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Inside Hollywood’s favourite baldness clinic
The Times
Chris Ayres
Chris Ayres on
the Wilshire Boulevard practice that’s a sanctuary for
Tinseltown’s follically challenged stars.
Aside from
the words “Alvi Armani” etched into a smoked-glass
partition, the entry lounge of the tenth-floor suite at 8500
Wilshire Boulevard – located above a nondescript bank branch
on the edge of Beverly Hills – gives no hint as to what goes
on beyond the unmanned reception desk. There’s just a sofa,
a vase of purple orchids, a flat-screen TV and a coffee
table with a glossy magazine placed on top at a perfect
right angle.
Such
meticulous anonymity – there are no product brochures on
display, no informative posters, no slogans or branding of
any kind – makes you wonder for a moment if you might have
found yourself in a field office for some
unofficial branch of the CIA.
The real
explanation, however, involves a matter of far greater
delicacy. Here in this suite, an unspeakable taboo is
confronted, often after years – decades, even – of private
anguish. In many ways, it is a place of Ultimate Reckoning:
where the impossibility of death in the mind of someone
living – as Damien Hirst so memorably put it – meets the
unyielding reality of human decay. Yes, Alvi Armani is a
clinic… for balding men. And not just any
men, either – but some of the richest and most prominent
individuals on the planet.
If the name
“Alvi Armani” sounds familiar, it’s most likely because of
the alleged patient who was recently caught by paparazzi
climbing into a limousine in the facility’s underground
garage – one Gordon Ramsay, of Kitchen Nightmares fame. In
the photograph, the Michelin-starred chef was fitted with a
surgical cap and looked dazed and puffy-eyed. “Gordon
Barnet!” sniggered The Sun.
In spite of
such jeers, however, the Armani clinic – founded by the
esteemed Italian surgeon Antonio Armani (unrelated to the
clothing designer of the same name) – is at the follicle-tip
of a revolution in so-called “hair restoration” technology
that is already well on the way to eliminating baldness in
notable males of a certain age. Its
secret? The treatment is pre-emptive. Plus, the new hair
grows in over 18 months, which is why, if not for the
occasional enterprising photographer, the work goes mostly
undetected.
actual Alvi Armani
patient results
Although it is
impossible to know who has had the procedure, the
statistical fact that two-thirds of males should by rights
have lost their hair by the age of 60 doesn’t make it hard
to guess. John Cleese, now 71, is one of the few who’ve come
clean, explaining that he got a transplant because, “I’ve
got a very strange-shaped skull, very pointy, and I don’t
like wearing wigs.” In fact, the shock these days is more
when men don’t take action – hence the recent
serious-minded reports on Prince William’s scalp by the
Associated Press, and the incredulous whispers in Hollywood
whenever Hugh Laurie gets his thinning crown touched up with
a spray can on the set of House, M.D.
“I would say
that more than 90 per cent of everyone you see out there has
had it done,” says Dr Baubac Hayatdavoudi, the 35-year-old
surgeon who took over the Armani clinic in Beverly Hills two
years ago, when I ask him to guess how many suspiciously
hirsute celebrities have undergone some kind of major
scalpwork. “They just come here before it gets obvious. It
used to be a taboo in this business to treat young people.
It was always, y’know,
‘Let’s wait and see how your hair loss progresses…’” Well,
not any more.
There are
other advances, too, says Dr Hayatdavoudi – who is tall and
of Iranian descent, with a disarmingly gentle manner, and a
tendency to break into the kind of muffled, professorial
giggles that bring to mind the more nerdish qualities of
Barack Obama. Soon, he predicts, men will be able to clone
their follicles, making the process of hair restoration even
cheaper and easier. “As an option, I think it’s about five
years out,” he says. “Patients could take out 100 grafts at
the back of their head and simply replicate the DNA. In
fact, Dr Armani is researching this now at his lab in
Toronto. It’s his passion.”
It was
Hippocrates, the father of modern medicine, who made the
first scientific observation on the subject of baldness when
he reported that of all the Ancient Greek men in 400BC, only
the eunuchs never receded or thinned. He didn’t know why, of
course.
