GLOSSARY ::: Hair Loss Help :::
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Hair-loss questions - general
Questions by Men
Questions by Women
Index to FAQs
Glossary of Terms
C L I C K    H E R E

Using the Micro-Dense-Pack method, sessions may last for between 3-4 hours depending upon the area to be covered and the number of grafts to be placed.

Session sizes break
down as:
small up to 800 grafts
medium up to 1300 grafts
large up to 2000 grafts
maximum up to 3500 grafts

Hair is taken from the back and sides of the head and implanted into areas of hair loss or hair thinning. This donor hair is genetically programmed to last a lifetime. Wherever it is implanted, it will resist the androgens in the blood which caused the original hair to fall out. The donor hair follicles will continue to grow and thrive as they would have done in the area from which they were taken.
Here you will find explanations of some of the words and
phrases used in this and other hair advice sites.

alopecia: the medical term which covers hair loss in general. Different causes of hair loss have more specific names, eg alopecia areata and androgenetic alopecia.

androgenetic alopecia: also called androgenic alopecia, the most common form of hairloss in men which also affects women too. Loss of hair is due to the damage caused by androgens circulating in the bloodstream. Some people are genetically predisposed to have follicles which are more sensitive to the effects of DHT, dihydrotestosterone, a chemical caused by the action of an enzyme upon testosterone. The effect of DHT is to cause progressive miniaturisation of the hair follicle and eventual permanent cessation of hair growth from it. The follicles most susceptible to DHT are those found on the front and crown of the head. Hair on the back and sides of the head are resistant to the effects of DHT.

angulation of graft: natural hair does not grow straight out of the skin but is at an angle. Replicating this natural angle during the process of transplantation gives a much more natural effect when the hair grows.

back of the head: the back of the head contains hair which is programmed genetically to resist the destructive effect of DHT. This resistant quality of the follicle continues even if the follicle is relocated into an area of hair loss. The back of the head is therefore a rich source of donor hair. The size of the donor area will govern the number of follicles available for transplantation. It is therefore helpful for the doctor to know the size of this area - in other words, the measurement from the start of hair growth at the base of the neck to the point at the top of the head where hair growth stops.

balding areas: areas of hair thinning or total hair loss. Hair loss occurs for different reasons and the areas affected by hair loss can be an indication of the cause and the stage of baldness. The rate of hair loss changes over time and can stablise. It is necessary for a doctor to know the areas of your head which are affected by baldness and the current rate of hair loss. A simple chart has been developed by doctors to categorise stages of baldness.

baldness: everyone suffers hair loss. It is part of the ageing process. As the density of our hair is reduced through hair loss, the effect gradually becomes more noticeable. As hair becomes more sparse, the term 'thinning' turns to' balding' which turns to 'baldness', although exactly where one stage ends and the other begins is more of a subjective judgement.

combined techniques: there are essentially only two methods of obtaining follicles for implantation - multiple follicular extraction and follicular unit extraction - but there are numerous techniques used for implantation. Each method of extraction has its own advantages but is dependent on the hair in the donor area. The requirements of the area of implantation - the area to be covered, the density to be created, the position of existing hair - often mean that a combination of methods and techniques is required to create the best effect. Each person is different so there is no one method or one technique which will always be suitable for everyone.

complete transplantation: see mega-session. A full hair transplantation in which all of the bald areas are covered. Hair transplants have been carried out for more than 50 years, during which time techniques have dramatically improved. There was a time when only a small number of grafts could be made in one session which meant that patients with large areas of hair loss had to undertake several sessions over a considerable period of time to make a complete transplantation of the area of hair loss. The obvious disadvantage was that the patient had to continue his life for months or years with only a partially completed transplantation. Techniques today enable large areas to be treated in one session avoiding the problem of partially completed transplantations.

cosmetic surgery: also known as aesthetic surgery or plastic surgery, is the term used for surgical intervention for reasons other than required by medical necessity. Though commonly used for enhancement of a person's natural appearance, the skills of the plastic surgeon can also be used to improve the appearance of people who have suffered trauma through accidental damage or through extensive medical surgery.

