Hair selftransplantation

Hair selftransplantation is a cosmetic surgery that restores lost hair quantitatively.

Hair selftransplantation can achieve permanent hair since because moved hair retain the characteristics of their place of origin (neck) and therefore do not fall over or fall much further in the years (Phenomenon of Orentreich dominance).

The number of hair, or rather the number of follicular units, which can be transplanted in a single intervention is normally between the 1500th in 2500, although it is theoretically possible to reach much higher numbers (3000 or 4000).

Although many patients give great importance to the number of hair transplanted for session, it’s better to keep in mind that usually the result obtained with two sessions from 1500 hair, done every few months, is higher for density and naturalness than achievable with single Session of 3000 hair, especially if the area that has to be thickened is not very extensive.

Regardless of the number of hair transplantation, hair transplant surgery is performed under local anesthesia without hospitalization and has reduced recovery time so much, and just 24 hours after its completion the visible signs are limited to small scabs at the graft and slight swelling in the eyelids.

The candidate for hair restoration can be defined like men or women, from eighteen years, have found a loss of hair (other than surgery are insulin dependent diabetics and heart patients severe). The thickening surgery is justifiable in the presence of spread small area, especially if the person lives with the problem like an element of discomfort and contempt.

Often the surgeon has to perform a hair transplant even very young patients with hair loss are still in progress.

It 'important that the surgeon exposes the limits of thickening honestly obtained, and avoids using all of the hair donation to recreate such a young attachment ideal too late. The aesthetic result of this strategy could be catastrophic later in the years when, with the progression of hair loss, hair fall immediately back to those transplanted (who, coming from the back, persist) at that point, no hair used in the donation, would do little to correct the error of the first transplant.

Although hair transplantation does not require, by its nature, large trial procedures, many surgeons require some routine preoperative tests: CBC, ALT, markers of hepatitis B and C and HIV, coagulation tests, ECG.

It 's important that the surgeon is aware of any medicines taken by the patient, whose components can interact with bleeding or with medications used in the surgical session.

It asks the patient to any allergies (ex. latex) or toxic reactions to anesthetics and medications used during the learning session surgery. The day of surgery we proceed to the next step of the preoperative images, is reviewed and possibly re-evaluated, and customized surgical plan completed during the preliminary visit.

Currently, the surgical techniques used in the field of 'hair transplantation are: microselftransplant hair and bald area reduction (simple or Frechet extender).

Although microselftransplant hair predominates over the scalp reduction technique, the best result, however, is achieved by knowing both the surgical options and giving the best (or state both) about the situation of the patient. A bald important (VI grade Hamilton / Noorwood, low density of the donor area) can often get a good cosmetic result with only a combined technique.

MICRO selftransplantation HAIR

The key moments of a microselftransplant hair are:

• preliminary visit and patient selection
• removal of the donor area
• preparation of grafts and follicular units
• installation of the grafts and follicular units
• postoperative period.

The pre-intervention visit is to assess a person who wants to undergo hair transplant, check the general health, dermatology and psychology, consider the possibility that it may be subjected to surgery of baldness (choice of intervention and subsequent assessments). Patients are likely to explain all aspects of 'intervention, including its real expectations. The evaluation of the density of the donor area is an essential element for the ability to transplant.

The removal of the skin in the occipital area or time zone (where there are healthy hair that is not affected by the disease process of androgenetic alopecia) leads to isolate the donor area or lozenge containing the number of hair or rather the number of follicular units needed to correct the bald or thinned area.

We shall close the area with accurate explanted suture technique. The strip of skin was carefully dissected to isolate individual follicular units.

- Contempora takes place during the preparation of recipient sites, time critical intervention that requires great experience, dexterity, patience and sense of artistic sites without apparent symmetry to reproduce the natural features of the hair; sites with a homogeneous density.

- L 'insertion of follicular units is done with precise arrangements (with the' correct angle depending on the area), not creating too dense areas (especially all'attaccatura front), using only minigraft that individual hair for hanging front and micrograft ie 2o3 hair behind the 'hanging.

