Before hair transplant surgery came along, how did men deal with their hair loss?  For centuries, men have been losing their hair to genetics, age and inevitability. For centuries, men have tried to disguise their hair loss with powdered wigs, toupees and, more recently, removable hair systems that adhere to the scalp with special adhesive.  Why all the worry about hair loss? Because feeling good is looking good and a healthy head of hair is intertwined, psychologically, to our feeling of well-being.

Why do thousands of men each year choose hair transplant surgery as a way to solve their hair loss?  Because we feel better when the person we see in the mirror is the person we still expect to see. When our hair goes, so does a chunk of our self-worth.  And while modern technology has made amazing breakthroughs in disguising the problem of hair loss, these solutions are not ever going to be like the real thing; the one important thing you get when you choose hair transplant surgery: your own hair growing back on your head.

To understand hair transplant surgery, you have to understand the answer to the question:  Why does hair fall out? In the case of men, genes predetermine which areas will thin and bald eventually. Hormones– particularly DHT (dihydrotestosterone) that can shrink the hair follicles and weaken them until they fall out for good – are a significant cause of hair loss. More accurately, once weakened this way, hair fails to regrow to replace the one that has fallen out in the natural shedding process. Thus if more fall out than regrow, baldness will ensue.

We’ve all seen the results of the early and awful attempts at hair transplant surgery with “hair plugs”, which resulted in a scalp that looked more like the surface of a brush, not at all natural looking.  Unscrupulous hair loss clinics even performed dangerous hair transplant surgeries by sewing a hairpiece directly onto men’s scalps. Never a good idea.  Both of these procedures are now a thing of the past. For good reason men became suspicious of hair transplant surgery at that time.

However, in the past ten to fifteen years, amazing technological breakthroughs have improved the way hair replacement surgery is performed. One type of hair transplant surgery is called Follicular hair transplant surgery, which utilizes micro-surgical techniques and the hair loss patient’s own hair, harvested from an area at the back of his head. One to two strands of hair at a time are individually implanted into the area of the scalp that requires hair. By the end of the hair transplant surgery, thousands of such individual strands with roots intact are implanted into the scalp of the hair loss patient. Great care is taken to angle the hair properly, to give a natural frontal hairline to the patient and to give what will become good coverage of the scalp.

The hair harvested from this back area of the scalp for follicular hair transplant surgery is not prone to the same genetic problems as the hair in the frontal areas. These harvested hairs are predetermined to keep growing, just as they would at the back of a man’s head throughout his life. Once hair transplant surgery is complete, the hair that is visible will shed or fall off. But the root that is still in the scalp will be settling in to grow. Within six months, a new head of hair will grow where no hair was before.   Hair transplant surgery is a viable solution to hair loss.

While men’s hair transplant surgery is more common, women, too, suffer from hair loss and can benefit from hair transplant surgery. Women tend to lose their hair in an all-over pattern instead of the typical pattern baldness men experience. Often, hair becomes extremely thin, because hair stops growing back once it falls out. Dihydrotestosterone can affect women in this same way as men, but other factors, such as chemical over-treatment, and tension Alopecia due to over-styling are more common in women who suffer from hair loss.

Gina Reyes underwent treatment for breast cancer with radiation and chemotherapy. Her hair fell out, as expected, but unlike others who regrew their hair, Gina’s hair never came back as thick as it had been before. Her recovery was difficult, made worse by how she felt when she looked in the mirror. She tried everything to cover her hair loss condition, but finally settled on hair transplant surgery.  Her recovery was relatively easy and within a month the hair transplanted into her scalp shed. But then, the roots began to grow and Gina’s hair began to look like it used to look. Within a year, she had a new head of hair and her chemo treatments no longer stared at her in the mirror whenever she looked at it. No more will she have to worry about hair systems that adhere to her scalp, or needing to shave what hair she has left to apply it. No more wigs that don’t breathe in the heat. The hair from her hair transplant surgery is real, growing hair.

If you’re suffering from hair loss and you’ve tried the other hair loss solutions only to feel like you’re wearing someone else’s hair, consider going to a hair transplant surgery clinic to see if you are a candidate for hair transplant surgery. The cost is relatively high, but financing is usually available.  And when you add up the other hair loss solutions over a lifetime, then add in how you’ll feel about yourself when it’s done, you may just find it’s worth the price of being you again.