But we do now:
men castrated before puberty don’t produce testosterone, and
therefore neither its evil mutant offspring,
dihydrotestosterone, or DHT. It is DHT that acts like
Kryptonite on men’s follicles, but only if those follicles
have been equipped with so-called “DHT receptors”, a factor
decided without consultation or appeal by the cruel lottery
of genetics.
actual Armani
patient results
“Everyone’s
hair has growth phases, which vary between two and six
years,” explains Dr Hayatdavoudi. “If you have a longer
phase, it means you can grow your hair to the ground. And if
you have DHT receptors, the growth phase becomes shorter and
shorter… until you end up with ‘peach fuzz’. You lose your
hair because it’s taking the DHT on board.”
Before such
things were known, “baldness cures” were nothing of the
sort, really. Hippocrates treated his own dying rug with
everything from sheep’s urine to horseradish, cumin, pigeon
droppings and nettles. It took a couple of millennia for the
first big advance in follicular treatments to arrive – the
1804 experiment by an Italian doctor, Giuseppe Baronio, that
involved cutting a strip of skin from a living sheep, then
grafting it back on to the unfortunate creature 80 minutes
later. To everyone’s surprise, the skin survived – thus
proving that “autografts” (removing skin from one part of
the body and moving it to another) were viable. From here
the action moved to Germany, where in 1914 a doctor named
Franz Krusius used the same principle for a successful
eyelash transplantation, and then to Japan, where Shoji
Okuda announced in 1939 that he had performed some 30 hair
transplants using various jerry-rigged circular punches of
between 1.5mm and 5mm (they were driven into patients’
scalps using nothing but “force and rotation”). Because his
work was published in Japanese just before the Second World
War, it took decades to reach the West. In the meantime,
however, a New York dermatologist, Norman Orentreich – now
89 years old – discovered in the Fifties that hairs on the
back and sides of the male head were immune to the influence
of DHT, and that if sections of scalp were removed from
these areas and grafted on to a balding pate, they continued
to grow healthily. “Donor dominance” was the term he came up
with, and it has been
the founding principle of hair-loss surgery ever since.
There was a
big problem with all of this, however. When clumps of 30 to
50 hairs were cut out of a patient’s scalp and relocated –
sometimes with the punch attached to an electric drill, to
speed things up and increase profitability – they created
scarring at the donor site, not to mention those
unnatural-looking “plugs” of hair in the area being
repopulated. As a result, various work-arounds were
attempted, mostly with disastrous consequences: “scalp
reductions” (the scars resembled axe marks); “hair flaps”
(there was risk of oddly angled hair and, in some awful
cases, “flap death”, or tissue necrosis) and “micrografts”
(splitting grafts into smaller pieces).
actual Armani
patient results Some of
these procedures were still being offered in the Nineties.
Then finally came the “strip method”, whereby all the donor
hairs were “harvested” in one go by cutting out a long,
rectangular section of scalp from the back of the head and
sewing the gap shut. The donor strip was then split into
micrografts and planted into holes on the top of the head
made by a scalpel nick. It was a relatively clean technique
with half-decent results, but still left a “happyInside
faced” scar on the back of the patient’s head, ruling out
short haircuts.
“I had the
strip method done when I was 20 years old,” recalls one
patient, Ben Jacobs, a businessman from Long Beach,
California, who started balding as if he were a middle-aged
man at the age of just 17. “The results were OK, but I
honestly expected better. Also, any time you get cut open
like that, you’re gonna have pain.” Still, he was willing to
take any measures necessary. “Losing your hair is a pretty
traumatic experience at that age,” he explains. “It affects
your whole life. The only things I should have been thinking
about at that time were college and girls. Instead I was
thinking about my hair and how it made me look a decade
older. I lost my confidence; I was depressed.”
This is
where Dr Armani comes in. Basically, he founded his business
in 1999 with the aim of harvesting only individual
“follicular units” – made up of one to four hairs plus the
surrounding oil glands, muscles, and connecting tissue –
using tiny, needle-like pricks in the donor area. Each
follicular unit, also known as an ultra-micrograft, is then
transplanted to the top of the head using a tool like
jeweller’s forceps. Scarring is barely detectable, even with
very short hair. Also, fewer hairs are lost during
harvesting, and therefore “transplant density” is improved.
