No study is necessary to prove the adverse effect that hair loss can have on individuals. Although shaving the head can be an easy and effective solution, this shaved look is not necessarily practical for some people, including those with unattractively shaped heads (in particular, narrow heads), those whose professional status or social standing prohibits it, those who have scarring from prior aesthetic surgery (eg, strip hair transplant), and, of course, nearly all women.
The article in this issue of JAMA Facial Plastic Surgery by Bater et al1 provides an objective quantification of how individuals with and without hair are viewed by society. It is a particularly relevant article for this journal, since hair transplantation is today being performed by more facial plastic surgeons in large part owing to the ready availability of follicular unit extraction technology, which makes it easier for nonhair specialists to offer the procedure.2,3 With more than 23 years of experience specializing in hair, I have readily embraced follicular unit extraction not just because of the improved results it provides for patients by avoiding a linear donor site incision scar (preserving the option of shaving the head) but also because it has lowered the barriers to entry for facial plastic surgeons to treat hair loss. Strip (also called follicular unit grafting) still has a role in the surgical armamentarium, in particular in women or in men who have prior donor site scars; however, follicular unit extraction is at this point the preferred technique in most cases.
Epstein J. Benefits of Proper Hair Restoration. JAMA Facial Plast Surg. 2016;18(6):419. doi:10.1001/jamafacial.2016.0843