Hair transplantation is a surgical technique that removes hair follicles from one part of the body, called the ‘donor site’, to a bald or balding part of the body known as the ‘recipient site’.
The technique is primarily used to treat male pattern baldness. Hair transplantation can also be used to restore eyelashes, eyebrows, beard hair, chest hair, groin hair and to fill in scars caused by accidents or surgery such as face-lifts and previous hair transplants. Hair transplantation differs from skin grafting in that grafts contain almost all of the epidermis and dermis surrounding the hair follicle, and many tiny grafts are transplanted rather than a single strip of skin. The use of both scalp flaps, in which a band of tissue with its original blood supply is shifted to the continue bald area, and free grafts dates back to the 19th century. Hair transplant surgery can now promote hair regrowth along the donor area. Both treatments have been observed to facilitate donor scar healing and follicle regeneration.
Cause of Baldness
The most common type of hair loss in both men and women is referred to as androgenic alopecia. The mechanism of androgenic alopecia is inherent in each individual hair follicle as it responds to external stimuli, essentially androgens. The progressive loss of hair is predetermined by genetic characteristics associated with these responsive scalp follicles.
Baldness typically refers to excessive hair loss from your scalp. The most common cause of hair loss is a hereditary condition called male-pattern baldness or female-pattern baldness. It usually occurs gradually with aging and in predictable patterns Anyone can experience hair loss, but it’s more common in men.
There are Remedies for thinning hair and baldness. Hair transplants are an effective, permanent solution for replacing hair. Male pattern of baldness is classified into 1-7 grades, grading on the basis intensity.
Hairs fall from the front and the vertex of the head. A variety of Hair transplant techniques exits today. Two of the more popular techniques Comprehends:
- Micro- minigrafting 2. Follicular Unit Transplantation
Mini grafting and micro grafting is an older form of strip surgery, which is where a “strip” of hair-bearing flesh is removed, dissected, then re-grafted onto the recipient scalp.
The resulting micro-grafts would contain one to two hairs (micro-grafts) but the amount of tissue left behind would be more than that found on properly dissected follicular units with the same hair counts. Mini-grafts, which are larger than micro-grafts, would contain as little as three or more hairs but many of these mini-grafts containing six to ten hairs.
Follicular Unit Transplantation
The follicular unit is a natural grouping of hairs on all mammals. A common misconception about hair growth is that all hairs grow out of the scalp separately.
The follicular unit was first mentioned in 1984 by Dr. John Headington’s paper, “Transverse Microscopic Anatomy of the Human Scalp”.
Follicular unit transplantation (FUT) is a hair restoration technique, also known as the strip procedure, where a patient’s hair is transplanted in naturally occurring groups of 1 to 4 hairs, called follicular units. Follicular units also contain sebaceous (oil) glands, nerves, a small muscle, and occasional fine vellus hairs. In follicular unit transplantation, these small units allow the surgeon to safely transplant thousands of grafts in a single session, which maximizes the cosmetic impact of the procedure.
FUT is considered an advance over older hair transplantation procedures that used larger grafts and often produced a pluggy, unnatural look. In a properly-performed follicular unit transplant, the results will mimic the way hair grows in nature and will be undetectable as a hair transplant.
Follicular unit transplantation uses follicular units to accomplish a number of objectives critical to the hair restoration process:
- Maximizing hair transplant growth
- Ensuring the naturalness of hair transplant
- Ease of surgical planning
- Minimizing trauma to the scalp
- Ability to perform large hair transplant sessions
Anesthesia used in hair transplantation is relatively simple. Most procedures can be performed with just local anesthesia, with use of nerve blocks in both the donor and recipient areas.
Transplant operations are performed on an outpatient basis, with mild sedation (optional) and injected local anesthesia.
We have a facility of Television in the Clinic, for the patient enjoying their preferred channels & can even move around, eat & drink listening music in duration of the surgery. 4 to 6 or more people work at the same time.
The duration cannot be ascribed in an exact timing but it can be intended in 6-8 hours for 3000-4000 hair transplantation.
In young patients the best approach is to graft the frontal and superior regions first and wait until their hair pattern is more mature before working on the occipital area. This is particularly important for patients with limited or fine donor’s hair, when there is a finite number of grafting procedures in the future. The amount of donor hair in the posterior scalp is a critical component in the assessment of these patients. It is useful to draw a specific pattern on the scalp to demonstrate as the patient is looking in a mirror where you think the most appropriate hairline pattern should be.
The procedure is begun with occipital nerve blocks in the donor area by use of lidocaine with epinephrine, followed by a tumescent solution that allows both adequate anesthesia and good hemostasis The supraorbital nerve, a branch of the frontal nerve,provides sensory innervation to the forehead. During graft a frontal–temporal recession, thus abnormally rounding off the frontal–temporal angle. Finally, large plug grafts were inserted, and the natural progression of hair loss posteriorly resulted in the patient wearing a hairpiece to cover his significant deformity.
Since hair naturally grows in groupings of 1 to 4 hairs, current techniques harvest and transplant hair “follicular units” in their natural groupings. Thus modern hair transplantation can achieve a natural appearance by mimicking original hair orientation. This hair transplant procedure is called follicular unit transplantation (FUT). Donor hair can be harvested in two different ways: strip harvesting, and follicular unit extraction (FUE).
Transplant operations are performed on an outpatient basis. For several days prior to surgery the patient refrains from using any medicines which might result in intraoperative bleeding and resultant poor grafting. Alcohol and smoking can contribute to poor graft survival. Postoperative antibiotics are commonly prescribed to prevent wound or graft infections.
