By Derek Cassels
Let's set the record straight - right off the top, as it were. A dusty billiard ball probably has more fuzz than I can display when I take off my hat.
Since my late 20s, more and more of my hair follicles have experienced a near-death state. My head between my ears and around the back is my only remaining fringe benefit.
To add to the monstrous regimen of appalling phraseology of the day, I am "follicularly challenged."
So here I am in the Scarborough, Ont. office of Dr. Larry Fremont and he is showing me pictures of all these guys, some of them the talking scalps you see and hear everyday on TV and radio sprouting a new hairline.
He is also looking at me like I am a plate of meat'n'potatoes.
And, to be honest I am looking back at him. He's a genial middle-age guy with a decidedly receding brow line. His widow's peak in mid-life has seen healthier days. It looks like his follicles are planning their own wake. In short he looks like he is balding, but he still has a way to go before he can challenge somebody like myself to a shining contest on a moonlit night.
Then he jabs me: What did I think of his transplant?
I try not to look impressed.
I am impressed.
There's no way I would have thought the result was anything other than Ma Nature having her way with an ageing male scalp.
I confess I am still living in the old days when you could spot a transplant across a crowded room. You know what I mean. Row upon row of circular plugs that look like, well, row upon perfect row of circular hairy plugs. Preferably with all the plugged hair sprouting in the same direction.
"Those days are long gone," Fremont tells me. "The early transplants were done with 1-mm plugs inserted in rows and you could tell what they were.
The next stage went to half plugs, then down to quarters and so on. 'Now we transplants single hairs with their follicles. And very often we transplants one hair, we get two, sometimes three, growing in."
It turns out that when the hair and their follicles are harvested for transplantation, other progenitor cells called stem cells also go along for the ride. For reasons that are not clearly understood, these follicular stem cells are reactivated during the transplant surgery.
Voila! New, more plentiful hair.
Fremont and I start off the interview talking hypothetical cases.
"What would you suggest for me?" I ask, casual as all get out.
"Well, you are not a young man," he says, stating an obvious, but unkind, truth. "So I would suggest that we don't attempt the entire scalp. What we should aim to do is frame the face to bring attention back to the centre of your face. So we would aim to leave the male-pattern bald spot and start a bit back from the front. Most people can live with that."
I nod. Sure, I could live with that.
"Your hair hasn't entirely gone grey. So we would aim to bring that mix to the top of your head," he continues. We would transplant single follicles at the front, and as we go back, we would use two and three follicles to recreate the look of a man who has lost a lot of his hair, but nothing like all of it. In other words, try to make you look as when you still had hair to lose.
"If you were younger - m your 20s or 30s - you might want to transplant more hair and cover more of your scalp towards the back.
How many grafts would it take to do the job, I want to know.
It depends how thick I want my thatch to be, apparently. In my case, there is no reason it couldn't be done in a single three-hour session. And, given the fact that I am still pretty well-endowed below the tree line, Fremont reckons he could take a skin-deep, 5"xl " donor strip of hair from the side or the back of my head. The deficit would be pulled together and sutured shut.
There must be two kinds of pain here - physical and financial.
"When we are doing the transplant, there is no discomfort at all," Fremont says. "But when the freezing wears off later in the day, there will be discomfort. But it can be easily handled with analgesics."
Surgery is performed with the patient sitting in a chair similar to that used by dentists. The painkillers, too, are similar to those used in dentistry.
And the cost kicker? Well, like anything else, it depends on how much hair you want. A 5"xl" strip that I would need cost $4,000. If l wanted the donor area bulked up, each additional donor inch would add $650 to my bill. A younger man who wants to thatch up would probably be looking at a cost of $8,000 to $10,000 (Frankly, hair transplantation costs a lot less than I figured.)
Fremont says the price has been down because he has moved away from labour and time-intensive techniques like laser and microsurgery.
Instead, he now prefers to use multi bladed harvesting, a technique that is centred on a medical device that stretches, then cuts, the donor area into hundreds of smaller pieces, rather like that gizmo you see on late-night TV cutting an onion by pushing it past a network of sharp edges. The resulting hair sections are sorted out by Fremont's assistant into single and multiple hair grafts, which are then essentially pushed through the skin into their new position. This is where art meets science.
Fremont tells me he has been in the hair-transplant business for almost 20 years. And a business, it is. His MOR HAIR clinics are changing the look of Baby Boomers and others with a too-wide central part from Canada to Israel to Hong Kong. In Canada, Fremont's MORHAIR-affiliated clinics can be found in Vancouver, Calgary and Halifax, with another coming soon to Winnipeg.
A born publicist, Fremont has transplanted personalities even while they are broadcasting.
Can he, I wonder, transform writers as they write?
Derek Cassels, is a follicularly-challenged medical writer in Toronto.
The hell with this, I think. I am the possessor of an empty canvas on top of my head. Let's see how an artist like Larry Fremont might be able to transform it.
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