Hair Transplantation in Toronto


What causes hair loss?

Numerous medical conditions can cause temporary or permanent hair loss. These include thyroid or other hormonal imbalances, nutritional deficiencies, auto-immune disorders, medication side effects, trauma to the hair or scalp, stress and many others. Nevertheless, the cause of hair loss in the vast majority of patients seeking hair restoration is what is know as male or female pattern hair loss.

Male Pattern Hair Loss (Androgenic Alopecia)

Male pattern baldness is sometimes referred to as androgenic alopecia. “Alopecia” means “hair-loss” and “androgenic” refers to male sex hormones or “androgens” that are responsible for the progressive miniaturization and loss of hair with age. The hormone testosterone is converted to dihydrotestosterone (DHT) by an enzyme called 5-α reductase and it is now understood that DHT is responsible for beard and body hair growth as well as for scalp hair loss. The medication Propecia (finasteride) prevents androgenic alopecia by blocking 5-α reductase. In general, the horseshoe shaped area of scalp hair starting above the ears and extending to the back of the head is resistant to the effects of DHT and so is not lost with male pattern baldness. The resistance of these hairs to DHT is retained even when they are relocated to other areas of the scalp and it is this property that makes modern hair transplantation possible.

The effect of androgens on the male hairline can begin as early as the teenage years and most men will have experienced some degree of pattern hair loss by the time they reach their fifties. The pattern typically begins as recession of hair in the temple areas and in the crown and can gradually progress until only a thin rim of hair is left around the edge of the scalp. It can be very difficult to predict the ultimate extent and pattern of hair loss for any individual patient.

Predisposition to male pattern baldness is thought to be largely inherited however the genetic process is complex and poorly understood. It is a myth that the “baldness-gene” is inherited from the maternal grandfather. Other myths include that poor scalp circulation, caps or hats, or shampoos cause baldness. (Although certain products such as strong relaxants can damage hair).

Female Pattern Hair Loss

Women are also subject to hair loss and while this can be particularly upsetting and can have a devastating impact on self-esteem, in most cases it can be effectively treated. As noted above, there are numerous medical conditions that can cause hair loss in women and hair loss can be associated with other factors such as recent pregnancy or long-term pulling of the hair in pony-tails or tight braids. Women who experience hair loss should seek professional advice from a hair restoration specialist.

As in men, the most common cause of hair loss in women is inherited androgenic pattern baldness however the pattern is generally different from what is seen in males. While female pattern hair loss can start early, it often begins later than the male variety and is more frequently, but not always, associated with a diffuse thinning effect over the entire scalp sparing the frontal hairline. Many women complain that the part in their hair seems to get wider.

While female pattern hair loss is extremely common, many women do not realize that treatment is available and effective and so continue to suffer with the embarrassment and anxiety that frequently accompany thinning hair. Fortunately, more and more women are seeking out advice from hair loss specialists like Dr. Korman and Dr. Solomon and are availing themselves of the excellent treatment options that are available.

Can hair loss be prevented?

Medical treatment can slow or stop pattern hair loss in a large proportion of patients. Some patients will even experience re-growth of hair. The key to medical prevention of hair loss is to start as soon as possible and preserve your existing hair. Although there are many options to restore hair that has already been lost, our philosophy is that problems are almost always easier to prevent than to treat.

The mainstays of modern medical treatment include Propecia and Minoxidil. Propecia blocks the action of 5-α reductase and will stabilize hair loss in approximately 90% of men who take it. The mechanism by which Minoxidil affect hair growth is unclear however it has been shown to be effective in both men and women. Propecia and Minoxidil appear to work synergistically, meaning that greater effect is achieved by using both medications at the same time. We also offer Platelet Rich Plasma (PRP) therapy for hair loss.

There are numerous other products available that are marketed as hair loss cures. While some of these may have effect, many are unproven and some can even be harmful. You are encouraged to do your homework and realize that if a “miracle” lotion or potion seems too good to be true, it probably is. We will be happy to answer any questions that you have about other hair restoration products.

It is important to remember that if left untreated, male pattern baldness will progress relentlessly. While some patients experience re-growth, the primary goal of medical treatment is to prevent additional hair loss. If there is no change in the appearance of your hair during the treatment period, this should be viewed as a success, not a failure.

