Hair Loss (3)
What causes hair loss?
Hair loss can have many causes, from environment to stress and diet, disease or illness or commonly, male pattern hair loss. A certain amount of hair loss occurs naturally as a part of the hair’s life cycle, and noticing a few loose hair on a brush, pillowcase or in the sink is not cause for alarm. People regularly shed up to 100 hairs each day, which are normally replaced with new growth.
Alopecia is a term that means “Hair Loss.” Androgenic Alopecia is hair loss caused by hormonal activity, and is the cause of baldness experienced by most men. Some studies suggest that 25% of men will start experiencing Alopecia by age 30 and 66% of men will see hair loss by age 60. This type of hair loss is triggered genetically, and can (occasionally) appear soon after puberty.
Androgenic Alopecia may be instigated by the action of DHT (a form of testosterone, called dihydrotestosterone.) DHT appears to make the hair follicle deteriorate to the point where it can no longer produce normal hair. Some topical medications and shampoos claim to work by blocking DHT.
Dr. Hasson and Dr. Wong both frequently recommend Finasteride to combat further hair loss and hopefully prevent damage done by DHT. While the results vary between patients, the impact is noticeable for most.
Hair loss can also be caused by emotional stress, physical trauma, poor nutrition, pregnancy, medications and environmental factors. Medications that impact hormonal levels and medications for blood pressure, heart disease and diabetes can all cause hair loss. Medications used for chemotherapy are often associated with rapid (and temporary) hair loss.
Rapid Hair Loss
If you are experiencing rapid hair loss, or your hair is falling out in clumps, seek professional medical advice. Hair loss can indicate serious underlying health issues.
Women’s Hair Loss
Women are also susceptible to genetic pattern hair loss, although it is less common than in the male population.
What causes female hair loss?
There are a variety of causes of female hair loss, from genetics to pregnancy to traction.
You can read about female hair loss here.
How do I know if I’m losing my hair?
While this seems like a simple question, there are no simple answers. Many methods have been devised and tried, but even counting individual hairs is not reliable, since healthy hair goes through a phase where it falls out then regrows months later. So, just because you see hairs on your pillow or in your sink, it does not mean you are suffering from permanent hair loss.
The truth is, there is no easy, reliable way to monitor your hair loss. All you can do is be aware of your overall density, how easy or difficult it is to see your scalp through your hair, where your hairline rests and how all of that changes over time. It is too easy to be paranoid and obsessive about hair loss, and all of that stress is surely not helpful.
If you are losing hair due to an illness, stress or disease, you may see rapid hair loss, hair falling out in clumps or bald spots appearing on your head and should consult with a physician. Rapid hair loss can result from serious underlying factors and should always be investigated with your doctor.
Our best suggestion to monitor your hair is to take standardized photos of yourself every 6 to 8 months and compare them. Set up your camera so you can duplicate the same position, lighting and pose when you retake your photos.
Hair Retention (4)
How can I prevent my hair from falling out?
To reduce the chance you will lose your hair or to reduce the amount of hair lost, you first need to identify what is causing or is likely to cause hair loss in your particular case.
Do I have to take Propecia or Medication?
Propecia and Proscar are a brand names for Finasteride, a medication taken as a pill. If you are susceptible to pattern baldness and want to keep your hair for as long as possible, Finasteride can help.
If you are considering hair transplant surgery, you will also want to think about the continued long-term loss of your hair. While Propecia does not promote hair growth in all patients, it is effective in preventing further hair loss for many. Hasson and Wong are all about achieving outstanding, natural-looking cosmetic and aesthetic results. If you have a surgery today, we’ll do our best to make you look good, but if you continue to lose hair, your transplanted hair may begin to look less natural and may not cover as well as it initially did. It makes sense to maintain your appearance by taking Finasteride.
While it is rare, some patients report side-effects and feel unable to take Finasteride, we often suggest the topical Minoxidil as a second-line of defense, but the results are not nearly as robust. We currently have thousands of patients successfully using Propecia with no side effects and can help adjust your dosage in cases where there is extreme sensitivity.
Do I have to use Rogaine or Minoxidil?
