More Frequently Asked Questions

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What is Shock?

Any medical treatment for hair loss carries with it some slight risk factors. Shock occurs in a very small percentage of recipients of hair transplantations. Shock can occur when placing grafted hair between growing hair. Trauma from the procedure can cause some additional hair shedding. The strong hairs will grow back, while the weak hairs that were destined to fall out may or may not return. Back to top


What is Follicular Unit Transplantation?

Follicular Unit Transplantation [ FUT ] is a procedure where hair is transplanted exclusively in its naturally occurring groups of one to four hairs. These groups or follicular units are obtained through the microscopic dissection of skin tissue taken from the donor region of the scalp. Because Follicular Unit Transplantation reproduces the way hair grows naturally, results appear completely natural and are indistinguishable from one’s original hair. Back to top


How Does Follicular Unit Transplantation differ from Follicular Unit Extraction?

In Follicular Unit Transplantation the hair for relocation is obtained by surgically excising a strip of hair bearing skin from the donor region of the scalp. The skin edges of this wound are then sutured closed and the result is typically a thin, fine line scar oriented horizontally across the back of the head. Follicular Unit Extraction or FUE is a contemporary revival of an antiquated technique of obtaining donor hair in which a small circular cutting instrument is used to harvest follicular units one at a time from the donor area. Each harvest or extraction creates a small circular scar and a transplant session creates a number of discontinuous, individual scars contrasting with the continuous linear scar of FUT. Short hair styles are well supported with either method of harvesting. Large session sizes are much more easily accomplished utilizing FUT technique and costs for FUE are often quadruple the cost of FUT on a per graft basis. Back to top


How long will the transplant last?

The transplanted hairs will last and grow forever. This is the result of harvesting follicular units from the permanent zone of hair in the back and sides of the scalp. This hair is genetically different than the hair on the top of the head and within the crown that is affected by the hormone DHT [the culprit in male hair loss responsible for miniaturization of the hair and eventual baldness]. When these ‘protected’ follicular units are transplanted they maintain their original immunity and thus grow as they would have within the donor area. This phenomenon is termed ‘donor dominance’ and though not entirely understood from a histochemical standpoint is the well established foundation for hair transplantation that is now time tested over nearly fifty years. Back to top


With today’s surgical techniques is it possible to restore a full head of hair?

Although the cosmetic benefit can be dramatic a hair transplant by nature involves the relocation of hair that is redistributed within the transplant zone in a density that is less that nature’s original density. As such the goal of literally replacing all the hair that is absent from an area is usually impossible unless the involved area is quite small. Fortunately the appearance of full or at least substantial coverage can be obtained by the introduction of a smaller number of hairs into the affected area(s) provided they are artistically arranged to create an optimal cosmetic effect. Ziering Medical has the technological proficiency to provide density [hairs per unit area] on par with industry leaders and is unsurpassed in the even more important area of creative artistry. Back to top


What complications are associated with a hair transplant procedures?

Today’s hair restoration surgery is a low risk and very safe procedure and complications of any form are a rarity. Infection is virtually unheard of provided one adheres to postoperative instructions. An adverse or allergic reaction to the local anesthesia is possible through practically never encountered. Ingrown hairs can occur when the hair first begins to emerge from the scalp. These are a minor nuisance and will resolve completely. Postoperatively patients experience transient numbness in the donor region which abates within weeks. This is a normal consequence of the procedure. Swelling involving the forehead and in extreme instances the whole of the face can occur following a hair transplant; particularly one focused upon the hairline or the front of the head. If swelling occurs it begins the day following the surgery and resolves within the first five days postoperatively in most instances. Back to top


Will the Transplanted Hair be Curly?

Transplanted hair does tend to have a slight wave, but if your donor hair is straight, it will not become curly. Medical hair loss therapy as practiced by Dr. Ziering and staff is not to be confused with laser hair loss treatment. We are extracting hairs from your donor area and creating natural looking results through follicular unit grafting. Back to top


Are there age limits associated with having a hair restoration procedure?

Male pattern hair loss is genetic in nature and can begin as early as the second decade of life. Increasing numbers of men are affected as they age so that by age 50 approximately 50% of men have appreciable hair loss. Medical therapy designed to ward off future hair loss can begin as early as a young man reaches maturity and begins to exhibit early signs of hair loss. Ziering Medical’s philosophy emphasizes establishing contact early with patients experiencing or destined to experience hair loss so that educational efforts can begin to establish a thorough understanding of the nature of hair loss and medical and surgical options for managing this condition. Surgical intervention can begin early provided the patient understands the importance of concomitant medical therapy and the implications of early intervention in a condition that is often progressive over many decades of time. Again Ziering’s physicians are experts in assessing the future evolution of male pattern balding and designing a restoration program to optimize one’s appearance today as well as tomorrow. Back to top


What causes hair loss in women?

