Hair Transplant Glossary

0-5

5 Alpha –reductase – An enzyme that is naturally found in the body that helps the body to perform a variety of important functions. 5a-reductase is responsible for creating 5 alpha-dihydrotestosterone (DHT) which can be the cause of balding for some patients.

A

Allograft – When grafts are taken from one person and transferred to another person. Using donor hair from another person is not favoured on when performing a hair transplant.

Alopecia – A general medical term for balding.

Alopecia Areata / AA – An autoimmune condition where the body fails to recognise its own cells and destroys its own hair follicles – usually on the scalp.

Alopecia Reduction – Scalp reduction surgery is also known as Alopecia reduction surgery. It involves removing areas of the scalp experiencing balding and using healthier areas of the scalp to stretch over the areas removed reducing the amount of balding present on the head.

Alopecia Universalis – A rare form of alopecia where there is a complete loss of hair from the body including the scalp, underarm, legs, eyebrows and eye lashes. The body’s immune system mistakenly sees hair follicles as being foreign entity and attacks them.

Anagen Effluvium – When hair is no longer actively growing despite being in the anagen phase. It is most commonly associated with chemotherapy but those suffering with alopecia areata may also be susceptible.

Anagen Phase – Part of the hair growth cycle when your hair enters a state of active growth. This time period can last from 3-5 years but can be lengthened through the use of certain medications designed to increase hair growth.

Androgen – A naturally occurring male sex hormone produced by both male and females. There are different variants of androgens including testosterone and Dihydrotestosterone (DHT) which can affect baldness.

Androgenetic Alopecia – A common heredity form of hair loss where the balding pattern is usually controlled by hormones.

Anterior Scalp – The frontal regions of the scalp including the temples, forelock, hairline and the areas immediately up behind the hairline up until the midscalp.

Antiandrogen – Medication that works to lower the production of androgen for those who are suffering with any of the side effects such as balding.

ARTAS – A robot hair transplant tool that harvests the donor hair using the FUE method.

Autograft – A graft that is taken from one area of the body and moved to another area. Follicular unit grafts are autografts.

Azelaic Acid – A topical cream usually used to help reduce the signs of rosacea and acne which can also help to reduce the production of DHT which can cause male pattern baldness.

B

BAHRS – British Association of Hair Restoration Surgery is a non-profit association of professionals with an interest in hair restoration, hair transplant surgery, hair loss, hair research and education.

Bald – Having little or no hair on your head.

Balding – The process of losing hair from your head. See also hair loss.

Baldness Resistant – A term that is given to hairs that are unaffected by male pattern baldness.

Beard Transplant – A procedure where hair is transplanted from the scalp into facial regions that are lacking in density and fullness.

Body Hair Transplant – A rare technique when hair from the body is used for a hair transplant when no donor hair scalp is available.

Bulge – The middle portion of the hair shaft that contains the highest portion of stem cells and permits hair regeneration and growth.

C

Camouflage – When smaller grafts are placed in front of larger grafts to make them look more natural.

Catagen Phase – The second part of a hair lifecycle that alerts the hair bulb to disconnect from the blood supply and start to move upwards from the base of the hair follicle. During this time the hair follicle actually shrinks which results in the bulb becoming club-shaped which is then often referred to as club hair.

Central Centrifugal Cicatrical Alopecia / CCCA – A form of scarring hair loss that occurs on the crown or back of the head, it only usually occurs in those of an African descent.

Central Forelock – The area at the front of the scalp that sits behind the hairline but before the midscalp.

Club Hair – Hair that is in the telogan phase and has stopped growing. The hair has a ‘club like’ root which will eventually be pushed out by new hair growth.

Cobblestone – A type of scarring that can occur when transplanting hair grafts. The scar tissue is raised giving the appearance of a cobblestone street, hence the name. It is usually a result of surgical error. Cobblestone scarring usually occurs if too much tissue has been removed from the donor zone – the excess tissue transplanted back into the recipient site then heals incorrectly resulting in a bumpy appearance. The scarring can also be a result of the hair grafts not being transplanted deep enough into the recipient site as the surrounding tissue will rise as the incision heals.

Coronal Incisions – An incision technique where the hairs are lined up side by side instead of on top of each other. This helps to increase the illusion of density.

Crown – The area on the top of the scalp where the hair often grows in a swirl pattern. It is often an area that balding is first noticed.

CQC – Care Quality Commission is an independent regulator of health and social care services within England ensuring that patients are receiving safe, effective, compassionate and high-quality care.

