Over the past several years surgeons have used various techniques to perform follicular unit hair transplantation. One such technique is the Lateral Slit Technique, also known as Coronal or Perpendicular Grafting. This technique’s name is derived from the angle and direction in which the graft incisions are made.

While there are other techniques for performing densely packed and highly refined follicular unit transplantation, the lateral slit technique offers a high degree of control over the angle and direction in which the transplanted hairs will ultimately grow.

The lateral slit technique has been used both intuitively and systematically for years by hair restoration physicians. However, it has recently gained popularity as a systematic and precise way of performing follicular unit hair transplantation.

How our member physicians use the Lateral Slit Technique.

Many of our physician members use the Lateral Slit Technique exclusively or in combination with other techniques for creating graft incisions. The lateral slit technique enables a surgeon to create graft incisions at varying angles (ranging from 10 to 90 degrees to the scalp), including very acute angles that will make the transplanted hair grow out lying flatter to the scalp. The ability to create incisions at very acute angles is particularly useful in areas such as the front temples and sides where the hair normally grows out lying flat on the scalp.

The graft incision determines the direction of the hair growth

The lateral slit technique also helps enable a surgeon to determine the direction of the graft incisions. This then determines the ultimate direction of the transplanted hairs growth. Thus a surgeon can use this technique to control and vary both the direction and angle at which the transplanted hair will grow in order to mimic the subtle changes in hair direction that occur naturally.

Each graft incision is created by analyzing the neighboring hair so the surgeon can reproduce the correct hair pattern. As a result, as each transplanted hair emerges from the scalp it will grow and lay in a similar direction as its neighboring non-transplanted hairs.

Lateral slits can enable denser packing of grafts

Lateral slit incisions also tend to be more parallel to the scalp and thus more superficial and less invasive to the scalp’s underlying vascular structure. This parallel alignment also enables a physician to place more grafts per square centimeter with out the grafts compressing or popping up since the pressure exerted on the grafts does not push them upward from the scalp.

Using blades cut to the size of the grafts

Some of our members use custom blade cutters to create tiny blades to make incisions that match the size and depth of each follicular unit graft being transplanted. This enables a surgeon to safely dense pack more grafts into a given area during a surgical session. Healing time is also more rapid, with minimal scarring.

Typically most clinic’s blades range from 1.5mm to 2mm in size. However, by using the custom blade cutter our physicians can create blades as small as .7mm for a single hair graft and .9mm for a multi hair graft.

In addition, the blades created by the custom cutter are squared off to match the shape of the bulb end of a hair follicle. Non custom cut blades are typically spear pointed which requires them to be inserted deeper thus causing more trauma to the scalps vascular structure.

The ability to control the depth of the incision each blade makes is also critical. Each blade is placed in a blade holder that is set to not allow the blade to go any deeper than required for the graft to being placed in the incision. This minimizes unnecessary trauma to the deep vasculature of the scalp, thus enabling close tight incisions, minimal tissue swelling, and quick healing that leaves no visible scaring, pitting, or cobble stoning of the scalp.

Placing grafts to maximize their aesthetic result and coverage

The plane and direction in which each follicular unit graft is placed on the scalp can also impact the ultimate appearance of density that can be produced with a given number of grafts. This is because hairs within a follicular unit are typically next to each other inline.

Therefore by arranging each multiple hair graft on the scalp in a linear fashion to the line of sight, each follicular unit will provide the maximum appearance of fullness and scalp coverage. This also mimics how hair is normally aligned on the scalp.

Special thanks to Dr. DeYarman, Dr. Sharon Keene, Dr. Jerry Cooley, Dr. Alexander, and Dr. Glenn Charles for contributing their expertise and photos for this section.

Truly a "Full Head of Hair in 30 Seconds?"

Of all the hair loss concealers available, like topical powder applications or "sprinkle solutions," Toppik is amongst the most popular. What's more, of all the "shaker" options currently available to hair loss suffering men and women, Toppik is one of the most recognized and trusted.