Rogaine is a brand name for Minoxidil. Minoxidil is a topical (cream or spray) that can be applied to the scalp daily to promote hair growth. The mechanism behind Minoxidil is not well understood, but it appears to work as a vasodilator, and likely improves blood flow to the area, bringing additional oxygen and nutrients which may encourage hair growth.
In our experience, Minoxidil can help some patients hold onto or even regrow some hair, but patients who use the oral medication Propecia (Finasteride) experience much better results. Your first line of defense in keeping your hair is to look into the use of Propecia. Our Patient Advisors are fond of comparing Propecia to toothpaste: if you want nice teeth for the rest of your life, you need to brush them daily, and the right toothpaste helps! If you want to keep your hair from falling out, a daily dose of Finasteride might be the right stuff. For those patients who cannot take Finasteride, Minoxidil is often the next best solution.
Are laser cap treatments effective?
Dr. Wong has seen some positive results from the use of laser stimulation, however, the method required to achieve those results includes the use of topical Minoxidil, so the results cannot be exclusively attributed to the use of lasers. Additionally, the medication must be applied with a specialized Dermal roller that creates microscopic punctures to allow the medication to penetrate the scalp more effectively.
The combination of minoxidil and laser is better than either one used alone but the overall result for the majority of people is still rather disappointing in terms of growing new hair. It may however slow down hair loss but we do not at this time have long-term or conclusive results.
Transplant Cost (3)
How much does a hair transplant cost?
The cost for your procedure is dependent on a number of factors. Every hair transplant operation is unique and specifically planned to meet your goals. The final price will depend on how much work you want done, what kind of results you are looking for, how much actually needs to be done, how much donor hair is available, and which extraction method is used.
Prices are based on a per-graft unit. A graft is a grouping of individual hair follicles that grow collectively as a unit. To find out how many grafts you need to achieve your goals, you can send us some pictures and we will be able to assess your hair loss and donor availability. Once we are able to estimate the number of grafts, we can estimate how much your procedure would cost. During your actual procedure, the number of grafts are carefully and exactly counted, so you pay only for what you receive.
How much does a hair transplant cost?
Hasson and Wong do not provide financing for hair transplant surgery, however, financing can be acquired through independent medical financing companies. Hasson and Wong has no association with any financing companies.
Some of our patients have used these financing services.
What is the price of surgery?
There are two prices, depending on which method of extraction is used. If you know the number of hair grafts required to achieve your desired result, you can use this calculator to figure out the cost.
Hair Surgery (19)
Everything you need to know about Hair Transplant Surgery. Read some of our frequently asked questions.
Will a transplant cover Alopecia Areata?
Alopecia areata is hair loss caused by your own immune system. For reasons not yet understood, your hair follicles can suddenly become targets of your immune system, shutting down their ability to produce hair. Alopecia areata can manifest as patchy bald spots and is not always permanent. Hair transplant surgery is a suitable solution if the loss is permanent, and excellent aesthetic results can be achieved.
How long before the hair grafts grow?
The transplanted hair grafts are already growing when they are moved to your recipient area. As usual, these graft units are expected to go through their regular growth phases: anagen (growth), catagen (shrinkage, rest & renewal) , and telogen (dormancy of 1 – 4 months). These phases occur all at the same time, with each graft unit experiencing it’s own phases regardless of their location. Additionally, you may experience some “shock-loss” in the donor or recipient area in the weeks following surgery. This is a normal occurrence for many patients and is temporary.
Things start to come together for most patients after about 8 months. The majority of your transplanted grafts can be expected to be in their long-lasting Anagen phase, and so the growth becomes more dense and the final results of your transplant can finally be realized. Each patient is different, however, and some require 10 – 11 months to see their final results.
Take a look at this photographic hair transplant timeline.
Do you do eyebrows or facial hair?
Yes! Many people experience patchy hair loss in facial hair and eyebrows. We have had great success with facial hair transplants, however, each persons case is unique, and when it comes to facial hair, an assessment and careful consideration are required.
Other treatments may provide better options for some types of facial hair loss. Scalp MicroPigmentation has been successfully used to cover up facial hair loss and create the appearance of thicker hair or facial stubble. Scalp MicroPigmentation uses non-permanent pigments injected into the top surface of the skin to emulate hair growth. While we don’t perform SMP in the clinic, we can certainly help you determine if this is the right solution for your situation.
How long does surgery take?
