Hair Transplantation Surgical & Variour Methods

Hair transplantation is a surgical technique that removes hair follicles from one part of the body, called the 'donor site', to a bald or balding part of the body known as the 'recipient site'. The technique is primarily used to treat male pattern baldness. In this minimally invasive procedure, grafts containing hair follicles that are genetically resistant to balding (like the back of the head) are transplanted to the bald scalp. Hair transplantation can also be used to restore eyelashes, eyebrows, beard hair, chest hair, pubic hair and to fill in scars caused by accidents or 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 groupings of 1 to 4 hairs, current techniques harvest and transplant hair "follicular units" in their natural groupings. Thus modern hair transplantation can achieve a natural appearance by mimicking original hair orientation. This hair transplant procedure is called follicular unit transplantation (FUT). Donor hair can be harvested in two different ways: strip harvesting, and follicular unit extraction (FUE).

Procedure

Pre-operative assessment and planning

At an initial consultation, the surgeon analyzes the patient's scalp, discusses their preferences and expectations, and advises them on the best approach (e.g. single vs. multiple sessions) and what results might reasonably be expected. Pre-operative folliscopy will help to know the actual existing density of hair, so that postoperative results of newly transplanted hair grafts can be accurately assessed. Some patients may benefit with preoperative topical minoxidil application and vitamins.^[1]
For several days prior to surgery the patient refrains from using any medicines which might result in intraoperative bleeding and resultant poor grafting. Alcohol and smoking can contribute to poor graft survival. Post operative antibiotics are commonly prescribed to prevent wound or graft infections.^[2]

Harvesting methods

Transplant operations are performed on an outpatient basis, with mild sedation (optional) and injected local anesthesia. The scalp is shampooed and then treated with an antibacterial agent prior to the donor scalp being harvested.
There are several 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 paramount to ensure the viability of the transplanted hair and avoid transection, the cutting of the hair shaft from the hair follicle. Hair follicles grow at a slight angle to the skin's surface, so transplanted tissue must be removed at a corresponding angle.
There are two main ways in which donor grafts are extracted today: strip excision harvesting, and follicular unit extraction.

Strip harvesting

Strip harvesting is the most common technique for removing hair and follicles from a donor site. The surgeon harvests a strip of skin from the posterior scalp, in an area of good hair growth. A single-, double-, or triple-bladed scalpel is used to remove strips of hair-bearing tissue from the donor site. Each incision is planned so that intact hair follicles are removed. 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, which are small, naturally formed groupings of hair follicles, 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' which results in much finer scars at 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 technicians generally do the final part of the procedure, inserting the individual grafts in place.
Strip harvesting will leave a thin linear scar in the donor area, which is typically covered by a patient's hair even at relatively short lengths. The recovery period is around 2 weeks and will require the stitches/staples to be removed by medical personnel or sub cuticular suturing can be done.

Follicular unit extraction (FUE)

With Follicular Unit Extraction or FUE harvesting, individual follicular units containing 1 to 4 hairs are removed under local anesthesia; this micro removal typically uses tiny punches of between 0.6mm and 1.0mm in diameter. 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 technicians generally do the final part of the procedure, inserting the individual grafts in place.
FUE takes place in a single long session or multiple small sessions. The FUE procedure is more time consuming than strip surgery. An FUE surgery time varies according to the surgeons experience, speed in harvesting and patient characteristics. The procedue can take anywhere from a couple hours to extract 200 grafts for a scar correction to a surgery over two consecutive days for a megasession of 2,500 to 3,000 grafts.^[3] With the FUE Hair Transplant procedure there are restrictions on patient candidacy.^[4] Clients are selected for FUE based on a fox test,^[5] though there is some debate about the usefulness of this in screening clients for FUE.
FUE can give very natural results. The advantage over strip harvesting is that FUE harvesting negates the need for large areas of scalp tissue to be harvested, so there is no linear incision on the back of the head and it doesn't leave a linear scar. Because individual follicles are removed, only small, punctate scars remain which are virtually not visible and any post-surgical pain and discomfort is minimized. As no suture removal is required, recovery from Micro Grafting FUE is less than 7 days.
Disadvantages include increased surgical times and higher cost to the patient.^[6] It is challenging for new surgeons because the procedure is physically demanding and the learning curve to acquire the skills necessary is lengthy and tough.^[7] Some surgeons note that FUE can lead to a lower ratio of successfully transplanted follicles as compared to strip harvesting.

