Here are some facts about hair loss and Follicular Unit Extraction (FUE) transplants:
- The history of hair transplant began in Japan in 1939. In the 1960s and 1970s, larger grafts and plugs were placed far apart and then refined in 1984 to include follicular unit extraction. In 1994, stereoscopic assistant micrografts were developed. In the mid nineties, follicular unit placement and hair design became more paramount and a significant amount of research began. It was not until 2002 where there was a more defined state-of-the-art follicular unit placement map placed in the recipient area. Since 2004, singular follicular unit placement into the recipient area has become the gold standard.
- Over 45 million men and 21 million women in the US suffer from alopecia, commonly called balding. 1/4 of all men under age 30 have significant balding patterns and over 2/3 of males over age 60.
- Greater than 95% of male pattern baldness is related to androgenetic alopecia, due to the hyperactivity of dihydrotestoterone (DHT), which is a powerful sex hormone.
- Evidence shows that individuals with alopecia have a higher receptor activity and density in balding areas. The effects of DHT cause the hair follicle to shrink, degenerate and eventually die.
- Using modern hair grafting techniques, the transplant and hair follicles obtained from the donor hair is permanent. The donor hair follicles are genetically different from the hair follicles in the balding areas. They do not possess the DHT receptor and aren’t susceptible to the progression of balding.
- Less common causes of hair loss include medical conditions such as thyroid dysfunction and hormonal imbalance, cancer treatments, certain medications, severe infection and high fevers.
- Grafts are typically placed at 25 to 40 grafts per square centimeter per operation and increased density can be obtained with subsequent procedures and sessions.
- Normal hair density is between 80 to 110 follicles per square centimeter.
- Male pattern balding may include the loss of over 25,000 follicles throughout the entire balding region.
- The average amount of donor hair available is 6000 follicles and ranges from 4000 to 8000 follicles. Depending on the extent of the balding, it may be difficult to obtain previous density, but a modern and ethical approach can give excellent results that are permanent.
- It is important to know that the transplanted hair from the donor site is permanent and is not susceptible to the effects of DHT. These donor hairs are genetically different from the balding areas since they do not possess a DHT receptor.
- To assess the number of grafts required in a particular procedure, typically the area of the proposed hair restoration site is calculated and then multiplied by 25 to 30 grafts per square centimeter to obtain the proposed number.
- On average, 1500 to 1800 grafts are completed per hair restoration session.
- It is critical to determine who is a good candidate for hair restoration and who is a poor candidate for hair restoration. Most of that hinges on the amount of donor grafts available on the back and sides of one’s head.
- Normally a single hair will survive for approximately 4 to 5 five years before it is naturally shed. Typically 100 to 120 hairs are shed each day as part of this natural cycle The hair follicle goes through three different cycles – Anagen which is the active growth phase, Catagen which is the natural breakdown of the hair prior to shedding and Telogen which is the rest phase that begins after the hair is shed from the follicle and lasts 3 to 6 months. The cycle then begins again with another Anagen phase. Areas of the scalp that are thinning generally have reduced Anagen phases with individual hairs becoming thin and miniaturized and prolonged Telogen rest phases. As the conversion to less anagen and more telogen occurs within the affected balding areas, the follicles will become dormant and eventually die off. Laser Light therapy and PRP, along with topical and oral medication management protocols can restore the natural anagen phase and reduce or normalize the telogen phase. It is important to treat this early and theses medical management protocols are most effective if started 7 to 10 years from the initial signs of balding and thinning and may work up until 20 years.