A large number of men will experience what is known as male pattern baldness at some stage in their lives. While there is no doubt that that some men will find it upsetting to lose their hair, at least the condition is quite common among men. For women, on the other hand, hair loss, especially when it is sudden, can often be very traumatising. Fortunately, newer methods of treatment such as ‘single follicular transplant’ and ‘genetic predictability screening’ have become available, which now means a patient can be treated many times and technically does not have to go bald. A lot of these newer techniques have been perfected in Dublin. Rejuvenate Magazine spoke with Dr. Patrick Treacy about the option of the new H+ method of hair transplantation.

First, why do we actually lose our hair?

There are numerous factors that contribute to the cause of hair loss in both males and females but genetic pattern baldness accounts for nearly 95% of all hair loss in men, as well as affecting millions of women. Androgenetic alopecia in women rarely leads to total baldness and the pattern of hair loss differs from male-pattern baldness. In women, the hair becomes thinner all over the head, and the hairline does not recede.

Tell us more about androgenetic alopecia?

Researchers have determined that this form of hair loss is related to hormones called androgens, particularly an androgen called dihydrotestosterone (DHT). Androgens are important for normal male sexual development before birth and during puberty. The resulting effect is seen as baldness. The amount and patterns of baldness can vary greatly as the incidence varies from population to population based on genetic background. Interestingly, environmental factors do not seem to affect this type of baldness greatly.

How do genes play a role in hair loss?

First, any significant variation between the incident angle of the punch and the exiting hair can result in graft transection. It is known that it is difficult to keep the punch parallel to the follicles throughout the entire length of the graft as the visual cues used to guide one’s hand are lost once the punch passes into the depths of the tissue. Another disadvantage of both follicular techniques is the requirement of long hours of time and skilled teams of assistants for the preparation of 3,000 odd follicular hair transplants through dissection. My feeling is that the final result is very operator related.

How common is Male Pattern Baldness?

One large Australian study showed approximately 25 percent of men begin balding by age 30; while two-thirds begin balding by age 60. Some women also develop a similar pattern of hair loss. Male pattern baldness affects roughly 40 million men in the United States alone.

With evolving techniques like the newer single hair follicle extraction technique, follicles are extracted one by one from the donor area (back of the head) and re-implanted with the unique patented devices. The H+ method is based on the use of genetic testing as a means of screening, the use of growth factors, 633nm light for fibroblast stimulation and the use of quality control during the hair transplant procedures. The hair transplant doctor needs only a single surgical assistant to help him during the follicle hair transplants. The procedure also ensures maximum care to the grafts. The hair transplant doctor can decide upon the exact number of grafts to be removed while he is removing them one-by-one.

Certainly yes, the H+ technique uses a genetic test for male pattern hair loss, which reports the presence or absence of a specific variation in the androgen receptor gene. A positive test result means that a man has the high risk genetic variation. Men who test positive have approximately a 70% chance of going bald. This means the H+ genetic test can predict a patients risk for hair loss or thinning.

What are the present medical treatments presently available?

Another advantage of the H- transplant procedure is that it allows the hair transplant surgeon to extract as many grafts as is actually needed and on average, we usually extract and place 3,000-5,000 hairs per day. Bandaging is not necessary following the procedure, allowing the patient to leave the clinic looking just as they did on entering. Unlike the ‘strip’ technique, there is no scarring with the H+ method and a patient can shave his head or wear all the current cuts and styles. In addition, there is also no waiting period between H+ procedures and hair from all over the body can be used.

Body hair follicular grafts have shown growth patterns similar to head hair with no difference in texture but are usually used for enhancing the density in the posterior region of the scalp rather than the hair line. Hair regrowth will be seen after 16 weeks, depending in part on how quickly the capillaries form around the newly relocated follicular units. This newly transferred hair grows naturally in its new location for the rest of the patient’s life.

Hair transplantation is a surgical technique that involves moving sections of skin containing hair follicles from one part of the body (the donor site) to bald or balding parts (the recipient site). It is primarily used to treat male pattern baldness, whereby grafts containing hair follicles that are genetically resistant to balding are transplanted to a bald scalp. However, it is also used to restore eye lashes, eye brows, beard hair and to fill in scars caused by accidents and surgery such as face lifts and previous hair transplants.

When did hair transplantation begin?

Modern hair transplantation began in the 1950s based upon the pioneering work of New York dermatologist Dr. Norman Orentreich who demonstrated that such grafts were “donor dominant,” – the idea that grafts continue to show the characteristics of the donor site after they have been transplanted to a new site. This principle provides the basis for all hair transplant surgery. Although “donor dominance” insured that transplanted hair will continue to grow, it did not insure that the results would look natural.