Follicular unit transplant

Follicular unit transplant (FUT) is the traditional hair transplant method which involves extracting a linear strip of hair bearing skin from the back or the side of the scalp. The strip is then dissected to separate individual grafts.

Robotic hair restoration

Robotic hair restoration devices utilize cameras and robotic arms to assist the surgeon with the FUE procedure. In 2009, NeoGraft became the first robotic surgical device FDA approved for hair restoration.^[8] The ARTAS System was FDA approved in 2011 for use in harvesting follicular units from brown-haired and black-haired men.^[9] Despite the advantages of robotic hair restoration systems, there are still some disadvantages such as the size of the punches being relatively large in comparison to what is used in other methods of FUE, and the high costs associated with the devices.^[10]

Types of surgery

There are a number of applications for hair transplant surgery, including:

• Androgenetic alopecia
• Eyebrow transplant
• Frontal hair line lowering or reconstruction (naturally high hairlines without an existing hair loss condition)

If donor hair numbers from the back of the head are insufficient, it is possible to perform body hair transplantation (BHT) on appropriate candidates who have available donor hair on the chest, back, shoulders, torso and/or legs. Body hair transplant surgery can only be performed by the FUE harvesting method and, so, requires the skills of an experienced FUE surgeon. However, there are several factors for a potential BHT candidate to consider prior to surgery. These include understanding the natural difference in textural characteristics between body hair and scalp hair, growth rates, and having realistic expectations about the results of BHT surgery.

Post-operative care

Advances in wound care allow for semi-permeable dressing, 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 the patient shampoo the day after surgery. Shampooing is important to prevent scabs from forming 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, some of the transplanted hairs, inevitably traumatized by their relocation, may fall out. This is referred to as "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. 


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What is Bio-FUE hair transplant?

Bio FUE is nothing but just a new name for FUC method. Actually, it is a biotechnology of Follicular Unit Extraction or FUE hair transplantation. Rather, it is really an advantageous method for grafting also for the donor area.

It is done in the same manner as the FUE technique is done. As we know that in the best fue hair transplant the grafts are extracted from the part that is unaffected by hair loss. Then those grafts are then transferred to the recipient area. Now from here, Bio part differs. During, Bio FUE hair transplant, when the extracted follicular grafts are transplanted, so along with that a special growth serum as well injected into the scalp which allows to strengthen the follicles and additionally it ensure that they will grow healthy and strong.

The Bio FUE hair transplant includes three steps in it that are as follows:

Step 1:
Firstly, the cells that are regenerative taken from your blood and infused into the FUE donor site to heal rapidly. Moreover, they help in the growth of transected hairs.

Step 2:
Next, all the follicular units are immersed into the growth serum that has rich culture medium to reduce the death of a cell. It also helps in raising the way of transplanted follicular units.

Step 3:
Finally the last step, the enriched cells injected into the transplanted area to increase the quick healing feature, fast growth of the transplanted hair and accordingly it advanced the quality and density of your natural hairs.
 So, the Bio FUE hair transplant is same as an FUE hair transplant, but the difference is simply that in Bio FUE a growth serum is injected with the individual grafts. This will help your hair to look natural and grow faster with a good quality, additionally, it improves the density of your other follicular units. On the contrary, this is a part of the best fue hair transplant, you can go for it once if you are suffering from hair loss. 


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How Hair Transplant Can Transform Your Life

Hair loss is more common that people think. It affects thousands of people, both women and men alike. Hereditary hair loss is the most common cause, but it’s not the only cause, as hair loss can also occur from a number of other factors as well. If you suffer from hair loss and have been considering the possibility of a hair transplant, then check out our top four ways a hair transplant can transform your life.

1. Have a natural appearance
Thanks to the essence of time, hair transplant London procedures have vastly improved since the 80s when the procedure was known as ‘plugs’ which left patients with an unnatural appearance – not anymore. Nowadays, no one will ever be able to guess you’ve had a hair transplant. They’ll only focus on your beautiful features, and hair!

2. Feel more confident
When you feel unattractive, your confidence can take a hit. You begin to avoid social situations and activities with friends and meeting new people. You may even find yourself ignoring hobbies you once loved. A loss of confidence can also affect your job performance. A hair transplant can help lessen these issues by making you feel good, look good and give you a confidence boost, maybe even to levels you never thought possible!

3. Lasting results
Thankfully, a hair transplant yields permanent results. The hair follicles used from the so-called donor site are known to be resistant to genetic factors, which basically means that in the event of a genetic disorder, such as male pattern baldness, the hair in that area won’t fall out. Great news for you!

