Hair Transplant Terms & Definitions S-Z

Sagittal – The orientation of incisions made into the recipient scalp typically used by most hair restoration clinics. The generic definition of sagittal refers to the vertical plane between the anterior scalp and the posterior scalp but specifically, with reference to recipient site creation, sagittal incisions are parallel with the direction of hair growth which is in turn fairly parallel to the anterior and posterior scalp and the overall direction of the Langer’s Lines.

Saline – Sometimes referred to as saline “solution”. A liquid medium composed of water and sodium chloride (table salt) chilled to between 2C° and 8C° for the purpose of follicular unit and tissue storage during surgery.

Savin – One of two widely used charts to measure female hair loss. The main difference between Ludwig and Savin systems is that the Savin system of measuring hair loss also accounts for degrees of thinning as opposed to patterns alone found in the Ludwig system.

Saw Palmetto – A slow growing plant known as a fan palm that grows in the Southeastern region of the United States. Some examples have shown to be 500 to 700 years old. There is medical evidence that it acts as a DHT (dihydrotestosterone) inhibitor therefore being effective in the treatment of BPH (benign prostate hyperplasia) and MPB (male pattern baldness). Saw Palmetto is available over the counter as an extract or as one of several active ingredients in many hair loss formulations. It is available in most grocery and health food stores.

Scalp Micropigmentation – Also referred to as “SMP”. SMP is the process of applying micro tattoo dots to the scalp in order to mimic the appearance of hair stubble on a bald scalp. It is mostly used on male patients that do not have enough donor hair to achieve a worthwhile cosmetic outcome and turn to the “shaved look” as an alternative to a bald appearance. SMP can also be used as “filler” to give a thickening effect for longer hair. There are two types of SMP. Permanent SMP is more similar to traditional tattoo in that the ink is similar and the depth of application within the epidermis is also similar with the average depth being in the 2mm range. Temporary SMP is gaining in popularity due to several factors. The ink that is applied is specifically designed for cosmetic application on the scalp with a formulation that encourages the breakdown of the ink over time. The application is more superficial at .5mm with the expected life expectancy of the ink to be no more than two years. This allows for hairline design to be modified as the patient ages to insure a natural appearance and if any other modifications need to be performed the client is not restricted due to previous work performed.

Scalp Reduction – This is a surgical procedure in which the area of loss is surgical removed and the outlying areas of healthy hair bearing scalp are pulled together to close the wound. This creates a result that has a high density appearance that is difficult to replicate with grafting procedures. However, the hair growth geometry is severely altered sometimes causing an unnatural appearance and difficulty when styling the hair.

Seborrheic Dermatitis – Commonly referred to as “dandruff” seborrheic dermatitis is a condition that affects the scalp. It causes patches of skin to become “scaly”, red, inflamed and itchy. It is considered to be a long term condition that is difficult to treat. There is no known cure at this time but usually it can be controlled with prescription and over the counter remedies.

Shock – Sometimes referred to as “shock loss”. There are two types of shock. Temporary and Permanent. Both types of shock can occur in the recipient zone as well as the donor zone.

Temporary Shock – The result of transplanting hair into non-balding but thinning areas of scalp. The surrounding native hairs can become traumatized and they subsequently fall out temporarily but tend to regrow during their next anagen phase. In essence, the procedure induces the surrounding hairs into catagen then telogen growth phases. Temporary shock also applies to transplanted hair as they are expected to fall out temporarily after transplantation into the recipient scalp before they regrow into healthy terminal hairs. Temporary shock can also occur in the donor zone from trauma of too much tension during FUSS wound closure. It can manifest along the entire wound closure or it can be isolated to a smaller area the size of a quarter. FUE can also cause temporary shock from the general trauma of having multiple thousands of holes made in the donor zone.

Permanent shock – This occurs to native hair in the vicinity of graft placement due to the trauma of surgery. This can cause any native hairs that are already being affected by DHT to shed and not regrow as they most likely would have been lost in short time naturally. They are not strong enough to survive but they usually have little cosmetic benefit to begin with due to the extreme miniaturized state. Permanent shock loss also occurs due to Transection of neighboring hairs by the incision-making tool used for recipient site creation or by the scalpel used in FUSS tissue removal and in FUE when the punch transects a donor hair due to incorrect alignment.

