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Hair Transplantation The Basics Hair transplantation can be carried our by various methods. The goal of hair transplantation is to restore a natural undetectable hair line as well hair style to the face, giving a sense of fullness & well being to the patient. The modern techniques for restoring hair are use of follicular, micro , mini and slit grafts, scalp reduction, slit grafts, scalp reduction, strip graft and flap procedure. Use of one or combinations of these techniques gives desirable and satisfactory result in suitable cases. Follicular or single hair transplant are also more and more common in use these days. They also give natural result. The advantage being that this can be performed under local anesthesia on a day care basis and patient does not need hospitalization for this. The drawback is that to get the desired density multiple sittings are to be performed. MANAGEMENT OF HAIR LOSSBefore using any procedure or taking any tablets, it is very important to diagnose the cause of hair loss. This can be done with following investigations : One is a simple procedure called trichogram, which involves examination of hair roots under microscope & other is by routine blood testing. There is a wide range of products available in the market but it is only after investigation , proper medicine can be prescribed by a doctor. In females, if the hormone levels are found to be raised, anti androgens can be prescribed.
The Procedure TAKING THE STRIP:
GRAFTING: These grafted hair retain the property of the back hair & thus grow thick & long. Hormones have no affect on them & they do not become fine. Hair transplantation has also been under taken to correct alopecia of diverse etiology. These include alopecia areata, pseudopalade of brock & discoid lupus erythromatosis etc. Surgical restoration of eyebrow, moustache destroyed by accident or burns have been performed with varying degree of success. Unfortunately, procedures like punch grafting, which are more familiar to the patients, should not be carried out in practice as they lead to "Doll hair appearance" or "paddy field". The secret of successful hair transplantation not only lies in the procedure but also on the art & aesthetic with essence of hair styling. Single Hair Transplantation is the gold standard for creating a natural hairline, which gives patients a natural look. We use "follicular unit" micrograft for frontal hairline to give a natural look & thus avoid scaring. Management Of the
Donar Area AFTER
CARE In case of single hair transplantation, patient may not need to go for any dressing. In such case we just apply a transparent adherent gel to hold the grafts. HAIR LINE ENHANCEMENTHair line enhancement is done for those patient who has already undergone one sitting of hair transplantation & wants a more fuller or denser look or those who is the initial stages of hair loss. Management of hair loss with Tissue Expansion Tissue expansion is another technique of restoring hair which is though expensive, gives best result amongst all techniques in a suitable case. It involves two stage surgery 6 weeks apart. In first stage a balloon like device called tissue expander is inserted under the hair bearing area of scalp. This balloon is gradually inflated in a period of 6 weeks to expand hair bearing area of scalp .in second stage surgery this expanded hair bearing scalp is replaced over the bald area. This technique gives the best density and most pleasing result amongst all the techniques available today. Female Hair Loss Female pattern of baldness usually begins at about the age of 30, becomes more noticeable at the age of 40, & even more after menopause. They usually show overall thinning of hair over the top of the head, but hairline is maintained. Females may also show male pattern of baldness. With correct diagnosis & investigation it can be arrested medically; & if not, even females can go for hair transplantation. Possible Complications The incidence of complications is low, and when they do occur are relative minor. The scalp is rich with blood vessels and therefore excessive bleeding is possible. It can usually be brought under control with pressure and, if necessary, with sutures. Infection is rare and can be controlled with antibiotics. Problematic scarring is also rare but may occur and depends largely on the patient’s predisposition to keloid formation. Grafts that refuse to take are an unusual occurrence. More often than not the cause of graft failure is that the grafts are pulled out accidentally or are lost due to scalp injury. An unsatisfactory hairline may be adjusted by inserting more grafts or by removing them. Hair loss of non transplanted hair may occur in the recipient area. This is commonly noted in an area of marked thinning. The hair that is lost is hair that is genetically predestined to fall out but the transplant tends to accelerate the attrition rate. In grown hairs or pebbled graft sites may occur. Usually extraction with a needle and time will rectify this situation. Swelling of the forehead occurs most commonly when larger sections of the front portion of the scalp are transplanted. When the swelling extends to the eyelids black eyes may results. In the 2% of cases that this occurs it is resolved with in 4 to 8 days after procedure. Other problems may include allergic reactions to the anesthetic, pigmentary differences between grafts and recipient areas. And other equally rare complications all easily managed and corrected by the attending surgeon.
FAQs How soon can a transplant be performed? It depends on the patient’s attitude towards his receding hair. It is not necessary to wait until complete baldness before having a transplant. It may begin with small transplant areas and as the hair recedes new areas of baldness may be filled in. the surgeon needs to keep future transplants in mind when planning the removal of hair from the donor area. How long will transplanted hair last? The transplanted hair will grow for as long as the hair of the donor site from which it has been harvested. In most cases it will last a lifetime. As time passes most individuals continue to lose their hair. Therefore further transplants are usually required. Is there a minimum or maximum time period that is allowed between individuals’ sessions? Minimum time intervals depend on the number of the grafts that can be harvested from the donor site and transplanted to the area of baldness, the extent of the baldness, as well as on each individual’s circumstances. The shorter the time interval the more rapidly the hair transplant is completed. Usually sessions are performed at 3 to 4 months intervals if the same area is being transplanted. If different areas are being treated the time interval may be much shorter. There is no maximum interval between sessions. When there is a large area of baldness, is it possible to cover the entire area? This is dependent on the size of the donor area. Generally, when there is extensive baldness, a scalp reduction may be performed to decrease the area of baldness to a manageable size. Subsequently, grafting is done to camouflage the scalp reduction scar and to fill in the remaining areas of baldness. The end result may give the appearance of thinned hair rather than absent hair. Are laser assisted hair transplants superior to scalpel transplants? Although the use of laser light as a scalpel for hair transplantation is popular, many surgeons would agree that it is not optimal and that the use of a scalpel is still preferable. Although the laser seals the blood vessels as it cuts providing better control over bleeding, the transference of heat to the surrounding tissue tends to discourage the grafts from being accepted at the recipient site. Laser assisted hair transplants are also very operator dependent. Newer developments may eventually make this methodology of the future, but this is not yet the case. Are there any alternatives? Hair loss can be camouflaged. Numerous methods exist to camouflage hair loss. Wigs and hair pieces differ immensely in cost, durability, maintenance requirements, and quality. Some are fixed to the skin with glue, others are simply placed on the head, and some are attached to "tunnel grafts", surgically constructed pockets in the skin to which the hairpiece is clipped. Tunnel grafting may cause major problems, including infection and scarring. The skin may be permanently damaged to such an extent that it will no longer be possible to choose alternative methods of re-growing the hair, such as medication or surgery. Hairpieces should be chosen with care to ensure that the color of the hair matches, the hair has a natural texture and look, and it fits properly. The slightest discrepancy in any of these factors will make the hairpiece noticeable, and an obvious hairpiece looks far worse than a bald head. Hair weaving is another camouflage option. In this method, hair, usually of human origin, is matched in color and texture to the individual’s own hair, then woven or knotted to it. This method works especially well in a small area. The advantage of hair weaving is that it stays in place during vigorous activity, as well as in the water. The disadvantage is that it requires frequent adjustments because as the hair to which it is attached grows, the knots loosen up, and the woven hair lifts away from the head. Irritation of the skin under the woven hair is common, whether or not the hair used is real or synthetic.
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Hair
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