Female hair loss is a distinctly different entity from male pattern hair loss which has a known cause and usually follows a predicable path. Though some women experience hair loss that resembles male patterned loss, others experience diffuse loss that involves the entirety of the scalp. Such individuals are not candidates for surgical hair restoration in that they do not possess an uninvolved area of hair from which to obtain hair for transfer. Other causes for hair loss in women range from medical conditions associated with hair loss such as anemia, hypothyroidism and connective tissue diseases to adverse reactions to medications or deleterious effects of certain grooming practices e.g. tight braiding of the hair which causes traction alopecia. Back to top


Are surgical hair transplants a treatment option for women?

Depending on the nature and degree of hair loss women may or may not be candidates for hair transplantation surgery. Goals and expectations need to be carefully reviewed in advance of contemplating surgery and if there exists medical questions pertaining to the nature of the loss or its future course, then medical laboratory investigation may additionally be warranted. Back to top


Why are some women not candidates for hair restoration surgery?

Hair transplantation involves the relocation of hair from an area of greater density and fullness in the back of the scalp to an area of hair loss on top of the head. Women who have generalized thinning do not possess sufficient reserves of hair to allow for the removal of hair without deleterious effects upon the source of the donation. Additionally in these instances the usual source of donor hair may not contain healthy hair which will survive and grow when transplanted. In hair transplantation, as in many surgical procedures, it is important to balance the potential gain against the possible risks or downside when contemplating a procedure that is not reversible. Back to top


Is Rogaine™ effective for women?

Rogaine or minoxidil is valuable adjunctive therapy for both men and women with hair loss. It does not work in all individuals and only a trial of use [six months ] will give a definitive answer as to it’s merits in any one individual. The exact mechanism of action of this drug is not well understood however it has been demonstrated to be capable of lengthening the anagen or active growth phase of the hair within the hair growth cycle. This translates clinically into healthier hair for a longer period of time. Rogaine is the only FDA approved medication to slow or stop hair loss in women. Back to top


Can women take Propecia ?

Propecia is not FDA approved for use in women. Women of childbearing age should not take this medication because of its association with birth defects in the developing male fetus. Studies conducted using 1mg finasteride in post-menopausal women demonstrated the agent not to be effective in this patient category. The prospect exists that a higher dosage may be beneficial in this group of individuals, however good studies showing its efficacy and safety are yet to be completed. Back to top


Who is a candidate for a hair restoration procedure?

As many factors come to bear in assessing an individual’s candidacy for hair restoration, the answer to this question can only be determined with by a physician well versed in the surgical management of hair loss. Not everyone with hair loss is a candidate for hair transplantation though the vast majority of men and a small majority of women are fair to excellent candidates. The physician staff at Ziering Medical will provide any interested part with a thorough examination to analyze your type and degree of hair loss. At the conclusion of this complimentary consultation advice will be provided outlining medical and surgical options. Back to top


How soon can I expect the grafts to begin growing following a transplant session?

Everyone is different but on average the new hair will begin to emerge from the surface of the scalp at the four month mark following surgery. The range within individuals is from two to six months and is not easily predictable. A man or women with prior transplantation – particularly that done in the intermediate or remote past will not experience growth until later. A postoperative evaluation is scheduled at five months at which time the expectation is the visualization of early new transplant growth. Abundant growth and consequent cosmetic coverage is not anticipated until the nine-month mark following the procedure. By the year anniversary of the work most all of the transplanted hair has begun growing. Over the ensuing six to twelve months the individual hair shafts thicken to a fully mature state and this contributes significantly to the overall appearance of the transplant. Back to top


What should I expect to look like after the procedure?

For the first week following the procedure the transplanted zone displays small crusts associated with the creation of the receptor site incisions and a variable degree of erythema [redness] depending on one’s skin type. Swelling of the forehead is a potential consequence of a hair transplant; particularly one focused upon the hairline and frontal aspect of the head. By the time a week or so passes the transplanted patient’s appearance normalizes. The sutures placed inconspicuously in the donor region are removed on the 10th day following the transplant. The transplanted hair frequently responds to the act of relocation by entering the dormant or resting stage of the hair growth cycle. When a hair enters this stage the hair shaft breaks off and is shed leaving the follicle residing beneath the skin alive and well. From this resting follicle a new hair shaft will grow in 3 to 4 months. The hair then continues to participate in the natural cycle of hair growth for several years alternating with ‘rest periods’ of several months length. Back to top


Will I experience ‘hair shock’ and if so how much?

