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Hair Transplant

Dr. Hilinski and his team of cosmetic specialists offer hair transplant surgery to help those patients who are suffering from unwanted, early hair loss. Thinning hair and/or loss of hair is an incredibly common problem seen across society, especially in male patients. For a good proportion of those affected by hair loss, this can have a significantly negative impact on their sense of confidence and well-being. In women, thinning of the hair leading to outright hair loss can be borderline devastating.

Advancements in Hair Transplant

Fortunately for those men and women negatively impacted by hair loss, advancements in medicine have provided us the opportunity to treat this problem using safe, predictable, minimally-invasive hair transplant techniques. This includes a host of new, advanced surgical procedures that have effectively replaced the dated hair transplant surgeries that utilized the old ‘strip’ technique. Not only are these latest generation hair transplant procedures more successful, they can also be more cost-effective in many cases. The minimally invasive nature of the newer surgeries also translates into less recovery time since you do not have to recuperate from a surgical scar along the back of your head.

Why Dr. Hilinski for Hair Restoration?

Dr. Hilinski is a board certified facial plastic surgeon, which means that he has undergone extensive education and training specifically focused on cosmetic face and neck concerns. This includes maintenance and enhancement of skin and hair. If you look around San Diego, you will find that many so-called hair transplant surgeons aren’t even trained as surgeons. In fact, many of these folks performing hair transplant were actually trained as family practice doctors and internal medicine specialists. Even those hair transplant practices who have surgeons on staff often times have doctors who were trained in other specialties – like heart surgery or general surgery – and not in facial plastic surgery. With Dr. Hilinski, you are getting a Harvard Medical School graduate who has trained specifically for this surgical specialty, which includes the treatment of unwanted hair loss using advanced hair transplant techniques.

Hair Growth and Hair Loss

In order to understand hair transplant, you must first have some knowledge of how hair grows in naturally and how you lose it.

Hair starts growing out of the root, which sits under your skin at the bottom of the hair follicle. As the hair grows, or extends from the follicle root, it pushes past the surface of the skin. The visible hair extending above the scalp surface is termed the shaft. In any given visible area of the scalp, there are quite literally thousands of hair follicles, which are growing in hair at different paces.

On any given day, the average individual will lose between 50 and 100 hairs from their heads according to the American Academy of Dermatology. This normal loss of hair is termed ‘shedding’ and should be differentiated from the abnormal process termed ‘hair loss’ that implies a something is preventing hair from growing in naturally.

There is definitely a congenital component to hair loss. For example, we know that hair generally begins to thin out as we get older. There is also a hereditary predisposition in some people that can contribute to faster rates of hair loss compared with others. Miniaturization is one such factor that involves a predisposition in some patients to suffer from what is called androgenic thinning of the hair. As this occurs, the hair follicle begins shrinking in size and inhibits the ability of the follicle to grow longer hair. The resultant hair is abnormally weaker and thinner – and visibly can show as rather obvious hair thinning.

The most common type of hair loss seen in our office is called androgenic hair loss, or androgenic alopecia (AA for short). This form of hair loss or thinning is see frequently in both men and women. It is called male patterned baldness when seen in the former. A hallmark of  androgenic alopecia is frequently seen pattern of  hair loss where it starts to thin out above the region of the ears along the side of the head. This is referred to as temporal (in reference to the temples) hair loss. Unfortunately, in many patients, this temporal pattern of hair loss will commonly extend into other areas contributing to an even more obvious receding hairline that assumes an M-shaped pattern. If the hair loss expands into the crown of the scalp, patients can readily appreciate a markedly pronounced pattern of thinning and/or complete baldness.

Women tend to suffer hair loss in a different manner compared with men. Instead of losing hair in certain patterns, women commonly see hair loss more globally around the scalp. In addition, women tend to not have a receding hairline as much as men do with hair loss.

In other cases of hair loss, it can be attributed to other factors that include traumatic injury to the scalp, infectious causes, medication induced changes or autoimmune disease. Typically when hair loss results from these factors, the pattern of onset is more unusual and occurs over a shorter period of time. In many of these cases, Dr. Hilinski will ask that you get clearance from a dermatologist before embarking on the journey for surgical hair restoration.

Hair Transplant Surgery Options

Follicular Unit Extraction (FUE)

Follicular unit extraction, or FUE for short, is widely considered one of the cornerstones of modern day hair transplant surgery. FUE hair transplant surgery essentially involves harvesting what are called ‘follicular units’ of hair, which contain on average 1-4 individual hairs. Hair does not grow in like evenly spaced rows of corn. Rather, it grows in as clusters of follicular units, or islands of hairs. It is the follicular unit that is transplanted in whole or in part into areas where there is obvious hair loss. In this process, follicular units are carefully taken individually from out of the scalp, typically along the back of the head. The area where the hairs are being taken out of is termed the ‘donor’ site. These healthy follicular units are harvested from the back of the scalp because these hairs are considered to be genetically programmed to resist hair loss more so compared with other areas of the scalp. These follicular units are taken out very carefully without having to make an incision, or cut, in the scalp with FUE. Instead, a tiny device called a ‘punch’ is used, which measures 0.8 to 1.0 mm in size. On average, FUE will yield upwards of 2500 grafts. These are then placed into the region of hair loss – called the ‘recipient’ site – using tiny incisions or slits made in the skin surface where new hair growth is desired. The donor punch sites where the hair was taken are so small and so randomized in terms of distribution that they barely leave a visible sign of less hair density or scar. However, if patients have multiple rounds of hair transplant using FUE technique, these tiny punch scars may eventually become more visible to the naked eye as small polka dots.

