A

Abdominal hair, for hair restoration surgery, 472

Abscess, as surgery complication, 506

Adenosine triphosphate (ATP), liposomal, for graft growth promotion, 452–453

Advanced hair loss patterns, 385–395

concluding remarks on, 395

consultation for, 387–389

in middle-aged man, initial evaluation of, 388

psychology of, 389

in older man, initial evaluation of, 388

psychology of, 389

introduction to, 385–387

patient evaluation of, 387–389

in middle-aged man, 388

in older man, 388

in younger man, 387–388

psychology of, 389

surgical planning for, 389–395

estimating donor hair available, 390

expectations in, 389

hair pattern design in, 390–395

patient’s wishes in, 389–390

transplantation for, guiding patients on postoperative considerations of, 388–389

in Norwood class VI and VII patients, 389

surgical planning for, 389–395

Aesthetics, in frontal hairline restoration, 351–353, 357

in hair restoration surgery planning, 346–348

with dense packing, 431–432

Age/aging, advance hair loss patterns and, 387–389

hairline maturation variations related to, 320

vertex balding progression by, 399

surgical interventions based on, 399, 401

Aide to Extraction (ATOE) instrument, 381

Alopecia, androgenetic, 325–334

case studies of, 332–333

cicatricial, 326, 328, 525

central centrifugal, 330–332

future hair restoration therapies for, 521

hair restoration surgery for, 343–350 . See also Hair restoration surgery (HRS).

imposters of, 328

introduction to, 325–326

nature of the problem of, 326

nonscarring, 326–328

nonsurgical therapy for, 335–342 . See also Nonsurgical therapy.

scalp repair for, 487, 500

scarring, 328–332

summary overview of, 333

diffuse unpatterned, 346, 387

frontal fibrosing, 328–330, 333

retrograde, 346–347

scalp micropigmentation for, 501

traction, 318

vertex, 397. See also Crown.

Alopecia areata (AA), as nonscarring, 326–327

alopecia incognito, 326–327

diffuse, 326–327

hair transplantation for, 327

overlapping conditions of, 332

scalp micropigmentation for, 501

Alopecia areata incognita (AAI), with female-pattern hair loss, 408–410

Alopecia incognito, 326–327

Alopecia reduction (AR), with scalp repair, 487–488

Alopecia totalis, scalp micropigmentation for, 501

Amamnesis, in vertex balding, 399

Anagen, in hair follicle renewal, 470, 523

nonhead donor hair and, 471

Anchoring zone, in vertex transplant, 405

Androgenetic alopecia (AGA), 325–334

case studies of, 332–333

cicatricial, 326, 328

future hair restoration therapies for, 521

hair restoration surgery for, 343–350 . See also Hair restoration surgery (HRS).

imposters of, 328

introduction to, 325–326

nature of the problem of, 326

nonscarring, 326–328

nonsurgical therapy for, 335–342 . See also Nonsurgical therapy.

scalp repair for, 487, 500

scarring, 328–332

summary overview of, 333

Anesthesia, for female hair restoration, 411–412

for follicular unit extraction, 377, 380

for graft harvesting, 367

for hairline lowering, 482

for megasessions, 426–427

for nonhead donor hair procedures, 473–474

for scalp micropigmentation, 499

Angiogenesis, in graft revascularization, 452

Angle, exit. See Exit angle.

vs. direction, in eyebrow transplant, 463–464

in female hair restoration, 413–414

in frontal hairline restoration, 355

in nonhead donor hair procedures, 473

Angle of hair growth. See Hair growth angle.

Angle of incision, in follicular unit punch, 444

Antiandrogens, for hair loss. See Nonsurgical therapy; specific medication.

Anticoagulants, female hair restoration and, 411

Antioxidants, as graft growth factor, 453

Arch, in eyebrow restoration, 463

Arrowhead pattern, rounded, of advanced hair loss, 385, 387

hair pattern design for, 390, 392

ARTAS System, for follicular unit extraction, 382–383

Asymmetry, with eyebrow transplant, 464

ATOE (Aide to Extraction) instrument, 381

Autologous cell-based therapies. See Cell-based therapies.

