GBH American Hospital, Udaipur

         

Hair Transplantation                                                        

What is Hair Transplantation ?
Advantages of Hair Transplant by FUE
Patient Selection for Hair Transplant
Planning of Hair transplant surgery
Process of Surgery of FUE Hair Transplant
After the surgery
Team
FAQ's

What is Hair Transplantation ?

FOLLICULAR UNIT TRANSPLANTATION
Grow ten years younger today

Preface : The field of hair restoration has had a chequered history, from the days of punch grafting to the present day techniques of follicular unit hair transplantation, the field has seen a number of new advances.
History Speaks - Milestones in Follicular Unit Transplantation : Hair loss due to disease, scarring and in particular androgenetic alopecia, seems to have troubled members of the human race since the dawn of history.
Modern cosmetic hair transplant surgery dates from the work of New York Dermatologist Norman Orentreich in the early 1950s. By 1970, the technique known as "punch grafting" was being performed by small numbers of dedicated practitioners in many countries of the world. Orentreich's 4.0 mm punch graft method remained the basic procedure until 1975, although some surgeons used smaller grafts at times.
Hair Restoration Techniques : From the 1960s into the mid 1990s, transplanted hair appeared unnatural because surgeons used unnaturally large appearing hair grafts consisting of 10-25 hairs each. That era is over. Hair naturally grows in 1-4 hair follicular groupings/units.
Follicular Unit Transplantation is the redistribution of naturally occurring follicular groupings from the posterior scalp (donor region) into the region of thinning hair in the mid frontal scalp (recipient sites). The groupings are removed from the donor area by an elliptical excision and are carefully dissected using appropriate lighting and magnification. The donor tissue is separated into follicular units, which are then re-implanted into recipient sites created by some specific slit making instruments. Follicular unit transplantation is also used to correct unnatural-appearing plug like transplants, repair eyebrows, and redistribute hair in persons with inactive scarring alopecias.
             Key factors to consider in candidate selection include:
                           Donor density in the posterior scalp,
                           Caliber of hair,
                           Extent and rate of hair loss, and realistic expectations.                                          
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Extent & rate of hair loss
             In an era in which male and female pattern hair loss can be halted with minoxidil and/or finasteride (for men), transplantation should be performed in patients who have enough space between thinning existing hair.
            The net perceived density of a hair transplant is equal to the number of hairfollicles transplanted minus ongoing hair loss. All patients must understand that ongoing hair loss will affect the perceived density ofthe transplant.
Follicular Unit Extraction
           
Follicular Unit Extraction (FUE) is a method of obtaining donor hair for Follicular Unit Transplantation (FUT), where individual follicular units are harvested directly from the donor area. A ).85 mm punch is used to make a small circular incision in the skin around the upper part of the follicular unit, which is then extracted directly from the scalp. Because FUE does not leave a linear scar, it may be appropriate for patients who want to wear their hair very short. The procedure is also useful for those who have healed poorly from traditional strip harvesting or who have a very tight scalp.

Advantages of Hair Transplant by FUE

  • Stitchless

  • Less pain

  • No numbness at the site of hair donor

  • Less bleeding

  • No scar
     

Patient Selection for Hair Transplant

  • Age: 23 yrs. or older

  • Inadequate response to medication

  • Significant hair loss

  • Other causes of hair loss have been ruled out

  • No medical contraindication to surgery

  • Reasonable patient expectations                                                                                          Top
     

Planning of Hair transplant surgery

Once you decide to undergo hair transplantation from us, we will fix an appropriate date which is convenient to you. You will be required to undergo some routine blood tests. A file folder containing your medical records, pre-op instructions, basic facts about the procedure of Hair Transplant, post-op instructions will be made.

           On the day of Hair Transplant surgery, please have a head bath and a heavy breakfast.
Once you arrive at our clinic, we will click the pictures of you bald as well as the donor area. Then we trim and prepare the donor area from the back of the head for transplant it to the bald place (or place of implant like moustache, eyebrow ,beard).

 

Process of Surgery of FUE Hair Transplant


We make the patient lie down in prone position on the operating table. We then take utmost care to give local anesthesia with minimal discomfort in the donor area.

The grafts are then extracted from the donor area with the help of 0.8 and 1 mm special micropunches ( in case of FUE ) or a full skin thickness strip is taken up till the depth of hair follicles ( in case of strip method ) . The extraction of follicles is done under magnification. In the strip method a further dissection of the strip is done under the microscope up to the level of hair follicles. The extracted grafts are then preserved in cool Ringer Lactate solution. Each follicle may be consisting of 1,2,3,4 or rarely even 5 hairs.

