Alopecia affects a significant percentage of the population. It may affect any age or gender and can cause significant cosmetic deformity. A thorough understanding of the pathophysiology and etiology of alopecia, as well as a thorough evaluation, is essential for the surgeon interested in hair restoration. The field has evolved rapidly over the last two decades. An evolving emphasis on the use of the follicular unit to achieve natural-appearing surgical results has shifted the trend of hair restoration from the historical use of large plug grafts, scalp flaps, and scalp reductions toward follicular unit grafting and follicular unit extraction. Practicing surgeons should demonstrate a thorough understanding of the indications, contraindications, and potential complications associated with these procedures.
- Follicular unit
- Hair growth cycle
- Follicular unit
- Norwood classification system
- Ludwig classification system
- Hair transplantation
- Follicular unit grafting
- Follicular unit extraction
- Scalp reduction
- Scalp flaps
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Rousso DE, Stough DB, Rutherford KD. Hair restoration. In: Papel ID, editor. Facial plastic and reconstructive surgery. New York: Thieme Publishers; 2016. p. 334–50.
Norwood O. Alopecia. Classification and incidence. In: Stough DB, Haber RS, editor. Hair replacement. Mosby: St. Louis; 1996. p. 13–20.
Stough D, Stenn K, Haber R, Parsley WM, Vogel JE, Whiting DA, Washenik K. Psychological effect, pathophysiology, and management of androgenetic alopecia in men. Mayo Clin Proc. 2005;80:1316–22.
Rhodes T, Girman CJ, Savin RC, et al. Prevalence of male pattern hair loss in 18-49 year old men. Dermatol Surg. 1998;24(12):1330–2.
Birch MP, Messenger JF, Messenger AG. Hair density, hair diameter and the prevalence of female pattern hair loss. Br J Dermatol. 2001;144(2):297–304.
Norwood OT. Male pattern baldness: classification and incidence. South Med J. 1975;11(68):1359–65.
Ludwig E. Classification of the types of androgenic alopecia (common baldness) occurring in the female sex. Br J Dermatol. 1977;3(97):247–54.
Merk. How propecia works; clinical study. Available at: http://www.propecia.com/finaseride/propecia/consumer/about_propecia/propecia.jsp?WT.svl=2. Accessed 21 May 2017.
Dua A, Dua K. Follicular unit extraction hair transplantation. J Cutan Aesthet Surg. 2010;2(3):76–81.
Avram MR, Watkins SA. Robot follicular unit extraction in hair transplantation. Dermatol Surg. 2014;40:1319–27.
Limmer R. Micrograft survival. In: HR Stough D, editor. Hair replacement. Mosby: St Louis; 1996. p. 147–9.
Bharti J, Sidharth S, Patil P, Dhurat R. Scalp threading as a novel, effective and safe method of hair restoration. J Eur Acad Dermatol Venereol. 2017 Nov;31(11):e492-e493.
Giordano S, Romeo M, Lankinen P. Platelet-rich plasma for androgenetic alopecia: does it work? Evidence from meta-analysis. J Cosmet Dermatol. 2017;16:374–81.
Mahjour SB, Ghaffarpasand F, Wang H. Hair follicle regeneration in skin grafts: current concepts and future perspectives. Tissue Eng Part B Rev. 2012;1(18):15–23.
Bernstein RM, Rassman WR, Rashid N, Shiell RC. The art of repair in surgical hair restoration part I: basic repair strategies. Dermatol Surg. 2002;28:783–94.
Bernstein RM, et al. Standardizing the classification and description of follicular unit transplantation and mini-micrografting techniques. Dermatol Surg. 1998;24:957–63.
Bouhanna P. Multifactorial classification of male and female androgenetic alopecia. Dermatol Surg. 2000;26:555–61.
Brandy DA. An evaluation system to enhance patient selection for alopecia reducing surgery. Dermatol Surg. 2002;28:808–16.
Cash TF. The psychosocial consequences of androgenetic alopecia: a review of the research literature. Br J Dermatol. 1999;141:398–405.
Epstein JS. The treatment of female pattern hair loss and other applications of surgical hair restoration in women. Facial Plast Surg Clin North Am. 2004;12:241–7.
Epstein JS. Evolution of techniques in hair transplantation: a 12 year perspective. Facial Plast Surg. 2007;23(1):51–9.
Epstein SS. Follicular-unit hair grafting. Arch Facial Plast Surg. 2003;5:439–44.
Fiedler VC, Galan A. Androgenetic alopecia. Facial Plast Surg Clin North Am. 1994;2(2):101–9.
Gandelman M, Epstein JS. Hair transplantation to the eyebrow, eyelashes, and other parts of the body. Facial Plast Surg Clin North Am. 2004;12:253–61.
Irwig MS, Kolukula S. Persistent sexual side effects of finasteride for male pattern hair loss. J Sex Med. 2011;8(6):1747–53.
Konior RJ, Kridel RWH. Tissue expansion in scalp surgery. Facial Plast Surg Clin North Am. 1994;2(2):203–17.
Lam SM, Hempstead BR, Williams EF. A philosophy and strategy for surgical hair restoration: a 10-year experience. Dermatol Surg. 2002;28(11):1035–42. Discussion, 1042. Review.
Lee TS, Minton TJ. An update on hair restoration therapy. Curr Opin Otolaryngol Head Neck Surg. 2009;17:287–94.
Orentreich N, Durr NP. Biology of scalp hair growth. Clin Plast Surg. 1982;9(2):197–205.
Orentreich N. Punch grafts. In: Rees TD, editor. Aesthetic plastic surgery. 30th ed. Philadelphia: W. B. Saunders; 1980. p. 865–74.
Price VH. Treatment of hair loss. N Engl J Med. 1999;341:964–73.
Saraswat A. Minoxidil vs Finasteride in the treatment of men with androgenic alopecia. Arch Dermatol. 2007;139:1219–21.
Seery GE. Galea fixation in alopecia reduction surgery. Dermatol Surg. 2001;27:931–6.
Seery GE. Hair transplantation: management of donor area. Dermatol Surg. 2002a;28:136–42.
Seery GE. Surgical anatomy of the scalp. Dermatol Surg. 2002b;28:581–7.
Shapiro R. Principles and techniques used to create a natural hairline in surgical hair restoration. Facial Plast Surg Clin North Am. 2004;12(2):201–17. Review
Swerdloff J, Kabaker S. The state of the art. Donor site harvest, graft yield estimation, and recipient site preparation for follicular-unit hair transplantation. Arch Facial Plast Surg. 1999;1:49–52.
Unger MG. Scalp reduction. Facial Plast Surg Clin North Am. 1994;2(2):163–81.
Whiting DA. Possible mechanisms of miniaturization during androgenetic alopecia or pattern hair loss. J Am Acad Dermatol. 2001;45(3 Suppl):S81–6.
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Arnold, M.G., Owen, S.R. (2021). Hair Restoration. In: Wong, B.JF., Arnold, M.G., Boeckmann, J.O. (eds) Facial Plastic and Reconstructive Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-45920-8_23
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Print ISBN: 978-3-030-45919-2
Online ISBN: 978-3-030-45920-8