Meet Dr. Sharon Keene


Dr. Sharon Keene graduated from the University of Minnesota medical school before completing her residency training in general surgery at the University of Arizona, at a time when few women had been granted that opportunity. She went on to complete post graduate training in trauma, critical care and endocrine surgery but after a few years found herself eager to identify a practice environment that allowed her the independence to utilize her surgical skills while at the same time engaging her creative talents to improve surgical techniques and patient care.  She was introduced to the field of hair restoration surgery in the early 1990’s when the old method of “punch and plug” was the standard of care and which ,she observed, created a “dolls hair” appearance rather than naturalness.  This technique when performed improperly caused enormous scarring, and sadly for some patients, disfigurement.  She entered the field of hair restoration surgery determined to help create techniques which would improve aesthetic results and to inject more scientific method into the field in order to offer real cosmetic solutions for hair loss patients.


Early in her hair restoration surgery career Dr. Keene became an active member of the International Society of Hair Restoration Surgeons (ISHRS), the largest international society for doctors specializing in this field. She was also given an honorary membership in the Italian Society of Hair Restoration surgery in the early 2000’s. Dr. Keene believes the best award or reward any doctor can have is the thanks from a gratified patient who’s life and self esteem are improved by what we do. Furthermore, Dr. Keene acknowledges the professional satisfaction a doctor feels when they receive recognition from their peers and she feels grateful and fortunate to have received so much recognition from those in her field. There are 3 awards she is especially proud of:

ISHRS Platinum Follicle Award

Archimedes Award

Mouth of Truth Award

  1. The prestigious ISHRS Platinum follicle award considered to be one of the society’s highest recognitions and is described on their website this way: The ISHRS Platinum Follicle Award is given for outstanding achievement in basic or clinical research, or an invention or discovery, or furthering techniques and methods in a profound way that has resulted in the advancement of the field of hair restoration.
  2. Archimedes Award (Italian Hair Restoration Surgery Society): awarded in recognition of her presentation of the first multi recipient site scalpel ever designed which Dr. Keene developed to improve aesthetics and efficiency in follicular unit grafting mega-sessions
  3. Mouth of Truth Award (Italian Hair Restoration Surgery Society): awarded in recognition of ethics in hair restoration surgery, the legend of the ‘mouth of truth’ is that the mouth will bite the hand of anyone who isn’t telling the truth!

Additional awards for her various academic contributions and lectures have also been greatly  appreciated and can be reviewed by clicking the button below.


From a patient perspective, the importance of their surgeons leadership qualities can be seen in the ways their activities reflect commitment to medical policies and standards of care that benefit patients—because all patients benefit from such policies and standards. Dr. Keene made a decision early in her career to actively participate in various medical societies relative to hair restoration surgery such as the International Society of Hair Restoration Surgery (ISHRS), as well as smaller societies in Italy and Europe, not only to stay abreast of innovations by her peers, but also to contribute her own. The focus of her interest in policy was largely to create or uphold standards promoting ethical integrity, and the safety of patients as well as to develop training programs for doctors which teach principles and techniques that can achieve a high degree of naturalness while educating them on the limits of surgery, optimal use of finite donor hair resources and medication therapies as well as other treatment alternatives. As a pioneer of innovation in the mid 1990’s she was part of a team of doctors to demonstrate the earliest form of follicular unit grafting in live surgery for the Italian, European, World and International Society of Hair Restoration Surgery (ISHRS).

Her commitment to education of her peers inspired her to accept the role of program Chair for the ISHRS annual scientific meeting in 2007; and later as a member of the continuing medical education (CME) committee, facilitated and participated in programs and meetings which earned the ISHRS program accreditation by the ACCME (American Council on Continuing Medical Education). The latter indicated the society had met the necessary educational standards to provide CME credits. Following her role as scientific chair, she was given the honor to join the ISHRS board of governors, and became active in policy making for the medical society. 