The length of your procedure depends greatly on the number of grafts being processed. If you have a surgery with more than 5000 grafts, you can expect to be in surgery for 8 or more hours. Surgery is conducted in comfortable operating rooms with televisions and plenty of breaks to ensure your comfort. We also provide meal service when you are here through lunch or dinner.
Smaller surgeries of less than 2000 may be completed in 5 or 6 hours. There are many factors that can impact the amount of time required to extract, process and transplant your grafts, so these estimates are very general and may not be accurate for your own procedure.
Will there be a scar?
Yes, both the Strip Excision technique (FUT) and the punch extraction method (FUE) leave scars.
In FUE, the individual holes produced by extraction will produce small, almost imperceptible scars. When FUE is performed, extractions are dispersed widely throughout the donor zone to reduce concentrated stress and minimize appearance. The hair transplant scars produced are very small and hard to see.
In the FUT method practiced by Dr, Hasson and Dr. Wong leaves a thin linear scar in the donor area. Scars from the Strip method are easily hidden by short hair growth and are generally imperceptible. Our videos feature a comb-through segment where we try to show the scars created by FUT, you’ll see how difficult they are to spot, and in some patients it is almost impossible to see.
Will the hair grafts fall out?
Each follicular unit (graft) is carefully and individually planted in the recipient area. The incision for each graft is created with a blade that is carefully measured specifically for your procedure. Once the graft is planted, the surrounding tissue clamps onto the graft and the incision begins healing, locking the graft in place.
It is very rare to lose a graft after transplant, but it can happen due to strenuous activity, profuse sweating or infection. Transplant patients are cautioned to reintroduce strenuous exercise slowly in the weeks after their transplant to ensure the maintenance of the grafts.
When will my new hair start to grow?
The full impact of hair transplant surgery can be experienced after approximately 8 months, when we typically see the majority of grafts producing viable hair follicles. In the months immediately after your surgery, your grafts will go through a number of phases and the follicles may fall out before the graft starts producing new hairs.
Can you clone hair follicles?
We constantly monitor industry news and medical developments for any new advances in hair transplant technology and we know that cloning healthy hair grafts is still many years away. There have been some promising advances in working with stem cells to promote follicular growth, but there are still many obstacles to overcome and lots of testing to do.
While we are excited by some recent advancements, there is still no effective way to multiply your donor hair.
What is FUT and FUE?
FUE is a form of FUT that uses Follicular Unit Extraction to harvest donor grafts. In FUE, grafts are extracted individually from the donor area.
FUT is a general term that stands for Follicular Unit Transplant. While imprecise, the term is frequently used when speaking about the Strip Excision technique of harvesting donor hair grafts.
Read an overview of the two methodsRead an overview of the two methods
The major difference between Strip Excision and Follicular Unit Extraction is that Strip Excision leaves a single strip scar in the donor area while Follicular Unit Extraction leaves tiny individual marks. Scars from the Strip method are easily hidden by short hair growth and are generally imperceptible. Hasson and Wong offer both methods and are happy to help you discover which method will work best for you.
There are great debates online about which method is “better,” and we encourage you to learn more. It may also be helpful to remember that the final cosmetic results of a hair transplant depends on where and how the grafts are planted in the recipient area more than where they came from.
Why use the FUT Strip method?
While the debates continue about which method of extraction is “better”, Dr. Hasson and Dr. Wong are happy to offer both methods and will help you determine which will provide you with the results you desire.
The strip method has a few advantages over the punch method:
- The rate of viable graft extractions is higher because we are able to see under the skin to precisely extract each graft. Transections are rare.
- The number of grafts extracted can be higher than FUE because we can use almost every unit in the extracted strip.
- The required donor area is smaller.
- The higher yield means your surgery can be accomplished in a shorter period of time. Almost every FUT surgery can be completed in just one day.
What is a megasession?
Patients with advanced patterns of hair loss usually want the maximum number of hair grafts transplanted in as few surgeries as possible. We classify any hair transplant surgery requiring 3000 or more grafts as a megasession. Our patients enjoy more dramatic results with fewer hair transplant procedures when we perform these megasessions.
Follicular unit transplantation combined with dense packing in megasessions provides patients with outstanding results in a single surgery.