D

Dermal Papilla – Located in the uppermost layer of the dermis. It provides oxygen and nutrients to the hair follicle by connecting it to the blood supply. DHT can prevent the dermal papilla from reaching the hair follicle which then results in the follicle minimising giving the appearance of thinning and then eventually baldness.

Density / Hair Density – The amount of hair in a certain area on your scalp. People tend to have thick or thin hair which determines the amount of growth that they naturally have in one area. When having a hair transplant the aim is to match the density of your growth to ensure a natural result.

Dermis – The inner layer of skin that holds the hair follicles, glands, blood and lymph vessels.

Dihydrotestosterone / DHT – A derivative by-product of testosterone that over time can bind to the scalps tissue and block connection between the hair follicle and the blood supply required. Overtime this can be the cause of alopecia as it blocks the nutrients required by the hair follicle to continue to grow.

Dilators – Instruments that were previously used to keep track of where new hair had been transplanted during the procedure.  These are no longer used in modern day techniques.

Dissection – When the harvested donor hair is cut into individual grafts of various sizes to be transplanted into the recipient site.  This is performed under a stereo-microscope to ensure precision and quality.

Donor Area / Donor Hair – The area around the back of head where the hair follicles are extracted from in a hair transplant procedure. These hair follicles are genetically programmed to remain intact and continue to grow throughout life.

Donor Dominance / Theory of Donor Dominance – The notion that hair follicles will continue to grow in the recipient area once transplanted from the donor area.

Donor Zone – The area usually around the back and sides of the scalp that is considered safe for transplantation. It is believed that the hair in this area is resistant to Dihydrotestosterone (DHT) meaning the follicles are more likely to continue growing when transplanted into the recipient areas.

Diffuse patterned alopecia – Thinning of the hair that follows a pattern similar to the Norwood/Hamilton hair loss chart. It is a form of androgenic alopecia caused by androgen and DHT.

Diffuse Unpatterned Alopecia (DUPA) – Hair thinning that occurs over the entire scalp including the donor zone. Sufferers of this will be unsuitable for a hair transplant.

Dutasteride – A prescription medication for benign prostate hyperplasia (BPH) that actually works by inhibiting the function of the 5 alpha-reductase (5aR) enzyme. By reducing the functionality of 5aR, the production of DHT will be reduced enabling the affected hair follicles to produce healthy hair again. Dutasteride is not currently licensed or available in the UK for the treatment of hair loss.

E

Epidermis – The outer layer of cells that make up the skin. Grafts tend to contain almost all of the epidermis and dermis surrounding the follicle.

F

Finasteride – An FDA approved active ingredient in a hair loss medication. Finasteride blocks the 5aR enzyme from creating DHT which is one of the main causes of hair loss.

Female Pattern Baldness / FPB – A pattern of hair loss that occurs in women suffering with Androgenetic Alopecia.

Follicle –Small holes within the skin that hair often grows from.

Follicular Unit – The natural grouping of one, two, or three hair follicles found in the skin.

Follicular Unit Extraction / FUE –  The technique of extracting single follicular units, one at a time, from the donor site by using a specialised punch tool before being transplanted back into the recipient areas.

Follicular Unit Micrografting – When a strip of hair is taken from the donor area before being dissected into grafts containing single follicular units microscopically.

Follicular Unit Strip Surgery / FUSS – Another name for Follicular Unit Transplant where a strip of tissue is taken from the donor area at the back of the scalp.

Follicular Unit Transplant / FUT – A hair transplant technique where a strip of tissue from the donor zone is removed and is then divided up into thousands of individualized follicular units before being transplanted back into the recipient areas.

Front Fibrosing Alopecia / FFA – A form of scarring alopecia that affects the hairline. Loss can also be experienced around the ears and from the eyebrows. It is usually associated with the menopause.

FUE – An abbreviation of Follicular Unit Extraction.

FUT – An abbreviation of Follicular Unit Transplant.

G

Graft – The term used for any piece of hair-bearing tissue that is transplanted into the scalp.

Grafting – Procedures where skin is removed from the donor area to be transferred to balding or thinning areas of the scalp. Varieties include micrografting and minigrafting.

Gynecomastia – A condition where the male breast tissue enlarges.  Some hair medications can cause gynecomastia as a result. The biggest cause of balding is DHT which actually helps to prevent Gynecomastia but certain hair loss medications prevent this hormone from forming resulting in gynecomastia as a side effect.

GMC – General Medical Council. An independent regulator that all doctors and surgeons are required to sign up with in order to remain qualified to work in the UK. GMC aims to help protect patients and improve medical education and practice across the UK.