Transplant operations are performed on an outpatient basis, with mild sedation and injected local anesthesia. The scalp is shampooed and then treated with an antibacterial agent prior to the donor scalp being harvested.
There are several different techniques for harvesting hair follicles, each with their own advantages and disadvantages. Regardless of the harvesting technique, proper extraction of the hair follicle is paramount to ensure the viability of the transplanted hair and avoid transection, the cutting of the hair shaft from the hair follicle. Hair follicles grow at a slight angle to the skin’s surface, so transplanted tissue must be removed at a corresponding angle.
There are two main ways in which donor grafts are extracted today: strip excision harvesting, and follicular unit extraction.
Strip harvesting is one of the most popular ways to use the donor hair follicles in the surgical procedure. Firstly, it’s the scalp area which is anesthetized; the scalpel method is generally used for the strip removal process.
Each incision is planned so that intact hair follicles are removed. The excised strip is about 1–1.5 x 15–30 cm in size. While closing the resulting wound, assistants begin to dissect individual follicular unit grafts, which are small, naturally formed groupings of hair follicles, from the strip. Working with binocular Stereo-microscopes, they carefully remove excess fibrous and fatty tissue while trying to avoid damage to the follicular cells that will be used for grafting. The latest method of closure is called ‘Trichophytic closure’ which results in much finer scars at the donor area.
Strip harvesting will leave a thin linear scar in the donor area, which is typically covered by a patient’s hair even at relatively short lengths. The recovery period is around 2 weeks and will require the stitches/staples to be removed by medical personnel or sub-cuticular suturing can be done.
Follicular unit extraction :
Follicular Unit Extraction or FUE harvesting, individual follicular units containing 1 to 4 hairs are removed under local anesthesia; this micro removal typically uses tiny punches of between 0.6mm and 1.0mm in diameter. The surgeon then uses very small micro blades or fine needles to puncture the sites for receiving the grafts, placing them in a predetermined density and pattern, and angling the wounds in a consistent fashion to promote a realistic hair pattern. The technicians generally do the final part of the procedure, inserting the individual grafts in place.
The survival of follicular units upon extraction from the scalp is one of the key variables of successful hair transplantation. If follicular units are transected in the extraction process, there is a greater likelihood that they will not survive the transplant, and the hair transplant will fail. While FUT procedures using strip-harvesting of follicular units typically guarantees a large number of non- transected follicular units, FUE procedures can, and often do, transect grafts, rendering them useless in a transplant.
Types of surgery
There are a number of applications for hair transplant surgery, including:
- Androgenetic alopecia
- Eyebrow transplant
- Frontal hair line lowering or reconstruction (naturally high hairlines without an existing hair loss condition)
Hair Transplant Results and Hair Transplant reviews are the two main consideration for all patients planning hair transplant. All the results shown are 100% authentic. The hair transplant surgeons are recommended in many of the international forums and platforms. FUE Results Vs FUT Results :
FUE Hair Transplant and FUT Hair Transplant : is the ways grafts are extracted from the donor area which is non endrogenic hormonal dependent. Where as the recipient is a dependent of the hormone. The outcome of results is equally good in both. The choice much depends on the total requirement and future need. As of today most patient demand FUE for even very large areas. So the need to depend on Body Hair Transplant. In fact body hair transplant results are very good but still first choice is scalp. The Doctor recommend patient everything enabling him to make the right choice.
The Patient get completely natural-looking hair after hair transplant! You can wash, style and take care of your new hair just the way you do for your natural hair.
The Patient could notice new hair in a month after surgery. Though in the first month, the newly transplanted hair keeps falling and growing but you can observe a significant growth in other 5-6 months.
For complete results, the patient should wait for almost 12 months as this is the period which makes your newly transplanted hair follicles grow and look well. Once your hairs have reached the desired stage, you can opt for an appropriate haircut.
Hair transplantation can also be used to restore eyelashes, eyebrows, beard hair, chest hair, groin hair and to fill in scars caused by accidents or surgery such as face-lifts and previous hair transplants.
Body hair transplant surgery can only be performed by the FUE harvesting method and, so, requires the skills of an experienced FUE surgeon. However, there are several factors for a potential BHT candidate to consider prior to surgery. These include understanding the natural difference in textural characteristics between body hair and scalp hair, growth rates, and having realistic expectations about the results of BHT surgery.
Advances in wound care allow for semi-permeable dressing, which allow seepage of blood and tissue fluid, to be applied and changed at least daily. The vulnerable recipient area must be shielded from the sun, and shampooing is started two days after the surgery. Some surgeons will have the patient shampoo the day after surgery. Shampooing is important to prevent scabs from forming around the hair shaft. Scabs adhere to the hair shaft and increase the risk of losing newly transplanted hair follicles during the first 7 to 10 days post-operation.
During the first ten days, some of the transplanted hairs, inevitably traumatized by their relocation, may fall out. This is referred to as “shock loss”. After two to three months new hair will begin to grow from the moved follicles. The patient’s hair will grow normally, and continue to thicken through the next six to nine months. Any subsequent hair loss is likely to be only from untreated areas. Some patients elect to use medications to retard such loss, while others plan a subsequent transplant procedure to deal with this eventuality.
Hair thinning, known as “shock loss”, is a common side effect that is usually temporary. Bald patches are also common, as fifty to a hundred hairs can be lost each day. Post-operative hiccups have also been seen in around 5% of transplant patients.