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Biomedical subjects

W P Unger

Publications and source records attributed to W P Unger.

At least 19 recordsLinked to original sources
PubMed2003

What s new in hair transplants?

As hair transplant surgery has evolved, combinations of micrografting and minigrafting have enabled physicians to produce ever more natural combinations of both. A wide range of men and women can now receive significant aesthetic benefits from hair transplants. In recent years, practitioners have further refined hair transplant techniques to ensure that the hairs available for transplantation are used most efficiently. Specifically, methods of harvesting hair, preparing grafts, creating recipient sites, and placing grafts are designed to permit the maximum percentage of hairs to survive and thrive after transplantation. Careful planning, close cooperation with the patient, and a staged surgical approach can also result in hair conservation and optimal cosmesis.

Female↗
PubMed1999

The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia.

BACKGROUND: Data suggest that androgenetic alopecia is a process dependent on dihydrotestosterone (DHT) and type 2 5alpha-reductase. Finasteride is a type 2 5alpha-reductase inhibitor that has been shown to slow further hair loss and improve hair growth in men with androgenetic alopecia. OBJECTIVE: We attempted to determine the effect of finasteride on scalp skin and serum androgens. METHODS: Men with androgenetic alopecia (N = 249) underwent scalp biopsies before and after receiving 0.01, 0.05, 0.2, 1, or 5 mg daily of finasteride or placebo for 42 days. RESULTS: Scalp skin DHT levels declined significantly by 13.0% with placebo and by 14.9%, 61.6%, 56. 5%, 64.1%, and 69.4% with 0.01, 0.05, 0.2, 1, and 5 mg doses of finasteride, respectively. Serum DHT levels declined significantly (P <.001) by 49.5%, 68.6%, 71.4%, and 72.2% in the 0.05, 0.2, 1, and 5 mg finasteride treatment groups, respectively. CONCLUSION: In this study, doses of finasteride as low as 0.2 mg per day maximally decreased both scalp skin and serum DHT levels. These data support the rationale used to conduct clinical trials in men with male pattern hair loss at doses of finasteride between 0.2 and 5 mg.

5-alpha Reductase Inhibitors↗
PubMed1998

Standardizing the classification and description of follicular unit transplantation and mini-micrografting techniques. The American Society for Dermatologic Surgery, Inc.

Previous attempts at classifying small graft transplants have focused mainly upon graft size and have not taken into consideration other technical factors involved in graft production that may influence the outcome of the surgery. The proposed classification attempts to consider these factors by including various technical aspects of harvesting, dissection, and placement, all of which impact the quality and quantity of the small grafts used in the procedure. By standardizing the nomenclature, as well as the description of the other factors involved in the surgery, communication between physicians and patients may be facilitated. In addition, different procedures may be more accurately studied and compared.

Alopecia↗
PubMed1996

What's new in hair replacement surgery.

The "isolated frontal forelock," "bridge over troubled waters," and lighter density coverage of larger areas are new options for hair transplant patients. Alopecia reductions are playing an increasingly important role in overall planning after a period in which they had at least appeared to be losing popularity. Tumescent anesthesia in the donor or recipient area results in safer, more comfortable, and effective anesthesia. Total excision techniques in the donor area as well as improvements in minigrafting represent important advances that are being utilized by an increasing number of practitioners. Carbon dioxide lasers are likely to play an important role in hair replacement surgery.

Aged↗
PubMed1996

Planning for maximum coverage in surgical hair restoration.

