In the 1940s and 1950s Americans were amazed and disturbed by the publication of the Kinsey Reports, the volumes on human sexuality, prepared by Dr Alfred Kinsey which showed just how complex human sexual experience really was. For the first time, scientists could apply graphs and pie charts to this previously hidden area. Naturally, there were some hair-raising surprises.
It’s not on the same scale, but the 2009 census of the International Society of Hair Restoration Surgery (ISHRS) also makes surprising and entertaining reading. The report contains a wealth of statistics collected from 700-plus ISHRS members: Who gets hair restoration surgery done, when, where (in the world and on the body), how often, and so on. This is the third bi-annual census, so data from 2004, 2006 and 2008 can now be handily compared.
Like discussing one’s sexual practices, losing one’s hair can be deeply embarrassing, especially for young adults. An April 2009 survey on the ISHRS website, conducted (like the census) by private firm RH Research, found that given a choice between more money, more friends and more hair, 64.2 per cent of female and 59.1 per cent of male respondents chose more hair. About a third of all men develop male pattern baldness by age 45. In 80 per cent or more cases it is thought to be hereditary. Some women also lose hair, but the process typically starts later than in men.
The level of concern reflected in those figures can be gauged by the interest in the new surgical techniques of hair transplantation. Follicular Unit Transplantation (FUT) involves removing a strip of skin from the back of the scalp and extracting from it hair follicles, which are then implanted in the area of the scalp (usually the temples or crown) to be covered. Follicular Unit Extraction (FUE) is a newer technique in which the follicles are individually harvested from the back of the scalp and then implanted. In both FUT and FUE, the harvested portion of scalp eventually regains its normal crop of hair, and over three or four months most of the newly implanted hairs also emerge. But the advantage of FUE is that the patient doesn’t need stitches and can get back to normal life much sooner.
The 2009 census also reveals what “recipient areas” were targeted for hair restoration: Predictably, 92.9 per cent of procedures targeted the scalp, but the eyebrows got 4.4 per cent and moustaches and beards 1.4 per cent. Other sites included the eyelashes, chest and even the pubic region.
So far, says Dr Kapil Dua of AK Clinic in Ludhiana, apart from scalp work “We have done moustache, beard and eyebrow” — the latter for a woman patient. “We have a waiting list of one month.” Dr Dua is a member of ISHRS, founder member of the Association of Hair Restoration Surgeons, India, and one of the few FUE practitioners in the country.
“The technique is very laborious and very challenging,” he says. “It takes 6-7 hours for 800-1,000 grafts, out and in.” Each graft, with 1-4 hairs, must be artfully inserted so as to look natural. “You have to have to give,” says Dr Dua, explaining that hair surgery doesn't work miracles — you need follicles to get hair.
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The procedure is also expensive: The ISHRS survey says the average cost of hair surgery is $5,000, or Rs 2.4 lakh. Dr Dua says the cost varies from Rs 30-100 (FUT) to Rs 90-300 (FUE) per graft. In other words, an average 2,000 grafts with FUE will cost you Rs 1.8-6 lakh, depending on the location and whether automated instruments are used to take the grafts.
While the total number of cosmetic surgeries has slightly declined since the recession set in, “minimally-invasive procedures” have risen marginally, says the American Society of Plastic Surgeons. In the case of hair surgery, there has been some growth — worldwide, according to the census, 168,155 procedures in 2004 became 252,002 in 2008. But most of the growth has been in Asia and West Asia: At 39 per cent of the total, the two together tied with the US. And Asia, it might please some to know, leads the world in chest and pubic hair restoration, with 92 and 38 per cent of the total, respectively.
What does all this mean? We Asians win by sheer weight of population; but per capita, Americans are more hair-alert. Asia has some catching up to do. Luckily for the business, our celebrities are leading the way, forehead first. The ISHRS website survey revealed that 54.8 per cent of men and 45.3 per cent of women would be “more inclined to consider having a hair transplant” if celebrities were “more open” about hair surgery. Perhaps they should thank Salman Khan, Virender Sehwag and Harsha Bhogle, all of whom have allegedly surgically enhanced their superficial coverage.