With locations in Rockville and Towson and serving the residents of Alexandria, Potomac, Columbia, Bethesda, and the surrounding communities, Dr. John Kiely is helping his patients understand the solutions for hair loss.

When confronted with thinning hair or baldness, men and women consider hair transplantation, which is a permanent form of hair replacement. Anyone who has suffered permanent hair loss may be a candidate for hair transplantation. People who may benefit from hair transplants include the following:

  • Men with male pattern baldness
  • Women with female pattern baldness
  • Men and women who have lost some hair as a result of burns or other scarring injuries to the scalp, including those with permanent damage due to traction, as in some advanced cases of traction alopecia or trichotillomania.

Once it has been determined you are a candidate for hair transplantation, you will be informed as to what your options are. These options include the following:

  • Do Nothing. It is extremely important that you know what your goals are. You may just choose to be bald. If that is the right look for you, do not consider hair transplants an option.
  • Hair Piece. Wigs, hair pieces, toupees, hair systems, extensions, etc. all offer a temporary solution and may well be an option. They require regular maintenance for life or as long as you choose to go that route.

Topical or Oral Medications

  • Rogaine (minoxidil) has recently become available over the counter. It was a prescription-only topical solution for many years. It is now being offered with a higher strength formulation and is also available for women. Continuous use of this medication has resulted in some regrowth and the slowing of the hair loss process in some individuals, in certain areas of the scalp. It may be used in conjunction with hair transplants. It is a temporary solution. Once you stop using it, hair loss will continue its normal course.
  • Propecia (finasteride) was approved by the FDA to be used for hair loss in December 1997. It comes in 1mg/day tablets, is available by prescription only and may be used in conjunction with hair transplants.

Propecia is a specific inhibitor of 5-a-reductase, the enzyme that converts testosterone into DHT. It is indicated for the treatment of male pattern baldness (androgenic alopecia) in men only. It is not indicated in women or children. It may have some side effects, such as sexual dysfunction, and its benefits stop once you stop using the drug. It is a temporary solution. To benefit from it, you must use it for life. Results have been reported in patients with mild to moderate hair loss of the vertex (crown area) and anterior-mid scalp area only. No results have been found in bi-temporal or anterior recession.

Hair Replacement Surgery

When considering any form of hair replacement surgery, it is important to be aware that the practice of medicine and surgery is not an exact science and no guarantee can be made as to the final results. Even though excellent results can be obtained, there are some risks involved and results vary from patient to patient. Ask your doctor for details.

  • Flaps. Although they may be indicated in certain cases, this procedure has more risks than scalp reductions or hair transplants. It requires general anesthesia. This procedure involves dissecting out all but one corner of a strip of scalp and rotating it around across the front of the head to replace the hairless scalp. The skin around the area from which the flap is removed is pulled together and sutured shut. Hair bearing flaps often have an unnatural appearance. The flap hairline will invariably be directed in the opposite direction. Furthermore, the donor and recipient scar can be obvious with the de-pigmentation of the skin along the hairline.
  • Scalp Reductions. This is a surgical procedure in which excess skin is removed from the bald area on the top and crown of the head. The hair bearing areas on the sides and back of the head are drawn closer together, thereby reducing the bald area Undermining the scalp on either side of the incision is necessary to loosen up the tissue so that the borders can be drawn closer together for closure. This results in hair loss in the undermined areas. In many instances, the reduced scalp can also stretch back apart.
  • Hair Transplants. This is a permanent form of hair replacement. It is a surgical procedure which involves moving some hair from hair- bearing portions (donor sites) of the head to bald or thinning portions (recipient sites). With the use of modern techniques, excellent results can be accomplished, restoring one’s hair with density in the treated area. This is the most recommended form of hair replacement surgery. It has been proven safe, with very little risk involved. Once your own healthy hair is relocated, it can be cut, washed, combed and dried without undue concern.