GET HEALTHY HAIR NOW – WHAT YOU SHOULD KNOW ABOUT CHEMICAL RELAXERS

Hair breakage, hair thinning, lack of hair growth, scalp irritation, scalp damage and hair loss – These are just some of the complaints from many who experience problems due to the misuse of chemical hair relaxers. In fact, the FDA lists hair straighteners and hair dyes among its top consumer complaint areas. Yet, in so many stores around the country, chemicals are available for everyone to use, without much instruction, a powerful process which transforms the basic chemical makeup of the hair strand.  Before beginning any hair treatment, especially one that introduces chemicals to your hair, you owe it to yourself to be well informed. Armed with a better understanding of this process, you will be able to make good decisions with regard to hair and scalp care.

If you have naturally tightly curled hair you have the option of styling it using products specifically designed for your hair type as it is, or the option to straighten the hair which opens up further hair styles to be available to you. However, chemically straightening the hair should be carefully thought out and thoroughly studied.  We have compiled essential information on chemical hair relaxers and urge you to read the following carefully and, if not for yourself, share it with a friend.

His name was Garrett Augustus Morgan and he was born the seventh of eleven children of former slaves. He is best known for his invention of the automatic traffic signal and gas mask. But it was around 1910 that he stumbled upon what would become his contribution to the hair care products industry and what would pave the way for several other entrepreneurs and manufacturers over the next hundred years.

While working in a sewing machine repair shop attempting to invent a new lubricating liquid for the machine needle, it is widely believed that Morgan wiped his hands on a wool cloth, returned the next day, found the woolly texture of the cloth had “smoothed out”, and set out to find how the liquid chemical had changed the texture as it had. He experimented on an Airedale dog, known for their curly textured hair, and the effect was successfully duplicated.

Morgan then tried his lubricating liquid invention on himself, called it a “hair refining cream”, and thus patented the first chemical hair straightener.  He founded a personal grooming products company which included hair dying ointments, curved-tooth pressing combs, shampoo, hair pressing gloss, and the one that started it all: the “G.A. Morgan’s Hair Refiner Cream” (advertised to “Positively Straighten Hair in 15 Minutes”).

How can chemicals “relax”, or straighten hair? Well first of all, as assumed, the chemical would need to be potent enough to do so. Both lye and “no lye” relaxers are very strong chemicals that work in the same manner by changing the basic structure of the hair shaft. The chemical penetrates the cortex or cortical layer and loosens the natural curl pattern. This inner layer of the hair shaft is not only what gives curly hair its shape but provides strength and elasticity. Once this process is performed it is irreversible.

This process which produces the desired effect of “straighter” hair at the same time leaves hair weak and extremely susceptible to breaking and further damage. One must keep in mind that relaxers do not help the hair, but actually strip it. So by applying chemicals to the hair, even if it is to achieve a desired effect, is never really to the benefit of your hair health.  Due to this, it is first strongly recommended that it be applied only under the direction of a hair care professional with a record of success with healthy hair care and chemical straightening, and that the client regularly obtains conditioning treatments before and after the process.

Possessing a healthy scalp beforehand decreases the possibility of problems occurring. Relaxers should never be applied to already damaged hair, or on someone who has had scalp damage. Age should also be considered. Although your young children may want to have the hairstyles they see on adults or other young people, parents should seriously consider applying such strong chemicals to young hair and the potential damage that could last a lifetime if misused; most times it is not necessary to apply any chemical product to young hair.

“Over processing”, the excessive use of relaxers on the hair or applying the chemical to already processed or relaxed hair, is the most typical misuse of these chemicals. Once the initial relaxer is applied to “virgin hair” (or a “virgin relaxer” is performed), “touch-ups” (or chemical applied thereafter) should only be applied to new growth between 6-8 week periods (or more). This however, depends on the rate of hair growth and condition of the hair as advised by your hair care professional. (Some say that even six weeks is too soon to reapply relaxer to new growth). And it is standard to wait at least 2-4 weeks before applying hair color chemical (or dye) to recently relaxed hair, if applied at all. We remind readers that the more chemicals applied to hair the more possibility of damage may be experienced.

 We are well aware that chemical straightening is an option that many people will choose regardless of the education they receive on the dangers and cautions in doing so.  So we ask that if you are going to make the choice to chemically relax your hair that you take ever precaution necessary.  Seek the service of a reputable hair care professional who is concerned with the overall HEALTH of the hair.  A hair consultation should be suggested during which the hair may be felt to determine its elasticity and strength. Your scalp should also be inspected. And any problems you currently are experiencing with your hair or scalp should be disclosed to the stylist at this time. The stylist may also ask you pertinent questions regarding your current hair regimen and products you typically use. Your stylist may even recommend other methods to style your hair besides chemically straightening it. Even after you’ve personally done your research the stylist may strongly recommend that relaxing your hair ought not be done or that it is not needed. Their recommendation should also be carefully considered.