The medical term for ‘hair shock’ is telogen effluvium. This entity is an event in which a population of one’s native hairs synchronously enter the dormant or resting stage of the hair growth cycle and are shed. A number of situations can precipitate telogen effluvium inclusive of a hair transplant. The impact on one’s appearance if he or she experiences ‘hair shock’ is usually not cosmetically significant, though on occasion the temporary loss can present an additional styling challenge to someone already contending with less hair than they are comfortable with. All competent hair transplant surgeons are aware of this potential consequence of a hair transplant and attempt to minimize it’s occurrence through careful recipient site creation and avoidance of injuring the native hair in the region. Ziering Medical’s extremely small instrumentation further minimizes the risk of this event. The fate of a hair involved in ‘hair shock is related directly to its state of health. If the affected hair was genetically coded to live for an extended period of time then the hair will return as actively growing hair in about three month’s time. If conversely the involved hair was approaching the end of its natural life cycle, then the possibility exists that the transplant procedure may prematurely end this hair’s existence. Back to top


How do I assess my risk of ‘hair shock’?

In general the higher the percentage of mininiaturized hair one has and the more rapid the pace of one’s hair loss, the greater the risk of telogen effluvium shedding from surgery. Patients with longstanding and stable patterns of hair loss are less likely to be affected by ‘hair shock’. Back to top


I understand Rogaine™ helps prevent hair loss. When should I begin its use?

As soon as possible in most instances. If you are planning to have a hair restoration procedure within four to six weeks on your consultation, you can wait to begin it use after your transplant. If you plan to wait several months to years before having the procedure it should be started immediately as it is the long term continuous use of adjunctive medical therapy which optimizes results. Back to top


Is there a difference between the post-op Graftcyte™ healing kit and other therapies?

Yes there is a difference. GraftcyteTM contains a patented copper-peptide, tri-amino acid formula that accelerates the healing of the donor and recipient areas by about two to three days in comparison to the salt water soaks. We do recommend that it be purchased to help with the healing process. Back to top


How soon can I wash my hair after the procedure?

You will bathe the next day and wash your hair at that time. We will give you specific instructions on the day of your procedure as to how to care for your hair in the post-operative period. In short, the transplanted zone is washed by gently pouring a mild shampoo and water mix over the head and similarly rinsing is accomplished by carefully hand pouring water over the transplanted zone. The remainder of your scalp inclusive of the sutured donor region can and should be washed in a normal fashion on a daily basis following the transplant. Hair can be either air dried, gently patted dry with a towel or dried with a hair dryer on a cool setting. Back to top


How soon can I color or dye my hair after the procedure?

We recommend that you wait five to six weeks after the procedure before coloring or dying your hair. Hair can be colored within the week leading up to the procedure. Back to top


How soon can I cut my hair after the procedure?

You can have your hair cut or styled one week after the sutures are removed from the donor area. The sutures are typically removed ten days following the transplant. Back to top


Are my activities restricted after the surgery? If so, for how long?

Ziering Medical will provide you with a complete list of all activities that should be avoided in the post-operative period. Strenuous physical activity inclusive of vigorous aerobic exercise and power weight training should not be performed until two weeks following the procedure. After the sutures are removed at ten days one can slowly begin to reintroduce an exercise regiment beginning with cardio and slowing adding back weight training. Early excessive movement and particularly stain on the healing donor wound can increase the likelihood of a widened donor scar. Ideally one should reduce their activity profile and ensure adequate rest during the week immediately following the surgery. Back to top


When can I go back to work after the procedure?

We recommend taking at least taking three days off from work following the procedure. Thereafter it becomes a question of one’s comfort level in terms of appearance as to the timeframe of returning to the workplace. As residual erythema [ redness ] typically lingers for five or six days following the procedure, many individuals take off a full week from work. In instances where a hat can be worn, detectability is concealed immediately. Back to top


In what position am I supposed to sleep after the procedure?

We instruct you to sleep in a reclined position at about a forty-five degree angle. If you have a recliner at home this is an ideal sleeping device for the first several nights following the procedure. Alternatively, utilizing two or three pillows in bed accomplishes the objective. Back to top

Is financing available?

Yes. Ziering Medical has made it simple for you to partner with a number of different financial institutions to receive financing based on qualification criteria. Back to top


Do you offer a travel reimbursement program?