4. Style your hair
Thin hair or no hair at all can seriously limit your styling options. Both men and women find that a full head of hair means you have more choice when it comes to styling your hair. You can grow your hair long, tie it up or do whatever you want. You can even style for different events. Whether you’re going out for a jog, on a date or headed to work, you’ll be able to style your hair accordingly and really make a great impression.
If you’re ready for a hair replacement, visit the Chiswick Hair Clinic in London to see how we can help with your hair transplant and transform your life!
 

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Eyebrow Transplant: Recovery, Before and After

What is an eyebrow transplant?

Many patients are interested in transplants as a way to reinvigorate the growth of eyebrow hair that has been significantly altered after years of plucking.
Although originally intended to restore eyebrow growth in patients who had lost hair resulting from genetics or as a side effect of chemotherapy, transplants have recently picked up steam in both medical and cosmetic applications.
The entire eyebrow transplant procedure — from initial consultation to full recovery — takes about a year. The procedure itself is typically completed within three to four hours.

Eyebrow transplant before and after pictures

How does it work?

For your initial consultation, bring in a photograph to show your doctor exactly how you would like your new eyebrows to look. Taking into consideration fullness, symmetry and the natural shape of your existing brows.
Your doctor will then typically use a surgical marker to draw in the eyebrows to provide you with a better idea of what they’ll ultimately look like. Some doctors might even have software to help you visualize the result beforehand.
On the day of treatment, your doctor will administer local anesthesia so that you only feel minimal pain. During the procedure, they will use your own hair follicles (typically taken from an inconspicuous area – like the back of the scalp) in order to harvest individual follicular grafts, which are then meticulously placed, one-by-one, onto the eyebrow area.
While grafting hair follicles from the scalp, your doctor may use saline injections to expand the skin in order to to facilitate follicle removal. Depending on what your doctor recommends, one of two traditional hair transplant procedures will be used: either Follicular Unit Extraction (FUE) or Follicular Unit Transplant (FUT).

What is the recovery like?

Post-procedure, patients should experience a relatively simple healing process, with doctors often comparing the recovery time to that of getting a tattoo. You may experience some mild superficial bruising and/or crusting on the skin surrounding your eyebrows, but most patients report feeling completely normal just three days after their surgery.
Because the eyebrow transplant procedure is non-invasive — generally requiring only local anesthesia — you will be able to drive yourself home and return to your normal activities within a day or two.
Doctors warn that some bruising is normal and caution against touching the eyebrows for at least 24 hours following the transplant. In addition, you’ll be told not to get your eyebrows wet and may be asked to limit your use of makeup for several days.
Although recovery is pretty quick when compared to more in-depth hair transplant procedures, it still takes approximately four months for new eyebrow hair to grow, with maximum growth reaching its peak in roughly one year’s time. This is because the hair strands placed in your new eyebrows are meant to fall out in order to encourage new growth via the transplanted hair follicles.

Before it can do this, however, your hair needs to go through its regular growing-and-shedding cycle. You may want to invest in a pair of trimming shears, as the eyebrow hair will likely grow more quickly than you’d expect.
Sorce: zwivel

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The complete guide to hair transplants & Hair transplant frequently asked questions

air transplant surgery is on the rise – but what does the procedure actually involve, what are the risks, and are there alternatives? Here, we explain everything you need to know...

Hair transplant surgery

Techniques have become so advanced in recent years that FUE and FUT hair transplants can reverse female - or male -pattern baldness to the point where no one will know that you were ever losing your hair.
Breaking down the embarrassment-factor, a number of public figures have also spoken about having had hair transplant procedures. Footballer Wayne Rooney, actor James Nesbitt and reality TV star Calum Best have all gone on the record about it; while others, such as chef Gordon Ramsay, actor Rob Brydon and tennis player Rafa Nadal are all rumoured to have had transplants.
That said, it's not a decision to rush into: the cost is not insignificant and the effect will be dependent on who carries out the operation. So you need to know the different types of procedure and what questions to ask a hair transplant surgeon before making your decision.
But first, we need to understand what causes hair loss.

What causes male-pattern hair loss

Around one in three men experiences male-pattern baldness to varying degrees by the age of 30. Hair grows from follicles below the surface of the skin and a single hair will normally last between three and five years before it’s shed, and a new hair grows from that follicle. This cycle continues throughout life.

Male pattern baldness occurs when a modified form of testosterone, Dihydrotestosterone (DHT), begins to attack the hair follicles. This results in the follicles miniaturising and producing thinner and shorter hairs. As your thicker hairs fall out and are replaced by these weaker ones, you start to thin out on top.

