Education Centre

Get more information about hair loss and what to expect when you visit PAI

Hair loss can be confusing; different types of hair loss concerns make it difficult to identify without the right knowledge. Knowing your type helps determine the level of procedure to help restore your hair. Below is a chart with descriptions of different levels of hair loss.

A detailed questionnaire is routine before your first meeting with a PAI hair loss consultant. The answers will help guide the discussion to the best alternatives for your hair loss issues. Download the questionnaire today and submit it to us by email at (email address) before your meeting.

Types of Hair Loss

Hair loss is categorized differently by men and women. The Norwood class system is for male hairloss. The Ludwig class system is for female hair loss.

  • Norwood 6: Moderate to extensive hair loss in front, crown, scalp and upper occipital region of the back of the head.
  • Norwood 5: Light to complete loss in front, crown and mid scalp.
  • Norwood 4: Light to complete hair loss in the front third to half of top of the head, loss of hair in the front and or back of the scalp. Some light hair growth across mid scalp.
  • Norwood 3: Light to complete hair loss in the front quarter of the scalp.
  • Norwood 2: Light to complete hair loss in front fifth of the scalp.
  • Norwood 1: Early and light hair loss in front of the hairline.

Female hair loss is often categorized by type 1 – 5

  • Type 1: Diffused light thinning throughout the top of the scalp usually characterized by some light transparency through the hair with the scalp beginning to show.
  • Type 2: Moderate thinning throughout the top of the scalp usually characterized by some more transparency through the hair with the scalp showing.
  • Type 3: Advanced thinning throughout the top of the scalp usually characterized by more scalp than hair showing.
  • Extensive 1: Extensive thinning throughout the top and sometimes side areas. Very little hair coverage on the scalp at this point.
  • Extensive 2: Extensive thinning to complete baldness throughout the top of the scalp. Thinning into sides and occipital regions as well.

What Can I Expect?

From the moment you walk into one of our PAI Medical Group clinics for a consultation, you will know that your decision to find a solution for your hair loss with PAI is the right one. Your private, complimentary consultation with a qualified, trained hair restoration specialist will provide you with an expert, customized opinion on your specific hair loss.

Our physicians have trained our hair restoration consultants to discuss hair loss, how hair grows, how we lose it, and the various options available. During this consultation, we will determine if you are a candidate for hair transplantation or if you will benefit from a hair loss prevention treatment program. Many of our PAI consultants have had hair transplants themselves. We will discuss your specific goals for your appearance, review your hair loss classification, and explain the various levels that can be achieved with our hair loss solution procedures.

It will take about an hour of your time and we invite you to bring your spouse or a friend to help you reach a decision about our company, our procedures, and the expertise of our physicians. You will be asked to complete a confidential questionnaire about your goals and expectations in finding a solution for your hair loss and about medications you are taking or allergies you may have. Your hair restoration consultant will show you a video and/or photographs of PAI Medical Group patients and you may also arrange to meet with someone who has had the procedure. If you would like a further consultation with a physician, we can set up an appointment for the first available opening.

The complex part of hair transplantation is the artistry required by the surgeon. Expertise comes from very carefully creating the individual’s look according to what is natural to their overall appearance. This may sound easy, but it is the most difficult part of the procedure because of the extreme variations in human appearance.

Everybody is different. Therefore every hair transplant will be different, and each and every aspect must be taken into account down to the finest detail. Everything from hair characteristics, including coarseness and color, to the shape of the individual’s head and face and the color of their skin will be taken into account for the procedure. For example, different techniques must be used on an individual with black hair as opposed to one with blond hair (a much smaller variation in graft sizes must be used with the darker hair and lighter skin tone). Great skill is required to design and create a natural-looking hairline that is correct for the shape of your face and for your age, now and in the future.

Unfortunately, there are many companies and physicians in the hair restoration field who are unable to attain a natural result. However, at PAI, the surgeons have perfected this natural look with their fine attention to detail.

I’m going in for hair transplant surgery! Now what?

First, you have made a great choice. Be confident that you are going to look great when your hair begins to grow back like you hoped it would. Your appearance will be something you are proud of. Remember, this is your body and your hair; if you aren’t satisfied with your appearance, it shows. Going through the hair transplant process with PAI Medical is the easy part. Allowing your body to heal and giving your hair time to regrow that takes patience. Talking with a hair transplant specialist is often the best medicine for ‘cold feet’ before a transplant procedure and a good reality check afterwards.

If you aren’t in this situation yet, you have come to the right place! People considering hair loss solutions involving surgery have often already tried everything else. Traditional methods of changing diet and stress management have had no effect, purchasing the creams and using chemicals has left you disappointed. The leap from ‘thinking’ to ‘doing’ is a big one.

Here are a few questions you will want to consider:

  • How long have you been losing your hair?
  • Are you comfortable with the length of time after surgery it takes hair to regrow?
  • Are you open to discussing your hair loss? One on One? With family members?
  • Have you researched the hair transplant procedure?
  • Have you talked to a hair transplant specialist?

Don’t rush into any surgery. But take the time to educate yourself on what is involved in the hair transplant and restoration process. The only bad question is the one you don’t ask a professional. Consultations are free and so is the phone call. We are here to help and educate, not convince you. The choice is yours but you aren’t alone. Join the millions enjoying a renewed sense of self. We can help!