The advantages of megasessions include:
- Fewer hair restoration surgeries are required
- Better graft yield and survival
- Less donor scarring
- Less downtime for the patient
- Aesthetically excellent results
- No plugginess between surgeries
- Greater overall value
Megasessions are safe and produce exceptional results when performed by experienced hair transplant surgeons with well trained technicians.
What is Dense Packing?
If you have sufficient donor density, dense or ultra dense packing can be performed to restore hair density to levels previously regarded as unattainable using other hair transplant techniques. Density is critical in determining the quality of the transplant results.
Hair density is measured in numbers of follicular units per square centimeter of scalp. This varies enormously within a population and even more between different racial groups. In Caucasians the average density is usually between 90 and 120 follicular units per square centimeter. The density is lower in other racial groups and is lowest in those of African descent.
A key component of dense and ultra dense packing is the Lateral Slit Technique: the creation of recipient sites customized to the exact size of the follicular unit of the individual hair replacement patient. The technique is made possible by the invention by Hasson & Wong of a custom blade cutting device. This device is now commercially available and used worldwide by various respected hair restoration surgery clinics.
What is the donor zone?
The Donor Zone is the area at the back and side of your head where the hair grafts are taken from. You’ll notice that as men lose their hair, the back and sides are generally still intact even after the front and crown have receded. The hair that grows in the donor zone is less susceptible to pattern baldness and maintains this resilience even after being transplanted to a different area.
What is scalp laxity?
Scalp laxity is a measure of how loose the scalp is in your donor area. If you scalp is tight, the width of the donor strip will be limited and the number of donor grafts depends on the size of the strip. If you scalp is loose in the donor area, the strip can be wider and more grafts can be excised.
We have seen many patients with tight scalps exercise the donor area and greatly improve their laxity, allowing for more grafts and better results.
You can see how scalp laxity exercise are done in this short video.
Will people be able to notice I’ve had surgery?
The result of Strip Excision is a narrow scar in your donor zone – at the back or sides of your head. The Doctors work diligently to minimize the appearance of a scar, it is rarely visible and can usually be covered by just 1/2 cm of hair growth. In punch-extraction (FUE), tiny round scars re left in the donor zone, but are generally imperceptible and are covered by the density of growth of non-extracted units in the surrounding donor area.
Many patients are able to keep their surgery confidential with just a little bit of strategic planning. A short hair cut in the months before your operation sets the stage so your post-op short hair cut is not a surprise to your friends, family and co-workers. We are happy to help you plan your confidential recovery strategy.
Will my hair look natural after a transplant?
The goal for most hair transplant surgeries at Hasson and Wong is to provide an aesthetic or cosmetic effect that mimics your natural hair growth as closely as possible. You can see from these real client result pictures how natural the results can be.
We achieve these results by studying your hair growth patterns, understanding your loss progression and working with the donor hair you have available. The doctors employ specific techniques when designing age-appropriate hairlines and strategizing specifically where and how to plant each graft.
What will I tell people?
Many hair transplant patients prefer to keep their operation secret. A properly timed haircut in advance of your surgery sets the stage so your post-operative hair cut does not appear to be unusual. A few days off work immediately following your surgery allows any redness or swelling to subside, and hats can be worn event the same day as your surgery.
Our clinic staff are well versed in helping patients keep their operations under-wraps, and we’re happy to help plan your recovery strategy.
Where is the Hasson and Wong Clinic?
The Hasson and Wong Clinic is located in Vancouver, British Columbia, Canada.
The majority of our clients visit us from the USA, other parts of Canada, Italy, the UK and Spain.
Dr. Wong and Dr. Hasson have helped people from more than 70 countries.
How long do I need to stay in Vancouver?
Most hair transplant surgeries at Hasson and Wong happen in a single session on a single day. For some FUE surgeries, the procedure may need to take place over two days. Regardless of the extraction method used, patients return to the clinic the day after surgery for a hair washing lesson and so your surgeon can see how your first day of recovery is going.
So, plan for a minimum of three days in Vancouver. If you are unable to stay that long, please speak with your consultant and we will work with you to make other arrangements. Most patients are able to walk out of the clinic after their surgery wearing a loose-fitting baseball cap, and can enjoy sightseeing, outstanding restaurants and all the natural beautyVancouver is famous for.
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