Hair Transplantation Part I: An Overview of Surgery
What is Male pattern Baldness or MPB?
In male pattern baldness thick hair in androgen sensitive scalp are turned into small thin hair. This is called miniaturization. Frontal hairs are lost earlier than hair on back of scalp.
Classification of MPB
Hamilton-Norwood system of classification The Hamilton-Norwood system of classification of MPB has been the standard of classification since 1941. It ranges from Type I being the normal mature hair line. It pictures minimal temporal recession to Type VII patients have extensive hair loss with only a wreath of hair remaining in the back and sides of the scalp.
Diffuse Patterned and Unpatterned Alopecia
Two other types of genetic hair loss in men not often considered by doctors, “Diffuse Patterned Alopecia” and “Diffuse Unpatterned Alopecia,” pose a significant challenge both in diagnosis and in The progression of male hair loss in Diffuse Patterned Alopecia (DPA) and Diffuse Unpatterned Alopecia (DUPA).
What are treatments for Baldness?
- Medical treatment
- Surgical treatments
- Follicular unit transplant
- Scalp Reduction /
- Expansion surgeries
- Flap surgeries
What is Medical treatment & Mesotherapy?
The Standard cocktail of topical minoxidil, antioxidants & finestride is advised before & after hair transplantation for varying length of time. Scalp Mesotherapy is advised before & after transplantation to induce growth of hair roots.For those who are not a candidate for hair transplantation, are maintained on medical therapy and Mesotherapy.
What is Hair transplantation?
Hair transplantation is the surgical technique that involves moving skin containing hair follicles from one part of the body (the donor site) to bald or balding parts (the recipient site). Usually occipital scalp is the donor area, from which hair follicle units are transplanted to frontal area.
What are options in hair transplants?
- Punch grafts (10-20 Hair / Graft)-outdated)
- Mini grafts (3 to 5 Hairs / Graft)
- Micro grafts (1 to 2 Hairs / Graft)
- Single hair graft (1 hair)
- Follicular unit transplant (FUT)
- Follicular unit extraction (FUE)
Skincity is specialized in Follicular Unit Hair Transplant (FUT) and Follicular Unit Extraction (FUE) which is the best available method to give most natural look.
What is follicular hair transplant? (FUT)
Most of the hair follicles in scalp are naturally grouped together in units of 1, 2 or 3 hair, called follicular units. Transplantation of follicular units gives most natural look after surgery.
It is done in following steps:
- Harvesting the donor hair graft from back of the scalp.
- Separation of the follicular units containing 1, 2 or 3 hair.
- Recipient sites is created in bald area by slits by a needle.
- Placement of the grafts in the recipient area.
- Closure of the donor site on back of the scalp by suture that is not at all visible in hair.
After 3 to 4 months transplanted hair begin to grow and continue to grow a half inch per month for rest of your life.
Who are candidates for hair transplant?
- Any male/female in good health.
- Adult above 18 years.
- Stabilized hair loss.
- Medical treatment tried without success.
- No active scalp infection.
- Adequate hair available on back & side of scalp.
- No smoking, no alcohol two weeks before surgery.
- No diabetes/hypertension.
- Reasonable expectation.
During consultation at Doctor will discuss in detail about your hair loss pattern, extent of baldness, available donor area, plan of hairline, number of grafts required etc.
a) Hemogram blood sugar level.
b) Bleeding time, clotting time.
c) Routine Urine analysis.
d) Additional tests if required.
Precautions before Hair Transplant Surgery?
- Maintain an adequate length of hair on the back of your head as grafts will be removed from here.
- Two weeks before surgery No finestride, minoxidil, aspirin or anti-inflammatory medications containing aspirin, vitamin E.
- One day before surgery No alcohol / tobacco.
On surgery day:
- Wash your hair in the morning using your regular shampoo. Have a light breakfast two hour prior to your procedure. Wear loose & comfortable Cloths, no gold ornaments, no deodorant & Perfume. You should also bring a scarf along with you. Have someone to take you home after surgery. You should not drive any vehicle after Surgery.
How many sessions of surgery will I need?
A single megasession is usually enough to satisfy most of patient needs. Those with extensive baldness may require 2 -3 sessions. Correct evaluation &
estimation is possible after personal consultation.
How long it will take to cover bald areas after transplant?
3 to 4 months to start showing regrowth. It takes 9 to 10 months to show full growth.
How Hair line is designed?
Following are the principles of hair line design.
1. Consider Family pattern of alopecia. Assume that patient will reach worst stage of his family pattern in coming few years and design the hairline accordingly.
2. Consider upgrading the patient look from Hamilton grade VII to V rather than upgrading from VII to I.
3. Encourage patient to have thick frontal forelock and deep frontal triangles. Coverage of vertex is not encouraged in advanced alopecia.
The shape of the hairline should be designed in such a way as to match a patient’s head and facial features. For instance, a wider head should have a hairline that matches the wider arc of the frontal scalp. Conversely, a narrower head should be designed with some suppression (concavity) of the outer limit of the hairline. In addition, calculating the number of hairs that must be dedicated to the central scalp, the hairline, and the temple may also influence the possible design of a hairline. All of these considerations must be weighed when contemplating the perfect hairline shape for a particular individual.