Whether you go through this process depends on your genes. If they are coded to resist DHT, you’ll keep your hair. If they are coded to be susceptible, you’re in trouble. The follicles on the back and sides are usually coded to fend off Dihydrotestosterone, which is why it’s common for men to keep their hair there. The genes for hair loss can come from either parent.
Male-pattern hair loss is progressive, so if you start losing your hair happens at an early age, the overall effect is likely to be a very bald pate.

What causes female hair loss?

Hair loss among women is more common than you might think. It can be caused by a number of factors, including, like male-pattern hair loss, hormonal change. Specifically, these are male hormones (androgens) so the hair loss can happen any time from adolescence onwards, but is most likely to occur post-menopause when female hormones decrease and male hormones increase. As in male-pattern baldness, testosterone is converted to DHT and this results in the follicles producing smaller hairs.

Types of hair transplant surgery

There are two main types of hair transplant procedure, Follicular Unit Extraction(FUE) and Follicular Unit Transplantation (FUT), which work in a similar way. Because the hair follicles on the side and back of the head are more resistant to DHT, and therefore usually keep producing strong and healthy hairs when the follicles on top of the head are shrinking; those healthy follicles are taken from the back and sides and transplanted into the balding areas of the scalp.

FUE hair transplant

FUE transplants are the gold standard procedure. Single follicles are removed from the donor area of the scalp with a specialised cutting tool. These individual follicles are then inserted into tiny cuts made into the recipient site where they bed down. The skilled surgeon ensures that the recipient cuts are angle to reproduce the natural direction of your normal hair. The follicles then grow strong and healthy hairs in the previously bald patch.

FUT hair transplant

With FUT surgery, instead of taking individual follicles from the donor site on the scalp, your hair transplant surgeon cuts away a strip of them. This strip is then divided up into single follicles or small groups which are inserted as with the FUE procedure into the recipient area. Hence it's sometimes referred to as "strip harvesting".

Hair transplant frequently asked questions

Does a hair transplant hurt?

You will have a local anaesthetic so the operation will be painless. You might have some discomfort during the healing process. Because FUT strip harvesting is more invasive, there’s likely to be a bit more than with the FUE procedure. Afterwards, any pain should be treatable with standard painkillers.

Will a hair transplant leave a scar?

FUE surgery shouldn’t leave a scar, so if you want to keep your hair short then it’s probably the better option. FUT surgery is likely to leave a scar on the donor site, although it can probably be hidden under medium-length hair .

How long does a hair transplant procedure take?

It depends on the scale of the operation ie how many individual follicles you are having transplanted, but normally about eight hours. FUE transplant recovery is fairly quick because there are no stitches. An FUT transplant will normally take around a month for a full recovery, during which time there is likely to be a little more discomfort than with FUE surgery. Your scalp might be quite red for a few weeks, so if you don’t want anyone to know, book a holiday.

How much does a hair transplant cost?

Follicular Unit Extraction surgery will cost anywhere from £5,000 to £12,000 depending on the scale of the operation. Follicular Unit Transplantation costs less because the surgeon can harvest a donor hair strip of follicles at once, cutting down the work. Expect to pay £5,000 to £8,000 for FUT.

How long before I see the results of my hair restoration?

The first results will be visible after about four months. The full effect of a hair transplant operation should be apparent at the one-year mark. It’s possible that the transplanted follicles will themselves eventually begin to shrink and produce smaller hairs, in which case another transplant procedure is an option.

How many procedures will it take?

Quite possibly one, but perhaps a few transplant procedures will be necessary for good coverage on the recipient sites.

How successful is a hair transplant?

With the normal caveat that everyone is different, most people who undergo FUE and FUT hair transplants are happy with the outcome. The success will largely depend on how many good follicles you have left, how big a recipient area you want to cover, and the skill of the hair transplant surgeon - which underlines how important it is to do your research on hair transplant clinics and getting their predictions for the outcome.

Is a hair transplant permanent?

Because the transplanted hairs will behave just as they would have done if they had stayed in the donor area, a transplant isn't guaranteed to last forever. But it will probably last a very long time.

Who is a suitable candidate for a hair transplant?

To state the obvious, you need to have some hair left to transplant. The more you have available, the better the resulting coverage. But you might be surprised how few healthy follicles you need for a reasonable effect. Anyone with Diffused Unpatterned Alopecia, which leads to hair falling out, is unlikely to be suitable.