The position of the patient is changed to supine position. He can watch a movie or TV depending on his choice. Then the recipient (bald) site is then prepared by giving local anesthesia. The slits are made with the help of special blades of 0.8-1.5 mm in size and the extracted hair follicles are then implanted into this area.

Implantation of the hair follicles is the most skilful and crucial step in FUE. We discuss in detail again the hairline creation as it is the most creative work in this whole procedure and utmost care is taken to ensure a natural look in this area after hair will grow. The hair follicles containing single hair are implanted in the front to give a natural hairline and subsequently followed by units containing 2-3 hairs to give density to the area.

During the procedure we give a tea as well as a lunch break so the patient should not feel tired during the surgery. Infact during the surgery, the patient keeps on chatting and discussing about himself or herself that we become “friends” with them.

After the hair surgery procedure is done, the patient is again shown the transplanted area and a simple dressing in the donor area and front on forehead is given to prevent any swelling.

The transplanted area is covered with a loose cap. The patient is discharged to go on his own. He can go to the market, watch a movie or just do anything he wishes to do!            
                                          

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After the surgery


You are required to spray normal saline in the implanted area hourly for first 5 days after the surgery to prevent drying of the graft area.
It is recommended that the patient (if he is in-station) should turn up the next day for review of the donor area, cleaning of the area and fresh bandage if required. The dressing on the forehead is usually removed. If he cannot turn up, he can remove the bandage on his own also.
Small crusts start appearing in the donor area. There is nothing to worry about as the scabs start falling and the hair start growing in the donor area again .
Swelling may appear on the forehead within 24 hours after surgery. If it does come, then it may increase for about the 3 days, come around the eyes and cheeks and may take about 4 to 5 days to settle down. This is totally physiological, there is nothing to worry about it as it occurs because of the gravity and settles on its own without any further medication.
You can clean your hair with a mild shampoo 3 days after the implantation without rubbing them and then alternate days till tenth day and after that you can wash the area normally. For in station patients we only demonstrate the way how to take the head bath as utmost care must be taken for not touching the grafts while doing that.
There might be some redness in the implanted area in the post-op period but this is again part of the natural healing phase.
Avoid direct exposure to sunlight for about 3 weeks.

Avoid the following strenuous activities for 3 weeks like Body building, soccer, swimming, running etc.



Team


Dr Prashant Agrawal
Dr Prashant Agrawal is The Consultant Dermatologist , Cosmetologist and Hair Transplant Surgeon at GBH American Hospital for past five years. He has a vast experience treating the patients having complaints regarding their hair fall and baldness. He has got the training in Hair transplant from world’s most renowned Hair Transplant centre at Israel. He is one of the pioneers in Rajasthan in FUE technique. He also owns the Fellowship of reputed American Acadamy of Dermatology (USA).                                                       

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Dr Guru Bhushan
Dr Guru Bhushan is the Consultant Plastic and Cosmetic surgeon at GBH American hospital and needs no introduction in the field of plastic surgery. He has been a well known figure in the filed for past ten years and has worked in many reputed institutions and hospitals like Safderjang hospital, Delhi. He has attended many national and international conferences and seminars on aesthetic surgery including Hair Transplant.

Dr Priya Agrawal
Dr Priya Agrawal is the Consultant Dental surgeon at GBH American hospital. Apart from doing cosmetic and aesthetic Dental surgeries, she has a huge experience in Follicular Unit Extraction and expertise herself in implantation.

 

FAQ's

Q. What is hair transplant?
A.
Hair Transplant is the only permanent method of hair restoration in which one’s own hair from the back and sides of the head are extracted and implanted on front in the bald area.

Q. Who can undergo hair transplant?
A.
i) Age of the patient should be 23 yrs or older.
ii) Inadequate response to medications.
iii) Significant hair loss.
iv) Other causes of Hair Loss have been ruled out.
v) No medical contraindications to surgery.
vi) Reasonable patient expectations.

Q. Can females undergo hair transplant?
A.
Yes                                                                                                                                      
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Q. What are the techniques of hair transplant?
A.
Nowadays,Hair Transplant is being done by Follicular unit technique which involves two ways of hair extraction – STRIP method and FOLLICULAR UNIT EXTRACTION ( FUE).
In the STRIP method,a strip of skin from the back of head (donor area) is removed with the help of scalpel. The gap at the back of head is then sutured together. The strip is then divided into grafts containing one ,two or three follicles.