direct hair implantation: using the FUE (follicular unit extraction) method, follicles are removed one by one and implanted immediately into the area of implantation. This process is slower than multiple follicular extraction and not so many grafts can be placed in one session by this method.

direction of hair: hair does not grow straight out of the skin, nor does it hang straight down from the top of the head. Each of us has a natural direction of hair growth around the scalp - usually a spiral from a point near the crown. Plastic surgeons take care to follow the natural direction of hair growth when implanting follicles in order to achieve the most natural-looking results.

donor area: the area of the scalp which contains hair resistant to the chemical process which causes hair loss - usually this is hair on the back and sides of the head (sometimes referred to as the permanent zone). Hair from this area can be transplanted to any area of the head where it will continue to last a lifetime. In most people, up to 50% of the hair can be removed from the donor area without any noticeable effect. That same hair can be used to cover a much larger area by implanting it at a less dense rate. When hair loss has been caused by a medical condition, accidental damage or by reasons other than androgenetic alopecia, the size of the donor area may be restricted and a different part of the scalp may have to be used as a source of donor hair.

donor site hair: donor site hair differs from the hair in balding areas in that it is genetically programmed to last a lifetime - to resist the destructive effect of testosterone. In normal circumstances, nobody ever loses all of their hair. Celebrities who have used a hairless head as part of their image have usually achieved the effect by shaving at least part of their head!

donor strip: a small piece of hair-bearing skin which is taken from the donor area - that part of the head which contains permanent hair follicles - so that the follicles it contains can be separated and implanted individually in the areas of hair loss. The size of the strip will be determined by the number of grafts to be placed - every single follicle will be implanted, none are discarded.

extraction procedure: there are two ways that follicles are extracted, either singly by follicular unit extraction (FUE) or in a group by multiple follicular extraction. Both methods require the use of topic anaesthesia. Neither method, if it is carried out correctly, will leave a scar in the area from which hair was extracted (donor area). The FUE method requires that the single follicle is implanted almost immediately and the process of extraction and implantation is therefore slower and fewer hairs can be implanted safely in a single session (800 maximum). Multiple follicular extraction does not have these restrictions and up to 10,000 follicles can be implanted in one session.

female alopecia: hair loss and baldness in women. More common than people imagine, many women suffer from hair loss but are adept at concealing the fact. Hair loss in women may occur due to the same factors as male hair loss (including androgenetic alopecia) but may also be caused by other factors like lack of iron in the blood and hormonal problems. Female hair loss is often temporary and can be treated medically. When female hair loss is permanent, the remedy can be hair transplantation, the same as for male hair loss.

finasteride: Propecia (active ingredient finasteride 1 mg) is a pill originally developed for prostate treatment. Research has shown that some patients taking the drug noticed a delay in hair loss from the top and back of the head (though not from other areas). It should be noted that this only occurred where there were live hair follicles and that it only happened whilst the patients were taking the drug. Only 2% of men taking the pill for 1 year and 5 % of those taking it for 2 years had positive results and these positive results stopped 6 months after ceasing to take Propecia.

follicle placement: once the follicles have been detached, either after extraction by FUE or multiple follicular extraction, the follicle or follicular group is implanted as a single graft into an area of hair loss. There are various names given to hair transplantation procedures causing some confusion amongst readers but the final result of a hair transplantation is far more to do with the skill of the doctor carrying it out than it is to do with a 'technique'. Placement involves aesthetic judgments concerning the position and angle of a follicle, and consideration of the density and shape of hairs as a group and the overall effect on the head of hair as a whole. The transplanted hair will last for a lifetime so it is very important for it to be placed correctly.

follicle: the tiny tubular sheath beneath the surface of the skin containing the organ which produces hair. Follicles producing hair on the head are often grouped together naturally and emerge from the same pore in the skin. All follicles and follicular groups are surrounded by an area of hairless skin.

