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Hair transplant surgery has come a long way since it was first introduced in the 1950s. Back then, Dr. Norman Orentreich started testing a theory that hairs located at the sides and back of the head were genetically “programmed” to resist balding and that when relocated to balding areas, these “donor hairs” would retain this characteristic. It was an idea that was, quite literally, ahead of its time because while the theory was sound, the available surgical techniques were too crude to produce consistently natural-looking results.

The Bad Old Days of Hair Transplantation
In the 1960s and 1970s, hair transplants consisted of removing clumps of donor hairs with a round punch and then transplanting these plugs of hair into regularly spaced rows. Sometimes, if the patient had enough donor hair and dutifully completed all the sessions of hair transplant surgery, a doctor might be able to achieve good coverage, albeit with a very solid-looking hairline and limited ways the patient could style his hair. Too often, however, the patient would run out of donor hair before a good result could be achieved and the result would be the dreaded “doll’s head” look with obvious, evenly spaced plugs of hair. For an entire generation, the words “hair transplant” became virtually synonymous with “hair plugs” and many people, quite understandably, preferred to live with their hair loss than get an obvious-looking hair transplant.
When It Got Better
In the 1980s, hair transplant technique took a giant leap forward with the introduction of smaller grafts. Instead of large plugs of hair, surgeons would excise a strip of hair from a balding-resistant patch and section it into two types of grafts, mini grafts (4-8) hairs and micro grafts (units of 1, 2, and 3 hairs). The mini grafts were placed where fullness was desired and the micro grafts were places along the hairline for a more natural look. More grafts could be transplanted in each session than when surgeons used the “punch” technique and the results were definitely better looking.
When It Got Great
In the 1990s, we finally achieved a truly natural-looking hair transplant method called Follicular Unit Transplantation or Follicular Unit Grafting (FUG) that mimics the way hair naturally grows. The introduction of a new and powerful microscope, called the binocular microscope, made it possible for surgeons to take that same strip of donor hair and section the hairs the way they naturally grow, in units of 1, 2, 3, and 4 hairs. These “follicular units” can be transplanted into very tiny incisions placed very closely together. The result is excellent density, even after just one session. And because the hair is transplanted the same way it grows, there’s never an awkward phase where the patient looks strange or like a work in progress.
A further refinement of the technique, called Follicular Unit Extraction (FUE) does away with the strip. Instead, these follicular units of donor hair are removed one at a time using a small circular punch. There is no incision with FUE and the minimally invasive procedure leaves no visible scars. The donor hairs are placed the same way they would be with FUG and the results of both types of procedure are completely natural. When performed by an accomplished surgeon — no one will know that you’ve had a hair transplant.
Hair restoration product literature, including Propecia information, is available in our office. Please contact us at 817.473.2120 to schedule an appointment or visit our website at www.MarkBisharaMD.com

Beards, Eyebrow and Eyelash Transplants on the Rise

Beard 

The elusive hipster population has not been without their fads — from skinny jeans to plaid — but none have rivaled the importance of facial hair.

With the increase in beard popularity, some men who feel they lack the right amount of stubble have started visiting their local plastic surgeon for help.
As first reported in DNA Info, some New York plastic surgeons say they have even seen a rise in demand for beard transplants in recent years.
The American Society of Plastic Surgeons reported there was a four percent increase in hair transplants overall in 2012.
Dr. Jeffrey Epstein, a plastic surgeon based in Miami and New York, said he is now doing three beard transplants a week, up from about one a week a few years ago.
“We’re seeing more and more hipsters,” said Epstein, who said most of his patients are in their 30s and 40s. “People work from home and have the ability to be themselves and let their beard grow out.”
Beard transplants are just one example of hair-loss treatments that are a far cry from the days of toupee, glue and hats.
Plastic surgeons have been helping the follicly challenged for decades by grafting hair from the back of the head to the top of the scalp.
New technologies from “tattooed hair” to delicate transplants, where hair follicles are implanted one by one, has allowed people who are unhappy with the amount of hair on their face, or even chest, an opportunity to get the look they want.

PHOTO: Men are requesting hair transplants to make their beards more robust, here a patient is pictured after a transplant.  

Courtesy Dr. Jeffrey Epstein
Men are requesting hair transplants to make their beards more robust, here a patient is pictured after a transplant.

For the beard, men can have either just sparse areas filled in or a full beard.
Dr. Yael Halaas, a facial plastic surgeon based in New York, said many of her clients come in with pictures and ask for a beard similar to a celebrity such as Ryan Gosling or Jake Gyllenhaal.
Even though the hair comes from the back of the head, Halaas said after it is implanted and starts to grow, it blends with the rest of the facial hair. If a person wants that ZZ top beard, Halaas said it’s possible to obtain that look — they just need to be sure to get the right plastic surgeon. A beard transplant gone wrong can mean scarring or having facial hair grow in opposite directions, she said.
“The basic technique is the same [but] it becomes more much important on the face,” said Halaas. “It has to have design and angle.”
For men who want to replace the hair they lost on their head, a surgical technique (or toupee) isn’t their only option.
Anyone with an aversion to the surgical procedure can turn to Good Look Ink, which has another option: pigmented hair. The “hair” is tattooed onto the scalp.

PHOTO: In this stock image, a tattoo artists machine and ink are pictured.  

Wade Griffith/Getty Images
In this stock image, a tattoo artist’s machine and ink are pictured.

