Hair Transplant Overview
Hair Transplant in India is becoming increasingly popular because Hair Transplant cost in India is very reasonable in comparison to other countries. It is Natural Hair Transplant as no Artificial Hair Transplant is possible.
There are two important points to keep in mind. One, the hair that is lost i.e. the roots are gone, will never grow back and second, no new hair can be implanted. What actually happens is a redistribution of the existing hair. We know that the hair at the back of the head is not affected by hair-loss and are the so-called ‘permanent hair zone’. All Hair Transplant techniques in one way or another harvest hair from this permanent zone and put them in areas of baldness.
The most common cause of permanent hair loss is Hereditary Androgenic Alopecia commonly called MALE PATTERN BALDNESS (MPB) among men. In MPB hair is lost at the front, sides and crown region (i.e. the top of the head). Women are usually affected with Female Pattern Baldness where there is diffuse hair loss throughout the front scalp region.
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Hair Transplant Baiscs
Currently, there are two techniques of harvesting the hair from the permanent zone. One, Follicular unit transplant (FUT or “strip” technique) and other is Follicular unit extraction (FUE or “punch” technique).
Strip / FUT technique
FUT / Strip technique is the most commonly performed technique in the world and is considered as the gold standard. A strip of scalp skin along with hair follicles is harvested from the permanent zone and the remaining gap is sutured using ‘trichophytic’ closure technique to result in a thin imperceptible scar. The scar line gets covered by rest of the hair at the back of the head and so it is not visible. This strip is dissected under magnification using microscope and loupes and numerous follicular units are obtained.
The harvested strip is thin so that the scalp can be closed easily with sutures. Along with the size of the strip, the variability of the hair density among different people determines the number of follicles that are actually obtained. Once this number is known the surgeon creates appropriately placed very tiny incisions in the bald area and implants these follicles one by one.
Punch / FUE technique
In FUE / Punch technique the hair is harvested using a punch either by hand or by a machine. The punch is a small hollow needle-like thing which cuts a small circle around the follicular unit. The surgeon then plucks out the hair along with its root. No suturing is required. This is mainly useful in patients of low-grade baldness who require a lesser number of grafts. Similarly, Once this number is known the surgeon creates appropriately placed very tiny incisions in the bald area and implants these follicles one by one
Strip vs FUE? Which one is better? Which one is for me?
Well, Both are equally good, both give good results in trained hands. But each is meant for a different purpose. In the strip technique once the strip has been harvested the team of assistants dissects the follicular units under magnification looking directly at each hair follicle and its root. So that the damage rate is very low (< 1%), the work is faster and there is very little wastage. But to do that more staff is required, additional infrastructure and costly microscopes are needed.
In FUE technique the surgeon can not see below the skin. A calculated guess is made about the direction of the hair as it exits the skin. The punch is driven in the same direction as the hair along the hair shaft. If there is even a slight error in this angle the hair gets cut. This results in higher damage rates, from 10% to 20%. A surgeon is a single person taking out hair follicles one by one, hence the process is slow.
In strip technique, at a time around 1cm wide strip is harvested and the remaining donor areas may be used in further sessions. Around 3-4 sessions can be performed in a person depending upon the requirement. Although a six months interval is required between each session. In FUE at least two follicular units have to be left in between the harvested sites, the complete donor area cannot be harvested, otherwise, the donor area will appear bald. So comparatively the yield in FUE is low and to obtain a sufficient number of grafts often the entire donor area is utilized in a single session. This makes future sessions very difficult if not impossible.
It has also been seen that in some cases due to partial injury to the follicle at the time of FUE punch harvest, which is not visible at that time, the injured implanted hair grow weak and thin and may fall off in a few years.
Both FUT and FUE produce scars, all the advertisements for scar-less surgery are false. Both are painless because both are performed under local anesthesia. In the strip technique, there is a single line-like scar at the back of the head. It may be 1 to 2 mm wide and is not appreciable even when someone runs a comb through the hair because the hair grows through the scar by the ‘Trichophytic’ closure technique. In FUE there are many-many small scar dots from the punch harvest. If a person keeps normal length hair that is 2-4 cm or long hair then both the scars are not visible. If a person shaves the head then both are visible. If someone wants to keep the hair very small (“buzz cut”) the visibility of FUE scar is much less than the visibility of a clearly defined line like scar running across the back of the head.