If newly chemically straightened hair is not given special treatment and care it can become brittle, dry, damaged and break. Relaxed hair will tend to be drier and break easily. When combing it may be best to use a large tooth comb and start from the tips of the hair up to the roots. Regular deep conditioning is a must. Remember once you’ve made the decision to chemically straighten the hair you should also make a decision to commit to regular quality conditioning treatments to maintain not only the look you want, but the healthy hair we all desire.

http://www.gethealthyhairnow.com

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So you are wondering if you there are hone remedies that will make your hair grow faster? You always here the same old saying? You can’t make hair grow faster because it is genetic, this is not true! It is a bit like saying, no matter how much fertilizer you give a plant it won’t grow faster because it is genetic

Yes you have genes and that won’t change much but you can use steps to speed hair growth… It is much like a plant, it has genetic definitions but if you give it tender loving care it will grow faster. So long as respect your hair it will grow faster if you do the right things to it. So if you really want to grow hair faster read this carefully!

First step is to think of how good or bad is your hair condition-so is your hair healthy, shiny and strong, or is it full of split ends, damaged hair and frizzy. So you need to grow your hair out? Or do you simply need to give it more length, thickness and health?

If you hair is damaged you will need to grow hair faster so that you can grow out hair that is damaged and crunchy

So first step to grow hair faster is to get a trim to remove as much of the damage as possible and that is where cutting of split ends come in.

Lets get one grow hair faster myth out of the way and that is “does cutting hair make your hair grow faster?”

And the answer is no! Whiles split ends will not slow down growth, since your hair grows from the scalp, but getting rid of split ends will make your hair more healthy and attractive… if you don’t cut split ends , the split ends will run down to the root of the hair , damaging the new hair growth you get. So take a few snips off of your hair every 8 weeks

Hair grows faster because there is abundant blood flow to the scalp and you can boost the rate of blood flow several ways

First get an oil called Mira hair oil, it has several herbs that will send blood to your scalp and allow faster hair growth

Next use a scalp massage as follows: put the Mira hair oil into your scalp and then massage with your fingers in small circles, starting from the base of the scalp to the front of the head, 3-5 minutes is all you need. The oil together with the massage will boost hair growth

Using a wide toothed comb will also help distribute the Mira hair oil evenly around your scalp, and it will also stimulate blood flow to the scalp

A boar bristle brush will also help stimulate hair growth, use the oil with the brush and your hair will grow fast

To summarize you need a good herbal hair oil and then follow the methods I just shared to grow hair fast

Once we have taken external measures we can focus on the internal measures and to do this you need to follow the following steps for faster hair growth:

You need to check your diet to ensure you grow hair faster. You need to exercise and sleep enough?  To grow hair faster you need at least 8 hours of sleep and you need at least 30 minutes of exercise four times a week

Exercise is crucial;-when you sweat it cleans out the hair pores and allows the hair follicles to breathe and grow

It will also push blood to the scalp and the entire body

You need to minimize stress to grow hair faster. So do some meditation and yoga and quite the mind. You will grow hair faster when your body and mind is healthy

You can’t stress over your hair growth efforts as stress will make you lose hair and slow down hair growth
To grow hair faster you need to consume lots of protein as Hair consists of protein also known as keratinized protein. So be sure that you are getting enough. Protein

You need lots of vegetables and fruits such as: Nuts, chicken, egg whites, fish, vegetables, fruits, grains; milk will all allow good hair growth

I suggest you take amino avoid capsules for faster hair growth. Amino acids go right into the blood and if you are using Mira hair oil and following the suggestions you will grow hair faster

You need lots of hair vitamins; the best is Vitamin B, C and Biotin. Many vitamins and minerals will help grow hair faster-these include: biotin, beta-carotene, biosil, B complexes, magnesium, silica, selium, sulfur, zinc, nettle, and flaxseed oil.
Vitamin C will also help grow hair faster by boosting health of your system
prenatal pills are gold when it comes to growing hair, studies show that they will make your hair grow fast

it has been shown by studies that Biotin will promote hair cell growth, it also encourages the production of good fatty acids, allows good metabolism of fats, and produce good amino acids needed to grow hair faster

MSM is a  food that comes from the ocean  and it is found naturally in the human body. MSM has been shown in numerous studies to lengthen the anagen or hair growth phase.

