Real Locks, a Natural Look

Like his father, John Wall began to lose his hair around the time he was 30. In his mid-forties he decided — with a little help — to take action.

“I wasn’t, to tell you the truth, overly concerned about my hair loss, but my girlfriend at the time wanted me to do something about it,” he recalls with a laugh. “She made the appointments and one day said, ‘You’ve got an appointment to go here,’ and just as a keep-peace-in-the-family type of thing I said, ‘Okay, why not?’”

With his girlfriend’s encouragement, Wall visited HeadQuarters Hair Restoration Clinic in Halifax. At first he tried the non-surgical route: wearing a “hair system” made of a transparent base and human hair. “That just wasn’t me,” Wall says. After consulting with HeadQuarters founder Joe Graves, he decided to undergo hair transplantation — and 10 years later, he couldn’t be happier with the results. “With the hair transplant it’s your own hair; it grows,” he says. “As a matter of fact, I’m due for a haircut right now!”

Wall is just one of HeadQuarter’s many success stories since the clinic opened in 1963 (the clinic has been providing surgical treatment for hair loss since 1990). The Maritime-owned and -operated family business provides both surgical and non-surgical treatment options, performing approximately 150 hair transplant procedures every year.

The clinic’s surgeon, Dr. Robert Wadden, says these numbers are on the rise. “The population and our society at large is becoming more conscious and cognizant of their appearance, and I think there’s a sort of drive on from the baby boomers wanting to maintain their youthful appearance,” says Wadden, who has performed hair transplantation since 1996 and has conducted more than 1,600 procedures to date.

The typical patient coming through HeadQuarters’ doors is a man anywhere from his early twenties to late sixties. Wadden estimates that 90% of his work involves treatment of male pattern hair loss, both medically through prescription medications and surgically.

SURGICAL TREATMENT
Wadden performs follicular unit hair transplantation (FUT), also known as strip harvesting. “If you look way back to the early days of the field, hair grafts were actually four- and five-millimetre plugs. The grafts were quite large and yielded sort of a doll’s head or toothbrush appearance,” he says. “The general consensus among hair restoration physicians today is that follicular unit transplantation is the standard.”

The reason: FUT takes a “as nature intended” approach to transplanting hair. In nature, hair does not grow only as a single hair but also in follicular units. These units, or “bundles” as they’re also called, consist of two, three, four or even sometimes five hairs, all wrapped up in a common sheath and sharing a common blood vessel and nerve.

FUT strives to maintain the integrity of the follicular unit by transplanting the permanent hair follicles (generally located on the back and sides of the scalp) in these naturally occurring groups. “So the grafts are very tiny,” says Wadden. “Single follicular units of single hairs would be transplanted in, say, an anterior frontal hairline, and then follicular units comprising two, three or four hairs and so on would be transplanted farther back behind the hairline.” Because this is how hair naturally grows in men and women, the results are “very natural, very undetectable,” he says.

The procedure itself is minimally invasive and very safe, according to Wadden. Visitors to HeadQuarters generally begin by meeting with one of the non-physician counsellors to discuss the basics of hair loss and fundamentals of treatment. Then, Wadden meets with the patient and goes over a detailed surgical plan if he feels the patient is a candidate for hair transplantation. Alternatively, he will discuss other types of medical treatments if the patient is not a candidate for hair transplantation. The surgical patient undergoes routine pre-op blood work to check his or her blood cell counts and to rule out conditions such as a coagulation abnormality.
On the day of the surgery, the patient is settled in front of a TV and given a local anesthetic. The average procedure takes five hours. “It’s very relaxed and the patients are very, very comfortable,” says Wadden. “Many of my patients have remarked that it’s no worse than a dental filling.” He notes that bleeding is minimal or even negligible because the work is done at a depth of about seven or eight millimeters, above the level of the larger vessels in the scalp, and the risk of infection is “very, very low.”

Wadden sees the patient about 12 days after the procedure for suture removal. The follicular units remain in the resting telogen phase of the hair growth cycle for eight to 12 weeks after hair transplantation, after which the grafts begin to grow. The patient then returns for a check-up three months after the surgery so the doctor can further monitor the results.

NON-SURGICAL TREATMENT
For the best results, hair transplantation often goes hand-in-hand with medical treatment through prescription medication. “Generally with male pattern hair loss we like to throw everything at it,” says Wadden. For many patients this includes prescribing the oral medication finasteride (commonly known by its brand name Propecia) or the topical treatment minoxidil 5% (commonly known as Rogaine Extra Strength) to maintain existing hair or greatly slow the progression of hair loss.

“We know [from] at least one clinical trial that men who had hair transplantation and took Propecia grew an average 30% more hair from their hair transplant than men who had hair transplant alone,” says Wadden. “So it’s an important adjunct to their hair transplant surgery and the vast majority of hair restoration surgeons nowadays are prescribing Propecia along with the hair transplant.”

Along with prescription medicine and hair systems, HeadQuarters offers another non-surgical treatment in the form of a laser comb, which provides “low-level laser light therapy.” Wadden notes that the evidence to support using this treatment is weaker than for other treatments. “It seems to increase hair quality or hair shaft calibre more than it increases hair counts,” he says.

For the patient John Wall, he went through the expected wait period after hair transplantation surgery before the results started appearing — and how. “[The hair] goes dormant for a few months, nothing happens, and then it starts coming in like crazy — at least mine did!” He remembers the feedback from friends and family: “They just couldn’t believe it; I look like a completely different person.”

Wall says he would recommend this experience to anyone looking to turn back the clock on his or her hair loss. “They do such incredible work that nobody can tell you’ve ever had it done. It just looks like I’ve got my hair back.” •

Dr. Robert Wadden is a Diplomate of the American Board of Hair Restoration Surgery (ABHRS) and a member of the International Society of Hair Restoration Surgeons (ISHRS). 

For more information, visit hqhair.ca.

Hair Loss 
in Women

Like men, women also experience balding — but with some important differences. Wadden estimates that female pattern hair loss affects to some degree 30-40% of women at menopause, and the pattern differs from their male counterparts. Women tend to retain their hairline, so the pattern is usually one of thinning behind the hairline or thinning on top, as well as some thinning in the temples.

But most significantly, women tend to experience more hair loss in the back of the head. “That’s an important distinction because that’s where we harvest the hair for hair transplantation; that’s the location of the permanent hair follicles that we relocate to those bald areas on top or in front,” says Wadden. Therefore, women tend to have smaller donor areas that have less donor hair.

Another important difference, he says, is that in one-third of women who experience hair loss the cause is due to a medical condition, such as low iron or hypothyroidism. When hair loss is caused by medical reasons, it tends to affect the scalp globally. “The donor area in the back of the head is non-existent, because even those hair follicles are affected by the medical condition.” Therefore, it is generally only women with female pattern hair loss — about two-thirds of women who experience baldness — who are candidates for surgical transplantation, says Wadden.

For these reasons, only 5-10% of Wadden’s hair transplantation patients are female. However, he notes that he treats many female patients with hair loss who are not surgical candidates and so they end up being treated medically.

http://www.hqhair.ca/