Simultaneous Stick and Place – This is a variation on the stick and place method in which an incision is made into the recipient scalp and a graft is placed into the incision in the same movement. This is how grafts are placed using implanter pens such as the Choi Implanter and the Lion Implanter.

Single blade scalpel – For strip excision surgery this is the preferred tool as it greatly reduces transection rates thereby increasing the percentage of hairs that survive the transplant process from harvest to full growth.

Spironolactone – Known commonly as a “water pill” spironolactone helps to prevent too much salt absorption by the body and helps to treat hypokalemia, or low potassium. It is also a fairly common medication recommended for female pattern hair loss.

Storage Solution – This is a liquid medium in which follicular units are stored after they have been removed from the donor scalp via FUE or FUT. Once removed from the scalp the host tissue must be placed into a storage solution to prevent desiccation with the target temperature being between 2C° to 8C°. The purpose of storing tissue in chilled solutions allows for a slowing of cellular metabolism, which leads to degeneration. Typical storage solutions commonly used are chilled saline solution, and to a growing degree, Hypothermosol solution.

Stick and Place – For each incision made into the recipient scalp a graft is placed immediately afterward.

Strip Surgery – Strip surgery is the practice of removing a piece of hair bearing scalp from the traditional safe donor zone that can vary in width and length depending on how much hair is being transplanted. A typical strip is usually no less than .8 cm and up to 2.5 cm in width. The length can vary from 5cm to well over 35cm (depending on clinic and target number of grafts).

Telogen – This is the resting phase of growth in the life cyle of hair. It occurs after the catagen phase and usually lasts for three to five months before active growth (anagen) resumes.

Telogen Effluvium – An excessive degree of loss triggered by the early cessation of anagen growth and the subsequent transition into catgen and eventual telogen (shedding).

Temple – The region on either side of the hairline where hair direction turns downward and includes the region of hair anterior to both ears.

Temple Point – The triangular tuft of hair that forms in the temple behind each eyebrow.

Terminal hair – Thick, strong pigmented hair that shows no signs of miniaturization.

Testosterone – The hormone that is secreted by the testicles and is the primary androgen hormone in the male body.

Theory of Donor Dominance – The theory that the hair that grows in the safe donor zone is dominant over the recipient zone in which the hair is to be transplanted thus because hair fell out in the target recipient zone the new hair will not be affected by the same factors. The donor zone hair is dominant over the recipient zone in which it will be placed therefore, theoretically, the hair should continue to grow for life. Since this theory has been proposed over the subsequent decades it has been shown to not be entirely accurate but for the most part the theory is valid.

Tissue Expansion – Also known as balloon expansion, this is a procedure in which a ballon is inserted under the skin. It is slowly inflated over a period of multiple doctor office visits. After several visits the balloon as reached it’s full size. The purpose is to allow for additional FUSS procedures if the patient is in need of repair but his donor laxity is too low due to multiple previous procedures. Tissue expansion was also required for many patients in order to facilitate a hair flap surgery.

Traction Alopecia – Hair loss caused by the constant pulling of hair by wearing tight pony tails, turbans, or hair extensions for long periods of time. Hair normally grows back after it is pulled out but with the constant pulling by various methods hair eventually stops growing in the affected areas and smooth skin is left behind.

Transection – In hair restoration the act of transection is the unintentional (usually) transverse cutting of hair. Transection occurs in the recipient zone when little care is taken to make incisions far enough away from surrounding hairs. Transection also occurs during extraction of hair from the donor zone via FUE or FUT. The goal of any clinic is to keep transection rates as low as possible. In some cases, intentional transection will occur to kill aesthetically detrimental hairs.

Tricopigmentation

Tricopigmentation is a scalp micropigmentation procedure developed by Milena Lardi of Beauty Medical clinic in Milan, Italy. The procedure has taken on the name of scalp micropigmentation, or “SMP”, but it is not the same in that every aspect of the procedure has been designed for the purpose of hair replication. The procedure is not permanent like traditional SMP procedures and the ink is not known to turn drastic shades of blue or green with time. Procedures of this type are designed to completely disappear in two years time. More information is available on the scalp micropigmentation page.