Hair replacement is the procedure of transplanting of hair follicles which are collected from hairy parts of scalp with a predetermined order and direction to front or lateral areas. Hair loss is a problem which is seen on men and less commonly women and makes people look older than they are and shatters the self confidence. Hair that appears at back of the head, between the ears are resistant to hair loss genetically at almost every person. Frontal, lateral and top
sides of head are sensitive to hair loss along with differences between people. Hair replacement is the transplantation of the person’s own hair follicles from some point to another. Success rates are very high if a team lead by a specialist of plastic and reconstructive surgery makes the operation under proper circumstances.
Everybody might not be a suitable candidate for hair replacement. The subject of which technique is going to be used in men and women for hair loss should be discussed with details.
What are hair transplantation techniques?
There are two techniques for hair transplantation; FUT (Follicular Unit Transplantation) and FUE (Follicular Unit Extraction). In FUT hairy skin is removed from back of the head as a strip. The area is closed with suturing techniques to minimize scarring. Follicular units are separated according to transplantation plan under microscope.
In FUE technique follicular units from back of the hair are cut cylindrically on the same direction with hairs one by one with a micro motor. Follicles are extracted carefully with special forceps.
How is hair transplantation done?
Hair transplantation is done in a sterile environment on operating conditions. Before the operation the patient’s general health condition, existence of chronic diseases such as diabetes, hypertension is examined and routine blood analysis is done. Aspirin and aspirin like anti-coagulant drugs, nutritional supplies such as vitamin E, ginseng, ginkgo biloba should not be used for at least a week before the operation. Patient is asked to have a mild breakfast and wash his/her hair with a low pH leveled shampoo.
At the beginning of the procedure hair of area that follicles will be collected is cut 1 mm long and washed with an antiseptic solution. Local anesthetic is applied to operation site and a full anesthesia of the skull is provided. This way hair transplantation is performed pain free. The transplantation site and estimated amount of grafts is determined by the physician.
Follicle units collected with FUT or FUE technique are stored in a cold and moistened environment. Follicular units are planted one by one into canals that are opened with a predetermined angle which is the same with preexisted hairs of transplantation area by following a predetermined hairline.
How is postoperative phase of hair transplantation?
After transplantation whole scalp is washed. The area at the back of the head that follicle units have been collected from is covered with a bandage. Antibiotic and analgesic are prescribed. Patient is asked to sleep while he is lying on his back and with a little head elevation. Swelling and a mild bruising can occur at forehead region despite all these and begin to reduce after 3 days.
Hair is not to be washed for first 3 days. Being on dusty environments is not recommended. After 3rd day, to soften the scabs of transplantation site, hair is washed with a shampoo which has low pH levels by lathering it outside of transplantation zone, after application of Bepanthen solution for a few times a day. After 10th day, scabs of front are expected to come of completely and millimetric incisions to be closed. Intensive effort taking activities should be avoided for first week and a hat should be used for protection from sunlight for 4 weeks. Sauna, Turkish bath and solarium are not recommended for 6 weeks. Patients can enter sea or pools after 3 weeks.
After 3 weeks, transplanted hair starts to fall and after 3rd month fallen hair starts to grow again. Hair of transplantation site and the back of the hair should be shaped with scissors and razor and hair due applications cannot be done. Growth and forming of hair takes 1-1,5 years. Usually, hair transplantation is done in one session but, if the desired density isn't achieved; a second session can be done a year later.
Copyright/Main Edition 2012 Limited Revision 2022 Prof. Dr. Z. BURCAK TUMERDEM ULUG
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