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. Last Updated: 07/27/2016

From Big Heads to Hairy Heads

The two men in the hospital lobby watching the television show "Vremechko" looked alarmingly like extras from the set of "Star Trek."


The man with the classically handsome face hid his mammoth, mushroom-shaped head under a navy blue ski hat. The one with the badly burned face, his skin now a tight, waxy mask, had his grossly bulbous forehead bandaged with a white gauze strip.


What the two share is a condition that can strike terror into the heart of men and women who experience it: alopecia, otherwise known by its common name, baldness.


"I started losing my hair when I was around 21," said Edik, 27, a security guard whose head has assumed a normal shape after his recent operation. "I wasn't about to wear a toupee."


The men are patients of Natalya Vaganova, a physician and senior scientist in the Department of Rehabilitative and Plastic Surgery at the Vishnevsky Surgery Institute, which has 10 years' experience treating bald patients -- more than any other Moscow institution.


The patients' heads assume such strange shapes because of the expanders that are inserted under their scalps.


"I had three expanders in for about three months," said Edik, whose scalp now sports two long scars and a cap of short, fine hair growing uniformly all over his head.


The treatment for alopecia used at Vishnevsky is amazingly simple: Natural latex expanders are inserted under an area of the patient's scalp where healthy hair grows. Then, over a period of up to three months, the patient comes in every other day to receive, through a valve in the expanders, injections of a sterile solution.


As the expanders slowly fill up with fluid, the skin on the scalp stretches, thus providing better blood circulation to the area so that healthy hair can grow. Then, when enough new hair has grown, a surgeon extracts the expanders, leaving a flap of hair-covered skin that can be stretched over the rest of the scalp. The patient's bald patches are then surgically removed. "I'm very pleased," said Edik with a slight grin. "Sometimes I can't really believe it."


The procedure used at Vishnevsky for treating baldness -- hormonally induced or the result of burns or trauma -- has been around for decades, Vaganova said. But what is new is the price of the domestically produced expanders, made at the Moscow Rubber Factory.


"In the West, such expanders -- generally made of silicon -- can cost up to $265," Vaganova said. "The greatest advantage of [our] expanders is that they cost all of 20,000 rubles ($3.55). This small sum allows us to use the latex expanders a lot. Almost a quarter of the patients we see in our department are treated with them."


All in all, the procedure -- the expanders, the regular visits, the operation -- costs more than 15 million rubles. Until just three months ago, Vaganova said, the state paid the tab for burn and trauma victims. Now, as the institute faces budget constraints, most patients must pay out of pocket.


"I'm paying for this," said unemployed Zaira Abubakirova, 23, who lost 35 percent of her hair in a car accident last October. Touching her head lightly, bandaged since three expanders were inserted two weeks ago, the strikingly pretty Zaira said, "It hurts a little, but not too much."


Vaganova said that her institute cannot accept all who come for help. "To do this operation, there's got to be a reserve of healthy hair," with baldness no more advanced than 50 percent of initial hair volume. And, as with any invasive procedure, "there are hazards," Vaganova said. "There is the possibility that an expander will suppurate" -- pop.


A physician whose present work also includes treating badly burned veterans of the Chechen war, Vaganova said she initially regarded baldness as a non-issue.


"I never thought that it was such a great trauma for the patients. I even had patients who tried to commit suicide because of their baldness -- it was such a big problem for them.


"But I think everyone wants to look normal physically," Vaganova conceded. "And if every bald person had the possibility, means and time, maybe everyone would come to us."