Surgical planning with different types of hair loss
Since transplanted hair will usually last a lifetime, we believe that careful planning to fill the needs of an individual patient is the first and foremost consideration. Following a decade of successful transplant procedures, we have come to realize that the decision to undergo a hair transplant is more than just a medical procedure, as it is also about improving one's appearance and self-image.

For the most natural-looking results it is necessary to strike a fine balance between the considerations of density and coverage. This usually means transplanting above average density in front, to frame the face, and using less density towards the crown. Nevertheless, every patient brings a unique set of considerations that will influence the options discussed during his/her initial consultation. Dr. Rahal will take into account various factors, such as the patient's age, complexion, stage of hair loss and, of course, his or her personal expectations.

There is never a good age to experience hair loss, but for younger men it can very traumatic. The disturbing fact is that the earlier hair loss begins, the more extensive it is likely to be. Given that we all age differently, there is also no way to predict the extent of hair loss over a lifetime.

illustration of hair loss in young man (pre surgery)

The good news is, however, that the sooner a young man develops a plan to address hair loss through medication, hair transplantation or both, the better the results can be. At our clinic, a significant percentage of clients are young men. As a result, we have developed a specific approach to these patients and this has produced amazing results.

Typically, when it is reasonable to perform a transplant for a younger man, we can recreate a high-density hairline and reduce the angles of the temple hairline. The result is a very natural and youthful look. Keep in mind that all patients have a limited amount of donor hair to use for transplanting. At the Rahal Hair Transplant Institute we take the time to make sure that we are making the best possible use of the donor hair available.

Receding Hairline and Crown Hair Loss

In many cases, crown balding can be easily treated. Many patients are fortunate because they have a great donor area with plenty of hair density, and their entire head can be covered with transplanted hair as a result. For patients in the right age group who have crown balding and minimal frontal recession, transplanting hair into the crown can be a great option.

illustration of crown balding (pre surgery)

However, for younger patients and those with extensive hair loss, the crown area becomes secondary. In these cases, it is necessary to first treat the hairline and top of the head in order to frame the face. This is a very important part of a hair transplant.

A receding hairline is often the first sign of significant hair loss. When this happens, the hairs become smaller, the hairline starts to creep up, and the temples become more exposed. Many people begin to panic, but at Rahal Hair Transplant Institute we can help it disappear through proper treatment of a receding hairline.

illustration of receding hairline (pre surgery)

illustration of receding hairline (pre surgery)

illustration of receding hairline (pre surgery)

illustration of receding hairline (pre surgery)

Regular Norwood Classes
	Type II • Temporal recession < 1" • Mild recession along frontal hairline • "Mature" hairline
	Type III • Further frontal recession • Deeper recession at corners • Earliest stage of balding
	Type III vertex • Hair loss predominantly in vertex (crown) • Frontal hairline recession may be present
	Type IV • Further frontal hair loss and temporal recession • Enlargement of vertex (crown) • Solid band of hair across top separating front from vertex
	Type V • Frontal and temporal areas enlarge further • Band separating the two areas becomes narrower and more sparse
	Type VI • Frontal and vertex balding areas merge into one and increase in size

Dense Packing

Transplanting new grafts into the recipient area can be done at various densities. The definition of what dense packing is varies from one clinic to another. We feel any density grafted between 60 to100 grafts/cm is a realistic definition of dense packing. Dense packing the hairlines in this range is only done once certain criteria are met. These criteria include donor density and capacity, age, hair characteristics and ultimately patient's goals and expectations. Please note that we use follicular unit grafting that is exclusively prepared with microscopic dissection in order to create the ultimate natural hairline.

Mega Sessions

Just as hair loss presents at various degrees of severity, the treatment graft quantity required will also vary. What was a definition of a mega session years ago has now been surpassed quite easily on a regular basis. The number of grafts done in one sitting has been continually increasing. We will routinely perform sessions between 2,000 (old definition of a mega session) to 5,000 grafts per session. Yet, patient's needs and specific situation will ultimately determine the number of grafts required.

Suturing Techniques
With strip surgery there will be a residual scar in the donor area. The tricophytic method of donor closure will allow hair to grow through the scar. This will camouflage the scar and minimize its visibility for shorter hairstyles. We use the trichophytic closure method on all strip patients. Examples of healed strip scars are below.

Tricophytic Scar

Lateral Slit Techniques

We use the lateral slit technique exclusively on all patients. The lateral slit, in simple terms, is the orientation of the slit openings in the new graft recipient area.

It has been shown that by orienting the slit in a specific way, we can create a better illusion of coverage. It also ensures the grafted hair angle remains in its intended direction, as it exits the scalp.


Hairline Design

Hairline design is more art than science. There certainly has to be some scientific basis to support the surgical plan, but the end result will ultimately depend on the artistic approach to designing the hairline.

We feel that creating a natural-looking and absolutely undetectable hairline is the most important aspect of this procedure. Unfortunately, not every clinic values this important point, so the patient may end up with more hair, but the design used could clearly give it away as a transplant.