For best results combine all these vitamins and you will grow hair faster

To grow hair faster you need to stimulate blood flow to your scalp. There are several ways to do this, the best is doing aerobics as mentioned you need 4 workouts a week of 30 minutes

Next way to grow hair faster by stimulating blood flow is to massage your scalp.  To do this you need to take the tips of your fingers and simply massage your scalp all over small circular movements are best to stimulate hair growth, all you need is 10 minutes 4 times a week

another way to stimulate hair growth by stimulating blood flow to the scalp is to you a wide toothed wooden comb to brush your hair. You should note that you should not over brush your hair and you should not use a bristled brush since it years and damaged your hair

Wear loose hair styles and avoid tight hair styles as they will damage and weaken your hair roots

Also avoid hit showers as hot water will also weaken your hair roots and will allow hair to fall easily

A good way to stimulate blood flow to the scalp is to give yourself hair tugs, you put your fingers into your hair and gently grab it and pull gently for a few seconds and let go, do this for all the hair you can get, the pull will stimulate blood flow to the scalp

Finally use Mira hair oil, it is good herbal oil that contains herbs known to stimulate hair growth, herbs like Hibiscus and Aloe Vera have been know to give hair strength and length!

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It is an innate desire of human beings to look attractive regardless of the hair type they have. Each ethnic race has its own standards of beautiful hair. These days, people pay much attention to the state of their hair. This element of our bodies has pure aesthetic function. However, the latter should not be underestimated, for millions of men and women suffer from this lurking fear of going bald. Mere presence of some beautiful hair strands on the scalp is of not much significance if not with coupled with some healthy and voluminous hair to match. You can have both the beauty and quantity if you follow some faster hair growth tips.

Logically, to be able to take good care and preserve hair beauty, we should know what hair growth actually is and how it grows. To start with, one should realize that hair is made of dead protein cells, called keratin. Protein, being digested in the body, forms different amino acids. The latter can be connected in the particular combinations, producing different forms of protein in our organisms: keratin, collagen, insulin, etc. The first one is the source of our hair.

Lanugo is one of the very first hairs a human being acquires. It appears on the skin surface during the intrauterine development of a baby. Lanugo is silky, glossy, and almost invisible, since it has no pigment. Besides lanugo, there are three more types of the human hair: – vellus hair, which is soft, fine, short, and non-pigmented; – terminal hair is pigmented and quite long; male arms, chest, and legs hairs are terminal, as well as hairs on the scalp; – intermediate – it is something in between the first two types; it is usually moderately pigmented.

The structure of the hair has two main parts: the hair shaft (the actual hair we can see on the skin surface) and the hair follicle (the point from which hair grows). Hair cells are formed in hair bulb, which is nothing but lower part of a cup-shaped hair follicle. The newly produced cells push the older ones out of the bulb. A hair bulb contains nutritious elements, oxygen, and amino acids necessary for hair growth, as well as eumelanin or pheomelanin pigment melanin; former makes our hair black or brown while latter accounts for red or blond hairs).

All the cells pushed out of the bulb continue to move out of the follicle, and beyond its boundaries they are known as hair shaft. The hair shaft consists of the inner part (cortex), which contains small amounts of water, vitamins, fats, pigment, and the traces of different metals. Cortex is covered by a protective layer – cuticle. If the latter is smooth, glossy, and undamaged, hair looks beautiful else it loses its shine and smoothness.

Just like the plants, which have periods of active growth and time to rest, our hair has the anagen phase, when new hair cells are constantly produced, the catagen phase, when hair stops growing and prepares to have some rest (1-2 weeks), and the telogen phase – resting time itself, during which all fully grown hairs are shed (5-6 weeks). Then everything starts all over again.

Growth of healthy hair largely depends on its normal healthy functioning and structure. The hair structure is divided into two parts – the non living part that is projected out of the skin of the scalp and the other living part, that remains buried inside the scalp skin. Both hair parts have various functions to perform, besides being an integral component of the hair growth cycles. Alteration in the normal cyclical process of hair growth is one of the main causes of hair loss. The factors that affect the normal hair growth cycle are hormonal imbalance and genetics. Though it is hard to take care of the above two factors of hair loss, it is essential for you to keep your hair clean and healthy with the use of well-formulated cleansers and conditioners.

Healthy and faster hair growth not only helps you to look beautiful, it helps you to tie them to good hair styling. Here is an interesting opportunity for trying the hair styling tips. You can also imitate the hair styles of some famous Hollywood celebrities. Apart from imitating the hair styles of celebrities follow the natural hair care tips and discover the secrets of faster hair growth for beautifully shining hair. So take proper care of your hair, promote faster hair growth and also give you the opportunity to the follow the trendy hair style. The best hair oil is Mira hair oil, this oil is known to stop hair loss and promote the growth of healthy hair. Mira hair oil does it all.

