Surgical Approaches to Hair Restoration

March 1998 in “ Aesthetic Surgery Journal ”

James A. Vogel, Michael L. Beehner, Robert Bernstein, Martin Unger

scalp reduction transplantation minigrafts follicular units finasteride frontal hairline baldness miniaturization Propecia

TLDR Experts suggest various surgical methods for hair restoration, including scalp reduction, transplantation using minigrafts, and establishing a permanent frontal hairline with follicular units. The drug finasteride may also be used alongside these procedures.

In a 1998 panel discussion, experts discussed surgical approaches to hair restoration for a 33-year-old man with progressive baldness. Dr. Unger suggested a scalp reduction, followed by transplantation using minigrafts of three to four hairs, with a total of six operations. Dr. Beehner proposed a conservative approach, focusing on the front and top parts of the patient's balding problem, using follicular units and four-hair minigrafts, anticipating four sessions. Dr. Bernstein emphasized the importance of establishing a permanent frontal hairline and adding coverage to the frontal portion and top of the scalp, using approximately 2000 follicular units. The panel also discussed factors to predict the progressive nature of baldness, including family history, rate of balding, and degree of miniaturization in stable areas. The use of the drug finasteride as an adjunct to transplantation was also discussed.

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