Hair Transplantation

What is a Hair Transplant ?

Hair transplant is surgical procedure wherein hair roots are harvested (removed) from the back and/or, sides of the head (in some cases from beard and chest also) and planted in the required area (bald area).

Sides and back of the head are considered a permanent zone that means hairs in these areas are permanent and remain intact life long. Transplanted hairs maintain all qualities of the donor area ( from where hairs were removed), including color, texture, thickness, and life of hair also. So, transplanted hairs are also permanent.

Hair transplantation

The best donor area of hair roots for hair transplant is head (back and sides), followed by beard and chest in that order of preference.
Indications of hair transplant:

  • Androgenic alopecia (male and female pattern baldness).
  • Alopecia due to scar, burn.
  • To increase the density of hairs in beard, eyebrow, mustache or to redesign these areas.


Body hair transplant

When hair roots are harvested from any part of the body other than scalp (head) example - chest, beard, back, limbs, abdomen and pubic area and transplanted to the bald area of the head, it is known as body to head hair transplant. These hairs are not the first choice but selected when a patient has advanced baldness and hairs in the donor area of scalp and beard are not sufficient to cover the bald area. Growth rate and thickness are less in body hairs as compared to scalp hairs. Hairs from the body should be harvested with FUE technique and not with FUT because the later will leave a significant visible scar at the donor site


Treatment of excessive Hairfall

Medical treatment is prescribed to prevent hair fall. Treatment of hair fall that is not because of any disease or deficiency but due to androgenic alopecia or male or female pattern hair baldness is described here. Prior to start medical treatment, one must consult a doctor.

  • Minoxidil - is a vasodilator. Available in the form of lotion in 3 strengths 2%, 5%, and 10%. Applied locally over the scalp, 1 ml twice daily. it increases the blood supply of scalp and so nutrition to falling hairs.
  • Finasteride - it is 5alfa reductase inhibitor. That is required for conversion of testosterone to dihydrotestosterone, an active component of testosterone. DHT (dihydrotestosterone) acts on receptors present in the root of falling hairs and damages these roots. The usual dose is 1mg per day.
  • PRP (Platelet Rich Plasma) - it is prepared from the patient's own blood. 20-60 ml of patient's blood is taken to prepare 3-10ml of PRP. with the help of centrifuge machine PRP is separated from blood and separated PRP is injected in the part of the scalp with excessive hair loss. PRP acts by releasing multiple growth hormones in the injected part of the scalp.

It is clear with the above description that all 3 medical options have a different mechanism of action. So when prescribed to use all 3 simultaneously, maximum benefit is achieved.


Techniques of Hair Transplant

    There are two techniques of hair transplant

  • FUE or DHI (follicular unit extraction or direct hair implant)
  • FUT or Strip technique
FUE and FUT Technique

FUE

FUE is a hair transplantation method which involves taking the individual hair follicular grafts from the back of the head. Follicular grafts are cut one by one through a small specialised machine and are removed. This process is tedious and takes a few hours to complete.

Hair grafts may also be harvested from beard and chest. Procedure is done under local anesthesia. It leaves very small scars, less than a mm. So stitching is not required. Recovery is fast in this method.

Advantages

  • Stitching not required
  • Scars not visible
  • Faster recovery
  • Less painful
  • Suitable for beard/body to head hair transplant
  • Disadvantages

  • Require to shave the head
  • Not suitable in ladies if a large number of hair grafts required (head shave required)
  • Decreases density of hairs in the donor area.

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    FUT

    FUT is the oldest hair transplant technique in which a thin strip of skin is removed from the back of the head surgically. The hair follicles are then divided into individual units. The donor area is then stitched together.

    FUT technique leaves a noticeable scar on the donor area. Hair follicles are implanted by creating reception incisions or holes in the treatment area and placing hair follicles with forceps. Stitches are removed after 10 days.

    Advantages

  • Density in the donor area remains the same.
  • Suitable if the patient is not willing for head shave

  • Disadvantages

  • Require stitches
  • Recovery takes more time
  • Sometimes scar is significant
  • Assess Yourself - Your baldness type and requirewd number of hair grafts

    One can roughly know the required number of follicular units (with type or stage of alopecia in Norwood classification) to get good results with hair transplant.