It will * Stop hair loss * Prevent graying * Allow your hair to grow thick and healthy * Eliminate dandruff and as woman it will Restore health and shine to your hair in just one application. * Gets rid of dry frizzy hair- get sleek frizz free hair. * Completely eliminates a bad hair day. * Makes hair shine and turns it to its natural state. * Repair chemical and damaged hair in just a few simple applications

And Gets rid of dry, dull hair naturally removes frizz Plus it ensures you will never have a bad hair day and stimulates the growth of strong, thick, silky hair that will get you noticed wherever you go! Get yourself a free trial using the link below in the author’s box below?

Patient Assessment

Donor Supply

In performing a hair transplant, the physician must balance the patient?s present and future needs for hair with the present and future availability of the donor supply.  It is well known that one?s balding pattern progresses over time. What is less appreciated is that the donor zone may change as well.   

The patient?s donor supply depends upon a number of factors including the physical dimensions of the permanent zone, scalp laxity, donor density, hair characteristics, and most importantly, the degree of miniaturization in the donor area – since this is a window into the future stability of the donor supply.

The size of the donor area is determined by both its width (height) and its length.  When assessing the potential width of the donor area, doctors usually assess the lowermost point that the balding will reach, i.e. the top part of the permanent zone.  However, it is equally important to pay attention to the inferior margin as well.  It is common for the hair to thin significantly at the nape of the neck as a person ages, producing an “ascending hairline.”  Since this can significantly diminish the width of the donor area, any evidence that this process may occur should be taken into account in the planning.  Loss of the temporal points is another process that has a significant impact on the donor supply. Not only does it foreshorten the potential length of the donor strip but it often portends very significant baldness.   

Scalp laxity is another variable that affects the amount of available donor hair.  Very tight scalps significantly limit the amount of donor hair that can be removed through strip harvesting.  The constraint imposed by a tight scalp is not always apparent in the first session, but can plague the hair restoration down the line; therefore, it should be evaluated carefully in the initial patient assessment. A very loose scalp can present its own set of problems, as patients with very loose scalps often heal with widened donor scars. [18]   

The average donor density of a Caucasian is about 225 hairs/cm2. This can easily be measured using a hand-held instrument called a densitometer. (2) When the density of a Caucasian is below 180, a hair transplant should be undertaken with great caution. In this author?s opinion, when the maximum donor density is below 150/hair mm2, a person should generally not be transplanted, as there will not be enough donor hair to make the procedure cosmetically worthwhile and the risk of a visible donor scar is too great. (3) Exceptions would be an older person with very limited expectations and in races where the normal density is lower (i.e. Asians and Africans). 

Hair characteristics, particularly hair shaft diameter, are as important as the absolute number of hairs in determining the outcome of a procedure.  The amount of transplantable hair is related to both the number of movable hairs (determined by the size of the donor area, scalp laxity and donor density), multiplied by the hair shaft cross sectional area.  Since each hair in a person with coarse hair can have over 5 times the volume as a person with fine hair, the estimate (or actual measurement) of hair shaft diameter is important in determining the overall donor supply.  

Miniaturization, the progressive diminution of hair shaft diameter and length (the result of the action of DHT on the hair follicle) produces thinning on the front, top and crown of the scalp and is the hallmark of androgenetic alopecia.  But the back and sides of the scalp can miniaturize as well and when a significant portion of a patient?s donor area is miniaturized, the hair in this area can be rendered useless for a hair transplant. (Figures 1 and 2)

This condition, called diffuse unpatterned hair loss (or DUPA), is the most common type of hair loss seen in women and it is not uncommon in men.  It goes without saying, that every patient, male or female, in whom a transplant is being considered, should be evaluated for donor miniaturization using densitometry to make sure that the donor hair to be transplanted is stable. 

Recipient Demand

One should never assume that a person?s hair loss is stable. Hair loss tends to progress over time.  Even patients who show a good response to finasteride will eventually lose more hair.  It is always best to consider the reasonable worst-case scenario when assessing how bald the patient may become, so that the finite donor hair can be allocated properly. Although the Norwood classification is very helpful in staging the hair loss, it doesn?t take into account actual scalp dimensions. Just like the donor site, the recipient area should actually be measured.  Even within a single Norwood class, there is a vast difference between a patient with a narrow forehead and one with a very broad head with respect to the actual surface that needs to be covered, and thus the number of grafts required for the restoration. 

