Hair loss is inevitable for many men. Male pattern baldness is a prevalent condition throughout your family history. At a young age, you’d hoped against hope that you would not fall victim to the hair killing effect of the hormone DHT. Yet, by the age of 25, your hairline had begun to recede. And by the age of 30, your crown was thinning. You tried for years to wear your thinning hair with pride and not allow it to distress you emotionally, socially, interpersonally, and professionally. However, now at an NW 4, the condition is taking its inevitable affect on your self-confidence.

There are different options available when it comes to addressing loss of hair. This includes:

  • Surgical  hair transplantation
  • Oral and topical pharmaceuticals
  • Hairpieces, toupees, and wigs
  • Artificial hair implants
  • Cosmetic concealers made of creams and powder-based fibers


As for a surgical means of regaining one’s hair, we once had a few methods that are now considered antiquated in regard to hair restoration. These include:

  • Scalp reduction
  • Temporo-occipital flap surgery
  • Punch grafting

Though these surgical procedures still exist as solutions for various medical needs, they are rarely, if at all, used for hair replacement.

The most effective and permanent way to reverse hair loss is still, indeed, through surgery. But now it is particularly through the sophisticated practice of hair transplantation. And within this restorative medical niche, there are several different methods, techniques, and tools. When researching surgical hair replacement, one would easily come across:

  • Strip harvesting
  • Follicular unit extraction (FUE)
  • Body hair transplant (BHT)

Strip harvesting, also known as follicular unit transplant (FUT), is the oldest of the three. A practice that has been in vast usage since the 1980’s, this method cuts out a horizontal strip of flesh from the patient’s posterior scalp. The wound created is then closed with stitches or staples, and the excised strip is further dissected into follicular units (natural clusters of one to four hairs). This procedure, though effective and permanent in restoring lost hair, has become a little outdated itself. It lacks the ability for finer hairline design, since the donor hairs come from the thickest-growing portion of the scalp. And, worse yet, it leaves the infamous linear scar in its wake. This telltale sign of hair transplant surgery, along with unnaturally harsh hairlines, have been the reasons for which prospective patients are opting for follicular unit extraction instead.

Strip scars caused by strip harvesting, corrected by FUE.

Follicular unit extraction has proven itself as the superior hair replacement solution. In the care of an advanced and experienced surgeon, FUE outmatches any other form of hair transplant. Instead of harvesting the follicular units in a scar-bearing strip of flesh, this method excises the follicular units one by one. This means cosmetically acceptable scarring, the freedom of the surgeon to select specific hairs for hairline design (such as finer hairs from the nape of the neck), and NO LINEAR SCAR. Additionally, this micro-surgical technique has proven so sophisticated that it has developed into the optional use of non-head hair—body hair transplant.

Body hair transplant (BHT) or body hair to head transplant, is an extremely advanced form of FUE that utilizes non-head donor hair. Performed in much the same way as described above, BHT should only be entrusted to the highest-level FUE surgeons. This method is ideal for the NW 6’s and 7’s who have no other hope; and for victims of hair restoration surgery gone wrong that left them scarred and disfigured. These patients usually have no scalp donor source, as the majority of head hair is already depleted. Thus, advanced FUE surgeons are able to branch outside this traditional donor area and make use of hair from the beard, shoulders, chest, stomach, arms, and legs.

Body hair transplant restored this patient from an NW 7.


Many hair loss sufferers, who would rather find a non-surgical solution, will be best served by finasteride or minoxidil. These two drugs are the only FDA-approved hair loss deterrents available.

Finasteride, commonly known as Propecia, is an oral medication obtained by prescription. Usually taken once per day in 1mg doses, it is proven an effective inhibitor of DHT amid the vertex of the scalp only. Finasteride will not prevent hairline recession and is contraindicated in women and children.

Minoxidil, know commercially as Rogaine, is a topical medication sold over the counter. This method of hair replacement requires daily application, directly on the affected areas of the scalp. Rogaine comes in a 2% concentration for women and 5% for men. As with finasteride, it is proven effective with crown hair loss, but ineffective at preventing loss along the hairline.


Hairpieces can be a precarious method of concealing hair loss. However, some people find it their best personal method of hair replacement, even if only for a temporary period. A variety of hairpieces can be found online or at any wig store, and include real hair, synthetic hair, ready-made, custom, long, short, curly, straight, and come in an abundance of different colors. The main choice hairpiece wearers have to make is between:

Acrylic hair: This synthetic fiber makes relatively natural-looking hair and is easy to wash and care for. However, acrylic is extremely susceptible to heat, including hot weather. It may even melt when too near a grill, fire, or oven, and should never be styled with heated hair appliances. Acrylic hairpieces typically last up to nine months for daily hair replacement.

Human hair: This type of hairpiece is the more natural-looking choice, however its color may fade with time and it may require monthly professional cleaning. Human hair can be styled with heated appliances and worn safely near heat. It lasts up to two years when well cared for.


Believe it or not, there is the option of having synthetic hair surgically implanted in the scalp—but not in the United States. Due to the frequent cause and high risk of scalp infection, the FDA has banned the implantation of artificial hair. The now-foreign demand for such hair replacement is met by two main sources: Biofibre and Nido. Biofibre, initially sourced by Italy and made of plastic, claims to be human tissue “friendly” and non-reactive; while Nido, created in Japan, claims to have no harmful dyes and is covered in a layer of collagen for better bonding to scalp tissue. Though both of these lines of synthetic hair claim to be safe, effective, and permanent via implantation, they do not take root and grow, like human hair, thus are subject to being permanently pulled out. Results are pluggy and may leave severe scarring. This method to treat hair loss is not advised.

This patient had his hairpiece sewn into his scalp. Severe infections and scarring ensued.


Cosmetic concealers are the most temporary form of hair restoration. These creams and powder-based fibers are usually applied for a special night out, or perhaps for a photo shoot or the filming of a movie. Such products, like Toppik and DermMatch, are made of keratin and, once “sprinkled” onto the hair, adhere to each follicle through electro-magnetic force. They work by thickening each individual hair, giving an illusion of overall fullness. In terms of freedom with hair replacement, these often messy products can be limiting. They are not waterproof, and would thus be compromised in rain, while swimming, or while sweating heavily. Additionally, their use can be detected in direct sunlight.


If you are interested in learning more about surgical methods in hair restoration, click here to read more.

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