Hair restoration for women over 50: Female hair transplants, wigs, and hairpieces designed just for us

Until a few years ago, hair transplants for women were almost unheard-of. Hair transplants were pretty much for men only. This has changed. Also, you can forget the old, scary-looking grafts and plugs: new hair transplant techniques are undetectable to anyone looking at you and depend on microscopic dissection. Today, transplants are gaining popularity among women—but be aware that they solve only certain kinds of hair loss and you do need suitable donor hair from the back of the head.

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Top hair loss transplant doctors for women and a leading hairpiece/wig pro offer a range of solutions. According to Beverly Hills, California hair restoration surgeon Dr. Gary Perrault, here’s how it works: “Before considering a patient for a transplant, we need to screen out medical problems, undiagnosed illness, and thyroid issues, and take an extensive genetic history. The type of loss needs to be established and we need to be sure there is an adequate donor supply at the back of the head to harvest hairs.”

According to Dr. Perrault, a hair transplant involves four basic steps:

1. The surgeon designs the transfer of hairs from the back of the head to the front by mapping out a precise grid. Since hairs grow away from the head at an angle, the transplanted hairs must be replanted at a certain angle so the hair growth will look natural.

2. Next, the surgeon harvests the hair from the donor site by surgically removing a thin strip of hairs from the back of the head before closing that incision neatly. There will be a faint line hidden beneath your hair.

3. Then, the site of the transfer must be prepared for the graft making sure the grid matches the angle of growth.

4. Finally, the strip of hairs is separated into groupings of one, two or three hairs which are then refit into the scalp through tiny incisions that are stitched closed.

Dr. Perrault points out that heavy sedation and an I.V. are not required — just a local anesthetic. “It is important to keep the patient hydrated throughout the procedure so we encourage drinking lots of water. Results for female pattern baldness take six or seven months to see results. At ten months you see full benefits. The transplanted hair falls out after six weeks and new hairs start appearing in about three months from the date of the transplant. You’re really transplanting follicles, not hair; it takes three or four months for new growth to reach the level of the skin.”

Be aware that hair transplants require a specialist. This is not something every dermatologist or surgeon does. The procedure certainly should never be performed by anyone lacking the right credentials. To find a hair transplant doctor who specializes in transplants for women contact the American Academy of Facial Plastic and Reconstructive Surgery at www.plasticsurgery.org.

The true life story of one woman’s hair loss experience: How a transplant made all the difference

Here’s the scoop from a close friend of mine, aged 60, and a major force in the beauty business who went through the transplant experience recently. She prefers to remain unidentified. Let’s call her Madame X:

“I’ve always had fine hair and became very savvy about how to use volumizing shampoos, conditioners and styling products to my advantage. My bangs hid the thinnest area around the front hairline fairly well for years. But around 58, I started having the salon-only Japanese straightening treatments to keep my texture frizz-free, and thought my hair seemed thinner around the front hairline than ever.

My internist and dermatologist suggested I try the male version of Rogaine with 5% minoxidil instead of the women’s version with 2%. I refused to even try it because frankly I was in denial and the process was so unappealing. After several consultations with New York City transplant specialists, I contacted a transplant doctor in L.A. suggested by my colorist as “the only one,” emailed him some photos and set a date in mid-January for a consultation, with surgery planned for the following day.

He agreed I was an excellent donor candidate and on a Friday morning at 6:30 A.M. I showed up for the procedure which has changed my life. I was awake during the entire procedure although my scalp was numbed by local anesthesia. There were videos to watch and I was aware of everything going on. The doctor frequently asked me if I was okay, and I was encouraged to drink a lot of water and eat a lot of cookies (for carbs) during the operation. The doctor took a strip of hair from the lower back of my head where the hair was thick and divided it into 800 hairs. There were four or five nurses in the room and they were busy dividing hairs into grafts with three or four hairs in each clump. Then we all broke for lunch — no kidding — we had a lovely lunch and then got back to work. They marked out a grid in the bare part of my scalp and carefully planted the 800 hairs front and center. I had very little discomfort and it was all done in that one session.

When I left to go back to my hotel, I was instructed to take pain medicine even if I felt fine to stay ahead of the pain. That night I slept with my head elevated on a wedge they’d given me and took an antibiotic and extra-strength Motrin, but had no bleeding.