follicular damage: follicular damage can result in irreversible hair loss. Follicles can be damaged by a number of different causes. Androgens circulating in the blood stream progressively weaken the follicles (miniaturisation). Follicles can be damaged by trauma caused by an accident, for example burns. Follicles can be damaged by neglect - hair care is an important factor in reducing hair loss. If care is not taken, follicles can also be damaged in the surgical process of transplantation. Microscopically isolating follicles and follicular groups carefully can prevent follicular damage. Studies have suggested that the FUE method, if not carried out extremely carefully, can result in follicular damage both to the follicle being removed as well as to its neighbouring follicles.

follicular grouping technique: nature groups small numbers of follicles together around a common blood supply. This follicular group then emerges from the skin through the same pore producing between 1-5 individual hairs. Modern equipment and techniques allow for each follicular group to be isolated and transplanted intact in the natural grouping. By simulating the way hair grows normally, a skilled surgeon can create a natural-looking effect with natural hair density.

follicular unit: a group of 1-5 follicles which grow together in the scalp sharing the same blood supply. The group can be transplanted as a single unit by grafting it into an area of hair loss.

front line: or hairline, the shape on the forehead and top of the head defined by the extent of hair on the head. Nature determines this line at first but as hair loss progresses the line recedes and starts to break up. When hair is implanted it redefines the front line. The placing of hairs when they are implanted should be done carefully and in such a way as to create a natural effect - for example, defining a line which is curved, asymmetrical and slightly staggered. Often the Plastic Surgeon will physically draw this line on the head with a marker before the transplantation. Once the hair has been transplanted the hair will be permanent, the front line will not change again.

growth angle: the angle at which hair grows naturally. This angle differs from one person to the next. When hair is implanted it is important for it to fit into the natural pattern of the recipient.

hair density: the number of hairs contained in a given area of the scalp. The doctor will use a magnifying densitometer to measure hair density precisely. Hair density varies from person to person and varies with age for any one person. We all lose hair as we grow older and the density of our hair decreases. Some parts of the scalp are less susceptible to hair loss than others and retain a higher hair density. Hair density is important to the hair transplantation process. Firstly, hair density in the donor area establishes how many hairs are available for transplantation. Secondly, the density of implanted hair will establish what area can be covered by the available hair. Up to 50% of the hair in the donor area can be removed before it starts to show. Implanted hair can be effective even if it is placed at about half the normal density, enabling a much greater area of hair loss to be covered than the area occupied previously by the donor hair.

hair loss medications: a centuries-old industry built around the dreams of bald men to re-grow lost hair. Many concoctions fail to deliver on promised profundity. But there are some genuine medical remedies too. For men, research has shown that an unexpected side effect of some drug therapies is that hair loss can be stopped and, in some cases, hair re-growth can occur (see finasteride). Unfortunately, the effect only lasts whilst the drug is being used. For women, hair loss can sometimes be the side effect of a medical condition. Such hair loss in women can be reversed if medical conditions such as lack of iron in the blood are treated. It is best to consult a doctor about the causes of hair loss first, to establish if there is a clinical treatment appropriate before making decisions about hair transplantation.

hair loss: there are many reasons for loss of hair to occur. Some hair loss forms part of the natural growth cycle - old hair is shed as the new hair grows, some hair loss is temporary, for example, brought about by medication, stress or a shock, some hair loss is permanent, caused by the ageing process as follicles gradually lose the ability to grow new hair through the miniaturising effects of hormones in the bloodstream.

hair plugs: also called traditional standard grafts. The early method of hair transplantation was to take a small plug of hair-bearing skin (3-4mm in diameter containing up to 30 hairs per graft) and implant it into a slightly smaller hole in the skin of the area of hair loss. A number of these plugs would be distributed throughout the area of hair loss. When the hair in the plugs grew it covered the uneven density to a certain extent but the plug effect became obvious in the swimming pool or when the hair became wet. The result is called doll's hair for obvious reasons. Nowadays, this undesirable effect can be corrected by skilled treatment by a Plastic Surgeon.