H

Hair Cloning – A technique that is not currently available yet but has the potential to make your donor hair area unlimited.

Hair Economics – The theory that states only a limited or decreasing supply of hair exists but the demand for hair increases as balding patterns develop.

Hair Flap – An outdated hair restoration method where a section of hair bearing tissue is removed from one side of the scalp and inserted into the front regions of the scalp. It was an extremely invasive procedure and is no longer performed mainly due to the lengthy recovery process.

Hair Follicle – A hair follicle is a sac located under the skin from which hair grows. The follicle surrounds the base of the hair root and is lined by cells which have been taken from the outside later of the skin.

Hair Geometry – The natural direction that hair grows in and naturally sits in when un-styled.

Hair Grafts – Hair Follicles that have been explanted from the donor area and are ready to be transplanted into the areas being treated on the scalp. The number of hair follicles that are present per graft can vary from single follicles to multiple follicles.

Hairline – The line of hair that runs along your forehead. A common area where hair loss is noticed. See Receding hairline.

Hair Loss – The loss of hair from your head or other areas of your body which can be temporary or permanent. See Balding.

Hair Implant – A term that is sometimes given to hairs that have been transplanted into the recipient areas.

Hair Plug – An older hair transplantation technique where large round grafts were taken from the donor area and placed into the recipient zone. See plug hair transplants.

Hair Shaft – The part of the hair that is seen above the skin.

Hair Transplant – A surgical procedure where hair follicles are taken from a donor area and transplanted back into areas that are thinning or balding.

Hairline Refinement – Using hair grafting techniques to improve the appearance of an older transplant technique.

I

Implanter Pen – The instrument used to transfer follicular hair unit grafts into the scalp.

ISHRS – The International Society of Hair Restoration Surgery. An international non-profit medical organisation who are dedicated to promoting the highest standards of medical practice and medical ethics within Hair Restoration.

K

Ketoconazole (KCZ) – An anti-fungal compound medication used to control dandruff. Studies have shown that use of KCZ promotes an anti-inflammatory effect that can counteract some types of alopecia that is caused by inflammation although further studies are required before a significant claim can be made.

L

Lateral Slits – A particular incision method or technique for inserting new hair grafts into the recipient area. The lateral slits are created using a surgical needle and the hair grafts are inserted using small forceps.

Laxity – The amount that skin can be pinched or pulled away from the body. Your scalp skin laxity may be checked at a consultation to assess your suitability for a FUT procedure in particular as it gives a better estimate of how much skin can be safely used for transplant.

Laxometer – An instrument used to measure the laxity and looseness of the skin.

Loupes – A magnifying instrument that is used in Hair Transplant to give the surgeon high visibility of the hair grafts.

Ludwig Scale – A chart used to measure female pattern baldness.

M

Male Pattern Baldness / MPB – A pattern of hair loss often caused by androgenetic alopecia, genetics and hormones where hair follicles from the front or top of the scalp are gradually lost over a period of time.

Manual Punch – A cylindrical tool used to perforate the skin and remove the hair follicles during a follicular unit extraction (FUE) procedure.

Micrograft – A graft containing 1-2 hairs which has been extracted from the donor area with a micropunch.

Midscalp – The subregion of the scalp that is between the front and crown areas.

Minigraft – A graft containing either 3-4 grafts (small minigraft) or 5-6 grafts (large minigraft) which has been extracted from the donor area.

Miniaturization – A process where the hair follicle reduces in size causing the hair to look thinner. It is usually a good indication that hair loss is likely in the future. Miniaturization is caused by dihydrotestosterone (DHT).

Minoxidil – A licensed medication to treat both male and female hair loss in the UK. It does not require a prescription. The positive results of Minoxidil will stop after you stop taking it however and hair loss will resume.

Motorized Punch – An instrument used to cut around the follicular hair units removing them from the donor zone on the scalp. Unlike the manual punch tool, the motorized punch tool is powered by a small motor controlled with a foot pedal or a button on the device.

Multi Blade Scalpel – An instrument that was used for strip removal in the earlier days of strip excision.

Multi-Unit Grafts – Often abbreviated as MUG, this term replaces the older ‘minigraft’ term. MUGs contain 2-6 follicular units per graft.

Multi-Unit Grafting – A hair transplant procedure that uses hair grafts that contain multiple follicles.

N

Necrosis – Death of skin tissue due to a failure of blood supply, disease or injury. Necrosis can occur after a hair transplant if too many hair follicles have been planted into one area causing unnecessary trauma and a disruption to the blood flow. It can also be as a result of an infection or if you have a contradiction that increases your likelihood to developing necrosis such as diabetes, cardiovascular disease or even long term smoking.