Artas Robotic hair transplant is considered one of the most advanced methods of performing FUE as it is an artificial intelligence (AI) based technology. With Artas hair transplant, the surgeon works in conjunction with the robot to harvest the desired FUE grafts. In fact, the robotic arm will actually perform the graft harvesting with incredible precision and accuracy based on detailed computer algorithms, which include analysis of the angle of the hairs. The FUE grafts are the carefully transplanted into the desired location.

Neograft is another popular method of hair transplant FUE. This is because Neograft was specifically designed to allow for gentle, efficient harvesting of the individual follicular units using an intelligent motorized device. To be more specific, Neograft incorporates use of a mechanical vacuum that carefully removes the follicular unit from the back of the scalp allowing the hair transplant surgeon to do so with much greater efficiency and ease than by hand alone.

Follicular Unit Transplant (FUT)

The other principal method of hair transplant is called follicular unit transplant, or FUT. The main difference is in how the hair is harvested from the scalp. With FUT, a cut is made along the back of the head, which is essentially a strip of donor scalp containing the healthy hair follicles. From this strip, the individual follicular units are taken out and transplanted to the hair loss areas. Compared to FUE, FUT will yield more individual follicular units that can be transplanted. For example, FUT can sometimes yield upwards of 3000 grafts in one session. FUT is also considered a quicker procedure versus FUE because the strip technique can be done in a shorter period of time compared with individual harvesting of units with FUE.

However, one of the main drawbacks of FUT is the strip. This area where the strip was removed has to then be sutured together, which will eventually form a straight, or linear, scar across the back of the scalp. It is this scar formation that is considered such a detriment because it can result in rather unsightly scarring in many patients.

Cost of FUE Versus FUT

Because FUE is considered a more tedious process in terms of harvesting the follicular units of hair, it is more costly versus FUT. Simply put, FUE takes longer to perform versus FUT and, therefore, requires more staff effort and time to complete.

Goals of Hair Transplant

The goal of hair transplant surgery is to help patients realistically gain back some of the hair that was lost such that they look like they have less severe hair loss. Or put in different terms, the aim is to make the hair look fuller and/or more distributed once again. This would include restoring the hair in a manner that is still quite natural looking. For male hair loss patients, this often times means restoring the hair along the crown of the head, the mid scalp and/or the front temple regions – which are the most common patterns of hair loss in most men. In contrast, female patients with hair loss more commonly see sparing of the hairline in front. Instead, females will more so notice thinning of the hair more diffusely across the mid scalp. In this patient population, the goal of hair transplant surgery is to restore a more dense looking pattern of hair.

Special Cases of Hair Transplant

Although scalp hair restoration is by far the most popular form of hair transplant surgery, Dr. Hilinski and his team do offer other types of hair restoration. These include hair transplant for patients who previously underwent facelift surgery or brow lift surgery and have more visible scarring than desired. In situations like this, Dr. Hilinski can transplant 400 to 800 hair grafts to help camouflage the scarring and restore a less surgical appearance.

Eyebrow hair restoration using transplant technique is also routinely performed to help those patients with thinning eyebrows. This is typically accomplished with 400 to 600 grafts.

Hair Transplant Anesthesia

Hair transplant surgery with Dr. Hilinski is done using only local anesthesia to keep you pain free during the procedure. In most cases, patients will also be given an oral sedative to help further keep you comfortable and relaxed.

The Art of Hair Transplant Surgery

Although we often times use the term ‘art’ to describe various cosmetic surgeries, hair restoration truly is an art form arguably more so than most facial cosmetic procedures. The reason we say this is because there can be quite a bit of variability when it comes to creating and/or restoring what is perceived as a natural hair line. For instance, some hair transplant specialists have more of aesthetic eye than others when it comes to distributing and positioning the tiny incisions where the new hair is being placed. If this is not done with great care and some degree of artistry, the new hair and hair line will not blend as seamlessly with the patient’s native hair.

New Hair Growth

In most cases of hair transplantation, the patient will begin to appreciate new hair growth approximately 4-6 months after surgery. The new hair will then continue to flourish for upwards of the next 10-15 months.

Hair Transplant Consultation

If you are suffering from hair loss or thinning of the hair and desire cosmetic hair restoration from a board certified facial plastic surgeon, contact our San Diego office today to schedule your personalized consultation with Dr. Hilinski.

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