- The transplanted hair grows slowly and gradually at different times: before the sixth month has grown at least half but only up to the twelfth month is possible to evaluate the final result of 'intervention.

Reduction of the bald (Detonsuration Blanchard and Hunger - reduction scalp - scalp lifting - galeoplastica)

Trichological surgery is the simplest and most intuitive technique proposed by Blanchard and Hunger in 1977. Surgery consists in removing a 'diamond' of scalp alopecia and then suturing the edges. The purpose of the intervention is to reduce the bald area, and once it has been resized, refine, if necessary, work with a transplant.

Before the intervention should be assessed by palpation with the fingertips the elasticity of the scalp to avoid being then, once performed the surgery, unable to close the operating gap. The procedure is performed under local anesthesia and, if necessary, may be repeated several times, always with a few months lag.

Are common after surgery, edema and headaches that disappear in a few days. The washing of the head is usually made after 3 to 4 days.

Much less used is to reduce scalp expander with Frechet: This is a technique useful in forms of reconstructive plastic surgery they need to rebuild large areas of the scalp without hair, for example as a result of burns, removal of snow giants, tumors that require a 'particularly invasive removal.

This technique is important in the treatment of androgenetic serious and is performed as an outpatient with local anesthesia, without drainage, without significant deformity of the skull and resumption of daily activities in less than a week.

The expander tool is Frechet thickness of 0.5 mm, silicone rubber band, with hooks at the ends of titanium are part of the galley, and its length may be different in relation to size of area to be reduced. Under the bald area, usually the top, is charged an elliptical incision that allows the writer to insert the hooks anchored by the galea capitis and tension, then the wound is sutured with transparent thread and thin, essentially invisible.

The author is only perceptible to the touch but is hardly visible and allows a good social relations by avoiding the most serious drawback of expanders. After about a month extensor tension has greatly reduced the bald area approaching the edge of expanded skin and covered with hair. The surgeon removes the expander is removed and the skin bald edges aligned and sutured permanently.

The best results are obtained in cases of baldness average, land 10 to 13 cm in diameter.

New frontiers in hair restoration: FUE

For some years it is testing the technique of direct sampling of follicular units from donor areas (also known as FUE technique devised by Woods and Campbell) and the immediate replanting of the receiving areas.

The results are very satisfactory, giving a superior aesthetics and low morbidity. The extraction of follicular units is nowadays an approach be critical in 'field of possibilities of surgery hair. It plays a major role both as initial choice to direct dell'alopecia problem, both as a complementary action to be taken after surgery classical (strips, tabs, etc.).

Recently, the international scientific literature is being enriched content about this innovative technique, but until now little practice but is starting to have growth and dissemination. It 'obvious that we need to undertake some essential aspects of this technique.

In this context it is first necessary to select patients candidates for this approach, pointing out that the indications for FUE are very large, being able to use this method when you want to avoid postsurgical scars, when the orientation of the patient is to intervene less invasive in patients in whom the donor area is very dense not to allow the strip surgery in patients with thinning limited to areas such as thickening short eyelashes, eyebrows, small areas of alopecia secondary to dermatological diseases, to address the unsightly scars sometimes arising from traditional strip surgery, where scarring effects of trauma or neurosurgical procedures.

Opposed indications to FUE are essentially represented by inexperienced operators using the method, when you do not have the proper arsenal of equipment, in case of lack of consent of the patient, if expectations do not meet the real possibilities that technology can offer.

From a strictly technical point of view, the technique is to prepare first the donor area, which is shaved short hair to obtain 1.5 mm, followed by infiltration of local anesthetics to induce subcutaneous analgesia. For proper and efficient execution of the method is necessary to have: a special binocular microscope with the ability to zoom from 6 to 10 times the field, so as to get a good view; punch specific manual or automatic, of different shapes and size (6 to 10 mm in diameter) to extract the follicular units.

It 'important to establish the correct positioning of the punch when it penetrates the skin, so that it results in a certain angle of insertion of the instrument follicular unit, thereby avoiding the transdissection that compromises the quality and vitality of the unit follicle itself.

The operation of the punch extraction must be gentle but firm.