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Dr. Thomas Nakatsui
Dr. Nakatsui performs large sessions of ultra refined follicular units using the lateral slit technique with extremely natural results. -
Parsa Mohebi, M.D
Dr. Parsa Mohebi
Dr. Parsa Mohebi provides large sessions of high quality follicular unit transplantation with excellent results -
Dr. Rukshan Senanayake
Dr. Ruk
Dr. Ruk has years of experience with FUE. He tailors each procedure to individual needs, hair type, and desired outcomes. Dr. Ruk has raving reviews and high-quality before-and-after photos that showcase his exceptional results. -
What Causes Hair Loss?
As you see yourself balding, while others retain their hair, you may ask - why me?
The basic answer is – your hair loss is due to your genetic make up. Your thinning hair is not due to anything you have done, whether wearing too many hats, washing your hair too much or too little or any other hair loss myths. Alopecia or hair loss is primarily genetic and is referred to as "Androgenetic Alopecia" in the medical community.
Your hair's future is largely determined before you're even born. Your follicles have been genetically programmed as to when, where and how much baldness (if any), you'll experience in your lifetime. But the fate of your hair can be altered or compensated for with modern hair loss treatments.
So what are the specific causes of hair loss?
Baldness is largely the result of certain hormones interacting over time with those hair follicles that are vulnerable to their effects.
Both men and women produce "male" hormones. The three most common are testosterone, androsteinedione, and dihydrotestosterone (DHT). Hair follicles, as well as the sebaceous glands, contain high levels of an enzyme called 5-alpha-reductase. This enzyme converts testosterone into DHT, via the blood. DHT is the source of most male pattern balding.
In some people, their follicles on the top of the head are genetically vulnerable to baldness. Over time, these genetically vulnerable follicles are acted upon by the hormone DHT. This hormone binds with the receptor sites of these vulnerable follicles and cause the hair follicle to weaken over time. Propecia is a drug that has been shown to slow the creation of DHT and can be helpful in slowing, stopping or in some cases, reversing hair loss when it is used early enough.
Hair grows naturally in cycles of approximately 3 to 8 years. At the end of the growth cycle, the hair shaft is shed from the follicle and a new hair grows. With thinning hair or balding, each successive growth cycle is shorter and the hair produced is thinner and finer. This is called 'miniturization'.
Men and women don't go bald overnight, it is a slow progression of thinning hair and hair loss that eventually produces baldness. In many cases, the balding has progressed to such a stage that hair loss treatment products aren't enough to reverse the balding process.
Few treatments have the dramatic effect of restoring hair like hair restoration surgery. Click here to learn more about hair restoration.
Not all hair loss is permanent. There are many causes of temporary hair loss that can be treated with diet, stress reduction and a visit to your doctor. Click here to learn about other causes of hair loss.
Androgenetic Alopecia
And rogenetic Alopecia, commonly referred to as 'genetic balding', is the main cause of male and female hair loss. This genetic 'programming' accounts for 95% of male hair loss.
For baldness to occur three factors need to be present:
1.The presence of and rogens, or male hormones.
2. A genetic pre-disposition to balding.
3. Time for the DHT to degrade the vulnerable hair follicles.
While they comprise less than ten percent of permanent hair loss, there are several other Causes of Hair Loss like stress, nutrition, health, age and hormones, that can cause temporary as well as permanent hair loss.
There are also several categories of treatments for hair loss which include drugs, topical lotions, hair care products, hair replacement systems and hair restoration surgery. To learn more about each, please visit our Hair Loss Treatment section.
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Trichotillomania and Treating Hair Loss
Men and women who have the impulse to pull their own hair out may be suffering from trichotillomania. Trichotillomania is an impulse control disorder characterized by the repeated urge to and behavior of pulling out one's own hair. Impulse control disorders resemble substance addictions because the patient feels out of control of his or her own behaviors. Men and women with trichotillomania live relatively normal lives but typically show signs of hair loss, thinning, and bald spots all over the scalp and body from pulling it out.
Treating trichotillomaniagoes far beyond trying to stimulate hair regrowth.Even if Rogaineor laser therapy for hair losswere to regrow hair, there is a strong possibility that trichotillomania patients will continue to pull their hair out. Patients with trichotillomania therefore, should be treated at the source of the disorder in conjunction with using proven hair loss treatments.
In addition to medication, Habit Reversal Training (HRT) by a trained counselor has proven to be successful in treating trichotillomania. With Habit Reversal Training, the individual is taught to recognize and redirect their impulse to other more constructive activities. Often times, trichotillomaniapatients are asked to keep a journal of their hair pulling episodes. This can help the counselor and patient to identify and develop strategies to avoid situations that might trigger hair pulling episodes. Journals often include the location of the incident, number of hairs pulled, date, time, and their feelings and thoughts during the episode.
Treating a trichotillomania patient's baldness may be done simultaneously or after proper treatment of the disorder. Rogaine (minoxidil)can be a helpful aid to HRT by stimulating the follicles underneath the scalp, potentially facilitating or expediting hair growth.Treating a patient’s hair loss while they continue to pull their hair out is not constructive. Since this type of balding is not genetic due to the production of DHT, Propecia (finasteride)won't likely help.
Patients who've suffered from trichotillomania for awhile may damage or even remove the hair roots by excessive pulling, making non-surgical hair regrowth next to impossible. Surgicalhair restorationmay be an option for trichotillomania patients whose hair roots are too damaged to produce new hair on their own. Hairrestoration surgeryshould be reserved only for patients who've been successfully treated and no longer suffers from trichotillomania.
Catching and treating trichotillomania early will most likely reduce damage done to the hair follicles and eliminate the need for hair loss treatment, since undamaged hair will return on its own.
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Questionable Hair Loss Treatments
Balding Has Been Cured