Most importantly, the pluggy look doesn’t happen – or at
least not in theory. “In this clinic, plugs are a dirty
word,” says Dr Hayatdavoudi.
Ben Jacobs
agrees – and he should know, because Dr Armani agreed to
help fix the chop-job he’d had done as a 20-year-old (at a
different clinic). “I know it’s a cliché,” says Jacobs, “but
they’ve given me my life back. Even my girlfriend was
shocked when I told her I’d had it done before we met. She
told me, ‘I would never have guessed.’”
For privacy
reasons, The Times isn’t allowed to sit in on one of Dr
Hayatdavoudi’s consultations, but fortunately a test subject
is on hand in the form of… well, your very own
correspondent. I keep my hair closely shaved – after it
became obvious in my mid-twenties that it was staging a
retreat on all fronts. Thankfully, by then, the semiskinhead
look was acceptable (thank you, Jason Statham and Bruce
Willis) so I bought some shears and haven’t thought about it
much since. In fact, baldness came as something as a relief,
given that I had been cursed in the first place with
fluorescent ginger hair.
“You coped
with it really well,” says Dr Hayatdavoudi, soothingly. “For
others it’s like a jab in the back on a daily basis. Your
fair hair actually helps, because it blends with your scalp.
Contrast exacerbates the appearance of loss. You also have a
young-looking face. For me, it was a real sore spot, and it
signified ageing… which is why I’ve had two transplants. In
fact, everything you can see on the top of my head is
transplanted.”
actual Armani
patient results
Clearly, for
Dr Hayatdavoudi, this business is personal. He tells me that
he began losing his hair in his midtwenties, pretty much at
the exact moment he’d finished his medical studies and could
finally relax. Like many of his patients, he soon entered
the realm of “extreme styling” to conceal his loss. “I do a
lot of yoga and other outdoor stuff, so it was really…” – he
struggles to find a word – “bothersome.” You also get the
sense that his family’s Iranian culture wouldn’t have been
cool with the Buddist monk look, although with his strong
features and athletic bearing, he could surely have pulled
it off as well as anyone. So in 2003, at the age of 27, he
had his first transplant, performed by Dr Armani himself.
And when the hair further back on his scalp began to thin 14
months ago, he had a second operation. The result is
impressive enough that you’d never question it, as long as
you didn’t know what
he did for a living. As it is, there’s a certain level of
perfection to the hairline that made me suspect from the
beginning that he might be one of his own patients.
According to
Dr Hayatdavoudi, “We get guys who come in and they’re afraid
to take their hats off. They feel nude. We have to wrestle
them off. I had one patient who said he spent two hours
every day doing his hair.” By the time these tortured souls
end up at Alvi Armani, they’ve usually been researching on
the internet for at least two years. “A lot of people fly
here for a half-hour consultation from halfway across the
country, then fly back home again.”
Not
everyone is a good candidate, though – and not just those
with conditions such as alopecia totalis, which leaves them
without any suitable donor sites. “Some patients just aren’t
emotionally fit,” says Dr Hayatdavoudi. “If they think it’s
a full head of hair or life isn’t worth living – they’re not
suitable. With some other patients, they have underlying
behavioural issues that need to be addressed. But no one has
ever been turned away for price reasons. If they’re flexible
with their schedule, we can usually give discounts. The guy
we had in yesterday, for example, was virtually a pro bono
case. This person just took an amazing leap of faith at his
stage of life.”
The human
head, I learn as my hypothetical consultation begins, has
between 100,000 and 150,000 hairs, while each square
centimetre of scalp has roughly 70 to 90 follicular units.
Balding, meanwhile, is measured on the socalled
Hamilton-Norwood scale – an unhappy series of diagrams
showing various stages of decay (female hair loss is
measured on the separate Ludwig scale) – while at Alvi
Armani they have a proprietary system, based on four zones
of the scalp and their corresponding square centimetres of
coverage. “You’d be looking at 2,100 grafts in Zone 1 and
1,300 grafts in Zone 2,” Dr Hayatdavoudi informs me, after
studying my “peach fuzz” through a microscope. “Zone 3 is
adequate if you keep it short.” Those grafts would of course
have to come from somewhere: the back of my head. “You lose
hair density in your donor area, yes,” he confirms. “But you
have maybe 22,000 follicular units at the back, so if you
remove 3,400 of them, you’re still left with 19,000. That’s
not noticeable.”
