Dr. Leonard featured in Eagle Tribune

May 7, 2007

Locks of hope: Hair transplant offers young cancer survivor a chance to look like herself again.

The Eagle Tribune

By Julie Kirkwood, Staff Writer

 

After her diagnosis of brain cancer at age 24, Amy Finn had a lot of major problems to deal with.

 

Surgeons had cut open her head to remove 80 percent of a tumor the size of a lemon. Then she had to endure 32 days of radiation therapy to her head, followed by a year of chemotherapy.

 

So it was just one more piece of horrible news the night a clump of her long brown hair fell out in her hand.

 

"I was eating pasta at my mom's," Finn said. "I was scratching my head and a ball of hair came out."

 

This, she knew, was not the temporary hair loss typically associated with chemotherapy. This was hair loss caused by the intense radiation to her scalp, meaning the damage could be permanent.

 

Part of her head was already shaved for surgery, but Finn had been hoping to keep the rest. She was so upset by the clumps falling out that she shaved the rest of her hair off.

 

"People were saying, 'You look good with a bald head,'" Finn said. "If one more person told me that ...! I liked my hair long."

 

About a year after her treatments, Finn's hair started growing back but it was thin. Even now, nearly six years after her diagnosis, Finn's hair hasn't grown back fully on its own.

 

"Some of the spots didn't grow in, like over the left ear," Finn said, tilting her head and pushing back her hair to expose the area. "It's all baby hairs."

 

About a year ago, she decided to do something about it. Finn and her mother, an operating room nurse, made appointments with plastic surgeons to see if she might be a candidate for hair replacement surgery.

 

"I knew they did hair replacement for men," Finn said.

 

As it turns out, men aren't the only ones who are eligible. About one in 10 hair-replacement surgeries is performed on women, according to a survey of doctors in the International Society of Hair Restoration Surgery.

 

Hair transplant surgery has come a long way since the days of hair plugs, said Dr. Robert Leonard of Hair Transplant Associates in Newton.

 

"Years ago, it didn't look so nice," Leonard said. "Now it's not so common for people to recognize you've had restoration."

 

As recently as 20 years ago, surgeons would take a plug of hair the size of a pencil eraser off the back of a person's head and plant it on top, Leonard said. Now surgeons take a thin strip of hair from the back of the head, separate it under a dissecting microscope into clumps of just one to four hairs, and implant it in tiny slits on top of the head.

 

Finn found out she was a candidate for the surgery. The trouble was paying for it.

 

In most cases, hair-transplant surgery is not covered by insurance, but Finn was one of the rare exceptions. Her insurance did agree to pay for the procedure because her hair loss was the direct result of a medical condition. It didn't matter to the first two doctors she visited, though. They refused to accept insurance. There was no way Finn, who was on disability because of the cancer, could pay upward of $8,000 for surgery herself.

 

"It was depressing," Finn said. "I called two other places and they wouldn't take insurance, either."

 

So when Leonard agreed to accept her insurance as payment and to waive whatever costs it wouldn't cover, Finn said it was all she could do not to cry in his office.

 

Leonard told Finn that she had enough hair on the back of her head for three surgeries. She went in for her first treatment in October and the second was this month. The third will happen in a year.

 

The surgery is performed in a chair in the doctor's office and Finn was awake the whole time. She said the only pain during the first surgery was when they gave her a shot to numb her head.

 

She watched the movie "Mystic River" that day, as the medical team cut a strip of hair off the back of her head, about a half-inch wide and less than a foot long. The team then sewed the gap closed and put the strip under a microscope to separate the hairs. Then they implanted each cluster of hair into tiny slits on the top of her head, among the thin hair that was still growing naturally.

 

The entire surgery took about three hours, she said. She left the doctor's office without bandages, but with instructions not to wash her hair or scratch her head for a couple of days and to care for the surgical sites. The second surgery hurt a little bit more, she said, but it was generally the same. She watched "The Shawshank Redemption."

 

Dr. William Adams, a board-certified plastic surgeon in Peabody and Boston, said hair-transplant surgery has improved since the days of plugs, but women are still not always satisfied with the results.

 

"It's basically just a way to increase density," Adams said. "The problem for women is that their expectations are frequently higher."

 

Often a woman can still see her scalp, even after several treatments, he said. Surgery can make the hair thicker, but not as thick as it is on the sides of the head where the hair is not falling out. Adams, who does hair transplants as a small part of a broader practice, said patients should beware heavy sales pitches from hair-transplant specialists.

 

"There are a lot of hair-transplant clinics that sell the operation, trying to talk you into it," he said.

 

While it can be a good operation, he said he advises some people - particularly young people - to wait a few years and see if hair loss treatments get even better. In five or 10 years, doctors may discover what actually causes hair loss, which is still poorly understood, and perhaps will be able to develop drugs or creams to reverse hair loss.

 

"I think there will be something better than surgery," Adams said. "The surgery's going to be archaic at some point."

 

Finn acknowledges that she couldn't really tell the difference in her hair thickness after her first surgery, but her friends and family could.

 

It takes three or four months after each surgery to see the full results, Leonard said. The implanted hairs are shaved down to the skin, so you can't see them right away, and these little hairs actually fall out three or four weeks after surgery. Then, the follicles start growing new, permanent hair.

 

"I tell men and women that you have to be patient," Leonard said. "After the five-month mark is when a person can really start to see a change."

 

Finn said she knows that at the end of treatment her hair won't be as thick as it was before her cancer, but her hope is not for perfect hair but to be able to go out in public without covering her head and feeling embarrassed. That's something she hasn't experienced in years.

 

"I hated it," Finn said. "I hated my hair. I hated how it looked."

 

Finn still wears hats and bandannas to class at the University of Massachusetts Lowell, where she's studying criminal justice. Now that she's had the second surgery, she's hoping she won't have to much longer. "This was a huge confidence-booster," Finn said.

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