The procedure is done on people with shaved heads and gives the appearance that their hair is growing in.
Good Morning America consumer correspondent Elisabeth Leamy said there are a few factors to consider before getting inked hair. Leamy said potential clients should be sure that cosmetic needles rather than the larger tattoo needles should be used.
Additionally because ink can fade in the sun, Leamy said clients should be careful to wear a hat and put on plenty of sunscreen or risk losing their inked “hair.”
And ladies shouldn’t feel that there’s no hair transplant options for them. If you’re happy with the hair on your head (and chin) but still think your eyebrow or eyelashes are sparse, there is hope for you too.
Although cosmetics to enhance eyelashes and eyebrows have been around for centuries, now you can add transplants to the options available to you.

PHOTO: In this stock image, a closeup of a womans eyebrow is pictured.  

Maria Teijeiro/Getty Images
In this stock image, a closeup of a woman’s eyebrow is pictured.

Dr. Halaas said she has performed eyelash and eyebrow transplants on patients who have wanted a fuller look. Occasionally she’s even added just a tiny amount of hair to an eyebrow to change the shape.
However, Halaas warns that the procedure should not be taken lightly or done for reasons such as your favorite mascara being discontinued. Because the hair used in transplants is from the back of the scalp, it will grow and it has to be cut often or you risk having more hair curtains than long lashes.
“The hair on your head is not programmed to stop growing. It really requires a lot of maintenance,” said Halaas.
Halaas said there are numerous reasons for people wanting hair-transplants from never liking how their body looked to those who have suffered either a trauma or burn and want to replace hair that they’ve lost. For surgeons, Halaas said performing these unusual hair transplants take some artistic ability in addition to medical knowledge.
“It’s fun [to] design,” said Halaas. “There’s many surgeons doing hair transplant, there’s not that many doing hair transplants on the face.
This news is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX
 

Background

From the 1960s into the mid 1990s, transplanted hair appeared unnatural because surgeons used unnaturally large-appearing hair grafts consisting of 10-25 hairs each. That era is over. Hair naturally grows in 1-4 hair follicular groupings. In the early 1990s, surgeons began switching from using unnatural-appearing hair “plugs” (10-25 hairs) to using consistently natural-appearing hair follicular groupings (1-4 hairs). In current practice, all women and men should expect consistently natural-appearing transplanted hair.
Follicular unit transplantation is the standard surgical technique to treat male- and female-pattern hair loss. Follicular unit transplantation is also used to correct unnatural-appearing plug-like transplants, repair eyebrows, and redistribute hair in persons with inactive scarring alopecias.

The ARTAS System

The ARTAS System
For the very latest technology in hair restoration, Dr. Mark Bishara is now using the FDA approved ARTAS System. This interactive, computer assisted equipment employs image guidance to enhance the quality of hair follicle harvesting. ARTAS is the first hair transplant robot to improve the most challenging aspects of Follicular Unit Extraction (FUE).

Frequency

Male-pattern hair loss affects approximately 50% of all men, and female-pattern hair loss affects approximately 30-40% of all women. The rate of loss and extent of loss vary from patient to patient.
Follicular Unit Transplants (FUT) is designed to produce effective results with minimal downtime and no damage to surrounding hair follicles. Dr. Bishara is highly experienced in performing all of these procedures, and will help you determine which one is right for you in order to achieve the best possible results.  Please call our office to schedule a consultation appointment with Dr. Bishara at (817) 473-2120 or visit our website to learn more at www.MarkBisharaMD.com.

 




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Typical pattern baldness is something both men and women struggle with and we have our parents and ancestors to thank for it. Your hormones and what’s in your DNA cause baldness. Enzymes in our body react with hormones and cause the follicles in the scalp to shrink and stop growing new hair. Hair on the sides and back of the head isn’t vulnerable to pattern baldness and will typically grow for the duration of a persons life. We use these areas “donor areas” to extract from and move to the top of the head or balding areas “recipient site”. There are two different methods in which donor hair can be harvested: Follicular Unit Transfer (strip harvesting) and Follicular Unit Extraction.

In strip harvesting we take a strip of the scalp from the donor area and then suture the area back together. The strip of scalp is then cut into small pieces of hair follicles that have one to four hairs per graft. Holes are then placed in the recipient area and the grafts are placed in the holes in a natural but random pattern. The patient will be left with almost no visible scar on the back of the head and is typically hard to see once the surrounding hair grows out and conceals it.

Follicular Unit Extraction (FUE) is a procedure that uses a punch method to extract the hairs from the donor area. The head is first shaven and a local anesthetic is used to numb the head. The FUE surrounds the hair follicle and punches the follicle loose so it can be easily extracted from the head. The small holes left behind start to heal immediately and continue to disappear over the next few days. Tiny holes are then placed in the recipient area using a microscope and the hair follicles are planted.

The scalp takes about 3 to 5 days to heal and you should not attempt to resume normal activities for 48 hours to prevent the transplanted hair from falling out. The majority of the hair shafts in the follicle will fall out, don’t be alarmed. After a few months new hair will begin to grow from the relocated follicles. It takes about two days for the transplanted hair to settle permanently into the recipient sites. Small scabs will develop were the grafts were inserted so do not pick them or it will cause the hair follicle to dislodge. The scabs will fall off within 10-14 days. Re-growth is expected to occur within 3 months. It can take up to 6 to 10 months to see full regrowth.

Hair transplant is a major component of hair restoration. With the supporting medical management using 5% minoxidil (Rogaine) and finesteride (Propecia), 97% of androgenetic hair loss can be stopped and regrowth of hair can be seen in the large majority of these patients. Stop by for a free consultation or visit us via internet consult to see if you are a potential candidate for hair restoration or a hair transplant procedure.

 

This information is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX

 

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