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What picture comes to mind when you hear the words “hair transplant”?

Perhaps you envision a middle-aged man with mini-grafts or hair plugs dotting his scalp, creating an uneven hairline.

Such were too often the unsatisfactory results of hair transplants performed years ago with now-outdated methods.

“Doctors used to do hair plugs that were each a centimeter long, but that’s been refined into one follicular unit at a time,” says Dr. Justin Misko of JMISKO Surgical Design M.D., 5800 Hidcote Drive, Suite 103, in Lincoln.

Before going into the new transplantation technique, Misko explains why transplanted hair grows. Hair on the back and sides of a balding scalp is known as “donor-dominant” hair. This hair grows throughout a lifetime, even in men with extensive male pattern hair loss. Donor-dominant hair follicles are not subject to the inherited effects of balding genes.

So, when donor-dominant hair follicles are transplanted to bald scalp areas, they continue to grow.

Donor-dominant hair can be extracted in two ways, Misko explains. The most common method is to remove it in strips, usually from the back of the head, with a special scalpel-like device. Follicles are then separated out from the strip under a microscope and prepared for transplantation.

Since human hair grows in tiny bundles of 1-5 hair follicles called “follicular units,” which are 1-2 millimeters long and exit the scalp through a single pore, hair transplant technology now enables physicians to extract follicular units individually, Misko says. Using a 0.7 to 1.1 millimeter punch extraction device, Misko makes a tiny circular incision around each follicular unit to remove it from the back of the head. Each unit is then transplanted to areas of hair loss elsewhere on the scalp.

“Transplanting one follicular unit at a time is a long, tedious process, but it results in hair that has a soft, natural appearance,” Misko says.

Misko also uses the technique to correct the poor appearance of hair transplants performed by physicians years ago with outdated plug grafting methods.

He even uses the technique to fill in beards and sideburns in men and eyebrows in women.

Emily Burkholder, 47, says she never had eyebrows, even as a child.

“They just never grew,” she says.

Two years ago, Burkholder decided to get permanent eyebrow tattoos. Later, she had concerns about how they would appear when the rest of her hair turns gray. So she looked up Misko to find a solution.

“He suggested eyebrow transplants, which he did last February,” Burkholder says. “I still have a tattoo under each eyebrow, but when my hair starts to gray, the graying eyebrow hair will tone down the tattoo.”

Misko removed a strip from the back of Burkholder’s head – using a technique that allows hair to grow through a thin scar – and transplanted the follicle units to her eyebrows. “I have really short hair, and the girl who does my hair can’t even find a scar,” Burkholder says.

After the procedure, Burkholder says she only needed acetaminophen to control her pain, although Misko had prescribed pain medication.

Misko earned his M.D. from the University of Nebraska Medical Center and completed a residency in pathology and microbiology. A few years ago, he began reading about hair transplantation. Wanting to learn more, he attended hair transplant workshops throughout the U.S. and completed hands-on specialty training with leading hair transplant physicians in the United Kingdom, Germany, Dubai, Ukraine, Georgia (the country) and Spain.

Misko became a member of the International Society for Hair Restoration Surgery in 2009 and has been performing hair transplants in Lincoln ever since. As of early October, he had performed over 50 hair transplant procedures in 2012.

Depending on the type and extent of hair loss, a hair transplantation procedure may involve 1,000 to 2,500 grafts performed in a 6- to 10-hour period.

“Patients come in with their lunch, music and movies,” Misko says. “We numb everything, so they don’t feel a thing.”

The cost of hair transplantation ranges from about $6,000 for 1,000 grafts to $15,000 for 2,500 grafts, Misko says. Most are $8,000 to $12,000.

After experiencing his own hair loss, Misko shaved his head from 1999 until last January, when a colleague performed hair transplantation on him.

“A friend suggested that since I do these, I should get a hair transplant,” Misko says. “So I had mine done in January. About 20 to 30 percent of hair falls out after the procedure, but it grows back and reaches its full growth capacity after one year, so mine will continue to get thicker.”

For hair transplantation, a patient must have a sufficient amount of donor-dominant hair – and it must be his/her own hair. In addition to the back and sides of the head, donor hair can be taken from other areas such as the back, beard and chest to add density.

For men who lack sufficient donor-dominant hair, and for women who may not benefit from hair loss treatments suitable for men, JMISKO also offers non-surgical hair loss solutions. Today’s customized hair systems, which include several bases and hair color options, have an undetectable, natural look and feel due to the use of advanced materials and a better understanding of how hair grows.

Joe Hennecke, hair restoration consultant at JMISKO, says when you part hair that is attached to a hair system’s base, “it looks like it’s growing straight out of the scalp.”

Hennecke helps find and customize the best solution to fit a person’s situation.

“We do hair extensions too,” he adds. “Anything that replaces or thickens hair. We make it look natural.”

Misko continues to attend seminars to stay on top of hair transplant technology.

“In five years, we’re hoping to be able to use patients’ own stem cells,” he says. “Hair cloning will come after that – probably long after that. I like to stay on the technological edge.”

JMISKO is the only full-service hair restoration service in the region that offers a range of non-surgical to surgical hair-loss solutions at one clinic, Misko says. The closest other full-service clinics are in Denver, Kansas City and Minneapolis.

JMISKO also has an Aesthetics and Anti-Aging Center that offers boutique spa services and the latest in aesthetic procedures – all in one practice.

For more details, see www.jmisko.com or call 402-484-5144.

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