Neograft – An automated tool that can be used to perform an FUE Hair Transplant procedure.It is currently only available in the US.

Norwood Scale – A hair loss measurement system for diagnosing male pattern hair loss.

P

Pitting/Pit Scarring – Scarring that can appear within the hair after a hair transplant. It is most commonly caused by the incisions in the recipient site being too deep and although the transplanted hairs may be healthy the skin around them dips in giving the appearance that the hair is growing out of a pit.

Platelet Rich Plasma/PRP – A procedure where the platelets from your own blood is injected back into your body to help grow new, healthy cells. The use of PRP therapy in some cases can be used to increase the growth phase of hair follicles to help prevent hair loss.

Plug Hair Transplants – An older hair transplant technique where round grafts of hair are taken from the donor area and placed into the recipient area. In some cases the grafts can be quite large which can result in an unnatural appearance so it is not a favoured technique these days.

Posterior Scalp – The back of the scalp below the crown.

Propecia – A common brand name for finasteride. Propecia is a medication that can lower the amount of DHT in the body, which prevents any additional hair loss.

Proscar – A medical brand name for finasteride that is able to prevent the formation of the DHT enzyme which can help prevent hair loss.

Pubic Hair Transplant – A rare procedure where hair is taken from the patient’s public region and transplanted onto the scalp. This is not commonly performed as pubic hair has different characteristics to hair found on the scalp and doesn’t usually give a natural result.

Punch Graft – An older hair transplantation technique where hair follicles are removed from the donor area with a 4mm punch tool creating larger numbers of follicles per grafts.

R

Receding Hairline – The loss of hair from the front of the head causing the hair line to move back up the scalp revealing more of the forehead space.

Recipient Area/Zone– The area where hair loss or thinning is present and where the hair follicles will be transplanted to during the hair transplant procedure.

Retrograde alopecia – A relatively unknown, but common form of alopecia that can be seen in various areas of the scalp. Retrograde Alopecia is also known as vertical alopecia as the thinning usually happens in a vertical pattern usually from the neck up to the back of the scalp.

Ridging – A complication that causes raised scar tissue in the recipient area. It is usually caused when the follicles are packed too densely or too much tissue is transplanted which results in the follicles being pushed upwards creating the scarring. This is not to be confused with cobblestoning however.

Robotic Hair Restoration – A technique that uses robotic surgical devices to assist a surgeon at performing an FUE hair transplant.

Rogaine/Regaine – Known as Regaine in the UK, this is a commercial name for Minoxidil in America. It has been clinically proven to stimulate hair growth and prevent future hair loss. When you stop using Regaine/Rogaine it is likely that you will lose the new hair grown and revert back your previous hair loss pattern.

S

Sagittal Incisions / Vertical Slits  – A surgical incision technique used to transplant the hair grafts into. The incisions will run parallel alongside and in between existing hairs in the direction that hair is intended to grow.

Saline Solution – A liquid solution made up of water and sodium chloride. It has a wide range of medical uses but is commonly used as part of the patient’s aftercare routine after hair transplant surgery.  Many surgeons will advise that a saline solution is sprayed over the recipient zone on a regular basis to keep the wounds clean and avoid infection.

Savin Scale – A scale used to determine the pattern of female hair loss which looks at overall thinning as well as density. The Ludwig scale is similar but does not cover hair thinning.

Scab – A dry crust that forms over a cut or wound during healing to help protect it. Scabbing is common after a hair transplant in both the donor and recipient areas.  Scabs should not be picked off as it could dislodge the newly transplanted hair. You should follow the aftercare advice given to you by your surgeon and allow the scabs to fall off in their own time.

Scalp – The skin on your head where hair grows.

Scalp Micropigmentation – A unique procedure that uses specialised equipment to inject pigment into the scalp to give the appearance of a shaved haircut. It is not the same process as a tattoo and should not be performed by anyone who is not fully qualified and experienced to do so in order to achieve a natural result.

Scalp Reduction – A surgical procedure that involves removes the balding area of the scalp and stretching the skin over the area removed to cover it up. It is not commonly performed and has an extensive recovery time.

Scalp Rotation Flaps – A surgical procedure that involves lifting a strip of hair from the scalp and then replacing in back into an area of the scalp where bald skin has been removed.

Sebum – Oil that is created by sebaceous glands that opens up in the hair follicle to help keep hair shiny.