The
procedure itself would go something like this: a good
breakfast, get to the clinic early, take a local anaesthetic
and an anti-anxiety pill (“like having a couple of glasses
of wine”), listen to music, and wait as a surgeon “harvests”
follicles from my donor site. Then a half-an-hour lunch
break, followed by the “design session”, when the placement
of every single hair is discussed and mapped out. The Alvi
Armani clinic prides itself – a little pretentiously,
perhaps – on following the facial structure and hairline
guidance of Marcus Vitruvius Pollio’s 15BC masterpiece, The
Ten Books on Architecture (which later inspired Leonardo da
Vinci’s Vitruvian Man). “David Beckham’s name also comes up
a lot,” laughs Dr Hayatdavoudi. “But a Beckham hairline
isn’t right for everyone: he has the upper-pointing nose,
the small distance between the upper lip, the high
cheekbones. The aim is to bring out the features of the
patient that need to be highlighted, taking into account
race, facial dimensions, etc. You can’t just add hair.”
Once the
design is finalised, the incisions for the grafts are made.
Then it’s time for the hairs taken from the donor area to be
implanted. After that: pain medication, precautionary
antibiotics, a surgical cap, then home. “The first night is
the worst, and it’s possible you’ll get a mild headache and
maybe nausea for 10-15 minutes,” warns Dr Hayatdavoudi.
“After that, your face might get a bit puffy from the
numbing fluid. There’s minimum bleeding. And
when you come back in the next day, the scabs wash away.”
As for the
recovery period: the swelling – if any – goes down within a
week. There might also be more scabbing, flaking and
redness, and for 28 days you must perform so-called
“protocol washes”. Meanwhile, about 10 per cent of the “new”
hairs will grow within the first two months, hitting 50 per
cent at six months, and 100 per cent at 18 months. Dr
Hayatdavoudi says that, “For people who’ve been bothered by
hair loss, the reversal of the process – the
hair getting thicker and thicker – is like Christmas coming
every day.”
One recent
patient, Ryan Day, a 35-year-old IT consultant from New
York, doesn’t argue. “You can’t put a value on that bounce
in your step,” he says. “They gave me a whole lotta hair,
man – all of it pointing in the right direction!”
actual Armani
patient results Finally, of
course, there is the small but tricky matter of payment. The
cheapest option for my 3,400 grafts would come to about $5
per graft, or $17,000 (£10,500), with one of the clinic’s
junior surgeons holding the knife. The most expensive
option, involving Dr Hayatdavoudi performing the transplant
in my own home, would be more like $340,000. “The price
varies,” he shrugs. “If I’m doing it, a shaving case – where
we shave the patient prior to the procedure – costs $8 per
graft. But a news anchor, for example, can’t take a week off
work, so we can’t shave him. We call that an executive case,
and it’s $15 per graft, because it takes more time. For VIP
cases – which means we shut down the clinic and lock the
doors for them – it’s $30 per graft. Then there are the
house and hotel visits,
where we take the whole crew. That’s when you get up to $100
per graft. We end up recreating the entire operating room.”
After hearing
all this, I tell Dr Hayatdavoudi that if I ever wanted my
ginger locks back, I’d rather wait for less invasive gene
therapy. “The problem is, there are literally hundreds of
gene loci associated with hair loss,” he shrugs. “Even if
you found a treatment for one gene, you’d still have all the
others. And there are complications
when you manipulate genes. That’s the reason why there’s
never likely to be a silver bullet.”
For the near
future, then, the choice for men with underendowed scalps is
a simple one: the buzz cut or the surgeon’s knife. And, of
course, the earlier any action is taken, the better –
because these days, no one need ever know what happened.
Which brings Dr Hayatdavoudi to the subject of England’s
future king, Prince William – and whether or not his horse
has already bolted in that regard. “He actually has a great
donor area and would be a great
candidate,” he says.
Alas, however,
it’s unlikely that even the Alvi Armani clinic, with its
unmarked doors and security detail in the car park, could
handle such a client. “A VIP session would be best suited
for him,” agrees Dr Hayatdavoudi, apparently unfazed by the
prospect of an in-house transplant at Buckingham Palace.
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