When designing the hairline, Dr. Rahal takes into consideration as much information from the patient as possible. This will include age, hair characteristics, current and future level of hair loss, ethnic background, facial features and, of course, the patient's realistic goals.

While using this information, Dr Rahal has the eye and talent to create a hairline that has a proper placement height and temple angle closure.

illustration of receding hairline (post surgery)

Temple Angles

Proper approach to dealing with temple closure can separate an extraordinary hair transplant surgery from a merely good one. The small percentage of grafts used to close the temples will provide a huge return in the youthfulness and naturalness of the end result.

Every patient's design is individualized. The option of closing temple angles is discussed with the patient at length as part of surgical planning.

illustration of temple point hair loss pattern

Temple Points

There are patterns of hair loss where the temple points have receded. In the right patient, restoration of temple points is possible and is recommended to achieve a very natural overall appearance.

illustration of temple point angles

Donor Site Laxity Exercises

During strip surgery, the donor area should be as mobile as possible. This ensures minimal tension during closure, and ultimately a thinner scar. This is especially important when there is a scar tissue from previous surgery. Massaging donor areas on a regular basis prior to the surgery will increase this mobility. We will explain how to do this during pre-operative instructions.


Treating Female Hair Loss

Hair loss in females is less scientifically understood. It is also of hereditary nature but the hormonal influences may differ from the ones in males. Ongoing research is still being performed to understand this phenomenon better.

THE LUDWIG SCALE FOR WOMENS HAIR LOSS

FAQ’S

Who is a candidate?
Any male or female with hair loss may be a candidate for hair restoration. Age, expectations and medical conditions are also to be considered.

Why should I consider a hair transplant?
Quite simply, hair transplantation is the only method that gives you your own hair that grows naturally and permanently. Limited medications available may be effective but require a lifetime commitment and considerable expense.

Does a hair transplant really work?
Yes, and we have legions of happy patients who will agree. Hair transplant surgery involves moving healthy hairs from the "donor area" of the scalp to areas where the hair is lost.

Where is the procedure performed?
Hair transplantation by Rahal Hair Transplant Institute is performed in our comfortable, upscale, fully-integrated surgical suite, located on the premises of our private centre in Ottawa. Highly experienced, qualified staff members assist Dr. Rahal throughout every procedure.

Is a hair transplant painful?
Hair transplantation is only a minor "skin surface" procedure. Many other medical and dental procedures could be more uncomfortable than a hair transplant. At the clinic, we use a combination of oral tranquilizer and local anaesthetic. Most patients fall asleep during the procedure. After a hair transplant procedure, most patients feel minimal discomfort and always have the option to take pain medication (personally prescribed by Dr. Rahal, if necessary).

Should I expect a lot of bleeding?
The scalp is a very vascular region of the body and there will be a very negligible amount of bleeding. The good news is - this minimal amount of blood actually helps secure and bring nourishment to the newly transplanted grafts.

How many grafts will I need?
Every person's needs are different and the number and type of grafts can only be determined upon consultation. This is usually based on the extent of hair loss, hair characteristics and patient's expectations. Our typical procedures range from hundreds to thousands of grafts per session.

How dense will my new hair be?
Hair transplantation is a re-distribution of follicles from the donor area to the recipient sites. Since we are not creating any new hairs, the density will never be as thick as it once was. However, the transplanted hair, when properly done, can give the illusion of more hair. The result will be very pleasing to you. Keep in mind that (in the expert hands of Dr. Rahal) a little hair goes a long way. The change in appearance can be quite dramatic.

How long will the procedure take?
Surgery times vary from one person to another, depending on the quantity of grafts required to meet the patient's expectations. Typically, procedure times range from 3 to 8 hours.

How much will a hair transplant cost?
The total cost depends on the number of grafts and sessions needed in order to meet the patient's expectations. Hair transplantation is a meticulous and tedious process, which requires certain costs that are identified before the operation. The reward of the initial investment is that you will be comfortable and satisfied, knowing that you will have your own permanent and growing hair. Ultimately, this procedure is more cost-effective than non-surgical forms of hair replacement.

Are there any risks that I should be concerned about?
Hair transplantation is a minor form of surgery and is considered quite safe. However, as with any surgery, there may be some potential or minor complications. These will be discussed in great detail during your free consultation. Rest assured, Dr. Rahal would never perform surgery on any patient if he anticipates any possible dangers to the patient's well-being.

What is the most frequent question RAHAL patients ask after having their procedure?
Why didn't I do this sooner?

What if I have more questions?
Beyond the above frequently asked questions, you may still have others. Dr. Rahal feels that no question is too trivial. We highly recommend that you write them down prior to the initial consultation. You are about to embark on a journey that will forever change your appearance and your life. It is, therefore, imperative that you are comfortable with us and confident about the procedure. However, you will find, as many other patients have found before you, that your only regret would be not having done this sooner.

Have more questions? We can arrange a FREE consultation for you.