The most common reason men go bald is the male-pattern baldness gene. This involves a genetic inheritance from either the mother or father. The male-pattern baldness gene will be expressed if, and only if, there are normal levels of testosterone present in the bloodstream. Hair follicles around the sides and back of the head are not affected by this gene, so the hair can be transplanted from these locations and repositioned in the bald areas. The hair transplanted in the new location will grow, eliminating the baldness in these areas. If, however, one has generalized thinning all over the scalp, one is not a good candidate for hair transplantation
Hair loss treatment is most commonly performed for men with acquired male-pattern baldness, but it is also available for females who have thinning hair in the anterior scalp area due to various types of alopecia. In male-pattern baldness, one can change the posterior portion of the scalp and its normal hair-bearing state by transplanting varying amounts of hair from the anterior hairline back to the crown.
Another technique used in hair replacement surgery is the scalp reduction, which reduces the bald area by direct excision and removal of scalp skin.
The scalp extension is a flat, rubberbandlike device placed below the scalp to stretch the hair-bearing area. This technique is also used in conjunction with scalp reduction to accelerate the rate at which one can excise the bald scalp.
In tissue expansion, we surgically place a balloonlike device underneath the part of the scalp that contains hair. The balloon is then expanded weekly. This stretches the hair-bearing scalp to two to three times its length and width. We can then almost excise the bald scalp area and relocate the “expanded” hair-bearing scalp into the area of baldness.
The scalp rotation technique rotates the hair-bearing skin from the back and sides of the scalp to the front or anterior portion of the scalp.
How Expensive Are Hair Transplants?
The cost of hair restoration procedures depends on where they are being done and who is doing them. Cost ranges anywhere from as low as $4 to $5 per graft to as high as $28 per graft. Scalp flaps are considerably more expensive due to the degree of invasiveness. A flap procedure, such as extended scalp flap, with all of the ancillary procedures, will cost anywhere between $5,000 and $10,000. A scalp reduction is typically in the range of $1,500 to $2,800. A scalp extension technique may add another $500 to $800 onto the scalp reduction cost.
The wide range of costs for all of the procedures is principally due to the amount of training acquired by the surgeon and the degree of personalized care. The procedures, in particular the mini- and micrografts, are quite tedious, and splitting hairs into one, two, three, or four segments is time consuming and needs to be done in a precise, meticulous fashion.
Drugs to treat Hair Loss
One-third of the patients using Rogaine or minoxidil will have absolutely no response; another third may show an indistinguishable difference; and the last third may show some slight improvement. Overall, it will not “regrow” hair if one has some thinning or is in the early stages of hair loss. It may, however, slow down loss, and in some cases, it may increase the caliber of the hair. In a patient with a large degree of hair loss, it will do nothing more than grow peach fuzz over the hair-bearing scalp.
Propecia is a prescription pill originally marketed at a higher dosage to treat enlarged prostates; it has been available for the treatment of hair loss since 1998. The drug lowers the production of dihydrotestosterone, a male hormone blamed for hair loss. (It is not prescribed for women, as it can cause birth defects in their offspring and has not been shown to be effective in studies of women)
Propecia works best in younger people with limited hair loss. Results can be seen anywhere from a couple of months to a year after beginning treatment. While the drug appears safe — and may even have some health benefits related to keeping the prostate small — impotence has been associated with use of the drug in a very small percentage of men.
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