Which Types of Hair Transplant is Best For You

Men start experiencing hair loss and baldness by the age of 30 years. Hair loss is distressing for both men and women with increasing cases as age advances. With technology advancement, hair restoration techniques have gained much popularity in recent years. Due to effectiveness, safety, reliability, natural appearance and increasing success rates of hair

 techniques, those fighting hair loss are preferring hair transplant as permanent solution to their problem.

Important points of discussion while planning hair transplant

·   Cause of hair loss: Hair loss is common in both males and females and is visible.

·   Age: Hair loss is common with aging. If hair loss is severe in someone younger than 25 years then the treatment plan is based on underlying cause and realistic expectations.

·   Donor Hair Density: Those with good hair density are good candidates for hair transplant like Patients greater than 80 FUs per squared cm are regarded as excellent candidates of hair loss while having hair density less than 40 FUs per squared cm are poor candidates for hair transplant.

·   Skin conditions like vitiligo and pemphigus are contraindications of hair transplant.

·   History of medications: Some medications may affect hair growth and increases risk of bleeding after hair transplant. Such medications must be stopped before hair transplant.

·   History of stress and anxiety. These patients may have low satisfaction and have unrealistic expectations.

·   Analysis of Baldness pattern and hairline pattern.

·   Expectation of the patient from the hair transplant surgeon

Armamentarium of Hair Transplant

The armamentarium of hair transplant includes anesthesia, ergonomic chair, magnification/microscopes, topical antiseptics, retractors, FUE punch devices, graft preservation solution, cotton-tip applicators, Suture, Non-adhesive dressing, antibiotic ointment and petroleum jelly.

The team performing hair transplant consists of hair transplant surgeon, hair technicians and nurse.

Different types of Hair Transplant

There are two types of hair transplant, namely,

·   FUE or follicular unit extraction

·   FUT or follicular unit transplantation

FUE Hair Transplant:

The indications of FUE hair transplant includes patients preference, limited hair loss, conditions like androgenetic alopecia in Norwood class 3 pattern, athletes who want to resume activities soon after the hair transplant procedure, beard as donor area and many more case specific indications.

However, some of the major contraindications of FUE hair transplant includes unrealistic patient expectations, donor supply inadequate, uncooperative patients and case specific factors.

FUE hair transplant is the most preferred hair restoration technique because it needs less manpower, procedure is non-traumatic and safe, scars are invisible, graft preparation is minimal. These are major advantages from surgeon’s perspective.

Concerning patients perspective, the technique is safe, quick recovery times, requires less appointment, less restrictions on follow-up, no risk of infection, no stiches, excellent natural-looking results, more grafts are harvestable and less scarring.

Donor Site Harvesting in FUE Hair Transplant

Patient is positioned in prone position as it allows easy harvesting and site is shave to 2 mm. This makes surgeon visualize the follicle angle. Anesthesia is given. In manual FUE hair transplant, sharp punch is used for hair follicle collection. These are stored in chilled sterile saline followed by recipient site implantation.

The recipient sites are created in a random and irregular pattern under magnification using either flat-edged blades or a combination of needles followed by graft insertion using light pressure application with wet cotton-tip applicator to promote hemostasis (prevent bleeding).

Hair in frontal scalp hairline points anteriorly at an angle of 15 to 20 degrees, while those in temporal region are oriented inferiorly.

Recent advances in FUE Hair Transplant

Follicular isolation technique, automated FUE hair transplantation and robotics are the recent advances in FUE hair transplant technique.

In Automated FUE hair transplantation technique, it allows faster rate of extraction of hair follicles.

Robotic hair transplant has highest precision and enhanced productivity and efficiency. Their major limitations include cost.      

FUT Hair Transplant:

Donor Site Harvesting in FUT hair transplant

The patient is positioned in prone position and hair is trimmed to 2 mm.The calculated strip length is marked followed by anesthesia.

A beveled incision is made parallel to the exiting follicles, into but not beyond the subcutaneous tissue (about 4 to 5 mm in depth). The donor strips are collected and prepared by removing excess subcutaneous tissue.

To prevent damage to the follicle, care is taken to leave 2 mm of fat beneath the FUT.

This step is followed by strip dissection under magnification into vertical segments one FUT thick. These are isolated and placed immediately into a holding medium of chilled saline. The donor strip is then closed using sutures/ staples per surgeon preference.

Instructions given after hair transplant

·   Pain killers are prescribed.

·   While sleeping, head should be elevated for a week.

·   Avoid vigorous exercise for 2 weeks.

·   Ointments may be prescribed.

·   Avoid scratching.

·   Follow up after 7 days.

Contraindications of hair transplant

Some of the specific contraindications of hair transplant includes:

·   History of mental illness.

·   Unrealistic expectations

·   Severe hair loss       

·   Scalp inflammation           

·   Unexplained scarring

Conclusion

Hair transplant is a safe procedure. One may experience slight discomfort like pain, edema but these are manageable with medications prescribed and regular follow-ups.

It is normal to loose implanted hairs normally after few days. Visible results are observed in 6 to 12 months.