Hair today ...

Andrew Edwards

Admit it, image can be a big part of life. In a world where first

impressions can be formed before you say a word, is it any surprise

that thousands of people seek help from doctors to better their

appearance?

A large chunk of the American population faces the prospect of

losing their hair -- male pattern baldness affects 35-million men in

the United States, according to the International Society of Hair

Restoration Surgery. However, thinning hair is not exclusively a

men’s problem, female pattern baldness and other sources of hair loss

can affect women as well.

The American Society of Plastic Surgeons keeps track of the number

of hair replacement surgeries performed in the United States. In

2003, the most recent year available for figures, more than 31,700

patients sought a surgeon’s aid to ameliorate hair loss. The year saw

an increase of about 2,000 patients from 2002.

The increase came after two years of decline from 2000, when more

than 44,000 hair replacement surgeries were performed.

One of the many people who are dealing with hair loss is Costa

Mesa resident Charles Nowlin, a 47-year-old tree broker who underwent

hair restoration surgery about two weeks ago. His decision to go

under the knife was motivated primarily by his desire to have more

confidence about his appearance.

“It’s a self-esteem thing, definitely,” he said.

Though personal reasons like Nowlin’s are a common reason for

patients to seek hair replacement surgery, some have operations to

impress others, hoping a younger appearance will attract a date or an

employer.

Dr. Tony Mangubat, president of the International Society of Hair

Restoration Surgery, acknowledged some patients pursued hair

transplantation because they believe a younger look will make them

more competitive on the job hunt.

“Maybe it’s a preconceived notion that they have. It’s not my job

to tell you whether that’s true or not, but that’s their perception,”

Mangubat said.

The doctor who performed Nowlin’s surgery, Newport Beach surgeon

Dr. Craig Ziering, said that with the exception of people in

entertainment and modeling, he does not know of any patients who have

been advised to seek surgery to strengthen their professional

competitiveness, though the advantages of a full head of hair are no

secret.

“I don’t know that we’ve had anyone that said, ‘My career

counselor said I need a more youthful look,’ but it’s well-known,”

Ziering said. “The person with a better appearance has a leg up

getting a job position. Right or wrong, appearance does matter.”

Nowlin was interviewed in the middle of his operation while three

surgical assistants hovered over him. Nowlin had a close-cropped

haircut and tiny red flecks were visible around the back of his head

where hairs had been removed. His doctor, Ziering, would complete the

procedure by transferring the donor hairs back to him, where they

would be implanted just above his forehead in an effort to even out

his hairline.

The technique, called microscopic follicular unit grafting, is an

advance over the hair plug procedures of the past. In a typical

surgery, Ziering said he and his team perform 3,000 follicle grafts,

which contain 7,000 to 8,000 hairs.

Follicular unit grafting, Ziering said, can provide for a more

natural looking hair pattern than plugs, since less hairs are grafted

at a time. Ziering said he grafts hair in units of one, two or three

follicles, whereas in hair plug surgeries, about 16 hairs would be

implanted at a time.

“[Plugs] look very irregular and unnatural,” Ziering said.

Nowlin had undergone hair replacement surgery about two years ago,

he said, and opted for it a second time to try the grafting

procedure. Another patient who had surgery the same day, a

48-year-old Chatsworth man who gave his name only as Joe, was also

having surgery for a second time.

“It’s just touch up work,” he said. “I’m not going to do this at

65. I’m going to do it at 48 and enjoy it.”

About 30% of Ziering’s patients are people who want to touch up

previous surgeries, especially patients who had hair plugs implanted.

Joe, a water-skier who has worn his black hair long for years, sat

back with a couple “Star Wars” movies on hand during the all-day

surgery.

“It’s not that painful and you get to watch a video and it’s

done,” he said.

What does the procedure feel like?

“I’m awake and everything and I’m all numbed up, but you can hear

him pull it off and cauterize everything,” he said.

Dr. Michael Meshkin of the Cosmetic Hair Replacement Surgery

Institute, which has a clinic in Newport Beach, has been performing

follicular grafts since 1990. Most of his patients, he said, seek

surgery as a means to bolster their self-esteem as well as their

professional and personal lives.

“It’s the psychological effect of hair loss, it affects them

socially, their jobs, dating and all these things,” Meshkin said.

Ziering said his clients are mostly professionals, and that he has

treated both men and women.

“I probably do more doctors and attorneys than anything,” he said.

“I do entertainers, but I also do school teachers, military people

... hair loss doesn’t discriminate.”

The three regions in the country where hair restoration surgeries

are most often performed are Southern California, Florida and New

York, said Patrick Hennessey, a former hair restoration patient and

publisher of HairLossLearningCenter.com and other hair surgery

related websites. The three areas are hotspots for the surgery

primarily because of their large populations -- and the importance

their denizens place on image.

“I think L.A. and Miami, where I’m at, are more appearance

conscious,” Hennessey said in a phone interview.

Ziering agreed.

“Southern California is definitely a hotbed, and I can tell you I

do more surgeries in my Newport Beach office than my Beverly Hills

office,” Ziering said.