Axial force, applied by punch, in follicular dissection, 442

B

Baldness/balding. See also Hair loss.

genetic. See Phenotype.

in females, 385, 387. See also Female-pattern hair loss (FPHL).

in males, 343. See also Male-pattern baldness (MPB); Male-pattern hair loss (MPHL).

nonhead donor hair for, 470. See also Body hair transplants.

of vertex, 397. See also Crown.

Norwood classification and, 399–400

progression by age, 399

surgical interventions based on age, 399, 401

patterns of. See also Hair loss patterns.

perceptions of, by authors, 324

by patients, 317–318

“Baseball” stitch, for incision closure, in graft strip harvesting, 370–371

Beard hair, for hair restoration surgery, 469–477

anesthetic technique for, 473

angle creation in, 473

complications of, 474

daily session decisions in, 473

density of follicle transplants in, 473

equipment for, 472–473

follicular unit extraction vs., 469–471

immediate postprocedural care for, 474–476

indications for, 470

specific for use of specific donor sources, 470

introduction to, 469–470

maintaining follicle integrity in, 473

patient expectations of, 471

patient selection for, 471

practice pearls for, 473

preoperative instructions for, 471–472

preoperative planning of, 471

preparation for, 471–472

donor, 471

general, 471–472

procedural approach to, 472–473

process definition for, 470

recovery for, 475–476

rehabilitation for, 475–476

summary overview of, 476

transection minimization in, 473

treatment goals for, 470

Beard transplant, 458–462

complications of, 461

bumps in, 461

hair growth angle in, 461

final thoughts on, 467

graft placement in, 458, 460

immediate postprocedure care for, 461

introduction to, 457–458

long-term follow-up and care for, 461–462

patient positioning for, 458–461

preoperative steps for, 458–460

procedural approach to, 461

surgical preparation for, 458, 460

treatment goals for, 458

Bevels, punch, in follicular unit extraction, 439–440

Biochemical factors, of graft growth, 453–454

injury mechanisms in, 453–454

Bioengineered hair follicle germ, 525

Blade, for dense packing incisions, 434

for graft strip harvesting, 367–368

in megasessions, 423

Bleeding, as surgery complication, 411, 506

pigment, in scalp micropigmentation, 498–499

Blood supply, as graft growth factor. See Vascular entries.

of recipient bed, as graft growth factor, 452

to grafts. See Revascularization.

Blunt dissection, of subgaleal plane, in hairline lowering, 482

Body hair harvesting, donor preparation for, 471

follicular unit extraction in, 376–378, 469

minimizing transection in, 471, 473

procedure for. See Body hair transplants.

Body hair transplants, 469–477

anesthetic technique for, 473

angle creation in, 473

complications of, 474

daily session decisions in, 473

density of follicle transplants in, 473

equipment for, 472–473

follicular unit extraction vs., 469–471

immediate postprocedural care for, 474–476

indications for, 470

specific for use of specific donor sources, 470

introduction to, 469–470

maintaining follicle integrity in, 473

patient expectations of, 471

patient selection for, 471

practice pearls for, 473

preoperative instructions for, 471–472

preoperative planning of, 471

preparation for, 471–472

donor, 471

general, 471–472

procedural approach to, 472–473

process definition for, 470

recovery for, 475–476

rehabilitation for, 475–476

summary overview of, 476

transection minimization in, 473

treatment goals for, 470

Bone morphogenetic protein (BMP), in follicular progenitor cell reprogramming, 524

in reciprocal signaling between dermal and epidermal cells, 525

in trichogenic maintenance, of dissociated cells, 523

Bruising, as surgery complication, 511

with dense packing, 435

with eyelash transplant, 466

with female hair restoration, 414

Burn injury, scalp repair using tissue expanders for, 488–489

after multiple failed treatments, 494–495

temple restoration for, 458–459

B

Baldness/balding. See also Hair loss.

genetic. See Phenotype.

in females, 385, 387. See also Female-pattern hair loss (FPHL).

in males, 343. See also Male-pattern baldness (MPB); Male-pattern hair loss (MPHL).

nonhead donor hair for, 470. See also Body hair transplants.

of vertex, 397. See also Crown.