How do I choose a hair transplant surgeon/clinic?

Personal recommendation is very useful. Also make sure you see before and after shots of their work. Speak to one of their past patients if you can. And ask how many hair transplant operations they have performed. Start with the  International Alliance of Hair Restoration Surgeons. Take your time to research and choose.

I've heard of Turkish hair transplant clinics. What about going overseas?

There are numerous overseas clinics offer hair loss surgery, especially in India, Thailand and Turkey. They’re cheap, but you’re far less likely to know much about your surgeon’s background and if the procedure turns out badly, you’re going to have a bigger job getting them to put it right.

What are hair plugs?

Those awful 1980s hair plugs that made men look like they had doll-like ropes of hair? They don't exist any more. You can, if you have some, have them removed and replaced with FUE and FUT surgery.

Can women have a hair transplant?

Yes, although fewer will be suitable candidates than among men because the pattern of hair loss tends to be more widespread, meaning fewer good donor sites.

What are the risks of hair transplant surgery? Are there side-effects?

FUT and FUE transplants are generally very safe, but as with any surgical procedure, complications are possible. There may be swelling, bruising or bleeding; the existing hairs in the recipient area can die due to the shock of the procedure (they will normally return, but not always); small cysts can form, though these usually soon disappear or can be treated quite easily.

Can a hair transplant fail?

Yes, it’s possible for your body to reject the new follicles so the transplant fails. It's rare, though.
 Souce: Telegraph

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What is a Body Hair Transplant (BHT)?

A body hair transplant (BHT) is a procedure that transplants hair from the chest, back, legs, arms, or other sources to a balding area of the scalp using follicular unit extraction (FUE) techniques and tools. A secondary and less common type of BHT is transplanting hair from the scalp to areas of the body such as the beard, eyebrows and even the chest to augment the lack of hair in these areas. This is a very rare procedure so for the rest of this description we will focus on the transplantation of body hair to the scalp.

Body Hair and Dihydrotestosterone (DHT)

Dihydrotestosterone (DHT) is a male sex hormone that causes genetic baldness by residing in the scalp’s tissues in concentrations that are large enough to prevent hair growth by cutting off the follicle from its nourishing blood supply. Body hair is less susceptible to DHT than scalp hair (with the exception of a horseshoe-shaped strip of hair on the back of the scalp known as the “donor zone”). Therefore, a BHT often provides new donor hairs that are impervious to DHT’s harmful effects.

When are Body Hair Transplants Commonly Used?

Clinics will sometimes use BHTs in combination with more common hair transplant methods (such as a follicular unit extraction (FUE) or a follicular unit strip surgery (FUSS) to increase the overall density of the new hair. In other words, combining a BHT with an FUE or FUT can possibly increase the appearance of thickness within the hair due to the additional number of hairs available for transplantation above and beyond what is found in the traditional scalp donor zone.

A 2013 study listed by NCBI however, notes that it should be saved as a method of last resort in cases where no donor hair from the occipital portion of the scalp is available. With this suggestion in mind, a body hair transplant may be a possible solution if the patient is going through diffuse unpattern alopecia (DUPA), which is when the hairs on the donor zone also succumb to DHT, and are no longer viable candidates for a transplantation.

Will Body Hair Grow the same Length as the Rest of My Scalp Hair?

The same 2013 study notes that body hair will “grow longer when transplanted to a scalp” as a result of “recipient influence”. Recipient influence is when the transplanted hair adopts similar characteristics as the new area it was transplanted to. In this case, transplanting body hair increases the potential length of the hair, which suggests that the anagen (growth) phase of the body hair has  also increased to allow the hair to grow in a similar fashion as the rest of the hair on the scalp. On a similar note, the time period for the catagen (shedding) phase of the transplanted hair has also likely lessened.

Reasons why Body Hair Transplants are not more popular

BHTs are not commonly used because not all patients have a sufficient amount of body hair to make a cosmetic improvement, the hairs themselves are smaller and more difficult to extract, the hairs typically are found in 1-2 hair follicular units (meaning that they do usually provide a high-density hair coverage). Anesthesia is not always effective (which means the procedure is painful), and the procedure is relatively new compared to other methods.

Body Hair Transplant Evidence

BHT is an under-researched method of hair restoration, and evidence from clinical trials is lacking. The 2013 study notes a 63-year-old male who experienced such a degree of success with his BHT that he had to change his passport photo to match his new appearance. The study followed him for over two-and-a-half years and noted his satisfaction with the procedure.

Source: Body Hair Transplant Mentor

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