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Hair transplant

Ecto Derma Polyclinic - Dental - Medical - Laser  Educational and Research Center

1085. Budapest, József krt.37.  Hungary  Tel.: +36 1 3178175 ; +36 1 2350024
Fax.: +36 1 2350025  Email:  titkarsag@ectoderma.hu recepcios@ectoderma.hu

postheadericon Hair Transplantation

  • Hair transplant
  • Hair grower treatment (woman, man) 
  • On the spot/at the clinic 
  • At home

Basics

nutriol1Hair transplantation is a 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). It is primarily used to treat male pattern baldness, whereby grafts containing hair follicles that are genetically resistant to balding are transplanted to bald scalp. However, it is also used to restore eye lashes, eye brows, beard hair, and to fill in scars caused by accidents and 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.

Since hair naturally grows in follicles that contain groupings of 1 to 4 hairs, today's most advanced techniques transplant these naturally occurring 1 - 4 hair "follicular units" in their natural groupings. Thus modern hair transplantation can achieve a natural appearance by mimicking nature hair for hair. This recent hair transplant procedure is called "Follicular Unit Transplantation."

For men, baldness can be taken as a sign of old age, unattractiveness, and infertility. Although none of these signs may be true, clinical studies have shown that hair loss is a cause of low self-esteem and low self-confidence in men. About 70% of men and 50% of women experience some degree of hair loss in their lifetime. Causes of hair loss come from several factors, but mostly from these three - genes, hormones, and age.

In the past, men have gone to desperate measures in trying to cover up their hair loss. Hair restoration has vastly improved in recent years. Among the several options used for hair restoration now, hair transplantation is emerging as the most effective treatment for baldness.

On average, a person sheds and regrows about 50 - 100 hairs a day. A mix of emotional turmoil, medication, poor nutrition, and illness may cause excessive daily shedding. However, these factors are often temporary, and hair growth should continue once these factors have ended. Around 70% of American men and 50% of American woman will experience some sort of hair loss during their lifetime. Researchers have shown that around 80% of bald men are preoccupied about their hair loss, and men who begin to lose their hair in their early twenties are more likely to suffer from extremely low self-esteem. Permanent hair loss comes from hair follicles that become thinner and weaker. Male patterned baldness is scientifically called Androgenetic Alopecia, which is caused by genes, hormones, and age.

Hair transplantation is a minor outpatient surgery that simply relocates existing hair follicles from the donor site to the balding area. The procedure first begins with the surgeon removing a donor strip from the donor site, which is often located on the back or side of the scalp. During the procedure, local anesthesia is administered to relieve any discomfort. Our doctor will remove a strip of skin from the donor area and close the opening with self-absorbable sutures. The donor strip is further cut into 3 sizes of grafts - the micro graft, the single follicular unit, and the modified follicular unit. The single hair follicular unit has 1 hair; single follicular unit has about 2 hairs; and the modified follicular unit has 2 to 4 hairs. The surgical technicians then isolate individual hair follicles from the donor strip, and implant them to the graft region. The grafts are inserted into pre-cut micro and mini slits that are strategically designed to aesthetically improve the density of your existing hair, lower the hairline, and fill in balding areas.

Hair transplantation has a high success rate as long as you have enough donor hair. This procedure does not have any long term or major side effects. Taking the medication that we provide after the procedure can prevent possible complications such as infection and swelling.notriol2

The procedure generally takes about 3 to 5 hours depending on the number of grafts. There will be a fine scar on the donor area that you can easily cover up with the surrounding hair. Patients usually feel little or no pain, and can return to work the very next day. There is no additional care needed on the transplanted hair; just treat it like your ordinary hair, because it is your own hair! The transplanted hair will start to grow in 3 to 6 months, and will have the same strength, color, texture, length, and life span as your hair from your donor area.

Within 6 months of the procedure, the transplanted hair can be groomed and combed in any fashion you like. By doing a hair transplant now, you can replace your hair as it begins to thin and bald.

Procedure

At an initial consultation, the surgeon analyzes the patient's scalp, discusses his preferences and expectations, and advises him/her on the best approach (e.g.,single vs. multiple sessions) and what results might reasonably be expected.

For several days prior to surgery the patient refrains from using any medicines, or alcohol, which might result in intraoperative bleeding and resultant poor "take" of the grafts. Pre-operative antibiotics are commonly prescribed to prevent wound or graft infections.

Surgery

Transplant operations are performed on an outpatient basis, with mild sedation and injected topical anesthesia, and typically last about four hours. The scalp is shampooed and then treated with an antibacterial chemical prior to the donor scalp being harvested.

p_18_2In the usual follicular unit procedure, the surgeon harvests a strip of skin from the posterior scalp, in an area of good hair growth. 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 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' because of which much finer scars can be expected in the donor area.