Norwood classification and, 399–400

progression by age, 399

surgical interventions based on age, 399, 401

patterns of. See also Hair loss patterns.

perceptions of, by authors, 324

by patients, 317–318

“Baseball” stitch, for incision closure, in graft strip harvesting, 370–371

Beard hair, for hair restoration surgery, 469–477

anesthetic technique for, 473

angle creation in, 473

complications of, 474

daily session decisions in, 473

density of follicle transplants in, 473

equipment for, 472–473

follicular unit extraction vs., 469–471

immediate postprocedural care for, 474–476

indications for, 470

specific for use of specific donor sources, 470

introduction to, 469–470

maintaining follicle integrity in, 473

patient expectations of, 471

patient selection for, 471

practice pearls for, 473

preoperative instructions for, 471–472

preoperative planning of, 471

preparation for, 471–472

donor, 471

general, 471–472

procedural approach to, 472–473

process definition for, 470

recovery for, 475–476

rehabilitation for, 475–476

summary overview of, 476

transection minimization in, 473

treatment goals for, 470

Beard transplant, 458–462

complications of, 461

bumps in, 461

hair growth angle in, 461

final thoughts on, 467

graft placement in, 458, 460

immediate postprocedure care for, 461

introduction to, 457–458

long-term follow-up and care for, 461–462

patient positioning for, 458–461

preoperative steps for, 458–460

procedural approach to, 461

surgical preparation for, 458, 460

treatment goals for, 458

Bevels, punch, in follicular unit extraction, 439–440

Biochemical factors, of graft growth, 453–454

injury mechanisms in, 453–454

Bioengineered hair follicle germ, 525

Blade, for dense packing incisions, 434

for graft strip harvesting, 367–368

in megasessions, 423

Bleeding, as surgery complication, 411, 506

pigment, in scalp micropigmentation, 498–499

Blood supply, as graft growth factor. See Vascular entries.

of recipient bed, as graft growth factor, 452

to grafts. See Revascularization.

Blunt dissection, of subgaleal plane, in hairline lowering, 482

Body hair harvesting, donor preparation for, 471

follicular unit extraction in, 376–378, 469

minimizing transection in, 471, 473

procedure for. See Body hair transplants.

Body hair transplants, 469–477

anesthetic technique for, 473

angle creation in, 473

complications of, 474

daily session decisions in, 473

density of follicle transplants in, 473

equipment for, 472–473

follicular unit extraction vs., 469–471

immediate postprocedural care for, 474–476

indications for, 470

specific for use of specific donor sources, 470

introduction to, 469–470

maintaining follicle integrity in, 473

patient expectations of, 471

patient selection for, 471

practice pearls for, 473

preoperative instructions for, 471–472

preoperative planning of, 471

preparation for, 471–472

donor, 471

general, 471–472

procedural approach to, 472–473

process definition for, 470

recovery for, 475–476

rehabilitation for, 475–476

summary overview of, 476

transection minimization in, 473

treatment goals for, 470

Bone morphogenetic protein (BMP), in follicular progenitor cell reprogramming, 524

in reciprocal signaling between dermal and epidermal cells, 525

in trichogenic maintenance, of dissociated cells, 523

Bruising, as surgery complication, 511

with dense packing, 435

with eyelash transplant, 466

with female hair restoration, 414

Burn injury, scalp repair using tissue expanders for, 488–489

after multiple failed treatments, 494–495

temple restoration for, 458–459

C

Caliper, for graft strip dimension calculations, 365–366

in megasessions, 423–424

Calvarium, midline, in hairline lowering, 483

Camouflage products, for advanced hair loss patterns, 388

for female-pattern hair loss, 410

post-scalp reduction, 401

scalp micropigmentation as, for deformities associated with previous procedures, 502

