A problem that affects three in each five men is caused mainly by heritage and the production of androgens (DHT), which is testosterone converted in an enzyme called 5-alpha-reductase in the scalp; this explains why baldness starts right after puberty, time in which the body starts to produce male hormones in great quantity.

Since Cesar’s time, the Roman emperor, people research for a cure for this problem.
In the 50s, Norman Orentreich, an American dermatologist, described one original technique to soften the aesthetic aspects of the people who suffered from this problem, transferring small regions of the nape of the head and transplanting them to the bald areas; this technique was based on the observation that the hair in the nape had a longer life than the hair on top of the head, and even after the transplant, it kept on growing.

The main complaint about this technique was that the transplanted hair looked false, like doll’s hair.
In the 70s, an Argentine surgeon published a new technique called “rotation remnants”, where an extensive band of the lateral region of the hair was twirled for the frontal region, restoring a 4cm/s area; if the hair loss was more extensive, he proposed that up to 3 remnants of the lateral hair was twirled to the part without hair.

He still continues using this technique in his clinic in Buenos Aires.
In the 80s, I explained a new technique, popularly known as “fio a fio” (hair-by-hair) revolutionizing everything done in the past. It consisted of taking hair of a donor area, in the occipital region of the head, and from small grafts, containing from 3 to 5 hair (follicle) transplanting it to the bald areas using small incisions with tiny bistouries.

With the evolution of this technique, we started to separate the follicles using a potent microscope which enlarged the image up to 30 times, this leading to a loss of almost zero follicles per implant.
There is no age limit for this procedure, as long as the patient is in good physical conditions and the hair in the posterior area of the head is well preserved.

In cases where baldness has reached a well advanced stage, it cannot be corrected in only one transplant, dividing the process in two or even three transplants in an eight month period.
As for the clinical treatment (no surgery) the best medication used internationally is the Finasteride, it blocks the 5-alpha-reductase, and it was initially used to treat prostate problems in men by discontinuing the transformation of testosterone into DI hidrostestoterone in the scalp.
According to our experiences, there is no such thing as medication or lotions to make hair grow back again.

Finasteride has a powerful action preventing the hair on the top of the head to fall off.
For this reason we have associated surgery with medication but it has to be taken for the rest of life.
It is important to emphasize, looking at the facts published by the American Society of Aesthetic Surgery, the increasing number of Americans that seek the help of a physician to undergo hair transplantation: in 1998 the number of surgeries in United States reached 89.000, arriving in second in the list of most performed plastic surgeries, losing only to liposuction.
In Brazil the surgery is in 4th place because of the few surgeons that dedicate themselves to this area of expertise.

The increasing number of surgeries is due to the fact that the technique is improving daily, the great results and no morbidity rates.

Dr. Munir Curi