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 assistants generally do the final part of the procedure, inserting the individual grafts in place.

Post-operative care

Advances in wound care allow for semi-permeable dressings, 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 you shampoo the day after surgery. Shampooing is important to prevent scabs from occurring 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-op.

During the first ten days, virtually all of the transplanted hairs, inevitably traumatized by their relocation, will fall out ("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.

Modern techniques

There are two main ways in which donor grafts are extracted today. These are the Strip Harvesting Technique and the Follicular Unit Extraction (FUE) Technique.

The Strip Harvesting Technique involves removing a strip containing a large group of follicular units from the donor area - almost always from the back and sides of the scalp. The strip is then divided into grafts (or follicular units) containing 1 to 4 follicles.

The Follicular Unit Extraction (FUE) Technique involves removing one follicular unit at a time directly from the donor area - usually the back and sides, but also sometimes from the chest, legs or face (beard hair) - using a small punch usually of between 0.5 mm and 1 mm in diameter.

Side effects

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.

Other side effects include swelling of areas such as the scalp and forehead. If this becomes uncomfortable, medication may ease the swelling. Additionally, the patient must be careful if his scalp starts itching, as scratching will make it worse and cause scabs to form. A moisturizer or massage shampoo may be used in order to relieve the itching.

Several years after the surgery, more hair loss can occur, with the transplanted patches staying in place. This results in odd patches of hair, unless they are removed, or unless more hair is transplanted.

History

The use of both scalp flaps, in which a band of tissue with its original blood supply is shifted to the bald area, and free grafts dates back to the 19th century. Modern transplant techniques began in Japan in the 1930s, where surgeons used small grafts, and even "follicular unit grafts" to replace damaged areas of eyebrows or lashes. They did not attempt to treat baldness per se. Their efforts did not receive worldwide attention at the time, and the traumas of World War II kept their advances isolated for another two decades.

The modern era of hair transplantation in the western world was ushered in the late 1950s, when New York dermatologist Norman Orentreich began to experiment with free donor grafts to balding areas in patients with male pattern baldness. Previously it had been thought that transplanted hair would thrive no more than the original hair at the "recipient" site. Dr. Orentreich demonstrated that such grafts were "donor dominant," as the new hairs grew and lasted just as they would have at their original home. Today Dr. Orentreich's practice still performs hair transplants.

For the next twenty years, surgeons worked on transplanting smaller grafts, but results were only minimally successful, with 2-4 mm "plugs" leading to a doll's head-like appearance. In the 1980s, Uebel in Brazil popularized using large numbers of small grafts, while in the United States Rassman began using thousands of "micrografts" in a single session.

In the late 1980s, Limmer introduced the use of the stereo-microscope to dissect a single donor strip into small micrografts. In 1995, Bernstein and Rassman published the first paper on "Follicular Unit Transplantation," where hair is transplanted exclusively in naturally occurring groups of 1-4 hairs. With microscopic dissection of donor pieces from an excised portion of scalp, individual follicular units containing but 1-4 hairs could be prepared and individually relocated into needle punctures in the recipient areas. Since the transplanted hair mimics the way hair grows in nature, close to natural results were attainable.

The follicular unit hair transplant procedure has continued to evolve, becoming more refined and minimally invasive as the size of the graft incisions have become smaller. These smaller and less invasive incisions enable surgeons to place a larger number of follicular unit grafts into a given area. With the new "gold standard" of ultra refined follicular unit hair transplantation, over 50 grafts can be placed per square centimeter, when appropriate for the patient.

Surgeons have also devoted more attention to the angle and orientation of the transplanted grafts. The adoption of the "lateral slit" technique in the early 2000s, enabled hair transplant surgeons to orient 2 to 4 hair follicular unit grafts so that they splay out across the scalp's surface. This enabled the transplanted hair to lie better on the scalp and provide better coverage to the bald areas. One disadvantage however, is that lateral incisions also tend to disrupt the scalp's vascularity more than sagitals. Thus sagital incisions transect less hairs and blood vessels assuming the cutting instruments are of the same size. One of the big advantages of sagitals is that they do a much better job of sliding in and around existing hairs to avoid follicle transection. This certainly makes a strong case for physicians who do not require shaving of the recipient area. The lateral incisions bisect existing hairs perpendicular (horizontal) like a T while sagital incisions run parallel (vertical) along side and in between existing hairs. The use of perpendicular (lateral/coronal) slits verses parallel (sagital) slits however, has been heavily debated on patient based hair transplant communities. Many elite hair transplant surgeons typically adopt a combination of both methods depending on what is best for the patient.

From wikipedia

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