Since its inception, Toppik has been featured in various media outlets, including Time magazine, the Oprah Winfrey show, Fox News, NBC, and Eyewitness news. Throughout this media exposure and positive word of mouth, this hair loss product has been utilized by an estimated 3 million balding men and women worldwide.  So what makes Toppik so popular? How does it work? How does it compare to other types of concealers? Most importantly, what are real consumers saying about Toppik and where can interested parties purchase this popular concealer?

Toppik Hair Loss Concealer: What is it, and how does it work?

Toppik, like many other concealers available today, is a topical powder application. The powder formula is comprised of a series of charged, keratin-based, "hair binding fibers" that, when sprinkled on thinning hair, tightly adhere to individual hair strands. With each "shake" of the Toppik product, thousands of these particles are applied to the head and bind to hair shafts via opposing electrical activity (much like the way magnetized material attracts metal).

By tightly binding to hair shafts in such significant numbers, Toppik naturally recreates the appearance of a thick, dense head of hair.  According to the makers of Toppik, the bond created by the hair shaft and keratin particle is so strong that it will withstand wind, rain and perspiration, and will continue to naturally thicken and volumize the hair until "washed out" by shampoo. Additionally, because Toppik is available in a variety of different tones, the product is able to precisely match any hair color/texture and still remain completely undetectable.

What Benefits Does Toppik Offer Over Other Concealers?

Although Toppik is popular and well known within the hair restoration community, hair loss sufferers should still ask one crucial question: what benefits does Toppik offer over other, similar concealers? According to the manufactures, Toppik offers a variety of benefits that other, comparable products simply cannot match. First, Toppik's keratin fibers are completely safe, organic, all natural, and utilize electric energy to adhere to hair fibers with unmatched efficacy.

Next, not only is Toppik available in a variety of colors, but these tones can also be "mixed" to match any color and can even cover gray hair and new growth from hair transplant surgery.  Toppik colors include black, dark brown, medium brown, light brown, medium blonde, blonde, auburn, gray and white.

Furthermore, Toppik can be used in conjunction with other hair styling products (though the powder needs to be applied to dry scalp, and styling products should be applied before usage), will not "rub off" on clothing or pillows, can be safely utilized with other hair restoration products and medications,  will not clog pores or dry out the scalp, is equally effective in balding men and women, and is easily applied via the shaking method or by applying the popular "spray applicator" to the shaker apparatus.

Why is Toppik so Popular in the Hair Loss Community?

Because of its innovative design, positive "track record," ease of use, and effective nature, Toppik has developed a trusted reputation and large fan base in the hair restoration community. Hair loss sufferers not only trust the history behind the Toppik brand, but appreciate the product's single use longevity and lasting strength of the fiber-hair shaft bond. The fact that the product is effective for male and female hair loss sufferers and can be easily used with other styling and hair restoration products makes Toppik an even better option for any individual considering a topical concealer.

What Real Consumers are Saying About Toppik?

To see what real hair loss suffering men and women are saying and to read helpful tips about applying Toppik in a variety of situations and in conjunction with other hair loss treatments, visit our Hair Loss Forum and Social Community.  You can also read our product review by visiting "Product Review: Nanogen Versus Toppik".

Is it Effective in Treating Baldness?

Hair loss suffering men and women are always seeking new and credible treatments and with good reason. Medical science is still years from producing a true hair loss cure and current treatment options are vastly limited. Women with hair loss have even fewer options than their balding male counterparts when it comes to proven, non-surgical hair loss treatments. Additionally, there is no shortage of cunning charlatans waiting to take advantage of the unwary consumer. Thus, when a new product like Kevis Hair Rejuvenation Formula comes along claiming to be a “permanent” solution and “the most successful and potent hair loss treatment on the planet”, potential customers would be wise to remain skeptical.