For more information about preventing hair loss please refer to the Non-Surgical Hair Restoration section of this website.

When should I consider treatment?

The decision to proceed with hair transplantation or other surgery is a major one and the timing must be right for you. It is absolutely critical however, to appreciate that your hair is a non-renewable resource and we strongly encourages that medical treatment to stop ongoing hair loss be initiated at the soonest possible time even if surgical treatment is not currently and option for you.

By the time an area has a thinned appearance, 50% of the hair in that area has already been lost. Halting your hair loss will conserve valuable donor hair and prevent progressive baldness, possibly reducing the extent or even eliminating the need for future surgery.

What treatments are available?

There are a wide variety of medical and surgical options available. Propecia and Minoxidil are the mainstays of medical treatment and hair transplantation is the backbone of hair replacement techniques. We also offer PRP (platelet rich plasma) therapy.

Please see the Our Services area of this website for more information regarding specific treatments.

How much will treatment cost?

The cost of treatment depends on the nature and extent of the hair loss and what treatment options are best for you.

Consultation with your family doctor or dermatologist for investigation and medical management of hair loss is generally covered by OHIP.

Medical treatment such as Propecia and Minoxidil vary in cost from $25-100 per month depending on the combination and format of medications that are used.

Grafting procedures vary widely in cost depending on the area to be transplanted. More advanced procedures such as scalp-plasty or scalp-reduction operations are assessed on a case-by case basis.

Under some circumstances, elective surgical procedures are deductible from your income as a medical expense. Patients are encouraged to contact their tax-professional.

There are several options for financing elective surgical procedures.

You are encouraged to contact us to arrange an appointment so that your specific questions can be addressed.

Hair Transplant Q&A

  • What is a hair transplant?

    A hair transplant is an operation in which hair follicles that are not susceptible to pattern hair loss (usually from the permanent fringe of hair at the back and sides of the head) are relocated to areas of the scalp that are bald, or destined to become bald. Hair can also be transplanted to other areas including the eyebrows, eyelashes, moustache, beard and body.

    The field of cosmetic hair transplant Toronto was born in the late 1950’s and has evolved dramatically over the last 50 years. With modern techniques follicular unit grafting, pluggy, unnatural “doll’s hair” results are a thing of the past. Follicular units are naturally occurring groupings of one, two, three and sometimes four or five hairs.

    In a modern hair transplant, follicular units are removed from the back or sides of the scalp to the hairline and other areas of the scalp that exhibit hair loss. Depending on the goals and individual characteristics of each patient, the follicular units from the donor area can be removed all at once in a long strip and then divided into individual follicular units using microscopic surgical dissection. Under some circumstances, the follicular units are removed individually using an alternative technique referred to as follicular unit extraction. Regardless of the technique however, our meticulous cosmetic surgical techniques usually result in virtually undetectable scars.

    Once the follicular units have been prepared, precise instruments are then used to create tiny recipient sites in areas of the scalp that are bald (or destined to become bald). The creation of the recipient sites requires surgical skill and artistry in order to achieve a long-term result that will continue to look totally natural even as the patient ages.

    Once the recipient sites have been created, the grafts are individually inserted into place. The transplanted hair is your own and will continue to grow for the rest of your life, just as it did in its original location. It can be washed, brushed, cut and styled just like any naturally occurring hair.

    Using modern techniques and instrumentation, our team is able to create a natural appearance with the hairline, density and coverage that are appropriate for each individual patient.

    Hair transplantation is performed under local freezing with mild sedation in a comfortable office setting.

    The side-effects of hair transplantation surgery are relatively minor and serious complications are extremely rare. Modern hair transplantation surgery in our setting is comfortable, predictable, and produces pleasing results.

  • Does it hurt to have a hair transplant?

    Part of our philosophy is that hair transplantation should be a comfortable and virtually pain-free experience. With the use of light sedation, local anesthetic and gentle and meticulous techniques, the vast majority of patients report that they experience little or no pain. Many actually enjoy the experience, asking questions, chatting with the staff, listening to music, or watching a movie as the procedure progresses.

  • What if I don’t want to look like I’ve had a hair transplant?

