By age 50, about 50% of substantial number of men and women-are affected by hair loss, much of which is hereditary. Micro-hair transplantation is a state-of-the-art hair transplantation technique that has replaced "plugs" or larger grafts of hair.

Technique:
Most micro-hair transplant procedures (individual hair micrograft restorations) use local anesthesia and are performed on an outpatient basis. Other procedures such as flap surgery, require general anesthesia and are performed in a surgical setting. After approximately six weeks, the transplanted hair will fall out and be replaced about three months later when the new hair grows in. To achieve sufficient density, several sessions may be required. Transplantation is a progressive process requiring hundreds of micro-grafts, each of which will generally contain from one to three hairs mini-grafted from a donor site on the side or back of the head. They are randomly implanted in the bald (or thinning) area so that they will grow in a natural pattern and produce an undetectable result.

Benefits:

• Procedure is permanent. Once the transplant procedures are complete, there is no further necessity for surgery.
• Restores a natural, more youthful, and vigorous look, with potentially positive psychological effects, such as a boost in confidence.
• Less expensive than other hair-loss treatments, when factored over time.

Other Considerations:

• Must have availability of healthy hair in donor areas of adequate density. May be combined with other surgical procedures in patients with larger areas of baldness.
• Time-consuming process that may require multiple sessions over 1 to 2 years.
• Procedure involves some degree of minor discomfort, bruising and swelling.
• There may be numbness around the donor or recipient site, which generally disappears within 2 to 3 months.
• Several days are required before normal activities can be resumed.
• Patient should not have unrealistic expectations about the nature and extent of transplanted hair growth. Individual hair characteristics, such as coarseness and curl, can affect the possible density of transplanted hair.
• Survival of transplanted hair is not always predictable.

Body fat makes excellent soft tissue filler material. Fat injection (also called autologous fat transplantation) transfers fat from one part of the body to another to recontour the face; diminish frown lines, crow's feet and nasolabial folds (smile lines); and provide definition to areas like the cheeks and chin. It can also be used to fill out depressed scarred areas on any part of the body. Fat injection is not permanent, and may require an effective maintenance program.

Technique:
The donor site (for example, abdomen, buttocks or thighs) and the treatment site are injected with local anesthetic. Intravenous (IV) fluids also are injected into the donor site to facilitate fat collection. Fat cells are extracted through a small needle attached to a syringe. The fat is then processed to remove excess fluids and reinjected with another needle in multiple thin strands in the desired area. "Overfilling" is a necessary corrective due to fat absorption in the weeks after treatment. Fat also can be harvested during a lipoplasty (liposuction) procedure in one area of the body, and then reinjected in another. For longest-lasting effect, patients generally receive 3 to 4 treatments over a six-month period.

Benefits:

• Natural, non-allergenic. · Outpatient procedure that generally takes under an hour.
• Injections may last from several months to permanently.
• Little or no downtime
• Minimal discomfort, which can be controlled with medication.
• Because fat is from the patient's own body, no pre-testing is required and the fat cannot be rejected.
• Good alternative if the patient is allergic to bovine collagen.
• Cost effective if combined with another procedure like lipoplasty (liposuction).

Other Considerations:

• Longevity of results can vary significantly from patient to patient.
• Some swelling, bruising-usually about 48 hours. Patient should avoid the sun until the condition subsides.
• Not every area is appropriate for fat injection. Injecting fat into the breast, for example, makes cancer detection via mammography more difficult and is strongly discouraged.
• Lasts longest when reinjected in relatively stationary areas (such as the cheeks).

Botulinum toxin injections (BTX), often referred to by the product names Botox or Myobloc®, are biological toxins (botulinum toxin) transformed into a therapeutic agent. Work with BTX began in the late 1960s to treat neurological disorders. Today, BTX is used for the treatment of frown lines, forehead furrows, "crow's feet," lines and wrinkles of the lower face, and even nasal muscles (to decrease nostril flaring). BTX injections have proven to be a very popular nonsurgical cosmetic procedure; see current American Society for Aesthetic Plastic Surgery (ASAPS) statistics. Aesthetic plastic surgeons have found that the type of lines and wrinkles that respond to BTX injections are those caused by the muscles - specifically those muscles that contract during facial expressions such as frowning or squinting.

Technique:
The patient is asked to contract the muscles in the area being treated so the surgeon can determine the proper location for injection. In most cases, BTX is injected directly into the muscle with a tiny needle. It takes a few days to realize the effect of BTX injections.

Benefits:

• No downtime. Patients can immediately resume normal activities.
• Long experience has proven BTX to be safe. To date, no systemic complications associated with BTX injections have been documented.
• Treatment is reversible within several months.
• May be beneficial for treatment of migraine headaches.

Other Considerations:

• BTX injections are a temporary solution for the treatment of wrinkles. The effects last from 3-4 months and require repeat treatments.
• Possible side effects include local numbness, swelling, bruising, or a burning sensation during injection. Some patients have reported temporary headache and nausea. Most complications are of short duration and can be avoided with proper injection techniques.
• A small percentage of patients are reported to experience no improvement at all.