Hair Transplant
Hair transplant techniques have improved dramatically in the past few years. Advances in FUE (Follicular Unit Extraction) techniques provide us the tools to deliver natural results that were not available before.
In the past 16 years, Ringpfeil Advanced Dermatology has become one of the largest dermatology practices in the Philadelphia area to treat hair loss in both men and women.
We see over 700 hair loss patients each year. We help our patients find the root cause of their hair condition, we treat their condition medically, and we offer hair restoration to patients who are good candidates for the treatment.
We've built one of the most advanced hair transplant centers in the Philadelphia area. Dr. Milchak, our Director of Hair Transplant utilizes both FUE and FUT techniques, combined with light therapy, stem cell, and PRP treatments.
Dr. Marissa Milchak - Director of Hair Medicine and Hair Transplant
Dr. Marissa Milchak is the Director of Hair Medicine and Hair Transplant at Ringpfeil Advanced Dermatology.
Seeing over 700 hair loss patients each year, Dr. Milchak and her team deliver the most advanced medical and surgical hair restoration treatments available today.
Dr. Milchak is a fellow of the American Academy of Dermatology and a member of the International Society of Hair Restoration Surgery.
Dr. Milchak sees Hair Restoration patients at both our Main Line and Philadelphia Center City offices.
FUE Hair Transplant
FUE - Follicular Unit Extraction - is a relatively newer technique in which the surgeon takes individual hair follicles from a donor area and plugs them accurately in the target area. The donor areas are usually located in the back of the head where most people have denser hair.
Follicular Units
FUT (Strip) Hair Transplant
FUT (Follicular Unit Transplant) hair transplant was the first big leap forward in hair transplant in recent years. Here, a strip of skin is cut from the donor area (usually the back of the head, where hair is usually denser). The extracted strip is then dissected and single follicles are separated and prepared for implantation in the target area. The open edges of the donor area are then pulled towards each other and sewn together creating a narrow scar that is later covered by the hair.
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FUT - Follicle Harvesting Steps
- The number of follicles needed is calculated
- Density in donor area is measured, and strip location and dimension is determined
- Strip area is marked and shaved
- Local anesthetic is applied to the area
- The Dr. makes the incision to remove the the strip
- The Dr. sutures and close the skin
- Technicians separate the follicles from the strip and store them in holding solution
Hair Transplant - Insertion by Dr.Milchak from Ringpfeil Advanced Dermatology on Vimeo.
FUE VS. FUT
FUE & FUT - different in harvesting but similar in implantation
| Treatment | Advantage | FUE | FUT |
| FUT | Graft survival rate | Lower (85%) | Higher (95%) |
| FUT | Shaving donor area needed | Yes | No |
| FUT | Number of grafts from "safest" donor area | Smaller | Larger |
| FUT | Number of grafts / day | Smaller (up to ~2500) | Larger (up to ~3500) |
| FUE | Scaring in donor area - shape | Dot-like | Linear |
| FUE | Scaring | Hiding by short hair | Hiding by long hair |
| FUE | Recovery time | Shorter (a day or two) | Longer (two days or more) |
| FUE | Invasive procedure | No | Yes |
| FUE | Donor area size | Broader | Limited |
| Similar | Number of lifetime grafts | ~6000 | ~6000 |
| Similar | Target area natural look | Yes | Yes |
Pricing
$5-$6 per graft
Facial Hair Transplant
We see a very strong demand for beard transplants. While the transplant to this area raises some challenges, the patient satisfaction for this procedure is extremely high.
The donor area can be hair from an area between the neck and the chin, but in most cases this area can not supply enough grafts to satisfy the desired results. In most cases, most of the hair will be harvested from the occipital scalp (back of the head).
The visible location of the implantation calls for very accurate and artistic implantation. Wrong insertion angles and inconsistent density becomes very visible. The facial hair consists of single and double follicular units that need to grow out of the surface at a 10-20 degree angle.
Most of our patients who are interested in this procedure are 25-35 year old young men who are looking to increase hair density and hair uniformity. Some patients are interested in enhancing specific facial areas such as the sideburns, cheeks, or chin.
Hair loss causes and treatments
| Forms of hair loss | Cause | Treatments | |
| androgenetic alopecia | male/female pattern hair thinning hormones, genetics |
topical/oral minoxidil finasteride spironolactone PRP( platelet rich plasma) hair transplant |
|
| alopecia areata | autoimmune condition in which the body attacks hair follicles | topical therapies steroid injections light therapy systemic immunosuppressants |
|
| telogen effluvium | "stress" hair loss, illnesses, childbirth, surgeries, rapid weight loss, emotional/mental distress | time- usually reverses topical minoxidil PRP |
|
| trichotillomania | habitual hair pulling can be associated with OCD or other psychiatric conditions |
habit-reversal therapy antidepressants N-acetylcysteine PRP hair transplant (after pulling stops) |
|
| traction alopecia | habitual hair pulling can be associated with OCD or other psychiatric conditions |
loose hairstyles topical therapies steroid injections hair transplant (after pulling stops) |
|
| lichen planopilaris (LPP) frontal fibrosing alopecia (FFA) | inflammation attacking hair follicles | topical therapies steroid injections finasteride light therapy systemic immunosuppressants |
|
| central centrifugal cicatricial alopecia (CCCA) |
unknown- genetics? chemicals/heat? | topical therapies oral antibiotics antimalarials steroid injections PRP hair transplant |
Male Baldness Pattern - Norwood Classification System
Donor Area
The Norwood Class VII depicts the relatively safer donor area. When planing the harvesting the surgeon applies considerations such as
- Hair density
- Hair caliber
- Hair pigment
- Changes in hair properties as patient ages
- Root cause for hair loss
- Hormones stability
- Reserves for future treatments
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