There has been much discussion in the hair transplant community over FUE- (Follicular Unit Extraction) which is a type of hair transplant procedure whereby individual follicular units from the the donor area are removed using a punch, rather than the more traditional donor strip harvesting (FUS).

Proponents of this technique point to the fact that no linear scar is produced in the donor area which allows the patient to wear their hair short at the back. FUE takes much longer than traditional FUS, consequently it is more expensive.

I read with interest a recent paper that was published in the Journal “Dermatologic Surgery” by Dr. M. Onda from Tokyo, Japan. His aim was to develop a device which would speed up FUE harvesting and his results were fascinating; I summarize them here.

The harvesting time using the FUE powered-device was 6.o minutes per 100 grafts compared to 14.2 minutes per 100 grafts with manual FUE. 

The follicle transection rate (i.e. the hairs that were damaged by cutting through their roots with the punch) varied from 3.0% to 8.6% with the powered device and 9.7% to 25.9% with manual FUE.

What does this mean for the hair transplant patient?

As is the case with many medical procedures, there are trade-offs between advantages and disadvantages of various techniques. Many consumers mistakenly believe that FUE is “scar-less surgery.” However this is not the case, as the holes created by the FUE punch heal by scar-formation which leaves hundreds or thousands of circular”dots” in the donor scalp. These white dots may be visible, especially if the patient has dark hair and white skin and the hair is trimmed very short. The linear scar resulting from FUS is usually 1-2 mm wide & will never be noticeable unless the hair in the donor area is trimmed very short.

With traditional strip harvesting the hair is dissected under binocular stereoscopic microscopes so there should be no transection of hair follicles. This results in a better yield of intact follicular units for transplantation.

Using the data from this paper, a session of 3,000 follicular unit grafts could take up to 7 hours to harvest. Re-implanting the grafts would add another 4 to 6 hours to this procedure. For this reason, many clinics which offer FUE will perform a large procedure over several days which causes more patient inconvenience.

 Similarly with a transection rate of 9.7% to 25.9% there is a potential for up to 777 grafts to be damaged during a 3,000 graft procedure. For the balding patient, donor hair is an extremely precious, non-replaceable resource and every effort should be made to preserve these follicles so that they can be used for transplantation. To risk their destruction simply to avoid a scar (which will likely never be visible) would appear to be illogical.  

Ref: Novel Technique of Follicular Unit Extraction Hair Transplantation with a Powered Punching Device by Masamitsu Onda, M.D., Ph.D et al, Dermatologic Surgery (1683-1688) 2008   

Lotions, Potions & Snake Oil – Hair-Raising or Heart-Breaking?

At the Seager Medical Group, clients often bring with them bottles of hair growth products, herbal remedies and special shampoos that they are using, with the question “Do they really work?”Ever since the times of the Pharaohs, people have been seeking cure for hair loss. It has been said that one Pharaoh drank a concoction of asses hoof, dates and dog paw to try to restore his hair and in the 19th century a mixture of coconut oil, borax powder, and the burning of Indian incense was believed to promote hair growth.

Wonder Drugs for Your Hair?

A simple Google search will yield countless pages of pills and lotions designed to cure baldness. Many offer “money-back guarantees”, but the dissatisfied customer usually sheepishly chalks up his failed wonder cure to experience & is too embarrassed to ask for a refund (minus shipping charges!” While there is no “Wonder Drug” that will give a bald person a full head of hair, there are 2 medications used in medical hair restoration which have shown effectiveness in treating hair loss.

(1) Propecia (Finasteride) is a pill which prevents the conversion of the male hormone, Testosterone, to DHT; it is the DHT which is thought to be responsible for triggering hair loss in people who are genetically predisposed to male pattern hair loss. In large scientific studies over 5 years showed that 9 out of 10 men had visible results; either no further hair loss or re-growth of hair. That’s the good news. Now if there is good news, this implies that there must be bad news!Propecia has to be taken every day; if Propecia is stopped for a period of time, the hair loss will “catch up” to where it would have been had the person never been on Propecia. It has not been tested on women, therefore it cannot be recommended for female pattern hair loss. There is also a 1-2% risk of erectile dysfunction with Propecia; which is reversible once Propecia is stopped.