She eventually ascended to the ISHRS executive committee which in 2015 culminated in Dr. Keene becoming only the second woman to become president of the international organization boasting >1000 members worldwide committed to the art and science of hair restoration surgery. As ISHRS president, Dr. Keene lead the society to publicly embrace what they had already quietly supported, and acknowledge the importance of surgeons performing their own surgery, rather than delegating critical aspects of hair restoration surgery such as donor harvesting in FUE, or incision creation of any kind on a patient, to unlicensed technical staff. Medical boards have generally supported the ISHRS policy stance, and Dr. Keene believes these standards should be upheld across the medical spectrum in all specialties for the benefit that accrues to patients both for safety and medical expertise.

Industry Innovation

As follicular unit grafting revolutionized the hair restoration surgery field due to its ability to achieve cosmetically pleasing results, Dr. Keene was aware of the need to improve the ergonomics and efficiency of instrumentation to facilitate the efficiency of performing mega-sessions. Grafting sessions had transitioned from hundreds of grafts to thousands of grafts, and completing surgery in a reasonable amount of time was advantageous for both doctors and patients. To that end, Dr. Keene contributed several innovations to improve ergonomics and efficiency in the field:

    • In 2002 she conceived and designed the first mult-blade recipient site scalpel, depth controlled to prevent damage to underlying blood vessels and to assure appropriate depth for a particular graft size; variably interdigitated to prevent the appearance of rows, and overall intended to improve the efficiency of recipient site creation;
      To facilitate ergonomic graft dissection Dr. Keene introduced the use of videoscopes, which allows this task to occur without bending over a dissecting microscope, and also allows visible monitoring of graft dissection as it occurs.

    • When researchers documented the critical importance of graft hydration for graft survival, Dr. Keene invented the first finger mounted graft reservoir to store grafts in solution on the surgery field in order to maintain graft hydration during graft placement, her specific reservoir has 4 separate compartments to separate graft sizes, and rotates to present the graft size preferred for a given area. It is a tool she continues to use in her surgery today. Many others copied this innovation in various forms, often using a single reservoir, but recognizing the value of such a tool to maintaining graft hydration for improved graft survival.

    • Similarly, Dr. Keene presented the advantage of creating hydrating dissecting stations, which lead to medical device companies to mass produce similar devices which helped hair restoration surgeons maintain graft survival.

    • Dr. Keene studied the role of the androgen receptor gene for medication response, and a particular genetic variant to predict response to finasteride in women. The same variant in a Japanese study had been shown to correlate with finasteride response in men. Subsequent studies performed in the hair research community established the value of finasteride for hair loss treatment in some women.
    • When topical minoxidil was approved by the FDA for hair loss therapy, most doctors and patients were unaware that it was a prodrug that needed to be converted to its active form by the presence of an enzyme (sulfotransferase) which was present in sufficient amount in only about half of the population. Currently patients must commit to months of regular application to assess for a response, and many will do this with no response. Research performed by Dr. Keene helped establish that this enzyme and a response could be predicted by plucked hair follicles, however, to date there is not yet an available method to predict minoxidil response prior to using it.

Hair Line Design & Placement

Based on feedback from her own patient population, Dr. Keene became aware of the lack of scientific evidence to support many of the hair line “rules” for design (4 finger breadths above the glabella—who’s 4 fingers? 8 cm for everyone—does this apply the same to every shape face? Rule of 3rds—does this occur in nature for everyone? No.), as well as the lack of scientific support for an “age appropriate” hair line. Her patients shared their stories of family members, such as uncles or grandfathers, who were not affected by androgenetic alopecia (AGA) and who carried the same hair line they had as a young man well into their 80’s or older. 

These stories along with various observed examples in history support the lack of a standard “age appropriate” hair line, examples include several US presidents who had their natural hair lines well into old age, before hair restoration surgery was popular. In 2007 Dr. Keene co sponsored a survey of men over age 55 with no personal or family history of hair loss to record the various hair line shapes and elevations to establish the lack of age related hair line recession in men who are unaffected by AGA. While this survey was presented at the ISHRS annual meeting in 2007, unfortunately the findings were never submitted for publication so not all surgeons may have realized this for themselves. However, does this finding mean that every man can have the hair line they had when they were in their 20’s? 

Donor availability and especially donor limitations for advanced pattern hair loss remain a factor. Not every patient should try to achieve a more youthful hair line if their goal is some level of coverage to a larger area of the posterior scalp. The nuances of hair line design and placement is an important conversation to have with the doctor, but Dr. Keene’s survey was instrumental to helping her design natural hair lines even in advanced patterns of hair loss.