Often in people of dark-colored skin, there may be color changes in the FUE scars, so that they may be visible if the hair is kept too short.
Strip technique can only be used for harvesting the scalp hair. To harvest other body hair FUE technique is used. Other body region hair such as beard hair is used to increase the density by placing them in between transplanted scalp hair.
To summarize, the strip technique is relatively quicker, cheaper and gives much more hair follicles so anybody with moderate to severe baldness should pick strip technique. If the grade of baldness is low and the baldness is not increasing then FUE is equally good although strip is still the preferred choice because MPB may progress at any time and more hair grafts may be required in the future.
What are the benefits of Hair Transplant procedure ?
- It is permanent. The transplanted hair is taken from the permanent zone. So they never fall off. But the pre-existing hair that is in the transplanted region may or may not fall in the future.
- It gives absolutely natural results. Well, only hair can replace hair anything else looks unnatural from miles away.
- It Is a safe procedure with almost no risks.
- It may help you get back your confidence.
Who are the best candidates for a Hair Transplant procedure ?
All individuals from grade 1 to grade 7 baldness may benefit from a hair transplant procedure. There is no age limit for hair transplant although we refrain from performing it in young men and women below the age of 22yrs. An ideal candidate for a chemical peel is in good physical health, understands the procedure, and has realistic expectations of the outcome.
How is Hair Transplant procedure performed ?
Before the procedure, you are asked to come to the Hair Transplant clinic in the morning after having your breakfast. You should scrub/shampoo your hair the night before and in the morning before coming to the clinic.
Hair transplant surgery is performed under local anesthesia and you will remain awake throughout the procedure. There is no pain. It usually takes 6-8 hours to perform the entire surgery. During this period you will be fully awake and have multiple breaks for snacks and lunch. You may enjoy soothing music and television.
While the Hair is being harvested from the backside of the head you have to lie face side down on the special hair transplant chair. Afterward, the surgeon makes a pattern of tiny holes in the bald areas and the surgical assistant’s transplant one hair follicle at a time in these small gaps. During this period you have to lie comfortably on your back. The surgery is over once all the grafts have been placed. A light dressing is applied at the donor site and the transplanted site is left open. Once the surgery is complete you are allowed to go home.
There is usually no pain or discomfort in the grafted area. There may be some tightness in the donor region for the first 2 to 3 days. Any pain is treated with pain medication.
When will I see the results ?
Normal hair has a growth cycle of three phases. During the first phase they grow for 3 to 7 years it is called Anagen phase, during the second phase they gradually thin out and fall this is the Catagen phase and lasts for around 3 weeks. After that, They go into a resting or sleeping phase which is called the Telogen phase and lasts for 3 months and then the cycle is repeated.
After surgery, the transplanted hair go into Telogen or sleeping phase. The small grafts are shed by the 3rd week but the roots remain inside. These roots start growing from the third month onwards and grow at a rate of around 1 cm per month. The final result is appreciable after the hair achieves sufficient length that is after 7 to 9 months.
How many Hair do i need for a natural looking result ?
What are the risks and safety considerations ?
Like all surgeries where incisions are placed hair transplant surgery also has risks associated like wound healing problems, suture dehiscence, chronic pain, altered sensation in the surgery areas. Please read the Informed Consent document thoroughly and completely before agreeing to a hair transplant procedure.
What are the After-Procedure instructions and precautions ?
- It is important to read and follow the After procedure instructions given to you at time of the hair transplant procedure.
- You will have to sleep upright with two pillows under the head for a few days.
- Normally small crusts are formed at the graft site. You will be asked to come to the clinic on the 3rd day for shampoo and cleansing of the grafted site for the first time. After that, you may do it daily yourself.
- Sutures that are placed during the strip harvest are removed after the 10th day of surgery. If non-absorbing sutures are placed they will require removal and for that, you may have to visit the clinic or you may get them removed by any surgeon nearby. If self-absorbing sutures have been placed they will dissolve by around two weeks. Still, it is a good idea to visit the surgeon at least once after 10 days to access the health of the suture line.
Scalp hair-loss is also called Alopecia which may be temporary or permanent. Temporary hair loss is easily treated with proper nourishment. But permanent hair loss requires early therapy to prevent roots from …