Hair Restoration Surgeons Research Articles

Different orientation of the incisions: an efficient method to facilitate the implantation process

1. Alex Ginzburg, MD (alex{at}hairtransplant.co.il) 1. Raanana, Israel Since 2002 there have been discussions among hair restoration surgeons on the comparison between the following methods of making the incisions: 1. Perpendicular to the existing hair, or coronal angled grafting (CAG) 2

Letters to the Editors: Re: Indian Association of Hair Restoration Surgeons

Letters to the Editors: Re: Indian Association of Hair Restoration Surgeons

Core Competencies for Hair Restoration Surgeons Recommended by the International Society of Hair Restoration Surgery

Because hair restoration surgery has changed so significantly, the International Society of Hair Restoration Surgery (ISHRS) recently developed and published a Core Curriculum for Hair Restoration Surgery (CCHRS). The ISHRS organized a task force to develop training programs that would not only present the CCHRS but also provide the practical experience necessary to allow a physician to practice safe, aesthetically sound hair restoration surgery. The task force recognized early on that identification of core competencies for hair restoration surgeons was essential to guiding the development of these training experiences. This article presents the competencies that have been identified. The intent of the Core Competencies for Hair Restoration Surgery is to outline the knowledge and skills that are essential to accurately diagnose and treat hair loss, to ensure patient safety, and to optimize aesthetic results. The ISHRS hopes that all existing surgery and dermatology training programs teaching hair restoration surgery procedures will find the Core Competencies useful in developing their curriculums. The Core Competencies were developed through an organized review of the CCHRS by a team of experienced hair restoration surgeons and educators and reviewed and approved by the ISHRS Board of Governors. The diversity of these competencies demonstrate that contemporary hair restoration surgery is a specialty requiring knowledge of several medical disciplines, including genetics, endocrinology, dermatology, tissue preservation, and surgery. The International Society of Hair Restoration Surgery believes identification of these Core Competencies is an important contribution to physician education in hair restoration surgery, and physicians who demonstrate competency in these skills will satisfy patients with contemporary results in a safe environment.

Follicular Unit Transplantation

Follicular unit transplantation (FUT) is the culmination of decades of refinement and evolution of hair transplantation techniques. Hair naturally grows in groups of one to four individual follicles separated by intervening soft tissue. These clumps or groups of hairs are termed FOLLICULAR UNITS. FUT uses microscopic dissection to separate these units for transplantation in a fashion that most closely resembles naturally occurring hair. FUT has grown to become recognized by many prominent hair restoration surgeons as the state-of-the-art method of hair replacement surgery for both male and female pattern alopecia. Although larger punch grafts, scalp flaps, and alopecia reductions may play a role in certain cases, FUT achieves results that are difficult to differentiate from naturally occurring hair. The central attributes of the technique are the provision of natural-appearing hairlines with reasonable density together with low morbidity and minimal "downtime." Nevertheless, the technique is only as effective as the technician, and results are heavily dependent on the forethought of the architect.

Hair Restoration Complications: An Approach to the Unnatural-Appearing Hair Transplant

Hair restoration surgery has emerged as a leading technique for rejuvenation of the upper third of the face. Using contemporary techniques, the results are generally indistinguishable from the appearance of native scalp hair. Unfortunately, older techniques of hair transplantation did not produce this quality result. As a result, there are a considerable number of patients who bear the visual and psychological burden of older hair transplant techniques. In addition, there are regrettably additional patients who have similar unnatural hair transplant results from poorly performed procedures completed in recent time. Understanding the anatomic problems associated with the unnatural-appearing hair transplant is fundamental to the successful correction of the deformity. The most common problems associated with the unsatisfactory hair transplant seen in clinical practice are reviewed, and possible approaches to treatment are presented. The challenge for the hair restoration surgeon is to provide a level of expertise and honesty to these unfortunate patients to restore their appearance and self-confidence. Fortunately, a tremendous benefit for the patient can be achieved when a correction of the unsightly transplant is performed.

Scalp Dermatology for the Hair Restoration Surgeon: Folliculitis

Scalp Dermatology for the Hair Restoration Surgeon: Folliculitis

Scalp Dermatology for the Hair Restoration Surgeon

1. Bernard P. Nusbaum, MD 1. Miami, Florida Actinic (sun) damage thins the connective tissue of the scalp and possibly increases the incidence of avascular recipient necrosis and/or poor growth after hair transplantation. As an intra-operative adjustment for the recipient anesthesia in these

Scalp Dermatology for the Hair Restoration Surgeon

Scalp Dermatology for the Hair Restoration Surgeon

Scalp Dermatology for the Hair Restoration Surgeon

Scalp Dermatology for the Hair Restoration Surgeon

A Technique for Reconstruction of Eyebrows and Eyelashes

Eyebrow and eyelash reconstruction surgery has expanded the options for hair restoration surgeons to assist patients seeking to recover self-esteem by enhancing their appearance. This type of surgery can be performed efficiently and effectively in a properly equipped clinic. This article, in addition to detailing eyebrow and eyelash reconstruction using hair follicular unit transplantation, addresses the etiology of eyebrow and eyelash loss, offers suggestions on evaluating prospective patients, and explains preoperative and postoperative procedures. The author demonstrates how undesirable eyebrow and eyelash conditions can be altered to recuperate their natural design using a technique that has a more natural appearance than scalp hair strips, is easier to perform than temporal artery island flaps, and the results of which are more discreet than punch hair transplantation.