Try telling that to 80 million men and women who are suffering from hair loss in the United States. They will laugh at you. Yet on a daily basis we are bombarded with ads for hair loss treatments like Avacor, Hair Genesis, Fabao and Procerin that use misleading advertising to sell their products. Thanks to their persuasive messages promising to regrow hair, consumers will spend nearly one billion dollars trying to find an effective hair loss remedy and fall victim to misleading advertising like this.
Thinning hair is a source of distress for millions of men and women so it is not unusual for them to seek help from anything that sounds like it will work. Most questionable hair loss products use similar, misleading marketing techniques ranging from claims to testimonials and photos.
Hair Loss Product Claims
Many hair loss products claim to be able to restore hair through the use of drugs, herbal lotions or other exotic applications like lights, lasers or electrical fields. While many of these products have been around for years, there is little evidence that they can restore hair.
How are they allowed to make such claims? These products often use small amounts of generic drugs found in Propecia and Rogaine (finasteride and minoxidil) which allows them to make the claim to stop hair loss or they imply hair growth with 'cosmetic' claims.
Misleading Marketing
Some hair loss products lead you to believe that they can stop hair loss by parsing their words. They can't come out and claim to regrow hair or stop hair loss, so they advertise vague claims like "thicker, fuller hair". This is a 'cosmetic' claim that any product can make. Be advised that cosmetic claims cannot restore hair or grow hair because they are not proven to do so.
False Testimonials
With the anonymous nature of Internet postings, people posing as users will mislead others with false testimonials. Often, positive reviews are produced by people compensated to post these messages. Since there is no real regulation of online postings, consumers are advised to take testimonials with skepticism.
Phony Photos
Most product advertising that claim that you can "Regrow Hair!" or make your hair 'thicker and fuller' and show a photo of a balding person with thin hair next to a photo of the same person with thicker hair covering the baldness. Photos don't lie, do they?
Well, yes they do.
You can prove it yourself. Take a photo of a head with thinning hair using a flash camera and then photograph the same head without the flash. The photo with the flash will look like a bald head and the photo without the flash will look like more hair.
Lighting, length of hair and how the hair is arranged on the head determine whether a photo of a head looks bald or not. Most people go through the same routine as balding advances: they push hair from here to there and hair spray it into place in the hope that no one will notice that we are going bald. To the extreme, this becomes the 'comb-over' hair style.
Review the photos of hair loss products you've seen. In most cases there will be just a few and they will all have misleading elements like lighting, hair style and length of hair in the 'before and after' photographs. If the products or services are really legitimate, there should be dozens of photos, if not hundreds or thousands.
The FDA and the FCC
Sadly, we think that the United States Food and Drug Administration and the Federal Communications Commission (agencies who regulate such issues) can stop these scams. Unfortunately, they can't. Since the FDA approved Minoxidil and Finasteride as effective in stopping hair loss, any inclusion of these products in any form enables marketing companies to make hair restoration claims.
Even the studies done for Rogaine and Propecia are not that encouraging. When Rogaine was studied (active ingredient is minoxidil), 16% of the placebo group had measurable new hair growth. Four out of twenty-five people had real, measurable hair growth when they believed they were using something that worked. Both studies were limited in time and scope. To read the studies that were done achieve FDA approval, visit the FDA web site and scroll down to Propecia and Rogaine. (http://www.fda.gov/cder/foi/nda/index97.htm )
Hair Loss and Hair Restoration
If a person is genetically prone to hair loss and balding, FDA proven hair loss treatments may help slow the process if they are used early and often. If you are like many and have already lost more hair than you're happy with, there is only one option to restoring your own natural hair: hair transplants. Hair transplants have become an art in the restoration of natural hair which is genetically resistant to the causes of balding.
Like any surgical solution, your success depends upon the quality of the doctor you choose. Doctors who are successful in restoring a natural looking head of hair are carefully reviewed by the Coalition of Hair Restoration Physicians for membership in this exclusive organization. They must allow access to past patients, confirm their training and provide photos and videos of their patients.
While hair transplants are not possible for everyone, they are now more natural and affordable than ever before.
View hundreds of real hair transplant photos done by the world's top hair loss specialists who are members of the Coalition of Hair Restoration Physicians.
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Child Birth
Childbirth may result in hair loss. It's common for many women to notice hair loss about 3 months after they've had a baby. This too, is caused by hormones. But this is not something to worry about. You see, during pregnancy, hair that normally falls out is kept in by high levels of hormones. Once the hormones have returned to pre-pregnancy levels, this extra hair falls out. The normal cycle of hair growth and loss then begins again.
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Dr. Felipe Pittella
Dr. Felipe Pittella
Dr. Felipe Pittella performs ultra-dense mega-session and Giga-session FUE procedures on Norwood 6 and 7 patients with excellent density and coverage. Dr. Pittella combines quality and affordability with coverage and density. -
The Coalition of Independent Hair Restoration Physicians
Chosen by Patients and Peers for meeting the highest standards.
This Learning Center is sponsored by the Coalition of Independent Hair Restoration Physicians.
This elite group of independent surgeons have been carefully selected by patients and leading physicians and are committed to providing Ultra Refined Follicular Unit Hair Transplantation.
This minimally invasive hair restoration procedure enables patients to achieve very natural and dense hair growth after only one surgical session.
Coalition members agree to have their results openly critiqued and reviewed on the world’s most respected online patient based community - the Hair Restoration Network. Learn more about the high standards Coalition physicians must meet for membership.
Find an an elite Coalition Physician in your area and consult for free about how to restore your own natural hair.
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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.



Plugs Mini Micros Follicular UnitsFollicular 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.


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”

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.
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.
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