Yes. At Ziering Medical, we realize that some of our patients do not live near one of our surgical facilities. We are proud to offer a travel reimbursement plan for your convenience and affordability. Ziering Medical will reimburse up to 10% of the total surgery cost with a maximum of $400.00 to any patient who travels 100 miles or more for surgery. We will reimburse for gas, tolls, airfare and a two day hotel stay. Food and entertainment are not included. Reimbursement requests with receipts must be presented the day of surgery. Back to top


Will the Ziering Blades make any difference in my result?

Most certainly. The blades offer the Ziering Medical surgeon the ability to precisely locate and create each recipient site opening. They are custom designed with a diamond shaped tip to allow for better graft fit. This refined instrumentation allows for the recipient sites to be made as close together as possible which correlates with a greater density of transplanted hair. The use of these smaller blades also results in cumulatively less trauma to the scalp and individually faster site healing. Back to top


What is the Ziering Whorl?

The Ziering Whorl is a hair growth classification scheme recognized and named by Dr. Ziering following a focused study to gain full understanding of hair growth and behavior with the crown region of the scalp. Ziering’s physicians are interested and well versed in the management of crown hair loss and when appropriate use the understanding of the whorl brought by Dr. Ziering’s research to recreate nature’s pattern in this area of the head. Back to top


When should I begin Propecia™?

PropeciaTM should be started as soon as you notice that your hair is beginning to thin. Propecia™ is a pill that is to be taken once daily to slow down your hair loss progression. It currently requires a prescription from a physician. Back to top


What will happen if I stop taking Propecia™?

If you stop taking the medication the hormone DHT that was being blocked will then begin to reform and your hair loss will begin again anew and continue on its genetically programmed course. It’s use therefore needs to continue for as long as one desires to minimize hair loss. Finasteride needs to be administered daily to effectively block the DHT hormone formation. Back to top


What are the side effects of Propecia™?

The most common though very infrequent side effect of PropeciaTM is that of sexual dysfunction. It occurs in less than 1 % of patients. Biologically this should not occur because PropeciaTM blocks testosterone from being broken down into DHT which in turn causes a transient increase in testosterone levels. Testosterone is the hormone responsible for sexual drive and function. However, as with any medication, one may experience a side effects. With finasteride the sexual performance side effects usually resolve and function normalizes even with continuation of the drug and always in the event the medication is stopped. Other less common reported [and also reversible] side effects include itching, rash, swelling of lips or face, and breast tenderness or enlargement. These remote side effects occur with no more frequency than placebo. Back to top


What is the laser hair comb and should I be using it?

The laser hair comb is a device the employs a low level diode light energy that functions to stimulate the cells that form the hair follicle to function at an optimal level. This helps the follicle cells to produce a hair that is healthier, more vibrant and lustrous. This device has not been FDA approved to claims of hair re-growth of hair, however it appears promising as a device which will make your existing hair thicker and fuller. This device is especially useful for women whose medical therapy options are limited. Back to top


Can eyebrows be transplanted?

Yes they can. We at Ziering Medical specialize in a whole variety of facial hair aesthetics including eyebrows, eyelashes, mustaches, sideburns, and goatees. However, one must keep in mind that the donor hair is still the posterior scalp hair. It will grow as scalp hair does which will make trimming/grooming of the transplanted hair essential. Back to top


How do I know if I am a good candidate for a hair transplant procedure?

Most men and women in good general health are candidates for hair transplantation. In order to accurately determine one’s candidacy [ based upon degree of hair loss and hair type ], a complimentary private consultation with a Ziering Medical physician is recommended. During a consultation the physician performs a thorough examination of your scalp and hair to determine donor density, scalp laxity and the requirements for restoration. This determination takes into account one’s individual hair characteristics such as color, texture, and the presence or absence of curl to develop the right plan for your hair restoration procedure. Back to top


Is it safe to remove large amounts of donor hair?

The amount of hair needed for an average large session is well within the safe limits of what can be removed provided that the surgery is done properly. It is the experience and judgment of the surgeon that will ensure that the amount of hair that is harvested from the donor area is safe and appropriate for the planned session. Back to top


Is the blood supply of the scalp adequate to support large transplant sessions?

Yes. Graft survival and growth following transplantation is limited by tissue oxygenation, not blood supply as is commonly perceived. Today’s most refined technology of microscopic follicular unit transplantation allows oxygen to easily diffuse to the small one to four hair grafts contained within the follicular units. The blood supply of the scalp is among the richest in the entire body which enables it to support the growth of large numbers of grafts provided that they are small in size. Ziering Medical performs exclusively follicular unit transplantation which ensures optimally small graft size. Back to top


If I elect to do a second procedure how long should I wait between sessions?