Designing the Hairline 

Hairline Position

In the adolescent, the hairline sits just above the upper brow crease formed by the upper border of the frontalis muscle directly below it.  The position of the normal adult male hairline is approximately 1.5cm above this crease at the midline). A common error is to place the newly transplanted hairline at the adolescent position, rather than one appropriate for an adult. Although the younger patient, first experiencing hair loss, may put considerable pressure on the doctor to place hair in the lower position, the physician should not yield to this demand. 

Under normal circumstances, as a patient ages, his density decreases and the natural hairline will move back somewhat.  However, a transplanted hairline is immutable. Therefore, when the transplanted patient continues to thin or bald (which he invariable will) the fixed low frontal hairline will begin to look out of place, since it is natural for a person with decreased overall hair volume to have a slightly receded hairline, rather than one that is still in the adolescent position. 

Hairline Shape

A similar logic applies when choosing the shape of the hairline.  As a male passes from adolescence to adulthood, his broad, flat hairline evolves into a more tapered shape with some recession at the temples.  A persistent low, broad hairline is enjoyed by those who also maintain their adolescent density. This situation is not present in those who are suffering from androgenetic alopeica; therefore, a transplanted flat hairline will not “age well” over time and will look unnatural as the patient?s overall density decreases and particularly as the crown begins to thin. 

If a person is older, has maintained a high donor density, and has a small risk of extensive hair loss, a broader hairline is possible.  However, this is not this case for the person who is starting to bald at a young age, since he has a significant risk of extensive baldness and, more importantly, the extent of his future hair loss can not be known at the time the surgery is planned. 

Graft Distribution

The nuances of graft distribution and the multitude of problems that result from distributing grafts improperly are beyond the scope of this writing; however, there are two main but related themes that the hair transplant surgeon should be cognizant of when deciding where to place grafts. The first is to set a target area of coverage that takes into account the patient?s future balding pattern, as well as, his total donor hair supply.  The second is to forward weight the grafts, rather than distributing them evenly over the top of the scalp.

Extent of Coverage

The problem of deciding how much bald scalp a hair transplant should cover can be illustrated as follows.  As an example, take a patient whose total number of follicular unit grafts available to harvest is around 5,500.  The front part of the scalp has a surface area of about 50 cm2.  The top or mid-scalp has an area of about 150 cm2 and the vertex or crown about 175 cm2. However, the size of the bald crown can vary dramatically depending upon the extent of hair loss, reaching over 200cm2 in a Norwood Class VII patient. 

If the front and top of the scalp were transplanted using all of the patients donor hair, the transplanted density would be only 5,500grafts/200cm2 or 27.5 grafts/cm2 (less than 1/3 the density of the patient?s original hair). If the crown were covered as well, that would be 5,500 grafts/400cm2 or 12.5 grafts/cm2 (only 15% the density of the patient?s original hair).  Using various manipulations, such as creating different densities in different parts of the scalp, a skilled surgeon can make 1/3 of the overall density look like a substantial amount of hair. However, working with only 15% of the original density, can make the job of creating a natural look significantly more difficult, if not impossible.    

The way to avoid having a hair transplant with a look that is too thin, or see-through, is to limit the extent of coverage to the front and mid-scalp until an adequate donor supply and a limited balding pattern can be reasonably assured -  an assurance that can only come after the patient ages.  Until that time, it is best to avoid adding coverage to the crown.  

Another problem with transplanting the crown early is that as the crown expands additional hair will be needed to follow the expanding area of baldness outward, just to keep the first hair transplant looking natural. This may require considerable amounts of hair that will not be available to cover the front and mid-scalp if that were too bald as well. On the other hand, if the hair transplant was limited to the vertex transition point or VTP (see figure above), the restoration would look natural without further surgery no matter how far the hair loss in the crown progressed. The reason is that the front and top of the scalp represent a complete cosmetic unit, with the VTP as the natural posterior boundary – so it is natural for hair to cover this region of the scalp but not beyond.  

Density Gradients

Another way for surgeons to prevent a thin, see-through look is to avoid distributing the grafts evenly over the transplanted area. It goes without saying that only 1-hair grafts should be used at the hairline, with larger grafts behind them, but there are additional ways to produce the gradations of density to mimic the way hair grows in nature.  Specifically, the greatest density should be in the front part of the scalp (shown in brown) and particularly in the frontal forelock area (shown in dark brown).

