Illusion and Reality in Hair Restoration

Hair frames the face, and its shape, density and color can affect how youthful or healthy one appears. Thinning or loss of this framework leads to reduction of youthful appearance and often diminished self-confidence.

As we age, the possibility of rejuvenating or jump-starting hair growth also becomes smaller, secondary to cumulative damage to hair follicles by circulating hormones, compromised blood flow and cellular aging. Thus, at any age, the restoration of hair involves a combined approach, using both real replacement of hair as well as the creation of the illusion of more hair.

At The Rawal Institute for Hair Restoration and Aesthetic Medicine, Shamila Gupta Rawal, MD, examines your hair loss through a comprehensive and long-range lens, allowing her to develop a customized, natural-looking and long-lasting hair restoration plan.

What are some of the factors that determine candidacy for increasing hair growth without surgery?

Hair follicles require adequate blood flow, sufficient and robust nutrient delivery, and intact scaffolding to grow healthy hair. Blood flow and nutrient delivery can be compromised by the actions of stress and several circulating hormones, by smoking and poor diet, and by inflammatory conditions in the scalp.

Integrity of the scalp collagen matrix can be affected by natural aging and genetics, trauma to the scalp from high tension hairstyles, over-processing and styling, and replacement by scar tissue from inflammation. Therefore, the goals of many hair restoration treatments are to improve oxygen and nutrient delivery through enhanced blood flow to the follicles and to reduce scalp inflammation. Whether that involves use of oral or topical medications, low-level laser light therapy or regenerative medicine technologies, the aim is to optimize the growth environment for the hair follicles and promote a healthy cellular metabolism, leading to thicker, longer, more lustrous hair.

When hair follicles have sustained cumulative damage from the above issues for too long, it may be difficult to reverse the miniaturization process, and the goal of therapy is to maintain the live hair follicle for as long as possible, knowing that it is continually dying. If the population of follicles able to be resuscitated non-surgically is too low, the plan must lean more on adding hair transplant surgery and other camouflage techniques to provide comprehensive hair restoration.

Who is the ideal candidate for hair transplant surgery?

Hair transplant surgery can usually be performed in male and female patients who meet the following criteria:

  • Adequate supply of stable donor follicles (as determined by microscopic exam by Dr. Rawal)
  • Absence of auto-immune and scarring alopecias, or other medical contraindications
  • Commitment to ongoing maintenance with medical therapies
  • Appropriate and reasonable expectations of short- and long-term restoration outcomes

What happens if the area of thinning is too advanced or is larger than the supply of surgical donor hair?

When the recipient area has advanced miniaturization and exceeds the donor supply, Dr. Rawal will offer a hybrid restoration consisting of medical therapies to maintain the existing hair for as long as possible, surgical approaches to maximize the yield from the patient’s donor supply and semi-permanent camouflage through scalp micropigmentation.

Scalp micropigmentation (SMP) involves the deposition of thousands of tiny dots of medical-grade, charcoal-based pigment with a fine needle, that gives the illusion of many more hair roots and reduces the reflection of light from bare areas on the scalp. While loft and real hair density are not enhanced with SMP, the increase in perceived density can drastically reduce the embarrassment of thinning in windy or wet hair situations. Styling time can also be significantly reduced with this increased coverage. SMP can be performed as a standalone treatment, or as part of a hybrid program, and can be expected to last five to seven years with proper care.

Interested in a customized and comprehensive hair restoration plan? Call Dr. Rawal’s office to set up your consultation now. Exclusive to our BRAVA readers: be one of the first ten patients to schedule your hair restoration consultation and receive 10% off your procedural hair restoration package (PRP, low-level laser light therapy, transplant) booked within 30 days of your consult — which is a potential savings of up to $2,000.

2 Science Court, Suite 101 | Madison, WI 53711 | 608.721.6132 |

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