Senescent alopecia/ Senile Alopecia – A form of alopecia that is commonly associated with old age. The hair becomes very thin in diameter but it does not tend to fall out. The cause is usually unknown and a hair transplant is often not possible as the donor hairs will not be suitable for use.

Serial Extraction Placement – A technique used in FUE procedures that shortens the amount of time that the grafts are out of the body by breaking the procedure into smaller sections.

Shock Loss – A sudden loss of hair from either the donor or recipient area after a hair transplant procedure. Shock loss usually occurs after trauma but once your scalp has healed after the procedure your hair will grow back again as normal.

Single Blade Scalpel – A tool used by surgeons during a hair transplant procedure, more so for strip surgical procedures.

Slit Graft / Linear Graft – A hair transplant technique where small follicular units of 10-15 hairs are harvested at once. It is often used for patients who have curly hair or those with light coloured hair.

Stereo Microscope – A specialised microscope tool that provides different viewing angles to the left and right eyes giving an almost 3D effect allowing for a precise dissection with quality grafts.

Stick and Placement – A technique where the surgeon makes the recipient site incision and then places the hair graft immediately afterwards.

Storage Solution – A liquid solution in which hair follicles are stored once they have been removed from the donor area. This is to stop the follicles from becoming damaged and unusable before they are transplanted back into the recipient area.

Strip Harvesting / Strip Surgery – A method of hair transplant surgery where a strip of hair is taken from the back of the scalp in one go. The hair is then split up and divided into hair grafts before being transplanted into the recipient areas. Also known as Follicular Unit Transplant (FUT).

T

Telogen Phase – The third phase of the hair’s natural cycle. At this stage the hair is no longer able to grow and has become keratinized resulting in the hair falling out.

Telogen Effluvium (TE) – When a large amount of hair follicles are going through the telogen phase resulting in overall thinning of the hair or hair loss. TE is usually caused by an external source rather than genetic which can include pregnancy, stress, medications or poor nutrition.

Temples – The area on each side of the head located in front of the ear and above the cheek bone. This is usually one of the first areas where male pattern baldness is noticed which causes the hairline to then recede. Also referred to as the temporal area.

Temporal Point – The triangular shaped area of the hair which is located in the lower outer corners of the forehead where the hairline meets the sideburns on both sides of the head.

Terminal Hair – Thick strong hair follicles that grow all over your body. During puberty, vellus hair is often replaced with terminal hair. Males will have terminal hair in more areas of the body including facial and chest hair.

Tissue Expander – A surgical technique where an inflatable balloon is inserted under the scalp for a number of weeks or months. The aim is to stretch and produce more skin to form which can then be stretched over into the areas of the scalp that are experiencing loss or thinning.

Traction Alopecia – Hair loss that is caused by consistent pulling or tugging of the hair. Hair styles such as pony tails and cornrows are a common causes as well as regular use of wigs, headbands, and helmets.  It is a slow process and usually appears across the temporal region and around the ears.

Transection – The unintentional severing or damage of the hair follicles in the donor area during a hair transplant. Transection usually occurs in the lower part of the hair follicle affecting the hair bulb which then generates the risk that it will not be able to survive once transplanted.

Tricopigmentation – A temporary scalp micropigmentation technique that injects ink into the scalp to give the appearance of a short hairstyle which can cover areas of balding or thinning. Tricopigmentation does not last as long as micropigmentation so it is known as being temporary which is the main difference between the two.

Trichotillomania – The act of pulling hair from your body. It is usually diagnosed as a coping mechanism and many are not fully aware of the extent of the issue until others notice areas of hair loss.

Tumescence – The method of creating artificial swelling on the body through use of anaesthesia to help protect the nerves and blood supply located beneath the area. It is sometimes used in hair transplant strip procedures.

U

Unshaven Folicular Unit Transplant / U-FUE / Non Shaven FUE – An FUE hair transplant procedure that does not require the donor area to be shaven before-hand. The donor hair is also extracted at full length but the strand of hair is cut before being transplanted into the recipient areas.

V

Vasodilator – Medication that works by dilate blood vessels allowing for better blood flow. Minoxidil is a type of vasodilator that is known to help stimulate hair growth.

Vellus Hair – The short fine hairs that are found on the body, commonly referred to as peach fuzz. It is more common on women and children as many males find their vellus hair turns into terminal hair during puberty.

Vertex Area – Also known as the crown, this is the area on the top of the head where the hair often has a spiral or swirl pattern. It is another area where male pattern baldness is first noticed.

W

Whorl – Hair that grows in a clockwise or counter clock wise pattern at the back of the head. Whorls can also be found at the front of the head but are referred to as ‘cowlicks’.

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