When you arrive at the PAI clinic, you will be welcomed by a medical coordinator who will show you to your own private treatment room. During your procedure, you may listen to music, read, watch television, or enjoy a recent film from our library. You can also enjoy a drink from an assortment of beverages.

Your hair restoration plan will be reviewed and you will be asked to sign a consent form, indicating that you have been fully informed about every aspect of your surgery. A series of preoperative photographs will be taken.

The coordinator will discuss placement of your hairline, which is moderated by the density and quality of the available donor hair. The artistry and experience of the surgeon will help you meet your realistic expectations. The number and size of grafts needed for the current session will then be estimated.

After routine preparations, you will receive local anesthetic at the donor and recipient sites. Donor hair from the back or sides of your head will be harvested and transplanted to thinning or balding areas. Transplant sites are angled toward the nose. Grafts are randomly placed and spaced to approximate a natural growth pattern, thus avoiding a ‘doll’s head’ or ‘cornrow’ appearance and also ensuring adequate blood supply for each individual graft.

If your procedure includes refinement of a previous hair transplantation, it may involve the removal of ‘plug’ grafts along the frontal border and the subsequent re-sectioning of the ‘plug’ into mini or micro units for implantation into another site. Subsequent repair sessions will soften the abrupt hairline and fill in the newly created gaps. This produces a more natural and aesthetic hairline.

After your procedure is complete and your scalp has been inspected to ensure that grafts are secure, a medicated non-adherent pressure dressing is applied. This remains in place overnight, and is removed the next morning, when your donor and recipient sites are cleansed. You may return to work that same day.

You will be given detailed verbal and written instructions for care of your scalp, and any additional medications that you might need will be provided before you leave.

Activity should be restricted during the first 24 hours after the procedure, and strenuous exercise should be avoided for five to seven days. Alcohol, aspirin, aspirin-like medications, and vitamin E must be avoided for two days.

Within four to six weeks, the graft hairs will fall out, but the dormant follicles remain. At approximately three to five months, new hairs will appear and grow at the normal rate of about 1 cm per month. The onset of hair growth may be delayed with subsequent transplant sessions. Your consultant may recommend hair hygiene treatments to stimulate hair growth.

What Causes Hair Loss?

Losing your hair can be a traumatic experience. For men, baldness can be taken as a sign of old age, unattractiveness, or infertility. Clinical studies have shown that hair loss is a cause of low self-esteem and low self-confidence in men. Causes of hair loss come from several factors including genes, hormones, and age.

The typical adult head has about 100,000 hairs and sheds and regrows about 50 – 100 hairs a day. Each hair has a genetically programmed schedule that includes growth, shedding, and resting. A mix of emotional turmoil, medication, poor nutrition, and illness may cause excessive daily shedding. However, these factors are often temporary, and hair growth should continue once these factors have ended. Around 70% of American men and 50% of American women will experience some sort of hair loss during their lifetime.Permanent hair loss comes from hair follicles that become thinner and weaker, and eventually stop producing hair.

It is normal for a hairline to change from childhood to adulthood. In fact as one ages, the hair on the forehead naturally recedes. It is also common for the hair to thin slightly due to a reduction in the diameter of individual hairs. Any loss or recession after this point however, is considered male pattern baldness.

Truth about Baldness

So what is the real reason so many men around the world go bald in the same areas of the scalp? Balding involves more than just losing hairs from the head. Two simultaneous events are occurring: shortening of the anagen phase and shrinking of the follicle.

As these two events continue to work in conjunction with each other, the hairs become shorter and thinner and lose their pigment  – causing “normal” hairs to change to terminal hairs, then to intermediate hairs and finally to vellus hairs.

Following are the many types of hair loss and the reasons behind them:

Androgenetic Alopecia, commonly known as Male Pattern Baldness. The term androgenetic alopecia contains two of the three causes of hair loss. Alopecia is the Greek word for “baldness,” while androgenetic can be split into: androgens – “male hormones” and genetic – “genes.” The third component of hair loss is time. All three of these elements contribute to hair loss.

Genes are the biggest factor when it comes to hair loss. You inherit the tendency toward early hair loss, although hormones also come into the picture. Men reason that if their father is bald, they will be as well. Research shows that hair loss genes can come from either side of your family.

Although hormones govern many chemical processes in the body, only two affect hair loss: testosterone and dihydrotestosterone (DHT). Testosterone is responsible for deepening the voice, building muscle mass and promoting hair growth under the arms and in the pubic area.

DHT, on the other hand, promotes hair growth on the face and body and is responsible for acne, enlarged prostates and male pattern baldness. Without testosterone, the body cannot make DHT and without DHT, male pattern baldness cannot occur.

With the help of an enzyme known as 5 alpha-reductase, testosterone is converted to DHT. It is the presence of DHT in the hair follicle that activates the balding process.

Time is a factor in many things that occur in our bodies and losing hair is no exception. Baldness is a condition of advancing age.

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PAI Medical Virginia

8201 Greensboro Dr #610
McLean • Virginia • 22102