Scalp Dermatology for the Hair Restoration Surgeon

1. Bernard P. Nusbaum, MD 1. Miami, Florida One of the goals of the hair transplant consultation is to identify any concurrent scalp pathology that might influence the surgical outcome. In this regard, the most commonly encountered scalp conditions are seborrheic dermatitis (SD) and psoriasis

Scalp Patholog for the Hair Restoration Surgeon

Scalp Patholog for the Hair Restoration Surgeon

Intricacies of the single-scar technique for donor harvesting in hair transplantation surgery.

Although single-scar techniques have been published and are used by approximately half of all surgeons, this approach is not as common as one might suspect. The objective is to demonstrate several surgical gems that make the single-scar donor technique a viable method that can be performed by the vast majority of hair restoration surgeons. The author presents various techniques such as postauricular skin elevation, subcutaneous undermining of the nape scalp, debulking of underlying scar tissue, temporary staple closure, and permanent double-layered closure using magnification (preferably 2.5 x or greater). All of these contribute to a loose closure with an aesthetically pleasing single donor scar after multiple surgeries. Utilizing the various techniques described in this article, the author has been able to achieve a cosmetically attractive single scar after multiple surgeries in the vast majority of patients. An aesthetically pleasing single, thin donor scar is preferable to multiple scars or a thick single scar at the donor area after multiple hair restoration surgical procedures. The author presents several methods that help hair restoration surgeons conquer some of the obstacles that have deterred them from performing a single-scar technique with consistently excellent results.

President’s Message

1. Mario Marzola, MBBS 1. Adelaide, Australia </br>![][1]</img> There is good news and bad news for the hair restoration surgeon of today. The good news is that if you read this journal, attend our annual meetings and live surgery workshops, and take your training seriously you will

Notes for a Prospective Hair Restoration Surgeon

1. Richard C. Shiell, MBBS 1. Melbourne, Australia Dear Harry, Thank you for your phone call yesterday. I am sorry if I did not seem to share your undoubted enthusiasm for a career in hair transplant surgery but there is a great deal more to this business than learning how to plant hair

Disposable Instrumentation—The Future of Hair Restoration Surgery

1. Colin Westwood, MD <!-- --> 1. Manchester, United Kingdom Edited transcript of presentation at European Society of Hair Restoration Surgeons 5th Annual Meeting June 2002, in London. In the late 19th century, Dr. Joseph Lister from Upton, Essex, introduced antiseptic surgery. He

An evaluation system to enhance patient selection for alopecia-reducing surgery.

The author presents an evaluation system that helps optimize the chances of achieving good results with alopecia-reducing procedures. To help hair restoration surgeons select patients properly for alopecia-reducing procedures. Twenty criteria are scrutinized by the hair restoration surgeon during the initial consultation and given a score of one to five. The scores are added together and divided by 20. A patient with a score greater than four is considered a good candidate for alopecia reduction in most cases. This evaluation method has significantly decreased the number of patients undergoing alopecia-reducing procedures while helping the author achieve consistently good results. An evaluation system is presented that helps determine who is a good candidate for alopecia reduction and who is a poor candidate. This selection technique has helped the author achieve more consistently good results by eliminating poor and borderline candidates.

Salute to Surgeon of the Month

![Figure][1]</img> Glenn M. Charles, DO Boca Raton, Florida Our Surgeon of the Month for this issue is Dr. Glenn Charles, a radiologist turned hair restoration surgeon from Boca Raton, Florida. While the similarities between these two specialties may not be obvious, the same keen observation

Scalp Dermatology for the Hair Restoration Surgeon: Scalp Lesions

1. Bernard Nusbaum, MD 1. Miami. Florida It has been suggested that our specialty should expand its scope to encompass general scalp surgery.[1][1] In this regard, it is essential that we are knowledgeable in scalp anatomy as well as surgical principles that are unique to the scalp. The

Dispelling the myth of the required high hairline in follicular unit hair transplantation.

Hair restoration surgeons have historically taught that the hairline should be placed high on men undergoing hair restoration surgery. To evaluate the position of the anterior-most aspect of the frontal forelock on men experiencing type III-V male pattern baldness. Twenty men, ages 20-46 years, with type III-V male pattern baldness were evaluated for the distances between the chin to nose, nose to eyebrows, and eyebrows to frontal forelock. The mean distance from chin to nose was 6.96 cm. The mean distance from nose to eyebrows was 6.55 cm. The mean distance from eyebrows to hairline was 6.8 cm. The distance from chin to hairline was 20.3 cm. Therefore the eyebrows to hairline distance was 33.4% of the whole. When using follicular transplantation, it may be appropriate at times to divide the face into thirds at the time of hairline development.