Cancer, skin, scalp repair using tissue expanders for, following resection and radiation, 491–492

Catagen, in hair follicle renewal, 470, 523

Cauterization, in graft strip harvesting, 368

Cell-based therapies, autologous, for hair restoration, 521–522

alternative sources for, 524

delivery of, 525–526

dissected fragments in, 522

dissociated cells in, 522–524

future directions for, 525–526

human hair follicles in, 524

Central centrifugal cicatricial alopecia (CCCA), as scarring, 330–331

overlapping conditions of, 332

Central forelock, in normal hairline maturation, 321–322

hormonal influence on, 321

identifying prepubertal hairline with, 322

Central nervous system (CNS), lidocaine effects on, 426–427

Chamber assay, 522–523

Chest hair, for hair restoration surgery, 469, 472

Cicatricial alopecias, 326, 328, 525

central centrifugal, 330–332

Circulatory compromise. See Vascular compromise.

Clinical examination, for advanced hair loss patterns, 387–389

for dense packing, 433

for hair restoration surgery, 344–345

for megasessions, 426–428

of crown, 399

Clinton, Bill, 322

Closure of incision. See Incision closure.

Cole Instrument (CI) punch, 441

Cole Instruments, for follicular unit extraction, 380–382

Collagen IV substrate, in follicular progenitor cell reprogramming, 524

Concealers, scalp micropigmentation vs., 497

Connective tissue sheaths (CTS), regeneration of hair follicle from, 522

Consultation. See Patient consultation.

Contour, vs. shape, in frontal hairline restoration, 353, 358–359

Contoured surface punches, in follicular unit extraction, 440–441

Corneal damage, with eyelash transplant, 466–467

Coronet, vertex transition point in relation to, 398–399

Cowlicks, in frontal hairline restoration, 356

Crease region, with advanced hair loss patterns, 393–394

Cross-hatch scars, as donor-site complication, 508

Crown, management of, 397–406

amamnesis in, 399

anatomy of, 397–400

balding of, 399

clinical examination in, 399

introduction to, 397

nonhead donor hair for, 474–475

summary overview of, 406

surgery in, 401–406

anchoring zone of, 405

exclusive covering of upper zone, 405

good indications for, 401–402

incisions for, 403–405

Lam method for, 404–406

maximalist covering for, 403–405

minimalist covering for, 403–404

pros and cons wisdom for, 401–402

recipient zone preparation, 398, 402–403

regrowth of grafts, 405

technique for, 402–406

therapeutic options for, 401–402

follicular hair transport as, 401

general reflections about, 399–401

medications as, 401

scalp reduction as, 401

surgery as, 401–406

Crush injury, of hair follicles, during graft placement, 451

Crusting, excessive, as surgery complication, 518–519

Culture and sensitivity, of infections, 506

Cultured cells, in vivo regeneration of hair follicle with, 524–526

Cultures, in trichogenic maintenance, of dissociated cells, 523–524

Curve of the Forehead Rule, for locating MFP, 357

Cutting edges. See Punch cutting edges.

