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Facial Plastic and Reconstructive Surgery pp 337–350Cite as

Hair Restoration

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Abstract

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.

Keywords

  • Follicular unit
  • Alopecia
  • Hair growth cycle
  • Follicular unit
  • Norwood classification system
  • Ludwig classification system
  • Minoxidil
  • Finasteride
  • Hair transplantation
  • Follicular unit grafting
  • Follicular unit extraction
  • Scalp reduction
  • Scalp flaps

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References

  1. 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.

    Google Scholar 

  2. Norwood O. Alopecia. Classification and incidence. In: Stough DB, Haber RS, editor. Hair replacement. Mosby: St. Louis; 1996. p. 13–20.

    Google Scholar 

  3. 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.

    CrossRef  Google Scholar 

  4. 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.

    CrossRef  CAS  Google Scholar 

  5. 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.

    CrossRef  CAS  Google Scholar 

  6. Norwood OT. Male pattern baldness: classification and incidence. South Med J. 1975;11(68):1359–65.

    CrossRef  Google Scholar 

  7. Ludwig E. Classification of the types of androgenic alopecia (common baldness) occurring in the female sex. Br J Dermatol. 1977;3(97):247–54.

    CrossRef  Google Scholar 

  8. 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.

  9. Dua A, Dua K. Follicular unit extraction hair transplantation. J Cutan Aesthet Surg. 2010;2(3):76–81.

    Google Scholar 

  10. Avram MR, Watkins SA. Robot follicular unit extraction in hair transplantation. Dermatol Surg. 2014;40:1319–27.

    CrossRef  CAS  Google Scholar 

  11. Limmer R. Micrograft survival. In: HR Stough D, editor. Hair replacement. Mosby: St Louis; 1996. p. 147–9.

    Google Scholar 

  12. 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.

    Google Scholar 

  13. 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.

    CrossRef  Google Scholar 

  14. 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.

    CrossRef  Google Scholar 

Additional Resources

  • 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.

    PubMed  Google Scholar 

  • Bernstein RM, et al. Standardizing the classification and description of follicular unit transplantation and mini-micrografting techniques. Dermatol Surg. 1998;24:957–63.

    CAS  PubMed  Google Scholar 

  • Bouhanna P. Multifactorial classification of male and female androgenetic alopecia. Dermatol Surg. 2000;26:555–61.

    CrossRef  CAS  Google Scholar 

  • Brandy DA. An evaluation system to enhance patient selection for alopecia reducing surgery. Dermatol Surg. 2002;28:808–16.

    PubMed  Google Scholar 

  • Cash TF. The psychosocial consequences of androgenetic alopecia: a review of the research literature. Br J Dermatol. 1999;141:398–405.

    CrossRef  CAS  Google Scholar 

  • 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.

    CrossRef  Google Scholar 

  • Epstein JS. Evolution of techniques in hair transplantation: a 12 year perspective. Facial Plast Surg. 2007;23(1):51–9.

    CrossRef  CAS  Google Scholar 

  • Epstein SS. Follicular-unit hair grafting. Arch Facial Plast Surg. 2003;5:439–44.

    CrossRef  Google Scholar 

  • Fiedler VC, Galan A. Androgenetic alopecia. Facial Plast Surg Clin North Am. 1994;2(2):101–9.

    Google Scholar 

  • 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.

    CrossRef  Google Scholar 

  • Irwig MS, Kolukula S. Persistent sexual side effects of finasteride for male pattern hair loss. J Sex Med. 2011;8(6):1747–53.

    CrossRef  Google Scholar 

  • Konior RJ, Kridel RWH. Tissue expansion in scalp surgery. Facial Plast Surg Clin North Am. 1994;2(2):203–17.

    Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • Lee TS, Minton TJ. An update on hair restoration therapy. Curr Opin Otolaryngol Head Neck Surg. 2009;17:287–94.

    CrossRef  Google Scholar 

  • Orentreich N, Durr NP. Biology of scalp hair growth. Clin Plast Surg. 1982;9(2):197–205.

    CrossRef  CAS  Google Scholar 

  • Orentreich N. Punch grafts. In: Rees TD, editor. Aesthetic plastic surgery. 30th ed. Philadelphia: W. B. Saunders; 1980. p. 865–74.

    Google Scholar 

  • Price VH. Treatment of hair loss. N Engl J Med. 1999;341:964–73.

    CrossRef  CAS  Google Scholar 

  • Saraswat A. Minoxidil vs Finasteride in the treatment of men with androgenic alopecia. Arch Dermatol. 2007;139:1219–21.

    CrossRef  Google Scholar 

  • Seery GE. Galea fixation in alopecia reduction surgery. Dermatol Surg. 2001;27:931–6.

    CAS  PubMed  Google Scholar 

  • Seery GE. Hair transplantation: management of donor area. Dermatol Surg. 2002a;28:136–42.

    PubMed  Google Scholar 

  • Seery GE. Surgical anatomy of the scalp. Dermatol Surg. 2002b;28:581–7.

    PubMed  Google Scholar 

  • 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

    CrossRef  Google Scholar 

  • 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.

    CrossRef  CAS  Google Scholar 

  • Unger MG. Scalp reduction. Facial Plast Surg Clin North Am. 1994;2(2):163–81.

    Google Scholar 

  • Whiting DA. Possible mechanisms of miniaturization during androgenetic alopecia or pattern hair loss. J Am Acad Dermatol. 2001;45(3 Suppl):S81–6.

    CrossRef  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Otolaryngology – Department of Head and Neck Surgery, Naval Medical Center San Diego, San Diego, CA, USA

    Michelle G. Arnold

  2. Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Scott R. Owen

Authors
  1. Michelle G. Arnold
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  2. Scott R. Owen
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Corresponding author

Correspondence to Scott R. Owen .

Editor information

Editors and Affiliations

  1. Department of Otolaryngology Head & Neck Surgery, University of California Irvine, Irvine, CA, USA

    MD Brian J.-F. Wong

  2. Department of Otolaryngology, Head & Neck Surgery, Naval Medical Center San Diego, San Diego, CA, USA

    MD Michelle G. Arnold

  3. Facial Plastic and Reconstructive Surgery Private Practice, Pacific Coast Facial Plastic Surgery Laguna, Niguel, CA, USA

    Jacob O. Boeckmann

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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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  • DOI: https://doi.org/10.1007/978-3-030-45920-8_23

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-45919-2

  • Online ISBN: 978-3-030-45920-8

  • eBook Packages: MedicineMedicine (R0)

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