Written by Maria Sonnenberg
For Florida Today
Comedian Larry David of “Seinfeld” and “Curb Your Enthusiasm” fame may have produced the definitive explanation of the inherent problem with baldness.
“Anyone can be confident with a full head of hair, but a confident bald man — there’s your diamond in the rough,” said David, whose head is definitely not hirsute.
Hair loss, like gray hair, may be perfectly normal, but, for many individuals, it nevertheless can be disturbing. A crowning glory that is no longer that regal-looking is cause for alarm for millions of men — and women — who rely on their hair for at least some self-confidence. As many as half of all men and 20 percent of all women experience significant hair loss. Although issues such as thyroid disease, cancer and iron-deficiency anemia can lead to hair loss, a primary culprit is male and female pattern baldness.
Melbourne surgeon Dr. Clifford Gelman was alarmed that during his 20s and 30s, he noticed his hair was not as thick as it used to be. For years, he kept a watchful eye on his locks until things began to further deteriorate.
“At age 48, my hair loss began to increase significantly,” Gelman said.
He decided to seek help, so began researching the subject.
“I became acquainted with (hair transplant specialist) Dr. Robert Jones in Toronto,” he said.
After checking out various treatment options and discussing his problem with Jones, Gelman not only decided to go for a hair transplant procedure, but also to pursue hair restoration as a profession. Gelman trained with Jones, an internationally recognized authority on hair replacement, and now performs hair transplant surgeries in his Melbourne office.
“Hair transplantation has changed dramatically over the last decade,” said Jones, who practices in Canada.
“We now do 100 percent follicular unit transplantation. Follicular units are one- to four-hair families of hairs. Hair follicles present this way in nature and survive better if they are kept in these families during transplantation,” Jones said.
“Over the next decade, hopefully we will see hair multiplication and cloning, which should provide an unlimited donor site and a full head of hair in patients with a limited amount of hair on the backs of their heads.”
Hair transplantation is the Rolls Royce of the $4.5 billion hair loss and replacement industry, which also includes everything from unproven shampoos and herbal supplements to reasonably effective maintenance medications such as Minoxidil and Propecia.
“Hair transplantation offers the most dramatic results for those who have already lost a significant amount of hair,” Gelman said.
“Donor hair comes from the back of the head, and the hair in that area is not affected by the hormonal factors that cause male or female pattern hair loss, so the transplanted hair is virtually permanent,” Gelman explained.
“With the strip technique, a strip of scalp containing the hair to be transplanted is removed under local anesthesia and the individual hair follicular units are separated and transplanted one at a time,” Gelman said.
“With FUE, the hair follicular units are removed one at a time using a small punch under local anesthesia. It can be done using a hand device or devices automated to varying degrees.”
On the plus side for the strip technique are speed and cost.
“A large number of grafts can be transplanted in a single session,” Gelman said.
“With FUE, it takes longer to extract the donor follicles and, therefore, tends to require more sessions and is more expensive.”
The strip technique’s primary drawback is a scar at the back of the head, visible if the patient chooses to keep his hair shorter than a quarter of an inch. While FUE doesn’t leave a scar, it does require that the donor site be shaved to an eighth of an inch.
Both techniques are performed as outpatient procedures in a physician’s office, but doctors usually recommend that patients take a week off from work to let the evidence of the procedure disappear.
“Minor swelling of the forehead area is common, as well as crusting and scabs at the transplant sites,” Gelman said.
Although the procedure very rarely has complications, it can be tedious. A regular strip technique session lasts six hours to harvest 2,000 to 2,500 grafts.