BACKGROUND: Previous articles in this publication have suggested that an isolated frontal forelock is probably the best objective for a majority of patients undergoing hair transplantation. OBJECTIVE: This communication disputes the advisability of an isolated frontal forelock for a majority of hair transplant patients. METHODS: Previous studies and publications indicate a relatively low incidence of extensive male pattern baldness. Newer harvesting techniques require relatively small donor a areas to yield large numbers of grafts. Alopecia reduction can significantly improve the donor/recipient area ratio, and minigrafting can produce very natural looking results with less donor graft utilization. All of the preceding are presented to support the position of the author. RESULTS: Limiting oneself to an isolated frontal forelock is an overly conservative objective for a sizable majority of patients. CONCLUSION: The isolated frontal forelock is a wise goal for a minority of patients who should be chosen on the basis of their limited objectives as well as their family history and a careful physical examination at the time of presentation. For most patients, more extensive coverage remains a reasonable option.

Adolescent↗
PubMed1995

Laser hair transplantation II.

BACKGROUND: In a previous study, hair-bearing grafts inserted into slits prepared with an ultrapulse Co2 laser were shown to produce results that combined the advantages of round grafts and slit grafts: specifically, maximum density with minimum transitional clumpiness. A variety of other advantages and disadvantages of laser transplanting were outlined. OBJECTIVE: The purpose of this study was to investigate what would occur when larger numbers of grafts were involved. METHODS: Only alopecic areas were used as test sites. Each time any given number of grafts was studied, we would wait for good hair growth before increasing that number in subsequent individuals. Evaluations were made on the basis of direct observation and photographs. RESULTS: The benefits noted with small numbers of grafts were confirmed with larger numbers. Hair dispersion and density are remarkably natural looking after even one session in an alopecic area. These results assure an important role for Co2 lasers in hair transplanting. The procedure however is currently more time consuming and associated with other disadvantages, which are discussed. In particular, hair growth is delayed 2-6 weeks as compared with conventional grafting. The imminent availability of a scanner to produce consistent speed and ideal graft spacing and positioning will minimize or eliminate the most significant disadvantages and create important new advantages.

Alopecia↗
PubMed1995

Rapid laser scanning for facial resurfacing.

BACKGROUND: Laser skin resurfacing is growing in popularity in both the professional as well as lay populations. Freehand delivery of impacts is relatively time consuming. Accurate and precise placement of impacts to avoid unwanted overlapping and the superimposing of multiple impacts is difficult. OBJECTIVE: To evaluate a new computerized scanning device, the computerized pattern generator (CPG), and to compare it with freehand delivery of multiple laser impacts over large areas. METHODS: Sixty-one patients were treated using the CPG by surgeons who are experienced with freehand laser resurfacing. RESULTS: CPG delivery provides more rapid resurfacing with more uniform, accurate, and precise distribution of impacts. CONCLUSION: Combining the CPG with the Ultrapulse laser is a valuable addition making the procedure faster and more controllable.

Adult↗
PubMed1994

Laser hair transplantation.

BACKGROUND: A new ultrapulse CO2 laser has been investigated for its possible use in hair transplanting. This laser, because of its ultrashort high energy pulses, produces far less thermal damage to adjacent tissues, including hair follicles, than earlier types of CO2 lasers. The potential advantages of using such a laser in minigrafting are reviewed and include less bleeding, greater density, and absence of "compression." OBJECTIVE: The purpose of this study was to see if hair survival in grafts placed into laser-prepared sites would be as good or better than that seen with scalpel slits. METHOD: Hair counts were used in 10 patients to compare hair survival in grafts placed into laser-prepared sites and into scalpel-prepared sites in a comparable but contralateral location. RESULTS: Average graft hair counts were greater in laser-prepared sites in four of 10 patients, equal to grafts in scalpel-prepared sites in five, and fewer in one. Hair growth occurred earlier in laser-prepared sites in five of the 10 patients. CONCLUSION: The authors are optimistic that the ultrapulse laser will become an important tool in hair transplanting.

Hair↗
PubMed1992

Hair transplantation in females.

Hair transplantation in females, to thicken discrete areas of thinning, reconstitute a hairline, or cover scars from previous facial surgery, is a viable treatment option. Techniques dealing with hair transplantation in females are discussed.

Alopecia↗