The greater density in the front of the scalp forelock area can be created in two ways; by placing the recipient sites closer together in this location and by using larger follicular units in the area (i.e. 3- and 4- hair units rather than 1s and 2s).  These techniques may be use in combination to achieved greater density but, as will be discussed in the following section, if done to excess, may compromise growth.  

Summary

Follicular unit transplantation is a powerful hair restoration technique that allows the surgeon to create natural hair patterns and produce results that mimic nature. The success of the procedure depends greatly on proper patient selection, accurately assessing the patient?s donor supply, and distributing the grafts in a way that is appropriate for a person who will continue to age and eventually thin over time. With thoughtful planning, major mistakes can be avoided and our patients will be able to achieve the full benefit of this remarkable procedure. 

References

1. Orentreich N: Autografts in alopecias and other selected dermatological conditions. Annals of the New York Academy of Sciences 83:463-479, 1959.
2. Bernstein RM, Rassman WR, Szaniawski W, Halperin A: Follicular Transplantation. Intl J Aesthetic Restorative Surgery 1995; 3: 119-32.
3. Bernstein RM, Rassman WR: Follicular Transplantation: Patient Evaluation and Surgical Planning. Dermatol Surg 1997; 23: 771-84.
4. Bernstein RM, Rassman WR: The Aesthetics of Follicular Transplantation. Dermatol Surg 1997; 23: 785-99.
5. Gandelman M, et al: Light and electron microscopic analysis of controlled injury to follicular unit grafts. Dermatol Surg 2000; 26(1): 31.\
6. Bernstein RM, Rassman WR, Rashid N, Shiell R: The art of repair in surgical hair restoration – Part I: Basic repair strategies. Dermatol Surg 2002; 28(9): 783-94.
7. Bernstein RM, Rassman WR, Rashid N, Shiell R: The art of repair in surgical hair restoration – Part II: The tactics of repair. Dermatol Surg 2002; 28(10): 873-93.
8. Bernstein RM, Follicular Unit Hair Transplantation. In: Robinson JK, Hanke CW, Siegel DM, Sengelmann RD, editors: Surgery of the Skin, Elsevier Mosby, London UK. 2005.
9. Unger WP, Shapiro R. Hair Transplantation. New York: Marcel Dekker, Inc. 2004.
10. Bernstein RM, Rassman, WR. Follicular Unit Transplantation. In: Haber RS, Stough DB, editors: Hair Transplantation, Chapter 12. Elsevier Saunders, 2006: 91-97.
11. Norwood OT. Male pattern baldness: classification and incidence. So. Med. J 1975; 68:1359-1365.
12. Haas AF, Grekin RC: Antibiotic prophylaxis in dermatologic surgery. J Am Acad Dermatol 1995; 32: 155-76.
13. Otley CC. Perioperative evaluation and management in dermatologic surgery. J Am Acad Dermatol 2006; 54: 119-27.
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The typical hair and hair follicles of those of African descent are tightly curled, thus producing hair that spirals. Black hair also typically has a larger diameter than Caucasian hair and retains less water, thus its relative “kinkiness.” The many styling methods utilized on Black hair cause concern with hair loss. Black hair is very strong, fortunately so because Black hair styles cause a great deal of Stress on the hair and scalp.

For example, using a hair pick to pick the hair up to a bushy style is a very damaging process due to the constant pulling causing stress on the hair shaft as well as the follicle. In fact, combing Black hair in general can create high stress on Black hair and cause breakage, which perpetuates dryness. Conrowing and braiding are methods of hairstyling that pull the hair tight, and this can cause a great deal of stress on the hair and scalp resulting in hair loss. Braiding that results in the hair being pulled very tight can cause traumatic alopecia, a hair loss that is caused by trauma to the hair and scalp. Traumatic alopecia is usually reversible with proper hair care.

Hot combs and relaxers used to straighten hair can cause a great deal of heat and chemical damage to hair and scalp, which can also cause traumatic alopecia, and over time can cause permanent hair loss. This becomes especially true when the heat or chemically processed hair is pulled tight by rollers or a hot curling iron.

Hot oil conditioners are excellent for Black hair, as hot oil treatments contain proteins and polymers vital to repairing the hair cuticles. Hot oil treatments involve heating the oil and putting it into the hair and scalp, then covering the hair with a plastic cap to allow the oil to soak in. Follow the recommendations on the treatment you are using for the amount of time you should leave the treatment on the hair. This process can heal breakages and shinier stronger hair will be the result.