Cyproterone acetate, for female-pattern hair loss, 337–338

Cysts, as recipient-site complication, 516

with eyelash transplant, 466

D

“Danger zone,” in facial hair restoration, 458

D’Assumpção clamp, in hairline lowering, 482

Deep closure, of incision, in graft strip harvesting, 370–371

Defined zone (DZ), in frontal hairline restoration, 353–354

in normal hairline anatomy, 352

Dehiscence, wound, as donor-site complication, 510

Dehydration, graft, 451

Dense packing, 431–436

advantages to, 432

blood supply in recipient bed and, 452

complications of, 435

disadvantages to, 432

graft preparation for, 435

ideal patient for, 431–432

introduction to, 431–432

postoperative care for, 435

preoperative planning of, 432–433

design consultation in, 433

hair assessment in, 433

medication use in, 433

patient hair loss history in, 433

scalp assessment in, 433

smoking history in, 433

procedure for, 433–435

grafts in, 434–435

incisions in, 432, 434

patient positioning in, 433

Densitometer, for graft strip dimension calculations, 365

Dermal cells, in morphogenesis, 525–526

in vivo regeneration of hair follicle with, 524

reciprocal signaling between epidermal cells, 524–525

reprogramming of, 524

Dermal dissection, in follicular unit extraction, 441–443

Dermal follicular progenitor cells, future directions for, 526

reprogramming of, 524

trichogenic maintenance of, 523–524

Dermal papilla (DP), in follicular unit extraction, 446–447

regeneration of hair follicle from, 522

trichogenic maintenance of, 523

Dermal sheath (DS) fragments, regeneration of hair follicle from, 522

trichogenic maintenance of, 523

Dermatoscope, for alopecia areata incognita examination, 408–410

Diffuse alopecia areata, 326–327

Diffuse unpatterned alopecia (DUPA), 346

syndrome in younger man, 387

Dihydrotestosterone (DHT), hair loss related to, 336, 420

finasteride for, 336–338

Direction, vs. angle, in eyebrow transplant, 463–464

in female hair restoration, 413–414

in frontal hairline restoration, 355

in nonhead donor hair procedures, 473

Direction error, graft, as surgery complication, 513–514

Direction of hair growth. See Hair direction.

Discoid lupus erythematosus, as scarring alopecia, 331–332

Displacement of graft, by patient, 454

as surgery complication, 518–519

Dissected fragments, regeneration of hair follicle from, 522

Dissection, blunt, of subgaleal plane, in hairline lowering, 482

for follicular unit extraction. See Follicular dissection.

for graft strip harvesting, 367–368

in female hair restoration, 412

punch. See Punch dissection.

sharp and blunt, for graft strip harvesting, 367–368

skin, in follicular unit extraction, 441–443

Dissociated cells, grafting with expanded cells, for in vivo regeneration of hair follicle, 524

in morphogenesis, 525

regeneration of hair follicle from, 522–523

trichogenic maintenance of, 523–524

Donor cells, in cell therapy delivery, 525

Donor hair/site, estimating available, for hair transplantation, with advanced hair loss patterns, 390

follicular unit extraction and, considerations of, 379–380

methylene blue staining of, 451

preparation of, 380

in hair restoration surgery, complications of. See Donor-site complications.

for females, 409

for megasessions, 423–426

historical, 420

issues with, 345–346

nonhead hair as, 470–471

planning considerations of, 348–349

management of, 363–374

anesthesia for, 367

complications of, 371, 373

hypoesthesia as, 373

infection as, 373

widened scar as, 371, 373

harvesting the strip, 367–373

closure of incision, 370–371

tricophytic, 371–373

in previously used donor site, 369–370

intraoperative estimation of graft total, 369

procedure steps in, 367–369

in female hair restoration, 412

introduction to, 363

patient positioning for, 367

postoperative care for, 373–374

preexisting sites and, 365–366, 369–370

preoperative planning of, 363–366

calculating strip dimensions, 365–366

for megasessions, 423–425

hair color in, 366

safe selection considerations, 363–364

scalp elasticity formula, 364

scalp laxity and, 363–364

scars in, 365–366

preparing the site, 366–367

nonhead. See also Body hair transplants.

FUE process for, 470

Donor tissue, for megasessions, 423–425

Donor-site complications, of hair restoration surgery, 507–511

cross-hatch scars as, 508

depletion as, 509–510

effluvium (shock-loss) as, 511

hematoma as, 511

hypertrophic scars as, 508

hypoesthesia as, 511

infection as, 506, 510

keloid scars as, 508

multiple scars as, 508–509

necrosis as, 510

neuralgias as, 511

neuromas as, 511

summary of, 507

visible scars as, 509

wide scars as, 507–508

wound dehiscence as, 510

Donor-site depletion, as surgery complication, 509–510

nonhead hair as substitute for, 470

Double follicular unit (DFU), in female hair restoration, 412–413

Downward adjustment, in frontal hairline restoration, 359–360

“Dull” dissecting punches, in follicular unit extraction, 381, 442

Dull punch technique, in follicular unit extraction, 381–382

Dutasteride, for hair loss, 338–339

mechanism of action, 338

side effects of, 338–339

Dyes/dying, in scalp micropigmentation, 498–499

of hair, following female hair restoration, 415–416

E

Ecchymosis. See Bruising.