Kevis hair loss treatment is not an entirely new solution. In fact, their website states that it has been sold throughout Europe and Asia for over 25 years but has only been available in the United States for 15 years. This is simply the 8th generation of the formula; hence their new name Kevis 8. But how can such an impressive treatment exist for 10 years yet remain virtually unknown to roughly 70 million balding American men and women? What’s even more surprising is that Kevis claims that published clinical studies give this solution for baldness an average success rate of 92%. So why are so many people still seeking viable hair loss treatments today?

Kevis 8 is a drug-free topical lotion developed and manufactured by Italian pharmaceutical company, Farmaka, and distributed by Kevis Rejuvenation Programs in North and South America and by Pfizer in Europe and Asia. As such, it does not come under the regulatory supervision of the United States Food and Drug Administration (FDA). It is applied directly to the scalp and can be used by both men and women. Ingredients are listed as:

Water, SD Alcohol 40-c+SD Alcohol 3-c, Propylene Glycol, Hydrolized Glycosaminoglycans (Thioglycoran), Panthenol, Sorbic Acid, Methylparaben, Hyaluronic Acid (H.U.C.P.), Thurfylnicotinate HCL, Propylparaben, Sodium Hydroxide, Biotin, Fragrance.

H.U.C.P is a high concentrate of pharmaceutical grade hyaluronic acid which purportedly aids in the breakdown of accumulated DHT in the follicle and creates a binding effect in the follicle's receptor sites preventing further DHT buildup. Kevis also lists the ingredient Tricozyme™. Tricozyme is a protein enzyme that they claim attaches itself to free-floating DHT molecules rendering them “inactive and inoperable”.

Kevis claims that results from using their product are “permanent”. Once hair follicles are protected from the effects of DHT they will remain DHT resistant for life. Thus, their claim is that once the desired result is reached, there is no need to continue using Kevis.  This is a hefty claim considering all other non-surgical balding solutions are required to be used for life in order to experienced continued benefits.

In an effort to demonstrate its efficacy, Kevis provides complete, downloadable copies of seven clinical studies conducted by various institutions in France and Italy and provides summaries of each. They also offer several before and after photos (including those of company founder and President Brian Reichenberg) and written testimonials. What seem to be conspicuously missing are references to third-party studies and publications in peer reviewed journals. Without these critical components it’s impossible to verify the company’s hair growth claims.

Balding men and women may want to stick with clinically proven and FDA approved medical hair loss treatments.  For men those treatments are Rogaine (minoxidil) and Propecia (finasteride). Rogaine is also approved for use by females. However, women should not ingest or even come in contact with finasteride due to the risk of specific birth defects. Men and women who are unable or unwilling to use these drugs can find credible alternatives.

When it comes to purchasing and using hair loss treatments, there is much more at stake than your hard earned money. Dedicating months or years to ineffective treatments may result in the unnecessary loss of valuable and irreplaceable hair follicles.

The "Active" Ingredient in Many Popular Hair Loss Treatment Products

Many popular hair loss treatment options today such as Provillus, Procerin, and Avacor contain the “active” ingredient saw palmetto. It can also be purchased as a standalone supplement in most nutritional stores. But the age old question of whether or not it can effectively treat baldness in men and women with alopecia is still heavily debated. By taking a look at the scientific evidence available we are able to draw some conclusions as to its potential benefit for those with thinning hair.

What is Saw Palmetto?

Saw Palmetto berries are a deep red fruit that grow wild on palm trees in warmer climates, typically found in the Southeastern United States. The liposerolic berry extract is typically used as an herbal supplement for the promotion of a healthy prostate.

Saw Palmetto Hair Loss Study:

Similarly to finasteride (the active ingredient in Propecia and Proscar), studies have shown that when taken orally, it may be an effective anti-androgen by lowering dihydrotestosterone (DHT) levels in the body by blocking 5 alpha-reductase enzymes. Additionally it is said to block receptor cites on cells which is required for cells to absorb DHT.