(2) The other drug which is approved by the FDA for male and female pattern hair loss is Minoxidil (Rogaine / Regaine). Like so many “discoveries” in medicine, the hair-restorative properties of Rogaine were stumbled upon accidently. Some hair loss sufferers who were taking Minoxidil pills for high blood pressure found that they were re-growing hair, so the manufacturers of Minoxidil devised a liquid version of the drug (Rogaine) that could be applied to the scalp and, lo and behold, it worked!! Around 80 % of men using 2% Rogaine found that hair loss decreased, whereas only 5% of men showed moderate re-growth. A 5% strength of Rogaine shows improved results compared to 2% Rogaine. Occasionally Rogaine liquid can cause scalp irritation. This is due to the effects of the propylene glycol and alcohol in which the drug is dissolved. In order to combat this problem, the company has developed 5% Rogaine Foam which is less irritating; unfortunately Rogaine Foam is not yet available in Canada.

I hear you asking “But what about all the other products that are out there in the herbalist shops and salons that say they will unclog my pores and make my hair grow?” Male or female pattern hair loss is a genetic condition and is not caused by blocked pores, and scientific studies do not substantiate the claims of these manufacturers. This does not mean that we should neglect good hair care. Washing hair with a good quality, pH-balance, high protein shampoo will not only keep hair clean, but it will also give the hair more body causing it to appear thicker and healthier. It is essential to use conditioner in order to provide a protective lubricating coating to the hair shafts. This will stop the hairs from becoming brittle and will protect them from breaking.

So as we can see, there is no “Wonder-Cure” for hair loss, but these 2 products are very useful in our armamentarium of hair loss treatments in order to slow down or prevent hair loss, especially in the early stages. For those people for whom there is established hair loss, hair transplantation will grow hair back in those areas from where it has been lost. The science behind this technique is fairly simple; male or female pattern hair loss is genetic. The permanent hair on the sides and back of the head does not fall out because it is genetically programmed to grow for life.

In those people who are suffer from male or female pattern hair loss, the hair on the front and top of the head will fall out because it is genetically predisposed to do so. Hair transplantation simply involves moving the genetically-permanent hair from the back and sides of the head to the place from which it has been lost. The hair’s genetics “tell the hairs to keep on growing” so they do and we are able to restore hair from where it was lost.Although the scientific principles are simple, the hair replacement procedure relies not purely on science, but to a large extent on artistry. At the Seager Hair Transplant Centre we believe that “A hair transplant should not look like a hair transplant!”, and we pride ourselves on performing surgical hair restoration procedures that look so incredibly natural that, in many cases, even your own hairstylist can not tell that it is not your original hair.

Female hair loss gives a new meaning to the phrase “bad hair day”.  As women our hair is one of the most important accessories we use everyday to make us look our best.  Our hair has been defining us as girls, and then women, from the time we had enough hair for our mothers to put a bow in it.  So it shouldn’t come as a surprise that when a woman suffers from hair loss, it can have a devastating effect on her sense of confidence and self image.  When you see a man who is balding it is considered nothing out of the ordinary however, if you see a woman who is suffering from thinning hair she looks out of place and you think “I wonder what is wrong with her?”

We spend hundreds of dollars a year at the hair salon having our hair styled, coloured, and highlighted; not to mention the amount of money spent on hair care products.  So the first place we would look for a hair loss product would be at the salon.  Unfortunately there isn’t a shampoo or hair styling product that will cure hair loss.

The first place you should look for answers is at your family physician’s office.  The goal is to investigate the cause of your hair loss and make a diagnosis.  He or she may treat you themselves or refer you to a dermatologist.  Either way it will involve providing a medical history, a scalp examination, some blood work and perhaps a scalp biopsy.  The causes for hair loss in women can include low iron, thyroid disease, recent stress or illness, pregnancy, hormonal disorders and scalp disease. One of the most common causes is genetic female pattern hair loss or androgenetic alopecia which is characterized by hair loss which usually starts a few centimeters behind the hairline and progresses through the middle of the scalp.  A thorough investigation is required before any treatment is started because the causes of hair loss in women can be so varied.

There are a variety of non-surgical and surgical treatments available.  One non-surgical option is Rogaine, a topical solution that is applied twice a day to the affected scalp that can help slow down the progression of hair loss.  Topical cosmetics such as DermMatch can be used to camouflage the thinning areas.  Hair extensions can also be used to augment thinning hair.  For women who have extensive hair loss and are not suitable candidates for other treatments choosing a wig may be an option.

Hair transplantation is a very effective treatment for female pattern hair loss.  Hair is taken from the sides and back of the scalp and transplanted into the thinning areas.  Using modern techniques of “follicular unit grafting”, grafts are transplanted one at a time creating incredibly natural results.  Hair transplants can also be used to restore hair in the temples and hairline after a facelift or brow lift to camouflage the scars.  Eyebrows that are sparse due to over plucking can be transplanted and so can eyelashes.

