Author Topic: The Body Forum - Help with Alopecia Totalis Baldness and Total Hair Loss  (Read 7110 times)

Offline DrBermant

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Doctor, can you please help me with plastic surgery for alopecia totalis. I have realy being through a lot,doctor please if you can let me know.

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Sorry as a retired surgeon, I no longer offer medical advice nor treatments.

Alopecia Areta is a condition that causes round patches of hair loss, and can lead to total hair loss. When involving all of the hair, the condition is called Alopecia Totalis.

When I was in practice, the first step in managing a problem was to find an underlying cause. Treatment ignoring such causes increases risk of failure. There can be many possible causes for total loss of hair, many are autoimmune. Then the question becomes can the underlying problem be corrected. In some circumstances this alone permits hair growth to recur. Based on the consultation, I would then refer the patient to the best specialist, usually an Immunologist, sometimes a Dermatologist, and other times it would just vary based on what I found. Some would ask me to perform hair biopsies, others needed to do the testing themselves so that the proper methods would be done to get the best testing done. At one point in my practice, the pathologist would come right up into my office to manage the specimen straight from the patient's scalp or site we were evaluating. Other testing usually followed, these were ordered by the specialist.

Yet others the condition was a component of aging, and or the change of hormone levels. Here is Leonardo Da Vinci's Caricature of a Bold Old Man:


We can only speculate if the hair loss was from age, shaven, or testosterone levels or what ever. Here is a post on Matel To Make Bald Barbie / Suggest Missing Eyebrows. My comment was about the eyebrows present on their image:



vs my suggested one:



minus the eyebrows. But at least someone cares about the image of women with hair loss. Try to do a search for bald women, and there is just not much out there.

Sometimes the hair loss was not total and hair reconstruction could be done. Options also varied based on if the underlying cause was stabilized or if there were donor material. Not all individuals had medical or surgical options. Some chose to go with a bald look, other wore hair pieces. Some had conditions that prevented the use of wigs.

There can be a great deal of emotion involved with total hair loss. There are many preying on these victims. Trying to weed through advertising hype can be a challenge. Looking for standardized before and after pictures can help. This is not just for surgical options, but any treatments should be able to be documented showing the problem and results. Check out our How to Use Before And After Pictures resource. Although there is not yet a standard set for hair, the general principles can help with insight. Then there comes the issue of how long does the result last? This is a difficult one for something like hair loss. What may live for a little while, can frustrate the individual expecting it to last longer. This is the critical factor in going after the mechanism and stabilizing the problem before treatment when possible.

Some deal with it by acceptance. But for women, this can be a difficult road as few have pioneered that look unlike those in the song Bald Headed Men by Christine Lavin & SIX Bitchin' Babes . It had been a long time since I heard that track, (yes I purchased it years ago) but that youtube version shows it is also a problem for them to deal with.

Find Bald Headed Men byChristine Lavin on Amazon

You are welcome to join our discussion group to share your experiences, what has been diagnosed, what problems have happened. That is the purpose of this forum.


Hope this helps,

Michael Bermant, MD
Retired Plastic Surgeon
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« Last Edit: August 14, 2012, 09:31:46 PM by DrBermant »
Michael Bermant, MD
Retired Plastic Surgeon
Surgical Sculptor, Artist, Creative Thinker, Problem Solver
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