    • For Type 1 baldness roughly 1000 follicular units are required.
    • For Type 2 baldness, 2200 follicular units are required.
    • For Type 3 baldness, 3300 follicular units are required.
    • For Type 4 baldness, 4400 follicular units are required.
    • For Type 5 baldness, 5500 follicular units are required.
    • For Type 6 baldness, 6600 follicular units are required.
    • For Type 7 baldness, roughly 7700-8000 follicular units are required to get good results.

    Hair Transplantation

    The Ludwig scale

    The Ludwig scale has three primary classifications that display thinning hair, diffuse hair loss, as well as frontal hairline recession. Each image in the scale display a woman’s head with her hair parted down the middle. As an example, images I-1 through I-4 show the progression as a woman goes from no hair loss to increasingly thinning hair as indicated by a widening part. Further along in the scale, the hair loss becomes increasingly drastic. As compared to male hair loss, FPHL is not as wildly expected or accepted in society. Thus, women affected by androgenetic alopecia can experience emotional and psychological distress over their condition. Unlike men, women cannot shave their heads. This scale helps to normalize the condition and provide a point from which to discuss treatment with professionals in the field of hair restoration, dermatology, and other medical professions.

    Hair Transplantation

    Why should you select Bisoniya hospital for hair transplant ?

    Before selecting a hospital for hair transplant you should know

    • Qualification of surgeon - Medical Council of India allows only two specialities to do hair transplant, Plastic surgeons and Dermatologists. Plastic surgeons are familiar with microsurgery and so they are more comfortable with hair transplant also.
    • Who is doing hair transplant - Important steps must be done by surgeon him/herself. For eg. - insertion of local anaesthesia, making recipient site (slits), harvesting follicular units. Surgeon can take the help of assistants in transplanting harvested hair roots (FU) in already made slits (recipient sites).
    • The facilities at centre - hair transplant is an operation and should be done in a well equipped operation theatre only, not at the clinic. Hospital must be equipped to deal with any emergency, if any arise.
    • Surgeon and Assistants should be well trained and experienced.
    • At Bisoniya Hospital, safety of the patients is the no. 1 priority.
    • All the important steps done by Dr. Bisoniya himself.
    • Surgeon and Assistants have vast experience of hair transplant.
    • Treatment is cost effective.

    FUE Treatment

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    May I help you?

    1. What precautions should be taken before operation?

    Smoking should be stopped at least 10days before operation. Do shampoo with betadine scrub night before and on the morning of operation. Have a full breakfast.


    2. Is Hair Transplant painful?

    Hair transplant is done under local anaesthesia. There is slight pain of needle prick, while giving local anaesthesia. Once anaesthesia is given there is no pain.


    3. Is Hair transplant done at a stretch without breaks?

    No, patient can take as many breaks as he/she wants. For eg. going to the toilet, taking meals/snacks, can watch movies or listen to music during operation.


    4. How long it takes to do Hair Transplant?

    It takes about 6 to 9 hours to do 2500 to 4000 follicular units transplant with FUE technique (including all breaks during operation).


    5. Is there significant pain after effect of anaesthesia is over?

    No, there is slight heaviness in head and in some cases slight pain (especially on the 1st night after operation) that is controlled with tablets.


    6. What precautions should be taken after operation?

    • Transplanted area should be irrigated with normal saline (pour normal saline over transplanted hair) every 2 hourly between 6am to 11pm for at least 3days after hair transplant.
    • Avoid shower/head wash for 2 to 3 days after operation.
    • Avoid exposure to dust (can wear a cap to prevent it).
    • Can take shower 3 days after hair transplant but avoid shampoo/scrub for 10 days.
    • Avoid strenuous exercise for 3 weeks after operation.
    • After hair transplant, rest is not required. Patient can resume his/her office work from next day of operation.

    7. How much time it takes to get good hair growth?

    Usually hair growth starts 2 to 3 months after transplanting hair roots (follicular units). Then every month 10% new hair appears. By 6 months hair growth is appreciable and 60-70% hairs are visible. Maximum results are achieved by 10-11 months after operation.


    8. Are transplanted hairs permanent?

    Yes , transplanted hairs remain for life (as long as hairs are present in the donor area i.e., back and sides of head).


    9. Is hair transplant very costly?

    No, at Bisoniya hHospital it is very cost effective. Rs 25/FU or Rs 12/ hair + GST. May further consider for non affording/needy patients.

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