Edema, as surgery complication, 506–507

excessive, 518–519

with 2-day megasessions, 426–427

with dense packing, 435

with eyelash transplant, 466

with female hair restoration, 414

Effluvium, as surgery complication, in donor site, 511

in recipient site, 516–517

telogen. See Telogen effluvium.

Elasticity, of scalp, follicular dissection and, 445

in hair graft harvesting, for megasessions, 423–425

Elasticity formula, scalp, for hair graft harvesting, 364

Endotines, in hairline lowering, 483

End-stage donor-site depletion, 509–510

Environment, in normal hairline maturation, prepubertal group analysis of, 318

Epidermal cells, in morphogenesis, 525–526

in vivo regeneration of hair follicle with, 524

reciprocal signaling between dermal cells, 524–525

Epidermal cysts, as recipient-site complication, 516

Epinephrine-containing solutions, for bleeding, 506

for recipient-site necrosis, 517

Epithelial cells, thymic, reprogramming of, 524

Epithelium, host, in cell therapy delivery, 525

Evolving area, of vertex balding, 398, 400

Excision, for graft strip harvesting, in megasessions, 423–425

segmental donor, 368–369

in follicular dissection, 442

of forehead tissue, in hairline lowering, 483

Exit angle, hairline lowering and, 479

in frontal hairline restoration, 355

of follicular groupings, 445–446

of vertex hair, 399

Exogen, in hair follicle renewal, 470

Expanded cells, cultured, grafting with dissociated cells, for in vivo regeneration of hair follicle, 524–526

