Hair here, then there: Odd transplants take root

For aesthetician Mindy McGinty, eyebrows aren’t just sculpted arches framing her face — they’re a walking billboard for her business. So when she lost her eyebrows after a “bad experience with permanent makeup,” she was completely distraught.

“I wanted to give the illusion of a fuller brow so I got them tattooed,” says the 53-year-old from Gilbertsville, Pa. “But over time, the dye changed color and my eyebrows literally turned salmon orange. I had no choice but to get the tattoo removed with laser and the laser destroyed all my hair follicles.”

McGinty tried to make do with “fauxbrows” — powdering them on, penciling them in, even gluing on strips of hair which “came off every time I made a face.” But after several years, she’d had enough.  After months of research, she decided it was time to “borrow” eyebrows from the back of her head — via a hair transplant.

Thanks to advances in technology, hair-transplant procedures are sprouting up all over the country and the human body. While the majority of transplants still involve the scalp (and that remains the primary donor area), doctors are now able to harvest and replant hair follicles into eyebrows, eyelashes, beards, mustaches, sideburns, chests and beyond, allowing a growing number of people to become members of what you might call the “movable hair club.”

Nearly 99,000 surgical hair restoration procedures were performed in the United States in 2008, according to the International Society of Hair Restoration Surgery, a non-profit medical association. Of that number, approximately 93,000 procedures were scalp transplants (hair transplants to fill in bald or thinning areas), followed by 3,484 eyebrows, 1,369 mustache/beard procedures and eyelashes with 531 procedures.

“As the technology has changed from the large plugs we saw in the old days to moving single hairs, we can now do reconstruction in other places,” says Dr. Ken Washenik, medical director of Bosley, a large hair-restoration surgery provider, and the former director of dermatopharmacology at New York University School of Medicine. “You can transplant hair to any place you have hair.”

Hair down there?
The follicular unit, a naturally-occurring cluster of one, two, three or more hair follicles, seems to be the key to the current hair-restoration renaissance. In the early days of hair transplants (the procedure originated in Japan in the late ‘30s and was first performed in the U.S. in the early ‘50s), each skin graft (or plug) would contain as many as 20 hairs — less than subtle on the scalp and downright scary in an eyebrow.

Hair transplant resources To learn more about hair loss and hair restoration procedures and practitioners, check out these online resources: The American Academy of Dermatology The American Hair Loss Association The Bald Truth radio show and online forum The Hair Transplant Network The International Alliance of Hair Restoration Surgeons The International Society of Hair Restoration Surgery

Implanting individual units, or individual hairs, however, can leave the patient with a more natural look, however, allowing doctors to implant where no one has implanted before.

“The oddest one I’ve done is a pubic hair transplant,” says Dr. Paul T. Rose, former president of the International Society of Hair Restoration Surgery (ISHRS) and founder of a hair restoration clinic in Tampa Bay, Fla. “The gentleman who came to me had scars in his pubic area and had lost his hair. We took hair from the back of his head and moved it to the pubic area, in a pattern that fit the male pattern of pubic hair.”

Hairs are generally gleaned one of two ways.

“Strip harvesting,” involves taking out a strip of scalp skin, usually from the back of the head, and then microscopically separating that strip into hundreds — or thousands — of follicular units. Scalp hair transplants require thousands of grafts; an eyebrow transplant requires several hundred.

“Follicular unit extraction” (FUE) is a newer process in which the clusters are harvested individually with what Rose calls a “miniature cookie cutter.”

Both methods can leave scars on the donor site.

“If you strip harvest, you suture it close and can wind up with a linear scar on the back of the head,” says Rose. “In FUE, you have little holes that fill in by themselves over time. But if you harvest enough and you cut the hair very short, there can be little white dots that your eye can pick up sometimes.”

Once the hair is harvested and the follicular dissection gets underway, the doctor makes tiny incisions in the patient’s scalp or eyebrows or mustache or sideburns or pubic area and the seeding begins.

Roger Choukroun, 71, of Stamford, Conn., had both his eyebrows and his scalp done to help restore what time had thinned.

“I went there at 7:30 a.m. and left around 5:30 p.m.,” he says. “It was a full day and a complete operation, but I was able to drive myself home. Although I looked a little weird with a bandana and large glasses.”

The procedure can be time-consuming, especially if large areas are being transplanted or if the hairs are going into delicate areas (like eyelashes or eyebrows) where properly angling — and avoiding a proverbial “wild hair” — is crucial.  Results take time as well; follicles lie dormant for at least three to fourth months before new hair begins to sprout.  

McGinty’s new eyebrows, which were seeded in April 2008, took about 700 implants. Eight months later, she opted for a second procedure “just to fill in the areas where the hairs didn’t come in.” According to ISHRS, 43 percent of hair restoration patients achieve their desired result after one procedure; the rest have more.

While the price tag for a hair transplant may cause some to wince — an eyebrow or mustache/beard procedure runs around $3,000 to $5,000 and most transplants are not covered by health insurance — patients say the procedure itself is not terribly painful, claiming the shots to numb the donor and transplant sites generally cause the most discomfort. Bruising can occur at the transplant site afterwards; in the case of eyebrow transplants, that can mean black eyes.

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