    Many potential patients state that the only thing that they would find worse than baldness would be a bad hair transplant. The sight of unacceptable, obvious, pluggy, and frankly embarrassing results produced by older, outdated techniques would give anyone second thoughts.

    The field of transplantation has come a long way from the days of “corn-rows” of hair plugs. Grafts have gradually gotten smaller, hairline design more sophisticated, and technology more advanced. The advent of follicular unit transplantation with stereo-microscopic single-hair graft preparation is now generally regarded as the end refinement in surgical technique, able to yield results that are predictable and undetectable. Often, patients’ hairstylists are not able to tell that a transplant has been performed.

  • What is the difference between "follicular unit strip surgery (FUSS)" and "follicular unit extraction (FUE)"?

    Follicular unit strip surgery (FUSS) and follicular unit extraction (FUE) refer to different techniques of harvesting the hairs that are to be used for transplantation.

    FUSS involves removing one or multiple strips of donor tissue from the back or sides of the head. This strip is then dissected into smaller grafts, usually individual follicular units, using stereo-microscopes or other high magnification. The resulting wound in the donor area is then meticulously sutured, usually using a cosmetic surgical technique known as “trichophytic closure” which allows adjacent hair to actually grow through the fine linear scar thus rendering it almost completely invisible.

    FUE is a different technique whereby individual follicular units are individually extracted from the donor area using a very small cutting tool called a punch. The resulting holes in the donor area are so small that they simply heal over on their own with no need for sutures. The purported advantage to this technique is that unlike in FUSS, there is not a single, long donor scar.

    Many centres only offer FUE hair transplant Toronto surgery, aggressively marketing it as a “no-scalpel” technique. This can be misleading for some patients because while strictly speaking, no scalpel is used, FUE is still a surgical procedure requiring similar preparation and having the same (albeit low) potential for complications such as scar formation. It is just that instead of one long incision, hundreds, or even thousands of smaller ones are required.

    FUSS and FUE techniques for hair transplantation each have their advantages and disadvantages and can achieve excellent results. Our philosophy is that each candidate for hair restoration should be assessed and the most appropriate technique selected.

  • What is Follicular Unit Transplants (FUT)?

    When examined under a microscope, hair can be seen to grow in natural groupings that usually contain between one and four hairs. These natural groupings are called follicular units (FU’s). When donor hair is divided into grafts for transplantation, preservation of the integrity of these FU’s allows the hair to be transplanted in a way that maintains a very natural appearance. This is in stark contrast to the unacceptable appearance of historical hair transplants that paid no attention to FU groupings and simply inserted coarse plugs which could contain as many as 20-30 random hairs.

    The advantage of performing hair transplants using exclusively individual FU’s is that by mimicking nature, unparalleled naturalness can generally be achieved and even a small session can produce a stand-alone result that will continue to look natural, albeit thin, over the patient’s lifetime.

  • How many procedures will I require?

    The number of procedures required depends on several factors including treatment goals, the degree of hair loss, and the availability of donor reserves. Some people are satisfied after only a single procedure, while others will desire further treatment in order to add density, refine the hairline, temples or crown, or to keep up with progressive hair loss over the years.

    Regardless of the number of transplant sessions that are ultimately carried out, we design each one as a “stand-alone procedure.” This means that each transplant will be specifically designed to look natural throughout your entire lifetime regardless of the extent of future hair loss or future surgery.

  • What can I expect after my hair transplant?

    Hair transplantation is done as a day surgery procedure with patients able to go home on the same day. In general, no bandages or dressings are required. Most patients have only mild discomfort following a hair transplant and hair can be gently washed on the first day following surgery. Most people choose to take a few days off work but some people resume their normal schedule within 1-2 days. We discourage heavy lifting or vigorous exercise for one week following surgery.

    Following a hair transplant, new growth will commence within about 3 months and the transplanted hair then grows at the normal rate of about 1cm per month and continues to thicken over time.

Dr. Philip Solomon Sitting

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We appreciate your inquiry and look forward to helping you with your cosmetic needs. In order to best help you, we require all cosmetic patients to come in for a consultation. All Surgical & Non-surgical Consultations have a fee of $100 that will be deducted from the cost of your procedure or treatment. To schedule an appointment, you can complete the form below or call our office at 905-764-7799. We look forward to hearing from you