What is new in Hair Restoration Surgery 2012

Report of ISHRS 20th Annual Scientific Meeting

OCT 17-20 2012– Atlantic City, Bahamas

The annual meeting of International Society of Hair Restoration Surgery is the most significant hair restoration meeting worldwide.  This year’s meeting was one of the best in terms of the content of the information discussed.  The meeting was held in Atlantic City, Bahamas.

Hair Restoration Surgery is evolving rapidly with newer technologies that enhance our understanding of hair growth and the tools that help us expect better growth. This year’s conference hot topics had five areas of focus. These topics are reviewed below:

Robotic hair restoration

ARTIS or Robotic Hair Transplantation was actively promoting its robotic arm that helps the surgeon to extract the FUE Grafts for hair transplantation.  The Robotic hair transplant update for 2012 was not as significant as many attending physicians anticipated.  Considering that the robotic hair transplant is being promoted and used in several offices actively for over a year, most surgeons expected to learn more about the scientific evaluations that can differentiate robotic procedures with other techniques of hair restoration.

The doctors who used robot in their offices in the last year discussed their personal experience with robotic hair restoration.  Some discussed that the numbers of grafts have been improved, but there was not a significant evaluation on the quality of grafts to other methods of FUE hair harvesting or to compare the robotic grafts with grafts from strip hair transplants.

Stem Cell and hair multiplication

We have had a few discussions about new advancements in Stem Cell research in 2012.  Some of the familiar faces gave lectures about the status of hair stem cell research and where we are standing on hair multiplication.  At present it appears  that no one has started the phase III level of research.  In practicality this means we are unlikely to be able to have a way to multiply hair in the next 8 or 10 years. Until we hear the phase III level of hair multiplication studies are successfully completed our patience and our practices will be reliant on our present hair restoration methods.

FUE transplantation

Many doctors discussed the increased rate of FUE hair transplantations worldwide.  However, comparing different countries, it is apparent presently FUE is being used mostly in Asia and Europe in comparison to the United States.  I (Parsa Mohebi, MD) presented result of the study of the effects of delay in extracting follicular units on viability of FUE grafts.  I have discussed the conclusion of our study on 3 patients in which FUE grafts were initially punched and then removed in 5, 30, 60 minutes and 4 hours.

This study was the only study conducted  to compare the in-situ viability of the follicular unit grafts.  The study showed that keeping the punched grafts in scalp longer than a few minutes may decrease the survival of the grafts. The results of this study may help the design of the next generation of FUE devices and robotic surgery to try to be more efficient with the time that grafts are punched and before they could be removed from the scalp.

Methods for improving the aesthetics of hair restorations

I had another presentation on the advantages and disadvantages of extracting hair from temporal areas.  I have brought up the “Mad Scientist Phenomenon” which refers to the situations that hair transplant surgeons harvest maximum number of grafts from the donor area on the back and not take any hair from temporal areas in patients who have a high density of hair on the temporal areas. The thickness of hair on the temporal areas may undermine the drastic changes that a hair transplant may have on restoration on the front and top areas.

Finasteride Controversies

Dr. Washenik from Bosley discussed the controversies around finasteride (Propecia).  He discussed the persistent sexual dysfunction controversy and a Canadian lawsuit that could not link the side effects to the medication.   Dr. Sharon Keen discussed that the studies that reviewed the permanent side effects of finasteride did not have adequate objective evaluation of health status in those patients.  There were also some discussions about other side effects of finasteride such as the DHT blocking effects on increased production of testosterone and estrogen that may lead to gynecomastia (enlargement of breast tissue in men).