The scalp is sufficiently recuperated to allow a second procedure generally by the six month mark following the previous surgery. The hair from the prior procedure has begun to grow at this point but has not yet reached full maturity. Therefore, if one is deliberating the need for an additional procedure, waiting until the year anniversary of the last procedure is generally advocated. Conversely if an individual knows confidently that they desire additional density or coverage, a second or repeat surgery can be scheduled as early as six months following the last procedure. Back to top


What can I expect the day of my procedure?

After arriving at one of our offices at your appointed time patients first finalize paperwork and payment with the patient advocate and next are photographed to document the preoperative condition. Next individuals are moved to the room where the transplant will be performed and there, patients are visited by the physician who again discusses with you the plan for your procedure. Next your donor region is prepared for the harvest. You are then administered a mild oral sedative to facilitate relaxation. Local anesthesia is next injected into the donor area. Now prepared for the donor harvest, patients are situated in a prone position upon the fully reclined surgical chair. The physician then excises the strip and sutures the wound closed. This step of the procedure takes about twenty minutes. Thereafter the staff begins the process of microscopically dissecting the strip into follicular units ready for transplant. The patient at this time is resituated in the seated position for the remainder of the session. Anesthesia is again administered to top of the head next to prepare it for the steps of site creation and graft placement which follow. The physician performs the key step of creating the recipient sites for the grafts which determines their location, density and growth direction. Both steps of the dissecting and placing of the grafts by the technicians are overseen by the physician. Throughout the lengthy procedure patients are allowed to watch movies, listen to music or rest quietly. At the end of the transplant procedure a staff member will go over post-operative instructions with you. Patients are able to drive themselves home at the conclusion of the day although some opt to have a friend or family member drive them home. Back to top


After a strip harvest will the scalp laxity return to normal?

The scalp will regain most of its original laxity through the process of skin remodeling following a hair transplant. The majority of this occurs within the first 6 to 8 months following a procedure. Scalp flexibility or laxity varies from individual to individual and this difference to an extent dictates the amount of hair that can be removed from the donor area over time. If an individual possesses a tight scalp the maximum harvest or yield is less than someone with a very flexible scalp [ for a comparable density of hair ]. Even with multiple procedures patients rarely report lingering tightness unless their history includes scalp reductions or lift procedures. Back to top


Is fine textured hair a problem for hair transplantation?

No. Fine hair transplants with the same success as any other type of hair. The nature of fine hair is such that the coverage it affords is comparably less than thick hair. The appearance is none-the-less natural and familiar to the individual as his or her original hair type. Back to top


Why does the transplanted hair sometimes initially appear kinky or dry?

Occasionally following a hair transplant the emerging hair exhibits characteristics dissimilar to one’s native hair e.g. excessive curl. It is felt that this uncommon and temporary phenomenon is related to collagen activity in the skin surrounding the grafted hair its impact on the hair’s attributes as the hair emerges from the skin’s surface. The usual outcome in this scenario is the normalization of hair characteristics over the ensuing twelve months. Dry hair is felt to be cause by excessively tight trimming of the follicular units during the graft preparation stage and the inadvertent removal of the sebaceous glands surrounding the hair follicle. These glands provide a lubricating action to the surface of the hair and skin and their absence can create dry hair. Proper attention to detail during the process of graft preparation eliminates this also temporary post-operative effect. Back to top


How will I know if I have lost any grafts after a hair transplant procedure?

Every day following the procedure the transplanted grafts become more secure in the scalp. Graft attrition or loss should be only 1 %. Hair shedding is a different entity than graft loss and is expected following a transplant session. If a graft is lost it is almost invariable associated with some sort of trauma to the head and accompanied by bleeding. Back to top


Should I cut my hair before the hair transplant procedure?

Hair length entering a procedure should be sufficiently long in the donor area [ ½" or longer ] to allow hair from above the donor incision to drape down and cover the sutured area upon completion of the transplant. Shorter cuts are allowed provided the patient is willing to have the surgical wound on display for the ten days the sutures are in place. Hair length within the recipient zone can be cut to the patient’s preferred length. Shorter lengths make the work of managing the hair during the procedure easier and longer styles offer greater ease of concealing the worksite for the week or so that there is visible evidence of the procedure. Back to top


Can hair be transplanted into scar tissue?

Hair can most certainly be transplanted into skin affected by scarring – either that resulting from surgical trauma or other injury. Some adjustments are made when transplanting scarred areas such as decreasing the density of grafts placed per session. However repeat sessions are possible and often density values resulting in significant coverage and camouflage can be achieved. Back to top

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