Extensive scalp lift (ESL), as alopecia reduction, 488

Eyebrow rejuvenation, hairline lowering with, 479

Eyebrow transplant, 462–466

complications of, 464

asymmetry as, 464

lack of hair regrowth as, 464

final thoughts on, 467

immediate postprocedure care for, 464

introduction to, 457–458

long-term follow-up and care for, 464–466

nonhead donor hair for, 471, 475–476

patient positioning for, 463

preoperative steps for, 462

procedural approach to, 463–464

hair angle and, 463

hair growth direction and, 463

surgical preparation for, 462–463

treatment goals for, 462

Eyebrows, female, anatomy of, 463

head, body, and tail sections of, 462–463

Eyelash transplant, 465–467

complications of, 466–467

bruising as, 466

corneal damage as, 466–467

cysts as, 466

inconsistent regrowth as, 467

swelling as, 466

final thoughts on, 467

immediate postprocedure care for, 467

introduction to, 457–458

long-term follow-up and care for, 467

patient positioning for, 465–466

preoperative steps for, 465

procedural approach to, 466

surgical preparation for, 465

treatment goals for, 465

F

Facelift deformity, facial restoration for, 458, 460

Facial hair restoration, 457–467

final thoughts on, 467

introduction to, 457–458

nonhead donor hair for, 470

of beard/goatee/sideburns, 458–462

complications of, 461

immediate postprocedure care for, 461

long-term follow-up and care for, 461–462

patient positioning for, 458–461

preoperative steps for, 458–460

procedural approach to, 461

surgical preparation for, 458, 460

treatment goals for, 458

of eyebrows, 462–466

complications of, 464

immediate postprocedure care for, 464

long-term follow-up and care for, 464–466

patient positioning for, 463

preoperative steps for, 462

procedural approach to, 463–464

surgical preparation for, 462–463

treatment goals for, 462

of eyelashes, 465–467

complications of, 466–467

immediate postprocedure care for, 467

long-term follow-up and care for, 467

patient positioning for, 465–466

preoperative steps for, 465

procedural approach to, 466

surgical preparation for, 465

treatment goals for, 465

Facial plastic surgery, female hair restoration and, 415–416

Facial structure, hairline locations defined in relation to, 318–319

MFP and, 357

Female hair restoration, 407–417

complications of, 414–415

conclusions about, 416

immediate postprocedural care for, 414

initial consultation for, 407–409

preoperative planning of, 409–411

candidate determination in, 409–410

hair styling to determine transplant areas, 410–411

hair transplantation technique determination in, 411

hairline design examination in, 411

laboratory tests in, 411

preparation for, 411

procedural approach for, 412–414

anesthesia in, 411–412

dissection in, 412

donor harvest in, 412

graft size in, 412

preexisting hair direction in, 413–414

recipient site angle in, 413–414

recipient site care postprocedure, 415

recipient site creation in, 412–413

recipient site density in, 413

recovery considerations of, 414–415

special situations for, 415–416

treatment goals of, 407–408

Female-pattern hair loss (FPHL), advanced, 385, 387

alopecia areata incognita with, 408–410

dutasteride for, 338

finasteride for, 337

hair transplantation for. See Female hair restoration.

lichen planopilaris with, 408–409

minoxidil for, 336

other antiandrogens for, 337–338

telogen effluvium with, 407, 412

post-hair restoration, 414–415

treatment goals for, 407

Fibroblast growth factor (FGF2), 522

in trichogenic maintenance, of dissociated cells, 523

Fibroblasts, in vivo regeneration of hair follicle with, 523–524

Fibrosing alopecia. See Frontal fibrosing alopecia (FFA).

Finasteride, for hair loss, 336–337

mechanism of action, 336–337, 521

side effects of, 337

use in females, 337

for vertex balding, 401

Flap assay, 522

Fluid dynamics, in follicular dissection, 442

Follicle splay, 445–446

Follicles. See Hair follicle.

Follicular dissection, in follicular unit extraction. See also Punch dissection.

analysis of, 441–443

factors affecting, 445–447

microscopic, physical trauma from, 450–451

sharp vs. “dull,” 380–382, 442

Follicular groupings, exit angle of, 445–446

Follicular morphogenesis, 524–525

native vs. dissociated pathway of, 526

Follicular neogenesis, 524–525

Follicular pairing, 355

Follicular progenitor cells, dermal, future directions for, 526

reprogramming of, 524

trichogenic maintenance of, 523–524

Follicular unit (FU), anatomy of, 445

as vulnerable to injury, 437, 439, 445–446

during microscopic dissection, 450–451

in advanced hair loss patterns, 387

estimating donor availability, 390

individual vs. double, in female hair restoration, 412–413

Follicular unit extraction (FUE), 375–384

donor area considerations of, 379–380

indications for, 375–376

introduction to, 375

pearls for performing, 383

postoperative considerations of, 383–384

procedure for, 380–383

anesthetic considerations in, 377, 380

donor area preparation in, 380

“dull” dissecting punches in, 381, 442

dull punch technique in, 381–382

graft handling in, 383

graft planting in, 383

methodology in, 380–381

patient position in, 380

robotics in, 382–383

sharp punch dissection in, 380–381, 442

sharp punch technique in, 381–382

surgeon position in, 380

punches, mechanics, and dynamics in, 437–447

contoured surfaced punches, 440–441

dull punch technique in, 381–382

follicle dissection factors, 445–447

follicular dissection analysis, 441–443

force compression testing, 442–443

introduction to, 437–439

punch handle and trephine, 439–440

punch incision geometry based on size and hair growth angle, 444–445

depth of incision, 444–445

length of incision, 444

punch incision location based on cutting edges, 439–440

punch metallurgy and, 439

punch size variation, 444

sharp punch technique in, 380–382

summary overview of, 447

scars from, scalp micropigmentation for, 502

summary overview of, 384

utility of, 375–379

for body hair harvest, 376–378

for facial hair restoration, 458, 462, 465–466

for hair restoration, 375–377

in females, 411

vs. body hair and beard hair, 469–471

for hair restoration repairs, 378–379

Follicular unit (FU) grafts. See also Graft entries.

