Something about hair transplant

Microfollicular Hair Transplants - A surgical solution to Baldness

Hair restoration has become one of the most popular techniques in male plastic surgery. The use of punch grafts was reported by Orentreich in the 1950s. However punch grafts were associated with a lot of unsatisfactory results because of the poor aesthetic results with the punches, which gave a " corn in a field" appearance. A new era began in 1986, when Dr Carlos Uebel in the state of Rio Grande do Sul (Brazil) started the use of micro- and minigraft "megasessions." It is considered a safe procedure which, allied to a natural hairline, is today a much valued option for surgeons and patients.

Unfortunately in India, we were late to embrace the technique of Microfollicular Hair Transplant. A number of Plastic Surgeonin India felt that Hair Transplant was a procedure not worthy of their interest; this led to a large number of unsatisfactory procedures by professionals of other medical specialities, and a bad image of Hair transplant in the mind of the Indian public. However we must remember that revisions to correct the poor results of previous surgery are possible.

Male pattern baldness (MPB) can start at the age of 16 years, caused by a coincidence of three main factors: hereditary, androgenic hormone and age. In today's times, stress in the forms of smoking, late night jobs, long hours of work, irregular sleep cycles are contributing to the increased incidence in young men and women. Women are not immune from baldness, and indeed hair transplant is very successful in them also. In female patients hair fall appears more in the menopause period, but we also see androgenetic female baldness and thinning at earlier ages.

What is the Microfollicular Hair Transplant technique
In this technique, a strip of hair bearing skin is taken from the back of the head (which is relatively unaffected by the male hormones which are responsible for hair loss). This strip is then processed in a way that single hair bearing units are taken out. These are known as micro-grafts. These micro-grafts are required to make the anterior hair line. Further 2-3 hair bearing units are isolated. Each such unit is known as mini-graft. This procedure can take 5-6 hours. When sufficient numbers of grafts are isolated, they are then implanted one by one into the area of baldness. The stick and place procedure is performed with a microsurgical blade, while the follicular unit insertion is done at the same time. This procedure can take 3-4 hours. Usually these two procedures run side by side, so the whole process can be expected to last 4-6 hours. Usually for the front of the head about 1000 hair follicle units are required. For a complete coverage, about 3000 units may be required. It is preferable to make a second replacement after 8 months, when we can implant another quantity of grafts with success. Hair is like a plant - we need to keep a distance of 2-3 mm between each graft to enable each one to grow with better vitality. In the frontal hairline we insert only single hair irregularly. To achieve a greater density, repeat sessions may be required.

The entire procedure is done under local anesthesia using a mixture of agents which are fast acting as well as have a prolonged duration of action. This allows a comfortable procedure, even while the patient is awake, and actively participates in the planning of the hair line. We have had patients driving back themselves to their homes after the procedure, of course with an attendant.

Hairline Design
In young patients it is important to project the definitive frontal hairline.The frontal hairline is projected irregularly, maintaining the temporal recesses, and a non-straight line is important to achieve a natural and non-detectable result. The forehead middle point is normally 8 cm distant from the root of the nose varying from 7 to 9 cm depending on the facial structure.

Results
The tiny hair that is transplanted in the graft normally falls out within the first few weeks. This is normal. The hair will then grow normally from the hair root and will be noticeable by approximately 3 months and carry on growing as fast and as long as your normal hair, usually about 1cm a month. Some crusting will occur around the grafts. These must not be scratched as the grafts may be pulled out. These crusts will quickly dissolve once hair wetting is started. The grafted area of scalp will appear slightly pinker than usual for a few days but this soon passes. please note - the above views are that of the author, and this article cannot be used for referance or for medico-legal purposes.