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Notes from the 13th Annual Scientific Meeting of the International Society of Hair Restoration Surgery - by Dr. Richard Lee
The 13th Annual Scientific Meeting of the International Society of Hair Restoration Surgery (ISHRS) was held on 24-28 August 2005 in Sydney, NSW, Australia and attended by more than 500 surgeons, researchers and technicians from all parts of the globe. Winter was coming to a close with pleasantly mild weather and the harbor setting of the city provided a beautiful backdrop for this meeting.
The theme for the 2005 annual scientific meeting was "Working Towards a Sustainable Industry for the Future", which may sound more like a phrase from a corporate board room than a scientific meeting, but the field of hair restoration surgery is encountering both public and professional relations problems. The public and most other physicians don't have a good working knowledge of what hair restoration surgeons do. The ultimate irony is that 'the best work is never recognized'. So, the opening sessions addressed the tough issues of credibility, recognition and professional growth in an industry, which was admittedly "viewed negatively by much of the public'. In fact, the rapid and dramatic improvements in hair restoration surgical techniques, especially in the past ten years, have actually decreased the number of physicians entering the field.
It is estimated that in the U.S. there are 40 million men with androgenetic alopecia and 20 million women with female pattern hair loss. Yet, the American Society for Aesthetic Plastic Surgery reported that in 2004 only 19,503 surgical procedures for hair restoration procedures were performed by their members (although there were an estimated 50,000 - 150,000 procedures performed by all surgeons).
Hair transplantation surgery was described in the Japanese medical literature as early as the 1930s. Interest in hair restoration was revived by Orentreich in 1959 (Orentreich N: Autographs in alopecias and other selected dermatologic conditions. Ann NY Acad Sci 83:463, 1959) and significant improvements in techniques and instrumentation were made in the past decade, primarily with the recognition and utilization of follicular units.
As an illustration of the many new techniques, there was a panel that addressed the question: FIT, FUE, FUT, MUG: Is there a place for all these techniques? FIT is the acronym for Follicular Isolation Technique. FUE is the acronym for Follicular Unit Extraction. FUT is the acronym for Follicular Unit Extraction. And MUG is the acronym for Multiple Unit Graft. Some of the panel participants were the originators of the techniques, so, as you might expect, the presentations and arguments were quite animated.
Other sessions of the meeting discussed new concepts in harvesting techniques, donor sites, instrumentation, graft preparation, staff training, storage solutions, minimizing shock loss, hairline design and aesthetic results.
Many hours were devoted to 'Medical Updates' and to the 'Latest Research Cell Biology and Cloning'. There was a summary of the results of the clinical trials for dutasteride. Dutasteride, approved in January 2003 to treat benign prostatic hypertrophy, is a dual inhibitor of both 5-alpha reductase isoenzymes, but none of the presenters were recommending its off label use in treating male pattern baldness, citing the lack of safety studies. Dr. Jerry Cooley cautioned the audience to be wary of the use of dutasteride, especially in these post Vioxx and post Phen-Fen times. On the other hand, reanalysis of the controversial Prostate Cancer Prevention Trial, begun in October 1993, showed no correlation between the length of treatment with finasteride and the prostate cancer.
In regards to hair promoting medications, Dr. Cooley predicted that topical minoxidil would 'continue to be the best medical treatment for the next five years, but that new vehicles might improve the results'. Meanwhile, it's exciting news to know that Alderans and Intercytex have filed IND (Investigational New Drug) applications with the U.S. FDA for the use of dermal papilla cells to induce new hair growth.
This meeting was the first time the ISHRS had a Media Panel. Eminent speakers offered their perspective of the hair restoration industry and gave suggestions for achieving a better informed and a more supportive press. Michelle Kearney, pharmacist and Editor-in Chief of Australian Cosmetic Surgery Magazine, proposed, almost jokingly, that Prince Charles of England be made the poster boy for hair restoration and showed news photos that prominently featured hair covering a previously large balding crown.
In addition to the many presentations at the general sessions, the 13th Annual ISHRS Meeting offered live surgery sessions, video workshops and poster presentations.
One of the most affecting and compassionate programs sponsored by the ISHRS is Operation Restore, a pro bono foundation for hair restoration surgery whose mission is "to provide hair restoration services to individuals with hair loss as a result of trauma or illness and who lack the resources to obtain this corrective surgery". Some of these patients were presented to the attendees of the Annual Scientific Meetings. There was no disguising the joy of the patients and the satisfaction of the ISHRS members for the procedures well done. There should be no question that self-image and self-esteem play an important role in a person's overall health, as well as his or her success in school, work and in personal relationships. Dr. Mangubat, president of ISHRS, stated, "the program also has the potential to benefit the medical profession as a whole. Operation Restore will be a platform to demonstrate to the world what we have accomplished and how it can be used for reconstructive as well as cosmetic surgery. Most surgical training programs do not train their residents to perform hair restoration surgery to the high level the public expects today. It is our hope to affect change in this area in the near future, but in the meantime, Operation Restore will give us the opportunity to interface directly with our physician peers who do not perform hair restoration surgery, and allow us to build inroads of trust with our traditional medical colleagues. By educating them in our current capabilities and even offering to help train them, we hope that mainstream medical physicians will come to realize the extraordinary procedures hair restoration surgery has to offer today."
The 14th Annual Scientific Meeting of the International Society of Hair Restoration Surgery is scheduled to be held on 11-15 October 2005 in New Orleans, Louisiana, USA. Let us all support the efforts to rebuild and revive that magnificent metropolis.
Richard Lee, M.D.
Consulting Physician
Regrowth, LLC
http://www.minoxidil.com
