Dr. Roger Bassin is a board certified surgeon and a member of the American Society of Hair Restoration. After earning his Medical Degree at George Washington University Medical School, Bassin finished his internship at New York’s Lenox Hill Hospital and a residency in Ophthalmology at the Mt. Sinai Medical Center. He practices at the Bassin Center For Plastic Surgery in Central Florida with offices in Tampa, Orlando, Melbourne and The Villages. His Hair Restoration Centers are located in Tampa and Orlando and these are the only hair restoration practices in the state of Florida that offer both of the most advanced hair restoration technologies, NeoGraft and ARTAS.
Dr. Basin is co-author of the Bestselling Book, “Advances in Hair Restoration: Restore Your Youthful Appearance With The Latest Technology”. In this interview for BIM with Bill Kopatich he provides an overview of hair loss, alternatives for hair restoration and results that can be achieved with the latest in hair restoration procedures.
Bill: Dr. Bassin, thanks for talking with me today to educate our readers on what is possible with the latest in hair restoration procedures. It seems we have all heard about pattern baldness in men and how we seem to be predisposed to be bald if our mother’s father is bald. Is this really true and why is this happening?
Dr. Bassin: Male pattern baldness is caused by both hormonal and genetic factors. Androgens, or sex hormones, specifically the hormone DHT, which is a potent metabolite of testosterone, play a critical role in hair loss in men. The hair follicles on predisposed men have susceptibility for negatively responding to those hormones, inhibiting their growth.
Genetics do play an important part in male pattern baldness, but we know that men inherit the conditions from both sides of their families, although there is anecdotal evidence that shows possibly the maternal side does have a little bit more influence than the paternal side.
Pattern baldness occurs in a gradual process called “miniaturization”, where over time, thick hairs are replaced by thinner, finer hairs with shorter and shorter growth cycles. This process progresses, becoming more spread out in a characteristic pattern in the front and the top of the scalp and on the crown. Other hair follicles around the sides and the back of the head are resistant to this effect. Those are so-called “androgen-resistant hairs,” and those hairs do not go away in response to DHT.
This is important when we are performing our most common type of hair restoration – on men with male pattern baldness. We harvest the hairs from the back and sides of the head that are resistant to androgens and these transplanted hairs keep that genetic resistance no matter where we put them.
Bill: A lot of women have thinning hair. Is there such a thing as female pattern baldness?
Dr. Bassin: Yes, many women are affected by female pattern baldness, but it’s not really baldness like it is with men. For women, it’s more a diffuse thinning of the hair, mostly on the top of the scalp. Like with male pattern baldness, it is related to genetics and reaction to hormones. When we do hair restoration for women, our goal is to add density in target areas specific for women.
Bill: Who are good candidates for hair restoration procedures?
Dr. Bassin: Pretty much anyone who’s thinning or balding is a candidate for a hair restoration procedure; however, we need enough donor hair to move to the balding areas. In the most typical cases, with male pattern baldness, the donor hair will be coming from the back and sides of the head where the androgen-resistant hairs are. The more donor hair you have, the more follicles we can move from the back and sides of the head to areas of thinning.
The best results will be seen with thicker hair, darker hair or curly hair. Thicker hair just takes up more volume than thinner hair. Darker hair typically hides the scalp better, because it has better coverage of the scalp to the naked eye when it sees thinning hair. For the same reason, curly hair tends to give more volume than straight hair, which can sit flat on the scalp, so thick, darker, curly hair typically is the best.
Bill: Your hair restoration centers exclusively offer the most modern restoration procedures. What is the difference between the procedures you perform compared to other alternatives?
Dr. Bassin: Hair transplant procedures have evolved in the United States since the 1950s, when relatively large “plugs” of 10 to 12 follicular units were transplanted at a time to the balding area. Over time, the surgical technology progressed and the “strip surgery” method, also known as Follicular Unit Transplantation (FUT), was developed. With FUT, a strip of hair at the back of the head is surgically removed. After the strip is removed, the area is sutured to close the gap in the skin. Individual follicular units are separated from the strip and are transplanted in the balding area. With this method the patient is left with a linear scar at the back of the head. This method is still regularly practiced around the country. Manual Follicular Unit Extraction (FUE) methods were later developed, but these methods required relatively large punches and, being completely manual, were very time consuming.
At our centers, we exclusively perform hair restorations with Follicular Unit Extraction systems that automatically or robotically extract the individual hair follicles, getting away from the disadvantages of the earlier manual FUE process, as well as the older invasive strip surgery FUT transplants. Our Hair Restoration Centers use both the NeoGraft automatic FUE hair restoration system and the ARTAS robotic FUE hair restoration system.
Both the NeoGraft and ARTAS procedures are minimally invasive and we use assisted-automation or robotics to precisely extract individual hair follicles and we can make use of essentially every single hair follicle extracted. There is no cutting out part of the scalp like with the strip surgery methods, so no linear scar is left on the patient’s head where hair will not grow back. These procedures are very safe.