Surgical Treatments, Some Frequently Asked Questions

Q. Why should I go to a local doctor rather than a chain of “hair clinics”?

Because you will receive personal attention from Dr Kirwan and have an opportunity to voice your expectations and concerns. There are no non-medically qualified counselors to evaluate you or give you a hard sell. You have the reassurance of knowing that your physician is a member of the prestigious American Society for Aesthetic Plastic Surgery and has given instructional courses and papers on aesthetic surgery at National and International Meetings.

Q. Why would I see Dr Kirwan rather than another doctor performing Hair RestorationSurgery?

Prof. Kirwan is a Plastic Surgeon. Physicians from other specialties such as dermatology and otolaryngology, also perform hair transplants. As a Plastic Surgeon, Dr Kirwan practices all aspects of cosmetic surgery so that he can address all of the concerns that you may have concerning your appearance, rather than restricting his efforts to your hair restoration needs alone.

Q. Can Prof. Kirwan correct old-fashioned grafts with plugs?

Prof. Kirwan is able to surgically correct unsatisfactory prior surgeries by elevating the brow in cases in which the previous hairline has been made too low and by excising cornrows of previous grafts and recycling them as new mini and micro grafts. More extensive corrective surgery requires monitored anesthesia and a fully accredited surgical center as well as the skills of a fully trained surgeon.

Q. Is Prof. Kirwan’s facility fully accredited for surgery?

Prof. Kirwan operates in his own fully accredited surgical center, which adheres to the highest standards. Many physicians who perform Hair Restoration Surgery do not have a fully accredited surgical center.

Q. How does hair loss differ in men and women?

Men usually experience hair loss in the front-temporal region and the crown. Whereas women retain a relatively normal hairline. The most striking change in women is a widened central part.

Q. What are the goals of Hair Restoration Surgery?

To provide a natural appearance To frame the face and restore the aesthetic proportions to the face. To allow natural use of the hair in wind and when swimming To create a permanent hair line

Q. How many treatments will I need?

Treatments usually consist of at least two sessions of 500 – 1500 micro and mini-grafts. Sessions are spaced 8 months apart to allow the hair to grow out and to evaluate the need for future grafts accurately.

Q. How soon does the new hair start to grow?

It can take three months for the new hair to grow out. It will take a further four to five months to evaluate the result and plan future grafts.

Q. How painful is the procedure?

The procedure is done under light sedation. You can eat breakfast before you come to the office and take a light sedative 30 minutes before your surgery.

Q. Do I have a bandage on my head after surgery?

Prof. Kirwan does not use any bandages. A special dressing called Graf-Cyte, is applied three times a day after surgery

Q. When can I wash my hair?

You can wash your hair gently in the shower the day after the procedure. We recommend using a cup of water over a gauze pad to protect the grafts.

Q. When can I go back to work?

You can return to work the next day, wearing a baseball type hat or at about 4 days without a hat.

Caveats:

There will never be enough hair to create a thick covering of the scalp.
There is increasing demand and reduced supply.
The aim is to establish a natural hairline that will appear natural over the course of decades. Hair
loss is relentless and unpredictable.
The only true evils of Hair Restoration Surgery are un-naturalness and detectability.

Non-Surgical Treatments

There are now more treatment options than ever. These treatments include both topical and oral medications, which can be prescribed by your doctor. Determining which medicine or combination of medicines is right for you will depend on your age, degree of hair loss, and budget. For many people, the best results will be achieved by combining medical treatments with hair restoration surgery.

Propecia®: The first oral medication for hair loss

Men with hair loss now have a new medical option called finasteride (Propecia®). This oral medication actually treats the root cause of male pattern hair loss by inhibiting the 5-alpha reductase enzyme which decreases the formation of DHT, the hormone responsible for hair loss (see section "Hair Loss -Why?"). Finasteride has been available for many years to treat a common prostate condition affecting older men and has recently been found in clinical trials to be safe and effective in the treatment of male pattern hair loss.

In a study conducted on over 1,500 men with early to moderate hair loss, over 80% of men taking Propecia® stopped losing their hair and almost two-thirds noticed some regrowth. The majority of men taking the placebo (inactive medicine) continued to lose their hair. In addition, the men taking Propecia® reported greater satisfaction with the appearance of their hair than those who were taking the placebo did. There were certain side effects, which were experienced by approximately 2% of men taking Propecia®, and it is important to discuss this when you meet with your doctor. In general, women with hair loss are not prescribed Propecia® because of the risk of a certain type of birth defect should they become pregnant.

Propecia® works best for early to moderate degrees of hair loss. Men with extensive hair loss are unlikely to see much regrowth with Propecia® and are better candidates for hair restoration surgery (see section "Surgical Treatments"). In addition, regrowth that occurs with Propecia® is better over the crown of the scalp than at the frontal receding hairline. Many men will get the best results by taking Propecia® to prevent further hair loss and having hair transplantation done to fill in areas such as the frontal hairline.

Minoxidil: The topical solution

Minoxidil 2% (Rogaine®) topical solution has been available for several years to treat hair loss in men and women. It is available over the counter without a prescription and comes as inexpensive generic formulations. When it was first introduced, there was tremendous amount of media attention given to minoxidil and when it did not live up to the expectations surrounding it, there was significant disappointment. However, minoxidil is moderately effective and can be helpful for some people. Recently Rogaine® in a 5% concentration has become available and has been reported to be much more effective than the 2% product. Some doctors recommend combining Propecia® with minoxidil to get the best results. Your doctor can discuss this with you during your consultation.

Alternative and future treatments

Currently, only finasteride (Propecia®) and minoxidil (Rogaine®) are approved by the U.S. Food and Drug Administration for the treatment of male pattern hair loss. Many other products are being sold by infomercials and over the Internet to people who are desperate to find successful treatments for their hair loss. Before spending any money on any of these "miracle cures", keep in mind that these products have not been carefully analyzed in scientific studies to determine whether they are safe and effective.

Although finasteride and minoxidil are the best current medical treatments for hair loss, many others are being studied and will be available in the next few years. More than likely, they will be better at producing greater regrowth and stopping further hair loss than finasteride or minoxidil. Researchers are even studying gene therapy and cloning as possible treatments for hair loss.