Gone today, Hair tomorrow

-- from the musical "Hair"

High school is humiliating enough without having to return to your 20-year reunion and get voted "baldest in the class" by your former classmates.

That Embarrassment Hall of Fame flashback was the exact moment that Dr. Melvin L. Mayer decided it was time to do something about his Incredibly Shrinking Hairline.

"I had never really thought that much about being bald -- until they awarded me that wig," he recalls with a laugh made easy by the passage of time. Lots of time. "It triggered something in me and I developed a passion for hair."

Not only did Mayer, 49, begin the tedious process of hair transplants that has left him today with a healthy blond mane, he also changed his medical practice from general surgery and family medicine to hair transplantation -- and made it his mission to do the same for others.

Today, he is the regional director of Medical Hair Restoration, the second largest hair transplanting company in the country, with offices in 30 cities. Mayer rotates his services between Denver, San Diego, Seattle and Las Vegas, performing about 500 surgeries a year -- 4,500 since 1991.

In addition to performing traditional transplants, Meyer has been experimenting with follicular regeneration, a new procedure that attempts to revolutionize the field by producing two hair follicles out of one.

The procedure involves slicing each follicle in two at a spot called the "bulge," and planting both halves in the scalp. Each half of the bulge contains "germinal cells," which are the cells responsible for regenerating hair.

Early results are promising: Adding the two halves together has produced 133 percent hair growth, compared to 90 to 105 percent of regrowth when a single follicle is implanted.

The hair that is produced is finer than normal hair, which makes it ideal to reproduce eyebrows, eyelashes, or the fine hair needed at the temples and hairline.

"This is somewhat of a landmark study," Mayer says modestly. "It's exciting to be producing more than one hair out of one hair, which is something that basically hasn't been done in the past."

Meyer presented his findings at the International Society of Hair Restoration Surgery in Washington D.C. last fall, and will also present his findings to the second annual European Hair Restoration World Congress in Paris in May.

Meanwhile, he waits to hear if his study will be published in The Forum, the journal of the International Society of Hair Restoration Surgery, as well as the Journal of Derm Surgery and Oncology.

In March, Mayer will perform the procedure at a surgery workshop conference being held by the World Hair Society in Orlando.

It will be, he says, "the first time in history" the technique has been attempted on a hairline.

Patient profiles

Mayer's typical patient isn't just what one would imagine -- a room full of vain, self-absorbed George Costanza-types.

"We do lots of interesting procedures," he notes, pointing out that patients include those who have lost hair to industrial injuries or open heart surgery patients who have lost chest hair in their scar lines.

And about 15 percent of his clients are women who have undergone repeated plastic surgery and need to replace their hairline or sideburns due to repeatedly pulling the skin back from the face.

Among his client base are also fellow doctors learning the trade, and company employees. The old Hair Club for Men slogan, "I'm not just the president, I'm a member" seems to apply here as well.

But the most common patient is someone such as Tom, a 40-something Las Vegan who began treatments a year ago after he took a look in the mirror and simply didn't like what he saw.

"It's like a bad hair day for women, but it's even worse, having no hair to comb" he says, allowing the curious to run their fingers through his new soft brown hair. "The bald thing works for Michael Jordan, but not me!"

Tom never told his co-workers about his rendezvous with Mayer, and, amazingly, no one was brazen enough to ask.

Secrecy is common in this business, Chris Ritchie, the company's regional nursing coordinator, says.

"A lot of guys are self-conscious of who knows and who doesn't know," he says. "You have to keep it hush-hush. When we call, we say, 'MHR,' not 'Medical Hair Restoration.' The typical story is guys telling their wives they're out of town for three to four days, then coming and getting it done."

If so, they'll also have to find a way to hide deductions from the checking account: Most cosmetic-based transplants aren't covered by insurance and can cost anywhere from $3,500 to $20,000. That has come down from years ago -- prices have dropped in the past four years due to competition, according to MHR's Western Regional Director Tim Kittredge.

Despite bargain prices, consumers have to be careful that they're getting their money's worth in a field still vastly unchecked and licensed.

"There's a wide variation of skill level," Kittredge says. "Anyone with a medical license can perform transplants. You want to do it with somebody who does it full time."

Mayer is certified by the American Society of Hair Restoration Surgery and the American Board of Hair Restoration Surgery, as is every doctor within the company. He is a member of the Nevada State Board of Medical Examiners.

The business of hair restoration is also thriving: It was the No. 1 elective cometic procedure done on men in 1996; more than 244,000 people (including 27,000 women) had hair transplants that year, up 76 percent from 1990, according to the American Academy of Cosmetic Surgery.

But ironically, just as popularity soars, the field may soon join the ranks of the obsolete, along with typewriter manufacturers and hardcover encyclopedia publishers.

With the inventions of drugs such as Propecia and Rogaine (and others in the pipeline), hair loss can be halted before complete balding takes place, letting future generations of men sidestep the need for these services.

"Ultimately, we'll cut down on the amount of surgery that I'll be doing," Mayer notes, "and maybe 20 to 30 years from now, hair transplant surgeons may be a dead breed."

Until then, though, "there's still millions of men who have slick baldness that need our help," he points out. "If we can combine the best of both worlds (surgery and medical treatment), that's my goal."

Hair we go

On a recent afternoon, two men wearing turban-style bandages sit in the small waiting room of Medical Hair Restoration's East Las Vegas office, quietly reading copies of Sports Illustrated that litter the adjacent tables.

In an inner operating room, a patient sits calmly in a reclined chair, high on Valium, and in remarkably good sprits for a man who has just had a chunk of scalp removed from the back of his head.

Behind him, two medical assistants are meticulously chopping the removed section of his scalp into hundreds of individual follicles, each resembling a single grain of rice.

The small piles of skin and hair being placed neatly in clumps on a petri dish most resemble a plate of sushi.

By 5 p.m., Mayer enters and begins the procedure. The patient's hairline is sterilized, then his scalp area is given a numbing agent with a shot. Another solution is added to puff the skin up, and a clotting agent is also applied to deter the bleeding soon to come.

Mayer begins piercing the skin. "One, two, three..." he says briskly, counting out each hole he punctures into the scalp.

The patient stays awake during the whole thing, impervious to any sensation or to the splattering of blood.

Five hours later, each hole will be filled with one of the 482 follicles taken from the back of his head.

In four days, the scabs will be healed and fall off.

In three months, the hairs will have begun to sprout.

In six months, he is expected to have full re-growth.

And someday, he'll have hair, hair, hair hair....

Long, straight, curly, fuzzy,

snaggy, shaggy, ratty, matty,

Oily, greasy, fleecy,

Shining, gleaming, streaming ...

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