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:
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.
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.
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:
“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.