Hair transplantation is a surgical technique that removes hair follicles from one part of the scalp, called the 'donor site’, and transplants them to a bald or balding part of the scalp known as the 'recipient site'. Hair transplant technique is primarily used to treat male pattern baldness (Androgenetic alopecia).
At Cosmo Derm clinic Faridabad this minimally invasive procedure is done under local Anaesthesia, the grafts containing hair follicles that are genetically resistant to balding i.e. from the back of the head are transplanted to the recipient area. Hair transplantation can also be used to restore eyelashes, eyebrows, beard hair, chest hair, and to fill in scars caused by accidents or previous surgery.
Pre –operative assessment
At the best clinic for hair transplant in Faridabad, Delhi NCR, India during the initial consultation our hair restoration experts , would analyzes the patient's scalp, discusses their preferences and expectations from the transplant procedure ,design the hair line and advises them on the best approach and what results might reasonably be expected. Pre-operative Folliscopy is also done to know the actual existing density of hair, and to accurately assess the results in the post operative period.
There are 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 of utmost importance for ensuring the viability of the transplanted hair and avoids transaction, the cutting of the hair shaft from the hair follicle. The most important point to remember during the hair extraction is that hair follicles grow at a slight angle to the scalp's surface, so the follicular unit must be extracted at the corresponding angle.
At the Cosmo Derm Clinic we take all the necessary precautions and follow the best techniques to achieve the best results for our patients.
1. FUT (Strip) Technique – This is the classical technique for follicular hair unit extraction. In this a strip of approximately 1-1.5 x 15-30 cm in size is harvested from the donor area. We use the latest method of closure called 'Trichophytic closure' for very fine scars at the donor area. The extracted follicular units are dissected under “stereo microscope” .These are then implanted in the recipient area using fine needles. The recovery period is around 2 weeks and will require the stitches/staples to be removed by medical personnel. This technique gives a very fine scar that can be easily covered by the patient’s hair. The disadvantages of this technique are
- As there is cutting and suturing involved so the post operative pain, inflammation and indurations is expected.
- A visit to the clinic at about 15 days post transplantation procedure is required for suture removal.
- The procedure leaves a very fine scar which is permanent and is visible only if the scalp is shaved off completely otherwise the scar is well hidden under the hair.
2. FUE (Follicular Unit Extraction) Technique - With Follicular Unit Extraction or FUE harvesting, individual follicular units containing 1 to 4 hairs are removed under local anesthesia; this removal uses tiny punches of between 0.6mm and 1.0mm in diameter. The follicular units are then implanted in the recipient area angling the wounds in a consistent fashion to promote a realistic hair pattern.The FUE procedure is more time consuming as compared to FUT (strip) surgery. An FUE surgery time varies according to the surgeon’s expertise, competency of the team and patient scalp and root characteristics. The advantages of FUE technique are –
- There is no need for large areas of scalp tissue to be harvested, so there is no linear incision on the back of the head and therefore no linear scar. Because individual follicles are removed, only small, Punctate scars remain which are not visible.
- The post-surgical pain and discomfort is minimal.
- The patient does not have to re visit the clinic after 2 weeks for as no suture removal is required
- Recovery from FUE using micro grafting is much faster.
The disadvantages of FUE technique include -
- Increased surgical time as the individual follicular units are extracted
- Higher cost to the patient because of the equipments used during extraction.
- It is technically challenging as there is a learning curve to acquire the skills necessary so as to decrease the root damage to a minimum during extraction.
Robotic hair transplant
Robotic hair restoration devices utilize cameras and robotic arms to assist the surgeon with the FUE procedure. In 2009, NeoGraft became the first FDA approved robotic surgical device for hair restoration. The ARTAS was FDA approved in 2011 .The robotic hair transplant procedure is costly due to the high costs associated with the devices.
Body hair transplant
Conventional, hair transplantation utilizes harvesting of follicles from safe donor area of the scalp and transplantation of these follicles in to the balding areas on the scalp. There is a limited supply of follicles that can be harvested from the safe donor area zone; approximately up to 6000 hair follicles. This is inadequate to provide appropriate coverage, in advanced grades VI and VII of Norwood scale in Androgenetic alopecia. In such cases, hair follicles from other parts of body inclusive of beard, chest, arms, and legs in hirsute individuals can be utilized as source of additional donor supply.
Body hair characteristics such as thickness, length, and hair cycle may not completely match to that of the scalp hair. The techniques of harvesting body hairs are more time consuming, requiring higher degree of skill than regular scalp FUE. Body hair transplantation can be successfully used either alone or in combination with scalp hair in advanced grades of baldness, for improving the cosmetic appearance of hairlines and in scarring alopecia when there is paucity of donor scalp hair.
Post operative care
After the procedure a dressing is applied which is removed 24-48 hrs later? The recipient area must be shielded from the sun, direct injury or any other trauma. Shampooing is started two days after the surgery. Shampooing is important to prevent scabs from forming around the hair shaft.
During the first ten to fourteen days, some of the transplanted hairs, traumatized by their relocation, may fall out. This is referred to as "shock loss" but this is only temporary. New hair will begin to grow from the moved follicles by the third month. The patient's hair will grow normally, and continue to thicken through the next six to nine months. It is recommended that the patient continues with the medical therapy.