What is the cost of the H+ technique? .

Because the H+ technique may continue to place hair over a longer period we have decided to allow patients to join a ‘Samson’ club. This means they can contribute about 25 per week for six months and we will provide interest free financing to cover the rest of the cost. Plans usually this run over a 3-5 year period making it very easy for the patient to finally achieve his aesthetic goals

Can you explain the technique of ‘minigrafts’ and micrografts?

Patients also complained of a dimpling of the underlying scalp. Micrografts were frequently damaged during the removal process or were too fragile to survive. In ‘mini-micrografting’, the graft sizes were arbitrarily determined by the doctor who cut the donor tissue into different size pieces. This technique has now largely been surpassed.

What technique is presently popular?

During the past few years, follicular unit transplant grafts (FUT) have become popular due to a more natural effect. Follicular units were first described in the medical literature by Headington in 1984. Follicular Unit Transplantation has its roots in the single-strip harvesting method and microscopic graft dissection technique developed by Dr. Bobby Limmer in the late 1980s and published in 1994. In 1995, Bernstein and Rassman published the first paper on “Follicular Unit Transplantation,” where hair is transplanted exclusively in naturally occurring groups of 1-4 hairs.

What transplant technique is the best in your opinion?

The strip method is really an invasive surgical procedure requiring the attendance of a plastic surgeon and general anaesthesia. Post-operative care requires that the patient not play sports or weight train for at least 30 days. Many patients complain of scalp numbness for many months and sometimes permanently.

What is the ‘strip’ method of hair transplant?

. Should a patient shave their hair short in the donor area, a line or scar will always be visible. A patient forever gives up the option to shave their head or have a short haircut after a strip procedure. Although there are many good proceduralists of this technique, I personally would consider ‘strip surgery’ an out-dated procedure.

What are the problems do you have with the strip technique?

Over the past few years unit follicular hair transplant has emerged as the most reliable hair transplant procedure of hair transplantation surgery. As the name suggests, the graft in this case consists of a single follicular unit as it exists in nature. The follicular unit contains sebaceous glands as well as nerve and blood tissue. It is for this reason that it needs to be extracted as an intact unit and transplanted as an intact unit, to be able to grow into a hair. There are basically two types of technique.

1 Follicular Unit Transplantation (FUT) is a hair restoration procedure where hair is taken from a single donor strip or extracted directly from the donor area.

Over the past few years unit follicular hair transplant has emerged as the most reliable hair transplant procedure of hair transplantation surgery.

1 Follicular Unit Transplantation (FUT) is a hair restoration procedure where hair is transplanted exclusively in its naturally occurring groups of 1-4 hairs.

2. Follicular unit extraction (FUE) does not require a donor strip to be excised from the donor area and therefore does not involve any dissection of follicular units.

What is the H+ method?

The H+ method is based on the use of genetic testing as a means of screening, the use of growth factors, 633nm light for fibroblast stimulation and the use of quality control during the hair transplant procedures. The hair transplant doctor needs only a single surgical assistant to help him during the follicle hair transplants. The procedure also ensures maximum care to the grafts. The hair transplant doctor can decide upon the exact number of grafts to be removed while he is removing them one-by-one.

Any other advantages with the H+ method?

The H+ technique is a minimally invasive method of hair restoration which avoids the need for any scalpels or stitching to be required at any point during the procedure. Single hair follicles are extracted one by one from the donor area (back of the head) and re-implanted with the unique patented device;

Tell me about the advantages of the H+ method?

The H+ technique means the hair extraction is simple, painless, and the donor area heals within 2-4 days. Individual hair follicles are removed one by one using the H+ Extractor and Implanter by a surgeon who is wearing high magnification loupes. Patients can listen to music, watch tv and enjoy a light lunch during the procedure, which is completed in four to six hours. There is absolutely no risk of nerve damage because scalpels or stitches are not used.

Hair regrowth will be seen after 16 weeks, depending in part on how quickly the capillaries form around the newly relocated follicular units. This newly transferred hair grows naturally in its new location for the rest of the patient’s life.

It really depends on the size of the balding area, donor yield and the goal of the patient. In order to achieve a greater density, I would suggest starting treatment early and plan at least two or three sessions over the next six or seven years, so in effect you never really become bald.

What is the price of the H+ hair transplant technique?

Is the H+ technique expensive?