Dr. Keene’s list of Scientific Publications reveals the breadth of her interests and studies on behalf of improving the medical understanding of hair loss and various treatments:

  • “Vitamin D Deficiency and Hair Loss-A Case Report and Review of the Literature for Diagnosis and Treatment,” Hair Transplant Forum International, July 2022, 32 (4) 113- 122, Sharon Keene MD FISHRS
  • “Follicular Unit Excision-Linear Ellipse (FUE-LE): A New Way to Add the Linear Ellipse Donor Harvesting Method to any FUE Practice” Hair Transplant Forum International, Volume 32, Number 1 January/February 2022 p 1, Sharon Keene MD FISHRS
  • “Determining Safe Excision Limits in FUE: Factors that Affect, and a Simple way to Maintain Aesthetic Donor Density,” Hair Transplant Forum International, Vol 23, Number 1, Jan/Feb 2018, Sharon A Keene, MD FISHRS, William R. Rassman, MD, James A. Harris, MD FISHRS
  • “Graft Production,” Hair Transplantation 6th Edition, 2017 (Chapter 37) Sharon A. Keene MD
  • “Illuminating current pitfalls in optimal photo biomodulation device development and assessment for treating hair loss,” Experimental Dermatology, Sharon A Keene, July 1, 2016
  • “Illuminating current pitfalls in optimal photo biomodulation device development and assessment for treating hair loss,” Experimental Dermatology, 2016 Oct 25 (10) 758-9, Keene SA
  • “Part 3, Critically Assessing Recent LLT Device Trials Limitations, Recommendations, and Conclusions,” Hair Transplant Forum International, Sharon A. Keene, MD FISHRS, May/June 2015
  • “Part 2, LLT Devices, Medical Device Regulation, and Impact on Development,” Hair Transplant Forum International, Sharon A. Keene, MD FISHRS, Jan/Feb 2015
  • “Part 1, The Science of Light Bio stimulation and Low-Level Laser Therapy (LLLT)”, Hair Transplant Forum International, Sharon A. Keene FISHRS, Volume 24, No. 6, Nov/Dec 2014
  • “Hair Restoration surgery: State of the Art,” Aesthetic Surgery Journal, (co authored with colleagues) Vogel, Jimeniz, Cole, Keene, Harris, Barrrera, Rose, Jan; 33(1) 128-51
  • “Part III: Evidence suggests Endocrine Disrupting Chemicals (EDC’s) influence our hormonal environment and possibly AGA,” Cyberchat for the ISHRS, February, 2012
  • “Part II: Evidence that lifestyle choices may impact hair loss in androgenetic alopecia,” Cyberchat for the ISHRS, June 2012
  • “Part I: Beyond Genetics in AGA: Are Epigenetics just as important in determining and treating hair loss?” Cyberchat for the ISHRS, Oct 2011
  • “Genetic variations in the androgen receptor gene and finasteride response in women with androgenetic alopecia mediated by epigenetics.” Dermatology Therapy 2011 Mar- Apr: 24 (2) 296-300, Keene S., Goran A.

  • “Natural Hairline Density in Men: Findings of a Pilot Survey,” Sharon A. Keene, MD, Hair Transplant Forum International, Vol. 19, Number 2, March/Apr 2009.
  • “Midline Convergence” in the 2005 fall issue of The Hair Transplant Forum International
    • Contributing author to “Hair Restoration Surgical Instrumentation,” Hair Transplantation 4th Ed, 2004, chapter 22
    • “Improving the Visualization of Gray Hair Follicles,” published in the
    International Journal of Cosmetic Surgery, Vol. 3, No.2, 2001
    • Dr. Keene also co-authored the article “Clinical Significance of Molecular Markers in Cancer Staging” published in Surgery, Vol. 129, No. 1, January 2001
  • “Cosmetic Significance of Follicular Units vs. Small Mini Grafts,” published in the International Journal of Cosmetic Surgery, 1998
  • “Finasteride and Future Hair Loss,” published in The Hair Transplant Forum, 1ST Quarter, 1998