From the self-transplant particular aspects of hair, and the redefinition of the hairline and the thickening of the summit.

Redefining the front line the top and the tonsure at a hair transplant.

The redefinition of the hairline

Until a few years ago there was a tendency to over-achieve perfection by drawing a line too symmetrical front with instant density. However, experience has shown that this approach produces results unnatural. Overcrowding is also not advisable, especially if the reserves are limited donor areas.

Although the transplant surgery always the same in its execution, the end result should be slightly different because of the way in which the surgeon faces the design front line staff.

There are various formulas that indicate the ideal position of the front row. It always advisable, however, a conservative approach (8-9 cm from the glabella) to fit the face shape, age, extent of baldness, the density of the donor patient. To obtain the naturalness of all proceed to the creation of sites receiving a second path irregular and random.

The surgeon must constantly put in front of the patient to have a front perspective also.

During the first 2 cm of hairline incisions are performed sleepers, coronal, within which are inserted solely with individual follicle transplants from the lateral area of the head and particularly suitable for the greater subtlety of their hair. The distance between plants is related to the density you want to reach the understanding that gradient that allows a more natural appearance. The rest of the cuts are radial, sagittal, and receive follicular units.

The thickening of the summit and the tonsure.

Hair transplant surgeries is rightly given considerable attention to the reconstruction of the front row while the summit is often overlooked. And 'common conviction that the transplantation of young patients with apex tonsure should not be executed.

Having said that, for patients aged between 20 and 30 years, collecting family history on hair loss and found that the donor area is sufficient for three interventions, we can start to fix the tonsure even if we assume that future baldness can evolve to the stage 6 or stage between 6 and 7 of Norwood classification. The technical advantage that makes this "chance" is the transplantation of a single follicle.

A strip of skin with a thousand follicles, which once yielded 300 to 350 transplants, now makes all its 1000 grafts, ensuring the possibility of wider coverage even more sparse.

The goal is a "crown" often natural-looking, plausible. With the patient must also be discussed the benefits and risks of medical treatments available today. Is important to treat all the tonsure at once, but leave enough donor area for two interventions: the frontal area and the summit.

If the patient has 40 or more years instead of objective examination and family history indicate that hair loss is limited to one area of the summit, you can operate with greater density.

The thickening of the tonsure requires technical skill and artistic sense equal if not superior to that required for the front line in this area because the hair changes direction and the spiral vortices appear with many variations.

To facilitate access to the underside of the summit, the patient is placed in the prone position, as the sampling procedure. This position makes it more ergonomic and physically easier for the surgeon to create sites and reception for the staff, the insertion of implants. Follicles are put down, changing direction in a second time in a curve of 360 °, in order to create the vortex. Once you reach the center of the summit, the patient is sitting in the back seat. Should consider the center of the summit, where the hair grows forward, an extension of the frontal region, so care should be taken here with a higher density.

Considerations

It 'a far better transplant conservative too aggressive. The goal is not thickening as possible glabrous or sparse area, but the gradual density maximum in the central and lower as you approach the four peripheral sides. Experience makes every surgeon adopts its own modus operandi with his patients. It 'hard to stay on its exhaustive convictions and skeptical of new approaches. If you instead open to new perspectives will have a greater chance of finding a case the best surgical approach that responds to individual needs. Even the autograft has its limitations. The surgeon must adapt to what you have available to achieve a result as complete as possible. When the follicle cloning will be a reality, you can obtain the full restoration of hair in all cases of baldness. A successful transplant is that once a hair restorer, is not recognizable, even more critical eye, for the naturalness of the results achieved.

The postoperative

After surgery, the patient leaves the medical facility and can resume normal activities within a few hours. And 'possible in 24 to 48 hours, notify the donor in an unpleasant sensation of stretching the skin, solved with a mild analgesic. For the first few days, the patient is advised to sleep in a half-sitting, to prevent or minimize swelling and bruising.

The incision donor area heals with a scar thin and aesthetically negligible, because covered by surrounding hair. The external sutures applied here should be removed around the tenth day.

The scabs that form on the site of reception, a normal consequence of the healing process, leaving no visible signs of fall in a relatively short time: 4 - 6 days those related to individual follicular units within 10 days of those grafts multifolliculars.

Results and controls

The transplanted hair will begin to grow after 4-6 months after surgery. Usually it requires monitoring at 3 to 6 and 12 months later the self-transplant.