HAIR TRANSPLANTATION SURGERY

BACKGROUND

• 60% of men and in approximately 10% of women are suffering from hair loss.
• Balding is a major concern for many, and surgery to treat hair loss is the most common cosmetic surgery procedure performed on men today although a lack of scalp hair can potentially increase the risk of actinic damage and skin cancer.
• The market for hair transplantation in Ahmedabad is full of immense market for products that treat hair loss without surgery. And these products include shampoos, hair-care cosmetics, scalp massagers, laser combs, and many more.
• Interest in hair transplantation will increase as knowledge and the awareness that most modern hair-transplantation techniques can create virtually undetectable restoration spreads. Hair transplantation remains the treatment of choice for most patients with hair loss.

PROBLEM

• For millions of people around the world, hair loss is a major problem which is associated with loss of self-esteem, insecurity, and even depression. it can range from early thinning or hairline recession to complete loss of hair, along the top and upper sides of the head.
• A normal hairy head of contains approximately 100,000 hairs. The loss of up to 30% of the hairs that was present during the peak of adolescence that occurs by middle age is the symptom of the normal aging process. at least 50% of the hairs must have fallen out in an area for thinning to become cosmetically noticeable. It does not result in the cosmetic appearance of hair loss if loss of a smaller percentage takes place than in general.
• In women, the development of androgenic alopecia is classified into 3 stages. Typical pattern of hair loss in women is progressive diffuse thinning in an oval area on the top of the scalp. Hair loss taking place along the hairline is usually spared.

ANATOMY

 The scalp is divided into five layers, which are the mnemonic SCALP, in order from outermost to innermost layer, the skin, connective subcutaneous tissue, galea aponeurosis, loose connective tissue, and periosteum over the cranium.

• The skin contains all the epidermal appendages, including hair follicles, it extends into the connective subcutaneous layer. Into the areas where it has undergone hair loss, thinning of the outer two layers usually occurs in this case. when one compares the thickness of the scalp in recipient areas with that in donor areas the situation can be appreciated.

• Subcutaneous layer contains the main penetrating branches of the main arteries that travel primarily along the external surface of the galea. The importance of staying superficial along the connective subcutaneous tissue layer has only recently become apparent. The scalp has an immense blood supply. The supraorbital, supratrochlear, superficial temporal, postauricular, and occipital arteries are the primary vessels, and they typically travel with the veins.

• The galea aponeurotic is a non-elastic layer which connects the frontalis muscles anteriorly along with the occipitalis muscle at its posterior aspect. Superficial temporal artery travels are connected to the galea. The galea slides over the loose connective-tissue layer allows most scalp mobility. This loose connective-tissue layer and the periosteum below gets minimal sensory innervation.

• The sensory innervation of the scalp follows the vascular supply. The supraorbital and supratrochlear nerves provide sensation to the anterior half of the scalp. Sensation to the frontal scalp can diminish for several weeks when many graft recipient sites are made along the hairline. The occipital nerve serves the posterior half of the scalp, whereas the supra auricular and superficial temporal nerves contribute innervation from the sides.

• Scalp hairs do not grow individually most often they grow in tiny follicular unit bundles which contain 2-3 hairs and occasionally 1 or 4 hairs. A follicular unit contains 1-4 terminal hairs. A sebaceous gland element and insertions of the arrestor pili muscles all are wrapped in an adventitial tissue sheath. The follicular units are dispersed throughout the scalp where non–hair-bearing skin constitutes are up to 50% of the total tissue. By transplanting only these follicular units gets dissecting away the 50% of unnecessary non–hair-bearing tissue, the most natural-appearing results can be attained.

PATIENT EDUCATION

• With any surgical procedure, thorough counselling before hair-restoration surgery is critical and a must. Patients require education to take informed decisions regarding this elective procedure, i.e., whether to undergo it and if so which doctor should visit on their respective city for getting proper information patients should visit Clinicspots website to get proper knowledge about which procedures to follow because hair restoration is cosmetic surgery, discussing patient’s areas of concern, explaining treatment options, and providing a realistic picture of expected results are important to the patients.

• written information regarding both preoperative and postoperative instructions should be provided to the patients. After reviewing the patient’s list of medications to rule out any that may adversely interact with anaesthesia administered during the procedure, it is important that various medications that may affect bleeding time be discontinued. all aspirin-containing medications, vitamin E, and ginkgo 10 days before the procedure and all nonsteroidal anti-inflammatory drugs should be stopped and alcohol 3 days before. To further reduce the risk of bruising, patients are instructed to take vitamin C 2000 mg daily for 1 week before surgery.

• Understanding the limits of a patient’s donor hair reserves, and their goals and motivation for undergoing hair transplantation can best help evaluate and articulate the projected result.

Establishing this mutual understanding one can provide the most effective ways to increase overall patient satisfaction. Hair transplant is a most sought after procedure for people who want to look younger and boost their self confidence.