OUR PROCEDURES
At The Saratoga Hair Transplant at Williams, we provide the full range of hair transplant services. All of our hair transplantation is based on dissecting out individual follicular unit grafts of 1-3 hairs each under microscopes. In some patients, we use DFU (double follicular unit) grafts for the central areas if hair characteristics are favorable. Our goal is to always to have a relationship of mutual trust between doctor and patient. Over the years, this has been the key to our continued success and high rate of patient satisfaction.
Head
Eyebrows
Facials
Head
Corrective Transplant
Hair transplant surgery was started in the U.S. in the late 1950s and for many years the results were slightly unnatural and “pluggy” due to the large size grafts that were used. At The Saratoga Hair Center at Williams, all of our procedures feature much larger numbers of very small grafts, yielding very natural results, never “pluggy”. We currently utilize very sophisticated technical methods for repairing these old grafts, providing the patient with a “softer” look. In the majority of these formerly transplanted patients, the common issue is the appearance of a “wall” of dense plugs either right at the hairline itself or just behind it. We correct this by using a two-prong attack: first, by placing many hundreds of follicular unit grafts in front, using only 1- hair graft at the very front, and then quickly going to the 2- hair FU just behind the 1- hair ones. We then utilize the “Lucas Technique,” which is a method proposed by the late Dr. Manfred Lucas of Germany, in which 3-6 hairs are “slivered off” from each large graft, thus resulting in a smaller graft that doesn’t look so “pluggy.” These hairs that are removed from the larger graft are then cut into micrografts and are moved to another space where needed.
Temples/Temple Transplant
When we speak of the “temples,” we are referring to the vertical front wall of the hair that is above and to the front of the ears, usually featuring some degree of “temporal point” on each side. Obtaining a natural final result is only partially met by filling in the top of the head, as there isn’t any hair “holding up” the frontal projection of hair on top. By building up the temple hair, it better frames the face and serves to “hold up” the hair projecting out in front. If the temple hair under the frontal hair is weak and stringy in appearance, it will appear unnatural and sometimes even give the impression the frontal hair may be a hairpiece. Also, since many men have their hair turn gray or white in the temple region, transplanting this region just naturally darkens the hair there and makes it more youthful since most of the donor’s hair comes from the back of the head, where the hairs are darker. In recent years, we have become quite artistic in re-creating these temple areas with the dense-packing of tiny lateral slit grafts. It generally takes around 300-500 extra FU grafts to include the temples in the overall hair transplant plan for a single session. Please note, that not all patients are good candidates for this. In general, the patient should be over 35, have relatively straight, “non-kinky” hair, and have a plentiful supply of donor’s hair. In most “forelock” projects, there is by definition usually not enough donor hair to add this task to that of framing the face on top. We include transplanting the temples for approximately 30% of the male patients who come to us, and almost 90% of the females. It usually only has to be performed twice for most patients, each time involving placing around 100-160 FUs on each side per session.
Crown/Vertex Transplant
The crown (or vertex) is that circular area of baldness in the far rear of the balding scalp which lies on a mostly vertical plane. If there is residual hair in this area, it is directed in a swirl or whorl direction, similar to the spokes on a bicycle. When transplanting this area, the transplants are planted in this same pattern and with the same direction and angle as exists in nature. We generally tackle the crown as a separate project after first completing the top of the scalp for two reasons: one is that the amount of donor tissue that can be harvested without creating excessive tension on the donor closure is usually the amount necessary to fill in the top region. Secondly, when the entire top of the head is filled in along with the crown it is our experience that the blood supply to the crown area in some patients is slightly compromised and the growth of the grafts in that area is not ideal. When the crown is transplanted by itself, we consistently obtain 90-95% graft survival. While we are very good at making it look natural, in general, the crown cannot usually be made to appear thick, unless the patient has a relatively small area and a thick, loose scalp – which allows us to perform a scalp reduction before transplanting in the remaining area. Because the hairs in this region are in a “whorl” arrangement, going way from the center of the whorl, there is a minimal overlap of hairs, which does not lend itself to the appearance of fullness. They do, however, appear very natural in this arrangement. The crown is on a vertical plane and very exposed to the public. Therefore, none of the grafts can be over 2-3 hairs each, or they risk being slightly detectable. Because of this, only very small FU grafts are used in this region. The crown is not the most important area of the scalp. The frontal region and the mid-scalp are. Therefore, it is always wise and prudent to make sure that whatever donor’s hair is available is used primarily in these front and top sections first.
Frontal Forelock Transplant
In the mid-1990 Dr. Beehner began researching and writing about the ‘frontal forelock concept”, and has authored over 12 journal articles and 3 textbook chapters on the subject, in addition to 20-plus lectures all over the world. At The Saratoga Hair Center at Williams, we use two design patterns for patients who are a candidate for this procedure. These two patterns are the “oval forelock” pattern and the “shield forelock” pattern. The oval pattern is used as the more conservative of the two when the donor supply is quite small in comparison to the needs of the recipient area. In hair transplantation, a “forelock pattern” refers to a pattern in which there is a gradient of density from the front-center, where it is densest, to the sides and back, where the density tails off and is sparser in a natural way. The goal is to capture a relatively early stage of hair loss that many men naturally go through on the way to losing their hair. By doing so, the man’s hair doesn’t draw any attention as looking unnatural to someone that would view it. The chief requirements for this type of pattern to be successful are an artistic surgeon and a patient with realistic expectations. If those are present, there are very few patients who will not be satisfied with hair transplantation with one pattern or another.
Eyebrows
Eyebrow Transplant
We have been performing eyebrow transplantation for patients since 1996. Our techniques have improved vastly over those years, to the point where we are now able to control not only the angle but the direction of the curl of each hair. The number of procedures necessary to complete eyebrow hair restoration for a given patient can vary. Around 50% of our patients require only one procedure done and the other 50% have a second “fill-in” procedure done for additional density. This is heavily influenced by the remaining number of “native” eyebrow hairs that are present to build upon. Complications are very unusual, with the most common being a small area of purplish discoloration under the eyelids for a week or so or some mild swelling for a couple of days. For an eyebrow transplant, the donor hair is obtained is obtained from the back of the head, since this is the hair that will remain its natural darker color for the most years. If a person has a mixture of white and dark hairs in this donor area, we will usually “cherry pick” the better dark ones and use them only. Because this hair is from the back of the head, this hair will continue to grow, as it does on the scalp, and will have to be trimmed once a week by the patient for the rest of the patient’s life. The procedure takes around 3 hours to perform. We place around 120-160 micrografts in each eyebrow generally, the number being largely determined by the shape of the eyebrow the patient wants. For 4-5 days after the surgery, there will be tiny scabs that appear like dots of sand on the skin. These tiny scabs fall off a few days after surgery, leaving the eyebrow looking pretty much like it did before the surgery.
Facials
Mustache/Beard
Partial and full facial hair transplants have become increasingly popular in recent years. During this procedure, the doctor relocates hair from the back of the head to the beard/ mustache area. The follicles are individually placed, allowing the doctor to use his refined skill and artistry to customize the density and style to achieve your desired result.