Contemporary Hair Transplantation

August 2009 in “ Dermatologic Surgery ”

Marc R. Avram, Nicole E. Rogers

hair transplantation punch grafts follicular unit grafts minoxidil finasteride 5% foam formulation low-level laser light therapy hair cloning Rogaine Propecia LLLT

TLDR Modern hair transplants use small grafts for a natural look and drugs to prevent further loss, with high patient satisfaction.

The 2009 document "Contemporary Hair Transplantation" reviewed advancements in hair transplantation, highlighting the shift from large "punch grafts" to natural-appearing follicular unit grafts. It detailed the transplantation process, including candidate selection, hairline design, and postoperative care, and emphasized the role of medications like minoxidil and finasteride in preventing further hair loss. The review noted finasteride's effectiveness in maintaining hair growth for 90% of patients over 5 years and mentioned potential side effects. It also discussed the new 5% foam formulation of minoxidil. The importance of planning for a natural appearance and future hair loss was stressed, with a target density of 20 to 35 graft sites per cm² for transplantation. The document also considered non-surgical options and future trends like low-level laser light therapy and hair cloning, which was anticipated to be at least 5 to 10 years away from practical use at the time of writing. Overall, the document conveyed high satisfaction rates with contemporary hair transplantation and aimed to increase physician confidence in the procedure.

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Research cited in this study

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research Medical Treatments for Male and Female Pattern Hair Loss

212 citations, September 2008 in “Journal of The American Academy of Dermatology”

Minoxidil and finasteride treat hair loss in men, while minoxidil treats hair loss in women.

A Multicenter, Randomized, Placebo-Controlled, Double-Blind Clinical Trial of a Novel Formulation of 5% Minoxidil Topical Foam Versus Placebo in the Treatment of Androgenetic Alopecia in Men

research A Multicenter, Randomized, Placebo-Controlled, Double-Blind Clinical Trial of a Novel Formulation of 5% Minoxidil Topical Foam Versus Placebo in the Treatment of Androgenetic Alopecia in Men

142 citations, August 2007 in “Journal of The American Academy of Dermatology”

New 5% minoxidil foam effectively promotes hair growth and is safe for use.

research The Effect of 5α-Reductase Inhibition with Dutasteride and Finasteride on Semen Parameters and Serum Hormones in Healthy Men

195 citations, February 2007 in “The Journal of Clinical Endocrinology and Metabolism”

Dutasteride and finasteride may reduce sperm count and volume but don't affect movement or shape; effects are reversible after stopping.

Effect of 1 mg/Day Finasteride on Concentrations of Serum Prostate-Specific Antigen in Men With Androgenic Alopecia: A Randomized Controlled Trial

research Effect of 1 mg/Day Finasteride on Concentrations of Serum Prostate-Specific Antigen in Men With Androgenic Alopecia: A Randomized Controlled Trial

89 citations, December 2006 in “Lancet Oncology”

Taking 1 mg/day finasteride for hair loss significantly lowers PSA levels in men, which may affect prostate cancer screening.

The Importance of Dual 5α-Reductase Inhibition in the Treatment of Male Pattern Hair Loss: Results of a Randomized Placebo-Controlled Study of Dutasteride Versus Finasteride

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215 citations, November 2006 in “Journal of The American Academy of Dermatology”

Dutasteride more effective for hair growth, but has more side effects than finasteride.

research Polarized Light-Emitting Diode Magnification for Optimal Recipient Site Creation During Hair Transplant

5 citations, September 2005 in “Dermatologic Surgery”

Using a polarized LED magnifier during hair transplants eases recipient site creation and reduces eye strain but doesn't improve graft creation or placement.

research Laser-Assisted Hair Transplantation: A Status Report in the 21st Century

11 citations, June 2005 in “Journal of Cosmetic Dermatology”

Lasers in hair transplantation show promise but are not yet standard, with current methods causing some side effects and needles still being preferred for creating recipient sites.

research Hair Transplantation: New Concepts in 2005

9 citations, January 2005 in “Journal of Cosmetic and Laser Therapy”

In 2005, hair transplants looked natural and worked best with realistic goals, medication to preserve hair, and depended on the amount of donor hair.

research Principles and Techniques Used to Create a Natural Hairline in Surgical Hair Restoration

46 citations, May 2004 in “Facial Plastic Surgery Clinics of North America”

Creating a natural-looking hairline in hair restoration surgery involves using follicular unit grafts, proper hair placement, and artistic skills to give the illusion of density.

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63 citations, May 2003 in “Journal of The European Academy of Dermatology and Venereology”

Minoxidil use increases facial hair growth in females, more in older users.

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92 citations, October 2002 in “Journal of The American Academy of Dermatology”

Finasteride improves hair loss in women with hyperandrogenism.

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123 citations, February 2002 in “Journal of The American Academy of Dermatology”

Minoxidil can cause skin allergy; use alternative solvents or treatments if allergic.

research Lack of Efficacy of Finasteride in Postmenopausal Women with Androgenetic Alopecia

239 citations, November 2000 in “Journal of The American Academy of Dermatology”

Finasteride doesn't effectively treat hair loss in postmenopausal women.

research Chronic Treatment with Finasteride Daily Does Not Affect Spermatogenesis or Semen Production in Young Men

104 citations, October 1999 in “The Journal of Urology”

Finasteride doesn't harm male fertility or sperm quality, but may slightly reduce ejaculate volume.

research Distribution of Human Hair in Follicular Units

83 citations, April 1999 in “Dermatologic Surgery”

The research found that for a typical hair density, about 11 square centimeters of donor scalp is needed to get 800 hair grafts for transplantation.

research Finasteride

125 citations, January 1999 in “Drugs”

Finasteride effectively treats baldness but may cause sexual side effects.

research Laser Hair Transplantation

10 citations, July 1997 in “Dermatologic Clinics”

Laser hair transplantation can be effective but should be limited to small areas and requires more training to ensure safety and effectiveness.

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3 citations, February 1997 in “Annals of Plastic Surgery”

The document concludes that successful hair restoration surgery should consider facial proportions and balance, and requires surgical skill, artistic judgment, and realistic goals for a natural look.

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44 citations, January 1997 in “British Journal of Dermatology”

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36 citations, March 1987 in “Pediatrics”

Minoxidil use during pregnancy can cause excessive hair growth and multiple birth defects in the baby.

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5% minoxidil helps hair regrowth in androgenic alopecia.

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Minoxidil helped bald patient regrow hair.

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