for advanced hair loss patterns, 387, 389–394

for facial hair restoration, of beard/goatee/sideburns, 458

of eyebrow, 462, 465–466

of eyelash, 465–466

for vertex balding, 401

minimalist vs. maximalist density of, 403–405

regrowth of, 405

in female hair restoration, 409, 411

density of, 412–413

in follicular unit extraction, handling of, 383

planting of, 383

in frontal hairline restoration, 351–352, 362

megasessions for, 421–423

numbers and incisional density of, 355–356

selective distribution of, 355–356

temporal points and, 360

in graft strip dimension calculations, 365–366

intraoperative estimation of, 369

in hairline lowering, 480, 484

in megasessions, advantages vs. disadvantages of, 420–421

donor tissue considerations of, 423–424

efficient handling strategies for, 428–429

for frontal hairline restoration, 421–423

in nonhead hair transplants, density of, 473

strip of. See Graft strip.

trephine punch for isolation of, 437–440

Follicular unit punch, mechanics and dynamics of, 437–447 . See also Punch dissection.

Follicular unit transplantation (FUT). See Follicular unit (FU) grafts.

Folliculitis, as recipient-site complication, 515–516

chronic, 515

with female hair restoration, 415

Folliculitis decalvans, as scarring alopecia, 330

Force, applied by punch, in follicular dissection, 441

axial vs. tangential, 442

Force compression testing, of punches, in follicular unit extraction, 442–443

Forceps, for graft placement, crush injury related to, 451

Forehead edema, as surgery complication, 506–507

Forehead rejuvenation, hairline lowering with, 479

Forehead tissue, excision of, in hairline lowering, 483

Forelock patterns, in normal hairline maturation, central, 321–322

of advanced hair loss, oval, 385–386

hair pattern design for, 390–393

shield, 385–386, 388

hair pattern design for, 390–394

4 Finger Breaths Rule, for locating MFP, 357

Friction, applied by punch, in follicular dissection, 441–443

Fringe hair, with advanced hair loss patterns, 388, 392–395

Fringe zone, graft harvesting in, 509

Frontal fibrosing alopecia (FFA), as scarring, 328–330

case study of, 333

Frontal hairline, as hairline component, 351

Frontal hairline restoration, dense packing for, 432, 434

hairline design and, 351–362

introduction to, 351–352

locating borders of hairline for, 356–360

decision making and, 356–357

downward adjustments in, 359–360

FTA in, 356, 358–359

MFP in, 357–358

shape and contour determinations in, 353, 358–359

temporal points in, 357–358, 360

major components in, 351–352

natural characteristics in, 352–356

cowlicks and, 356

defined zone as, 353–354

FT area as, 353–354

FTA area as, 352, 354

graft numbers and incisional density for, 355–356

proper angle and direction as, 355

selective distribution of grafts for, 355–356

transition zone as, 352–353

step-by-step approach to, 360–362

summary overview of, 362

megasessions for, 420–423

Frontal temporal angle (FTA), as hairline component, 352

gender and ethnic variations of, 354

in frontal hairline restoration, 354, 356, 358–359

Frontal tuft (FT), as hairline component, 352

in frontal hairline restoration, 353–354

Frontalis muscle, in normal hairline anatomy, 319

FTA. See Frontal temporal angle (FTA).

FUE. See Follicular unit extraction (FUE).

Future therapies, for hair restoration, 521–528

alternative cellular sources in, 524

cell therapy delivery in, 525–526

cell-based solutions as, 521–522, 525–526

follicular neogenesis as, 524–525

hair follicle regeneration as. See Regeneration of hair follicle.

introduction to, 521–522

morphogenesis as, 524–526

trichogenic maintenance of dissociated cells as, 523–524