hair restoration: strictly speaking, hair restoration can only occur if hair loss was caused by a temporary factor and the follicle is still able to produce new hair. Some medication can restore hair in some cases but this effect is usually only apparent whilst the medication is being used and disappears when medication is ceased. Baldness usually occurs when the follicle dies permanently. Hair CAN grow again and thrive in areas of baldness but only if it is transplanted from a different part of the head.

hair root: hair grows from a small organ located beneath the surface of the skin commonly referred to as the hair root. The medical term for the hair-growing structure is a follicle. A follicle measures about 1mm in diameter and extends to about 3-4mm below the surface of the skin. The follicle contains the entire mechanism for growing hair. If this follicle is implanted into an area of bare skin it will establish itself and continue producing hairs.

hair transplant: the process of taking hair from the permanent zone and transplanting it into an area of hair loss.

hair transplantation: hair relocation, the permanent remedy for areas of hair loss. By removing hair roots from areas of the scalp which are resistant to hair loss and placing those roots into bald areas, hair will again thrive, changing your appearance forever.

hairline: or front line, the line at the top of the forehead where hair growth starts. The hairline forms the frame around the face and helps define our appearance. Hair transplantation changes this line forever so it is important for any alteration to the hairline to be made by the hands of an aesthetic surgeon.

implantation: or grafting, the insertion of single follicles or follicular groups into the scalp. Once the hair follicle has been removed from the donor area it is stripped of excess tissue and inserted into a tiny incision in the skin of the bald area of the head. The incision heals in a few days without leaving a mark and the implanted follicle grows in its new location as if it were natural.

implanted hair: exactly the same as normal hair. When it has grown fully it is indistinguishable from the rest of the hair on the head.

implanter: a tool used to place follicles into bald areas of the scalp. Modern techniques use microscopes, microsurgery and small, specialised tools to work with precision, creating superior results.

local anaesthesia: hair transplantation takes place using local anaesthesia. Topic anaesthetic is injected into the skin of the donor and implantation area to cause numbness in the same way that a dentist numbs gums prior to dental work. You will be conscious and comfortable throughout the whole transplantation procedure.

mega session: a hair transplantation in which a large area of baldness is covered using a large number of grafts. Up to 10,000 follicles can be transplanted in one session using multiple follicular extraction depending on the availability of sufficient donor hair.

method of hair transplantation: there is a confusing variety of names used for hair transplantation. Each clinic, each centre, each website, seems to have its own individual named method. Put simply, there are two parts to the process of hair transplantation - the extraction and the implantation. There are just two methods of extraction - FUE (follicular unit extraction) and multiple follicular extraction. Each results in small grafts of follicles or follicular groups which can be stripped of extraneous tissue and implanted into bald areas. The Micro-Dense-Pack technique for the placement used by the Plastic Surgeons here has been developed to recreate natural looking hairlines and natural density of transplanted follicles thus creating a totally natural effect.

micro session: one disadvantage of extensive hair transplantation is that it can have a significant affect on appearance - for example, someone thought of as bald later has a full head of hair. An alternative to the mega session is the micro session whereby a patient has a number of small transplant sessions as hair loss progresses thereby maintaining their appearance. The FUE method has many advantages for patients interested in this approach to hair loss.

micrograft: a graft smaller than 1.5mm in diameter which may contain between 1-3 hairs per graft

minigraft: a graft of between 1.5 - 2.5mm diameter which contains 4-12 hairs per graft hair

minoxidil: Rogaine (active ingredient minoxidil 5% solution) was originally used in the 1970s for patients with high blood pressure. As a lotion, it can delay hair loss and can sometimes result in hair re-growth whilst the drug is being used. The lotion is sometimes used after hair transplants.

natural appearance: nature is never perfect and it is these imperfections which endow a natural effect. Placing follicles so that they are too evenly spaced or form a straight line or are too symmetrical on the head, all of these give an unnatural appearance. It is the art of aesthetic surgery to enhance appearance by replicating nature as far as possible.