Consider that hair relaxers commonly used on Black hair contain lye or similar chemicals that break down the hair shaft. Left on beyond the recommended time, these chemicals would eat right through the hair and cause it to fall out in clumps. This is why these same products are used in products like Drano® to clean clogged drains which often are clogged by hair. No-lye relaxers are very popular today, mainly because it leads people to believe that the product is not caustic. This is far from the truth. The combination of calcium hydroxide and guanidine carbonate are combined to form guanidine hydroxide, which could just as easily clean a sink. Repeated use of such products can cause some degree of hair loss, and if scarring occurs while using these chemicals, the hair loss can be permanent in that area of the scalp. One must ask themselves is it wise to place such caustic chemicals in the hair on a regular basis for the sake of desired appearance? The question must be answered by each individual, however the facts should be known.

There is little that can be done to alleviate this syndrome without changing the typical hairstyles of African Americans. There is a catch-22 concerning relaxing Black hair, since combing natural Black hair causes so much stress and breakage of hair, while chemicals cause so much harm to the hair and scalp as well. There are a few hair-relaxing products on the market that use chemicals and are somewhat less harsh than sodium hydroxide (lye) or its popular equivalent in “no-lye” relaxers: calcium hydroxide (quicklime) mixed with guanidine carbonate. One such product is called Natural-Laxer® and Sahara Clay® by Baka ProductsTM that has been on the market since 1990. This product is all natural and because it does not contain many of the harsh chemicals of commercial relaxers and actually contains only a finely ground plant called Daphne Gnidium and clay from Africa it is figured to be relatively safe. Of course this product does not straighten hair in most instances the same way as commercial relaxers, however it does tend to make Black hair more manageable. There is yet another product on the market that is reported to be 92-96% natural which is called Naturalaxer Kit In A Jar™ that does not require the applicant to comb through the hair during the application, which results in a lot less damage.

Of course the bottom line is once again, if you can leave your hair in its natural state then you will experience less stress and damage to the hair and thus prevent at least one cause of hair loss. There is a growing segment of the Black population that is becoming comfortable with wearing their hair in natural styles. One such style is dreadlocks. There are many rumors and myths concerning dreadlocks, as there is little proper information available concerning this style, and as with anything that is misunderstood many myths arise around it. Dreadlocks can and must be washed; otherwise they will smell badly like any other dirty hair. The best process to use to wash dreadlocks is to use a residue-free shampoo. Most commercially made shampoos leave residue and can cause hair not to lock, lending fuel to the rumor that hair had to be dirty to form dreadlocks. Clean hair actually locks much better than dirty hair, as dirt is a residue in itself that will inhibit hair from locking. For best results one should use a fragrance free, conditioner free shampoo. Dreadlocks do not react well to oily and greasy substances, yet there are many good substances that are on the market today that will assist you in forming dreadlocks.

Dreadlocks are formed through a process, not simply by not combing or brushing the hair. Generally, one should start with hair about two inches in length, and the hair should be separated into even squares of hair and twisted gently together using a bonding or gel substance. Many use natural beeswax containing no petroleum, while others use loc and twist gels specifically formulated for locks. Once the hair is separated and twisted into small locks, it is important that they are left alone and allowed to bond naturally. The length of time it will take to lock will depend on the coarseness of your hair, but one can normally expect to wait several months before locks begin to form. While the hair is locking, it will need to be washed. Here is where washing should be extended for a while if possible, so that the hair can be allowed to lock for two weeks to about a month without manipulation. When you do wash your hair, use a stocking cap or “do-rag”, and low-pressure water to make sure that the newly forming locks do not come loose. It will be necessary to rinse for a much longer time than you normally do, because of the lower pressure of the water and the lack of direct manipulation of your hair with your hands. The water is good for your hair and locking process, so this is not a problem. It is also imperative as indicated before that you use a shampoo that does not contain a conditioner and leaves as little residue as possible. A little research on your part will be necessary here; your health food store should contain a variety of natural shampoos. Have a skilled professional or a friend re-twist the hair gently, reapplying the twist gel or beeswax that you used previously. Repeat this process every two weeks to a month, the longer you are able to wait the better, and within a few months your hair will begin to lock.

Again, if you have a fine grade of hair rather than a kinky grade of hair, a beautician skilled at forming locks (“locktitian”) or a friend who is very familiar with the hairstyle should be consulted. Even though dreadlocks are mainly a hairstyle for Blacks, there are other races that have people that enjoy the hairstyle. In general, it tends to be a style of hair that in the long run will give the hair and scalp needed rest from the rigors of chemical and heat treatments and rigorous combing and brushing, and therefore can contribute to longer life for your hair.

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