Tests have also been performed on its use in the treatment of benign prostatic disease, which similarly to androgenic alopecia, depends on the production of DHT.

It is also noteworthy to state that a small preliminary study in 2002 was performed as reported by The Journal of Alternative and Complementary Medicine(2002;8:143-52) that shows a select group of 19 men between the ages of 23 and 64 taking either (400mg of saw palmetto and 100mg of Beta-sitosterol) or a placebo orally. Those who took the herbal combination had 60% improved hair growth over those who took the placebo. There have been no studies to date indicating the efficacy of saw palmetto applied topically for male pattern baldness, female hair loss, or anything to date.

In our opinion, there are two potential difficulties with this study:

• Many scientists would argue that the control study group was too small to determine any real efficacy and improved hair growth could have happened by chance. A larger study therefore may be necessary to determine any level of real efficacy.
• “Improved hair growth” is not the same thing as newhair growth and hair regrowth, nor should it necessarily imply that it works to stop hair loss
• There are no regulations or suggested daily value as to how much saw palmetto would be required to successfully treat baldness. The appropriate dosage therefore is questionable.
• The above study was only performed on saw palmetto taken orally. Hair loss products that promote topical use for baldness are basing their belief in its efficacy on something other than published clinical evidence.

The Dosage:

But if there are no current standards on dosages of herbal medications in the United States, how do these popular hair loss treatments produce an appropriate dosage?

Clinical studies on Benign Prostrate Hyperplasia (BPH) have used a dosage of 320mg of the berry extract daily (either one 320mg pill or 2 X 160 mg pill). A daily dosage of 480 mg of saw palmetto berry extract was not found to be any more effective in a six-month study. If the entire berry was used, up to 1000mg or 2000mg would be required to reach the same goal.

The theory therefore is that if saw palmetto can successfully treat an enlarged prostate similarly to finasteride, it can effectively treat hair loss with a similar dosage Many popular “baldness cure” products contain approximately 1500mg of the berry which is equivalent to approximately 240-320mg of the berry extract.

Side Effects and Warnings:

One false assumption is that “all natural” treatments don’t have potential side effects. It is stated that use of saw palmetto has not proven to be safe for women with hair loss during pregnancy and lactation. Medical supervision is suggested for women of childbearing age. Similar warnings are listed about Propecia.

Conclusions:

Based on some anecdotal evidence, saw palmetto is said to treat baldness because of its tendency to act like finasteride by helping those suffering from BPH. However, authentic clinical studies have not been performed to date that support this claim. Dosage and how it should be used (orally or topically) therefore is based on conjecture rather that scientific evidence.

Birth control pills can be a great way of preventing conception however;all medication comes with potential side effects. In addition to the many serious possible side effects associated with birth control pills, some come with a risk of female hair loss. By suppressing ovulation due to the combined actions of hormones progestin or estrogen, women who are predisposed to hormonal related hair loss may experience varying degrees of balding while on the pill, or even more likely, a few weeks to months after coming off of it.

Yasmin is a birth control pill that combine sethinyl estradiol and drospirenone Because Yasmin may induce hair follicles into the telogen phase (hair shedding) of the hair growth cycle, hair loss is a reported side effect

We recommend women to use only low-androgenindex birth control pills. For women with a strong predisposition for genetic hair lossin their family, we recommend use of other non-hormonal birth control pills or other forms of contraceptives for the prevention of conception.

For your reference, here is a list of birth control pills ranging from the lowest androgen index to the highest: Desogen,Ortho-Cept, Ortho-Cyclen, Ortho Tri-Cyclen, Micronor, Nor-Q D, Ovcon-35,Brevicon/Modicon, Ortho Norvum 7/7/7, Ortho Novum 10-11, Tri-Norinyl, Norinyland Ortho 1/35, Demulen 1/35, Triphasil/Tri-Levien, Nordette, Lo/Ovral,Ovrette, Ovral, Loestrin1/20, Loestrin 1.5/30.