THE POWER OF HAIR.(hair transplantation)

Ali Amin sat in a small mahogany panelled room in Beverly Hills, his chin in his hand. He was contemplating the seven degrees of hair loss. On a low table in front of him, a chart showed a sequence of line drawings of a man's head, turned in profile or facing forward and bowed, as if in prayer. Each pair of drawings illustrated a typical stage in the slow but implacable progress of androgenetic alopecia, or male-pattern baldness. At the top of the chart, the subject had a mane so full that it crowded his brow. By stage three, his hair was in retreat, leaving a widow's peak in front and a balding spot in back. By stage five, the two receding hairlines had met in the middle, along a narrow isthmus on top. By stage seven, even this was gone. The last survivors hung forlornly above the ears and neck, as if clinging to the face of a cliff.

"There's no wrong answer," Carl Carlberg, a senior counsellor at the Bosley hair-restoration company, told Amin. "All we want right now is your self-identification." He'd once been in the same situation, he added, pulling a glossy photograph of himself from a folder and placing it on the table. Bosley offered free hair transplants to its employees after a year of service, and Carlberg had received two since taking the job. He pointed to his pale, narrow face in the old photograph, with its deeply receding hairline--somewhere between a stage five and a stage six. Then he glanced up at Amin and invited him to stare: Carlberg's white-blond hair now reached to his forehead. And though it was still thin, it looked perfectly natural--it was impossible to say where the original hair ended and the transplanted hair began. "Most people say I look younger now than I did then, and that picture was taken sixteen years ago," Carlberg said. "That is the power of hair."

It was hard to argue with him, though it wasn't clear why. Male-pattern baldness may be the only sign of virility that most men would rather do without. Like an adolescent's first beard, it's a condition triggered by the release of testosterone, only in this case the hormone reacts with an enzyme in the bloodstream, creating dihydrotestosterone, which shuts certain follicles off rather than turning them on. The best way to keep all your hair, Hippocrates noted more than two thousand years ago, is to be castrated. (Eunuchs are famously resistant to baldness.) In 1942, the Yale anatomist James B. Hamilton took this observation a step further. He studied a pair of identical twins; one of them was bald, and the other had been castrated in a mental institution and had a full head of hair. Hamilton gave the hairy twin shots of testosterone and watched to see what would happen. (He later repeated the experiment with more than a hundred other castrated inmates, with similar results.) Within a few months, the patient was as bald as his brother, and his locks never grew back.

Amin slouched back in his chair and clawed at his forelock. He was twenty-seven years old, tall and hulking, with hawkish features and dark-brown hair that was just beginning to recede at the temples and crown. (His name has been changed at his request.) He sold apparel and accessories in New York City, at a wholesale business in Manhattan's garment district--within walking distance of a number of hair specialists. Yet he'd come here, to the headquarters of the largest transplant firm in the world, to be worked on by the master. The next morning, L. Lee Bosley, the self-anointed Renoir of transplantation, would slice strips from the back and side of Amin's scalp, have nurses divvy up the follicles, and graft them to the bare areas on Amin's head. "I'm losing a lot," Amin said. "My wife says she doesn't care, but she cares." He leaned forward to show us the beginnings of his bald spot. It was barely visible to the casual observer, and Amin was young to be considering a transplant, but the problem had begun to obsess him. "It's falling, falling, a little, a little. It's scary. All my family, they're bald. And in business it's everything, the look."

Carlberg nodded. "We're an image-driven society," he said.

They were quiet for a while, then Amin pointed to a drawing halfway down the chart--a stage three--as if to say, "That's me."

At last count, roughly forty million Americans were going bald--about half of all men and more than a third of all women. Some wear wigs and weaves, some use hair-growth stimulants, like minoxidil and finasteride (better known as Rogaine and Propecia), and some use folk remedies like flaxseed and sawpalmetto berry. (The ancient Egyptians preferred rubbing their heads with a mixture of lion, hippopotamus, crocodile, cat, snake, and ibex fat.) Hair transplants have been available since 1952, when the dermatologist Norman Orentreich performed the first one, in New York, and last year alone more than eighty thousand Americans had the procedure done. Still, to the rest of the population all the fuss can seem slightly ridiculous. As one transplant surgeon I spoke to put it, "The man who isn't bald never thinks about baldness. The man who is ...