At the Seager Medical Group we are experienced in these techniques and have helped pioneer the advances in the field of hair restoration surgery.  We pride ourselves in being able to not only restore your hair but your self confidence as well.

Dr. McKenzie appears as a guest on CFRB 1010’s Guy Talk Radio Show on Sunday August 10. The topic of this live phone-in radio show was “Are bald men more sexy?”
Dr. McKenzie is pictured in the studio with hosts Dale Curd and Owen Williams.

At a recent Gala Reception, attended by business leaders, the media and civic dignitaries, Dr. Mark McKenzie was pleased to accept the Consumers Choice Award 2008  for the Best Hair Restoration Clinic in the Greater Toronto Area on behalf of the Seager Hair Transplant Centre.

The Consumers Choice Award is a mark of excellence and the winners are chosen based on the results of a survey which is performed among two major groups of consumers; the general public and the business community.

This award is a great honour & The Seager Hair Transplant Centre has shown that it continues to live up to its standards of excellence by winning this award for the second year in a row.

The Seager Hair Transplant Centre was privileged to be a Gold Sponsor in the recent Toronto Police Association Charity Golf Day at Angus Glen Golf Course.. Money raised was donated to the Canadian Centre for Abuse Awareness http://www.ccfaa.com/, which is a non-profit, non-government, charitable organization dedicated to eliminating child abuse.

Pictured are the “Intrepid Seager Foursome”: Staff Sergeant Kevin Murrell, Jaan Vaikla, Dr. McKenzie & Kevin Hurford.

Over 500 golfers participated in the day which was a great success.

Dr. McKenzie has been the Medical Director of the Seager Hair Transplant Centre since Dr. Seager retired in 2006, but his hair transplant career stretches back to 1994. He has been a member of the International Society of Hair Restoration Surgery since 1995 and is a Diplomate of the American Board of Hair Restoration Surgery.

In Dr. McKenzie’s own words “In the 1980s, when I was beginning to lose my own hair, I saw the results of the “hair plugs” and was never particularly impressed. In the early 1990s, a plastic surgeon with whom I was working, drew my attention to the advances that were taking place in the field of hair transplantation. I researched these new techniques and became involved as both physician and as a patient. Since the early 1990s, I have seen the trends from plugs, scalp reductions and flaps, to minigrafts, micrografts, follicular units, multi-follicular units, lasers, Minoxidil and Propecia. Having the luxury of being able to stand back and evaluate these innovations over time, I can honestly say that the results that we are achieving at the Seager Hair Transplant Centre are consistently the best that I have seen. In keeping with our traditions of excellence and innovation, we will continue to be at the forefront of the hair transplant field as we endeavour to provide the best possible hair restoration experience and results for our patients.”

The Seager Hair Transplant Centre, which is located at the Centenary Hospital in Toronto, is devoted to hair restoration surgery. Under the direction of Dr. Mark McKenzie we perform all-follicular unit megasessions using binocular stereoscopic microscopic dissection of the donor hair. The follicular unit grafts are then transplanted one at a time into the bald or thinning areas by dense-packing, using the “stick and place” technique which yields incredibly natural results. This is performed while the patient is mildly sedated which keeps them very comfortably relaxed.

This technique which was pioneered by our founder, Dr. David Seager, has been deemed by other hair transplant physicians to be the “Gold Standard to which we should all aspire.” This is borne out by the fact that patients travel from all over the world to have their hair transplant procedures performed in our clinic.

The staff and patients at the Seager Hair Transplant Centre are excited about the launch of our new website. E-mails are coming in thick and fast from colleagues, friends and patients about the new look and content of the site. There’s an old saying that “A picture is worth a thousand words”, and the website proves this maxim. The results of the follicular unit megasessions seen on the patient photos and videos coupled with the enthusiastic comments from our patients are very impressive.

Visitors to the site enjoyed watching the videos of Dr. McKenzie answering the frequently asked questions, such as, “Who is a good candidate for a hair transplantation?”, “What can I expect on the day of my hair restoration procedure?”, “How does your experience as a hair transplant physician as well as being a hair transplant patient affect your approach to patients suffering from hair loss? and “What makes the Seager Hair Transplant Centre different?” The explanations are clear & concise and Dr. McKenzie communicates in a way that is very easily understood.

We hope you find the information useful and welcome you to check us out in person or to send us an e-mail.