The next day I just took it easy, but by the second night I went out to dinner with my husband — no scarf. I just looked like I was having a bad hair day. I flew back to New York and my dermatologist took the stitches out a week later after consulting with my transplant doctor.

When I washed my hair I had to use diluted Neutrogena T-Gel shampoo and rinse my hair with a plastic bucket under the tub faucet rather than take a shower. I had to wait six weeks to color my hair again, although now I have my colorist use a gentle vegetable dye. The implants fall out eventually and new hair starts to grow. It’s been about seven months now and my new hair is about an inch and a half long. Yes it was expensive — but worth it. I’m thrilled with the results, but I do think (and my doctor agrees) that in my case it was a combination of hormonal changes and chemical straightening that contributed to the loss.”

Hair fillers and wigs

Hair fillers and wigs offer immediate gratification when you want hair in a hurry or regrowth is delayed or impossible.

Often, women opt for the extra vanity boost of a wig or hairpiece during medical or surgical restoration to camouflage work in progress. Others rely on fillers and wigs if they are going through temporary loss or for some reason are unable to regrow hair. A wig or hair piece can provide you with new hair in seconds but three factors make these add-ons work:

1. First and foremost, the look of authenticity. This is essential. No one wants a fake effect.

2. Second, you must have minimal or no traction or pulling on existing hair.

3. Last a diligent approach to maintaining a healthy scalp beneath it all. The biggest drawback to wigs is that they provide a warm, moist environment for bacteria to flourish. The result can be a flaky, itchy head. Be sure to give your wig and scalp breathers and keep both meticulously clean.

Look for “fillers” as opposed to “extensions” when adding pieces. Long extensions don’t make up for sparseness closer to the head and the extra weight can exacerbate loss and add breakage to the mix. Dr. Catherine A. Orentreich of the Orentreich Medical Group in New York City is a hair loss dermatologist. She does not recommend extensions that glue to the shaft: “I’m concerned about the effect of the bond on the hair shaft. You’re better off going with very light temporary filler pieces to enhance volume.”

How much do you need to spend to get a realistic look? Top New York City colorist Beth Minardi of Minardi Salon says, “Let’s face it, you can get a wig for $60 or $6,000, but clients have been bringing in the Raquel Welch wigs, which are not bad at all for the price. They are lightweight and contemporary and cost from around $118 to $600, depending on whether it’s synthetic, a blend or human hair.”

Research not only the style, color and cost but how the fiber wears, reacts to heat and water and maintenance. “Any wig should be fine-tuned by your stylist at the salon,” advises Minardi. “It should be trimmed to eliminate bulk and shaped to suit your face and features.”

One of the most famous specialists in supplemental hair is John D’Orazio, whose discreet but pricey work with hairpieces and wigs graces the heads of women in the news as well as everyday women dealing with hair loss. His two elegant salons, one at 872 Madison Avenue in New York City, and the other in Water Mill, New York on Long Island, are a headquarters for women wanting a non-medical alternative.

Made from real hair, John’s full wigs are expensive — around $10,000 — but they provide a confident solution for long-term or permanent hair loss, or for women recovering from chemo who want a top-of-the line custom wig. John has spent forty years refining his creative and technical skills and his medical knowledge about hair loss in women to design hairpieces and wigs that are totally undetectable.

“I’ve dedicated my career to finding the best hair loss solutions. One of my specialties is a fine hairpiece like a strip of false eyelashes that attaches to the hair with micro-clips so there is no tension on the roots, just the illusion of fullness. I personalize these fillers and add rows of them as needed depending on the degree of loss and location. They also work effectively as “highlights” to bring depth of color and a tone-on-tone look to the hair, which also enhances the illusion of more hair. For a receding hairline I’ve developed a filler that tapes on, somewhat like a band-aid, to restore fullness there. And it’s completely foolproof!” John D’Orazio is the name that hair loss doctors pass along to high profile clients.

For more great information, purchase and download Great Hair after 50: Hip hairstyles, best products for healthy hair, coloring secrets, whether (and how) to go gray, managing fine or frizzy hair, and solutions for thinning hair and hair loss and you’ll be looking fabulous by tomorrow!