FUE – Follicular Unit Extraction: A stitchless method of hair restoration in which hair root (follicles) are extracted from the back of head under local anaesthesia with the help of special micropunches and implanted in the bald area. In this procedure, no scalpel is required which is used for cutting skin in the ‘strip’ surgery. The entire procedure is done by the surgeons and not by technicians.

Q. What is the difference between FUE and Strip method?
A.
Both are methods of hair extraction where in one case whole strip of hair bearing skin is removed and defect sutured back whereas in FUE individual follicles are extracted.

Q. In which cases is FUE better than STRIP Technique?
A.
FUE can be done in all cases.
It is most useful for people who keep small hair or shave their head or have tendency of hypertrophic scars because they will not have any visible scars (As they are only Microscopic).
This is the only method by which adequate cover can be given for NH Gr VI-VII as the hair can be extracted from the head as well as the body in multiple sittings.
In the strip technique, the number of hair are limited as only those hair which are removed in the strip can be used for transplant.
It is also the preferred technique for eyebrow or moustache transplant or in patients having tight skin.
It is ideal for revision cases i.e. those who have already undergone surgery by strip method.
Multiple sittings can be given on consecutive days or later on to give “add-on” hair.

Q. What is the difference between hair and follicular units?
A.
Hair grows naturally in follicular units of one, two or three groups which if extracted together grow in a very natural way.                                                                                                                       
                                                                                                                                             
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Q. Does it hurt?
A.
Hair transplant is done under local anaesthesia all over the world which is administered with very fine insulin syringes which hurt minimally. Also we administer nerve blocks which cut down the number of pricks considerably and lead to prolonged anaesthesia.

Q. What is the time gap between individual sittings?
A.
Individual sittings of FUE can be planned according to the time available. They can be done even on consecutive days or few days or a week apart whereas in the strip , you have to wait for 6-12 months.

Q. What is the difference in the post-op precautions of both techniques?
A.
In STRIP method, sutures are put at the back of head, so special precautions like sleeping in a particular position, refraining from exercise, avoiding strenuous work etc. are required till the stitches are out.
In FUE, the patient walks out of the clinic ,rests for a while and is free to follow daily routine from next day. Even the bandage at the back of head is out the next day. As there are no sutures there is minimal pain post operatively.

Q. Is there any difference in the no. of follicles extracted by these methods?
A.
Yes, the number of follicles extracted in STRIP method is definitely more in one sitting as compared to one sitting of FUE .But even one sitting of strip is usually not sufficient for most of the cases which means multiple sittings and multiple scars. FUE is virtually free of scars (As they are only Microscopic) and patient can undergo multiple sittings without much discomfort.

Q. What about the scarring?
A.
Scarring is definitely more in STRIP method and sometimes numbness and abnormal sensation persists at the back of head.

Q. What about the healing period?
A.
Healing is much faster in FUE and patient is active and mobile immediately after surgery on the same day only whereas in STRIP a resting period of at least a week is required.

Q. When will the scabs fall off?
A.
The scabs at the back of head and at front fall off after 7-10 days and one cannot even make out the sites from where the grafts have been taken after 2 weeks.                                                                  
                                                                                                                                              
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Q. When can one see the final results?
A.
The hair start regrowing after 3-4 months. Full growth is usually appreciable after 10-12 months.

Q. What is the life of transplanted hair?
A.
It is lifetime as the donor area is the permanent zone.

Q. Why is it costly than the Strip method?
A.
FUE the world over is more costly than STRIP as it involves more hardwork and more time period is spent. Also the entire procedure is performed by the surgeons themselves unlike STRIP method where the assistants do upto 75% of the work.

Q. How many hair are required to cover the bald area?
A.
It depends on the bald area as well as the density required by a patient. You can send in your pictures in front-on, sides and from below view for free online consultation and we can advise you regarding the same.

Q. Do the transplanted hair look natural?
A.
The look is definitely natural as transplant is done by FOLLICULAR UNIT method where naturally growing groups are taken out and implanted as compared to the outdated punch transplant where the look was not natural.

Q. What is the role of Finpacea?
A.
Finpacea is a medicines for androgenetic alopecia which definitely work as long as one takes the medicines. Also complete regrowth is not observed. Hair again start falling once medicines are stopped.

Q. Can we do hair transplant if the patients is suffering from some medical condition?
A.
The patients having blood disorders, immunocompromise conditions (hepatitis, cancer, uncontrolled diabetes, etc) are usual not taken up for surgery.

Q. Why come to GBH American Hospital?
A.
Because the surgeons at GBH American Hospital are trained by international pioneers in the field of Hair restoration surgery, they keep themselves update about the latest developments by attending national and international conferences and firmly believe in honesty and hard work.                                                           

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