OCT 2017

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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Page 29 of 68 | OCTOBER 2017 27 Whether you specialize in hair restoration procedures, are introducing new noninvasive options or serve an aging patient base interested in looking its best, it behooves you to understand the multiple adjunct therapies that help slow hair loss; the latest transplant surgery techniques to create younger, natural-looking hairlines; and camoufl age products that help to hide hair loss. Hair transplant surgery remains the most effective treat- ment for patients with receding hairlines and bald patches. While the candidate pool is limited, the introduction of ef- fective adjunct therapies, including fi nasteride, minoxidil, and low-level laser therapy (LLLT), has expanded the number of patients who may benefi t from surgery. "In the past, we would say 'Nobody gets transplanted until they're 30' and 'Women don't make good transplant candidates.' Now we know differently," says Dr. Niedbalski. "More people have become good candidates for surgery mainly because we can provide more support to the rest of the hair with adjunctive therapies. If your existing hair can be maintained, it is possible to transplant in and around thinning areas with less concern about the rest of that hair coming out over time." Patient Selection and Expectations Despite advances that have broadened the patient base, Dr. Niedbalski fi nds that, "in general, the best candidates for sur- gery are men in their late 20s to early 30s and up," he says. "So much depends on how much hair they've lost and how much hair you think they will lose in the future." Men in their late 20s with fairly signifi cant hair loss typically have the most to gain from surgery. "If I see that the hair is thinning all over the top of his head, his hairline is gone, and it looks like he is going to be bald, we can go ahead and transplant hair all the way up from the hairline to the back of his scalp and create a pattern that will last a lifetime. Even if he loses more hair, it will still look normal," says Dr. Niedbalski. Older men (50 and up) who are just starting to lose hair are also good candidates for surgical hair restoration. "An older guy who has enjoyed a good head of hair his whole life is not going to experience hair loss front to back," says Robert J. Reese, DO, Reese Hair Restoration in Edina, Minnesota. "Typically all he wants to do is add some density and re- establish an adult-level hairline." More challenging are young men in their early 20s who are just starting to experience a change in their hairlines. "If a young guy comes in, and he has a really thick head of hair but he's receding in the hairline, that's a tough one," says Dr. Niedbalski. "He wants the hairline that goes along with the rest of his hair, but I don't know how much more hair he's going to lose behind that. So if I make a really strong hairline that's nice and thick and then he goes on to have a lot more

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