2. PROCEDURE
Hair transplantation involves relocation of hair from occipital area to bald
area.
Hair are dissected and transplanted in form of mini/micro or follicular grafts.
TYPES a) FOLLICULAR UNIT TRANSPLANTATION
b) FOLLICULAR UNIT EXTRACTION
3. Pattern of Baldness
Most Common:- ANDROGENTIC ALOPECIA (AGA)
Mechanism of AGA is predetermined by genetic characterstics and progression of
hair loss continues because hairfollicles are susceptible to external stimuli e.g
androgens
Target cells are bulbar region of hair follicles.
Pattern of hair loss in
a) MEN:- Frontal & temporal Areas (sensitive to androgens)
b) WOMEN:- Diffuse scalp (Christmas tree pattern)
5. Criteria for REJECTION
Inadequate Donor hair or less density (<40cm sq) [ Grade 7&8
patients]
Unrealistic expectations
Medical Problems like HTN, autoimmune diseases
6. ANATOMY OF NORMAL HAIRLINE
Natural hairlines are not straight. They are
irregular
Follicles sit 3-3.5mm below the scalp and
thickness of scalp is 6-6.5mm
Fronto-temporal angles are sharp in Men
unlike in females and children. Maintaining
these angles are critical to give a natural
result.
7. HAIRLINE DESIGN
Face is divided into 3 segments
In the midline, hairline starts 7-10cm from the
glabella
A curve sweeps laterally on both side of
forehead; at this point hairline should be
parallel to the curve when pt. looks straight
ahead
Lateral hairlines are 9.5-11.5cm above the
lateral canthus of eyes
8.
9. .
Throughout the Hairline transition zone
should contain micro & macro irregularities
250-300 Single FU’s are used to create
hairline
2-3 Unit FU’S are used behind the hairline
3-4,4-5 Unit FU’S are used in the vertex
10. Donor area
Ideal donor area contains hair that are
not subjected to the process of
miniaturization
SAFE DONOR AREA
Hair density is greatest at the midline
and decreases laterally above the ears
and below the nape of neck.
50% hair can be harvested from the
donor area before they are depleted
11. DONOR HARVESTING
FUT
1. A Strip is harvested from
occipital region
2. Gap is closed by
tricophytic stiches
3. Grafts are seprated into
FU’S
4. FU’sare transplanted into
frontal region
FUE
1. Grafts are harvested by
motorized punches
2. Closure not required.
12. FUT
A long section of scalp is incised of
length 10-25cm &width 0.5-1cm with
parallel angles to follicles
Tumescence anesthesia is given to
minimize transection
Donor area is closed by
Continous interlocking
nylon 3’0 suture.
Removal on 14th day
13. Silvering
Harvested donor strip is immersed in cold saline
Strip is 20cm x1cm contains 2000 FU’s
Section is fixed onto a cutting board; multiple
smaller sections are made and 1-2FU’s are
separated
14.
15. FUE
Motorised punch is inserted around
follicle to ease extraction
Rapid process, less post op pain
Serrated or Blunt punches are used;
0.8mm on body & 0.9mm on scalp
penetrated 4-5mm deep in scalp.
Angles of 45 deg is maintained.
Every 3rd follicle is extracted to
16. RECEPIENT AREA
Recepient area is prepared after trimming and making a hairline
Inflitrated with anesthesia containing Ropivacaine& lignocaine with
1;10,000 adr
Incisions are made along angle of hair
Separated FU’s are placed into the slits by multiple methods
1. Double forceps
2. Pen implanters
17. NEWER METHODS
Direct Hair Implanation [2010]
1. Evolved version of FUE, utilizing more precision and minimal
graft handling
2. Stringent follicle care
3. Implantation is via DHI implanter
4. Angle & direction of implanted hair is maintained better
18.
19. ARTAS
Virtually Pain Free – No stitches or linear scar associated with the ARTAS Robotic Hair
Transplant Procedure.
Intelligent Algorithms – Identify and select your best hairs for harvesting.
Physician-Assisted Robotic Technology – Delivers high quality robust grafts.
Robotic Harvesting – Digital mapping provides precise and consistent graft dissection
Robotic Recipient Site Making – Creates natural site distribution for optimal results
that avoids damaging existing healthy hair.
Eliminates Human Fatigue
Fast recovery
20.
21. Neograft
Automated system to improve harvesting phase of surgery
Uses suction to pull out hair follicles which are loosened by special devices
Neograft no touch implantation is done by unique implanters