The first hair transplants were performed by Norman Orentreich, M.D. in the mid-fifties. Dr. Orentreich followed his patients over the years and found that transplants performed more than thirty years ago are still thriving. Similar results have been observed by qualified practicing physicians indicating that properly performed hair transplants are safe, permanent, and effective. Why will hair transplanted into bald areas continue to grow when hair growing previously in that area fell out? The answer is surprisingly simple and goes back to the genetic issue. Certain hairs on your head have been preprogrammed to fall out; all other hair will last a lifetime, regardless of location. Relocating that healthy, growing hair to the bald area will not affect its growth pattern as long as the entire follicular clump along with its supporting structures is moved. In the September 1997 issue of Dermatologic Surgery, a study on micrograft size and subsequent survival mentioned the fact that hair grows naturally in follicular clumps, that is, clumps of hair follicles. These follicular clumps, although there are some variations, usually exist in the following distribution: approximately 10% of follicular clumps grow as one-haired units, about 50 to 60% grow as two-hair follicular clumps, and the remainder grows as three- to even five-haired follicular clumps.

Thus, it would make sense that whatever technique for hair transplantation is used, it must make certain that the naturally occurring follicular clumps be relocated as a whole unit. Single hairs should not be separated from the rest of the hairs in the same clump if we are to guarantee graft survival with subsequent hair production. In fact, that was the conclusion of the study mentioned. “Extremely high survival rates of micrografts are obtainable by transplanting intact follicular clumps with protective tissue around the micrograft, and preserving the follicular clump’s sebaceous gland. These survival rates were not achieved when micrografts were produced by splitting individual hairs away from a naturally occurring follicular clump.” These results were not surprising. Dr. Kiely has performed thousands of transplants using mini and micrografts harvested from the donor area in such a way that the entire follicular clump has been captured within the graft. In Dr. Kiely’s office, state-of-the-art instruments are used throughout the procedure. The size of the graft, whether mini or micro, is determined by the receptor location. Minigrafts are implanted throughout the top and the crown of the head to achieve density and provide maximum coverage and density while micrografts with 1 to 3 hairs are implanted along the hairline creating a soft natural look. The grafts are precisely placed at specific intervals to ensure proper nourishment and growth. Particular attention is given to the angle of exit and the direction of the individual hair shafts in each graft. A second procedure is usually required 6 to 8 weeks later to go back through all the previously placed grafts to ensure that the blood supply has returned to normal.

The grafts are harvested from the donor area, one at a time, and each graft is immediately placed in its receptor site. This method of immediate transplantation provides improved results since fewer cells die in the process of transplanting the grafts. Although some doctors prefer to remove all grafts before transplantation, Dr. Kiely advises against it. This procedure is done under local anesthesia, with relatively minor discomfort. It may take about 3 hours to complete. Dr. Kiely personally performs the entire procedure aided by two highly trained assistants. Patients return to the office the following morning for post-operative care and 1 week later for a checkup. Most people are able to return to work after their post-operative care. Although each patient’s hair grows at a different rate, new hair will usually begin to grow after approximately 90 days. This waiting period can be difficult, and patients who become anxious often call during this time to question the results.

Your hair transplant can be modified according to your desires. Patients may elect to speed up the procedure or slow it down depending upon their particular needs. While hair transplant surgery is one of the safest surgical procedures practiced today, the patient’s overall health does play a role in the final decision. Transplantation, however minor, is still surgery and reputable hair transplant physicians will perform the procedure only after analyzing the status of a person’s health. Age has little to do with hair transplant success since hair follicles are genetically programmed, thus affording men and women in their sixties and seventies excellent results. Hair transplants are becoming increasingly popular with women to augment thinning hair, hide plastic surgery scars, and lower receding hairlines. The process is an effective method to treat these conditions. Dr. Kiely has treated many women who have expressed great satisfaction with the outcome.

What Is the Cost of Hair Restoration in Washington?

The price of hair restoration varies for each person. The cost depends on the extent of surgery necessary to achieve your individual appearance goal. Dr. Kiely accepts cash, credit cards (Visa, MasterCard, Discover, and American Express), and checks as payment options.

Additional Hair Loss Topics

With more than 30 years of experience and over 14,000 procedures performed treating hair loss for men and women in Washington, DC, Maryland, Virginia, and Pennsylvania, Dr. Kiely recognizes that each patient has unique requirements and desires. His services have improved the lives of people from in and around Baltimore. Dr. Kiely specializes in hair loss solutions for men and women by performing hair transplantation procedures such as Follicular Unit Extraction, Mini-Micro Grafting and Micro Grafting. If you are looking for self-improvement in the form of hair restoration, Dr. Kiely and his professional team will accommodate your needs! Please call 301-468-2335 today to schedule your free initial consultation!