp or an allergic reaction can occur. When taken orally, it can cause upset stomach, burning, difficulty with urination, bloating and edema.  Nettle root extract should not be used in patients with heart or kidney problems, due to fluid retention properties.
    Those who want to try nettle root extract as a hair loss treatment should proceed with caution and consult their doctor before using it.

  • FUE – a new way of doing Follicular Unit Hair Transplantation

    FUE – a new way of doing Follicular Unit Hair Transplantation

    Follicular unit extraction is a minimally invasive procedure for performing follicular unit hair transplantation. However, unlike the predominant follicular unit transplant procedure, in which a strip of donor tissue is removed and dissected under magnification, the FUE procedure uses a small punch to extract each follicular unit one by one.

    Both the strip excision and FUE procedures create 1, 2, 3, and 4 hair follicular unit grafts that are then transplanted into the balding area in the same manner. The primary difference between these two procedures is the technique used to harvest the follicular unit grafts.

    Comparing the Strip Excision procedure to the Extraction (FUE) procedure

    The common strip excision method of performing follicular unit hair transplantation involves surgically excising a thin horizontal strip of bald resistant skin from the donor area.

    Strip Excision Procedure 

    Donor strip being excised
    Donor strip being excised

     

    Incision sutured together
    Incision sutured together

     

    Hair combed down after suturing
    Hair combed down after suturing

     

    This donor area is then sutured together. These sutures (either stitches or staples) are then typically removed about ten days after surgery. Some physicians use dissolvable sutures so that no removal is needed.

     

    Patient’s donor area 2 months after surgery
    Patient’s donor area 2 months after surgery

     

    Once this linear incision is fully healed the patient is left with a thin horizontal scar in the back of the head. This scar is typically hard to detect since the surrounding hair conceals it, even when the hair is cut short.

    To view a video of an actual strip excision surgery.

    How the FUE Procedure is performed

    With the Follicular Unit Extraction or FUE procedure 1, 2, 3, and 4 hair follicular unit grafts are carefully extracted one at a time using a tiny punch of one millimeter or less. Often the surgeon requires the patient to buzz cut a portion of their donor area so that they are able to see the patient’s scalp.

    The follicular units are extracted
    The follicular units are extracted

     

    The follicular units are extracted by placing the punch around a single follicular unit and cutting a small circle through the skin around that follicular unit. The follicular unit is then gently pulled up and away from the loose tissue underneath the skin.

    The small hole left behind after the follicle is extracted then heals over the following week. Normally this small round incision contracts as it heals making the resulting round scar smaller than the size of the 1mm punch that made the incision. The FUE patient ultimately ends up with hundreds of small round white scars, which are normally not detectable once the patient’s hair grows out.View a video of an actual FUE surgery.

    To Extract or to Excise, that is the question.

    Advocates for the relatively new FUE procedure claim that this procedure produces less noticeable scarring and no tightness or numbness in the donor area since no donor tissue has been pulled together and sutured. Many patients and physicians find the claim that FUE produces less visible scarring to be debatable.

    Some physicians and patients also have concerns about the relatively new FUE procedure, such as the lack of formal studies regarding the percentage of follicles that may or may not be transected during the sight unseen extraction process.

    In addition, since the physician must personally extract all follicles, one by one, the FUE procedure is very physician dependent and thus very expensive. The FUE procedure also requires considerably more time in surgery to move a given amount of hair to the balding area.

    The standard strip excision procedure has the advantage of utilizing a collaborative team to carefully create the grafts once the donor tissue is removed in a strip. This collaborative approach enables a well trained staff to do sessions of 2,000 to 3,000 all follicular unit grafts in a single day. This team approach enables a patient to get a much larger number of grafts/hairs in one sitting at a much lower cost per hair than with the FUE procedure.

    However, some believe that despite being relatively costly the FUE procedure may be appropriate for patients who have very limited elasticity in their donor area or who only need a small number of grafts.