non-invasive hair transplant: a term used incorrectly to describe FUE (follicular unit extraction). Implantation, transplantation, is an invasive process by its very nature. Extraction by FUE removes only a small area of skin which heals without requiring stitches.

no-scarring technique: if performed correctly, no transplantation method leaves a scar. With the FUE technique of hair transplantation a small circle of skin containing a single follicular unit is removed for immediate implantation. This leaves a small wound which heals without the need for stitching. Multiple follicular extraction requires the removal of a small piece of hair-bearing skin which is then dissected microscopically into individual grafts of single follicles or natural follicular groups. The incision made to remove the piece of skin will require stitches to aid healing. The technique used for this part of the operation is crucial to prevent scars or marks remaining after healing. The special techniques used by Plastic Surgeons have been perfected to allow incisions to heal without scarring. Plastic Surgeons performing hair transplantation use these techniques when they perform multiple follicular extraction.

number of grafts: the number of implants made in a session. Grafts could be single hair follicles or follicular groups containing a small number of hairs in a natural grouping. The doctor will use a microscope to individually prepare each follicle or follicular group for implantation and every single graft is recorded. The number of grafts will have been agreed before the procedure, the doctor removes this amount, prepares them and implants every one of them, none are wasted. You will receive a confirmation certificate of exactly how many grafts were implanted.

pain-free procedure: see local anaesthetic. All methods of hair transplantation are pain-free and are carried out with the assistance of an anaesthetist and using local anaesthetic.

permanent zone: the area of the head containing hair which is resistant to the effect of androgens circulating in the blood stream. This zone is usually the back and lower sides of the scalp. The hair here is considered permanent and it keeps this permanent quality even when transplanted to an area of bare skin or baldness.

plastic surgery: a term used for surgical intervention for reasons other than medical necessity. Plastic surgery is used to reconstruct tissues after trauma, an accident, burns or major surgery. It can also be used to enhance the appearance of a patient. Plastic surgeons who have specialised in hair transplantation can use their particular skills to great effect, ensuring the best results without signs of intervention.

procedure: the surgical operation of extracting and implanting follicles or follicular groups.

Propecia: see finasteride, the active ingredient in this medication.

recipient area: area into which the extracted follicles and follicular groups are implanted. The size of the recipient area is governed by the number of hairs available in the donor area.

scalp: the skin and hair covering the top of the head

sides of the head: the temples, high on the sides of the head, are usually the first areas to suffer hair loss as the hairline recedes. Lower down the sides of the head, just above the ears, the hair is resistant to the causes of hair loss and this hair is permanent and can be used as donor hair.

single hair grafting: a technique of hair transplantation in which the follicles are removed and implanted one by one.

strip extraction procedure: the multiple follicular extraction technique of hair transplantation in which a long narrow piece of hair-bearing skin is removed, usually from the back of the head. Then, under a microscope, the individual follicles and follicular groups are isolated from surrounding tissue and prepared for individual implantation. The advantage of this method is that a natural balance of sizes of follicular groups is available for transplantation unlike FUE which, because of the contraints of the punch size, restricts the doctor to extracting only smaller follicular groups (4 hairs maximum).

thinning hair: the first signs of hair loss become visible as the density of hair reduces to a noticeable extent. The effect of DHT in the bloodstream upon follicles (tiny hair-producing organs in the skin) is to begin to miniaturise them. These follicles become smaller and produce hair that is progressively thinner and less pigmented. DHT also affects the growth cycle of the follicle causing it to produce a shorter and shorter hair until the follicle finally dies and hair production ceases irreversibly.

transplant session: a single procedure, extraction and implantation of an agreed number of grafts in one 'sitting'. Depending on the methods used, up to 10,000 grafts can be made per session which can allow a complete transformation in one go. If further sessions are required, a second session can be performed about 10 months after the first.

transplanted hair: relocated hair, hair taken from a donor area and implanted into an area of hair loss.

treatment: the medical or surgical care given to a patient to achieve a desired result.
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