Hair Transplant

Md Salil Raj Thapa

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Hair, like good health and youth, is an essential element of one's life. Hairstyle and length are distinguishing characteristics of a person's personality. Hair can make a person appear more appealing, but loosing hair can also reduce a person's self-confidence and openness in public. No one wants to lose their hair if they had the option. Baldness is the most prevalent cause of hair loss in people all over the world. Baldness can affect both men and women of both young and old age. Especially old age people have baldness. Men’s normally tends to loose their hair in their mid 25 and as the age grows the loosing hair increases. Men's hair starts to fall out in their mid-twenties or early-thirties, and the rate of hair loss accelerates as they get older. While women hair loss usually start after the age of 40. In men, hair loss is notice as a baldness in some area where as women hair loss is notice as overall thinning. Women's hair loss typically begins after the age of 40. Hair loss can occur at any age and can be temporary or permanent due to disease or other factors. On average, people lose 50 to 100 hairs per day. Because new hair grows in at the same time, this is usually undetectable. Hair loss happens when the hair that has fallen out is not replaced by new hair.
Hair loss can be treated in two ways: medical and surgically. In terms of medical treatment, the US Food and Drug Administration (FDA) has only recommended two treatments for androgenetic alopecia (common form of hair loss) to yet. The first is an oral drug, Finasteride. This medicine inhibits 5-alpha reductase function and contributes to hair regrowth at extremely small doses. The second medicine is minoxidil, which helps to reduce hair falling and encourages new hair growth. But there are disadvantages of this medical treatment:
Medical care helps only in the early stage of the disease.
Medical care doesn’t promote hair growth in part that are already bald.
Once the medical care is stop the hair start to fall again.
The length of treatment isn't set in fixed. Drugs should be used for the rest of one's life, according to guidelines.
Due to these disadvantage people prefer to go with the surgical method. Patients with baldness have long regarded hair transplantation as a boon to them. A hair transplant is a minor surgery in which a plastic or dermatological surgeon transplants hair from one part of the hair fill part to another. Hair transplants are usually performed under local anesthetic in a doctor's office. The part of the body from which the hair is extracted for transplant is referred to as the "donor part," while the part where it is transplanted is referred to as the "recipient part". Hair transplants are usually performed under local anaesthetic in a doctor's office. Hair transplantation can also be used to restore eyelashes, eyebrows, beard hair, chest hair, pubic hair, and scars from accidents or previous hair transplants. Hair transplantation varies from skin grafting in that grafts contain practically all of the epidermis and dermis around the hair follicle, and numerous small grafts rather than a single strip of skin are transplanted.

Preoperative planning:

During initial consultation, the surgeon examines the patient's scalp, discusses their preferences and expectations, and advises them on the optimal method (e.g. single vs. numerous sessions) and expected outcomes. Pre-operative folliscopy will reveal the true density of existing hair, allowing the postoperative effects of newly transplanted hair grafts to be appropriately evaluated. Preoperative topical minoxidil and vitamin treatment may help certain individuals.
For several days before surgery, the patient avoids taking any medications that could cause intraoperative bleeding and inadequate grafting. Poor graft survival can be exacerbated by alcohol and smoking. Antibiotics are frequently provided after surgery to prevent wound or graft infections.  

Harvesting

Outpatient transplant surgeries are performed with light sedation (optional) and administered local anaesthetic. Before the donor scalp is extracted, it is shampooed and then treated with an antimicrobial substance. There are various distinct hair follicle harvesting processes, each with its own advantages and disadvantages. Regardless of the harvesting procedure, effective hair follicle extraction is essential to guarantee the viability of transplanted hairs and to prevent hair follicle hair shaft cuts. Hair follicles develop somewhat near the skin surface, so that tissue transplanted must be removed at an appropriate angle.
There are two ways of Harvesting Follicular Unit Transfer / Transplantation (FUT) and Follicular Unit Extraction (FUE)
Follicular Unit Transfer / Transplantation (FUT): In this case, a linear piece of skin is removed in the donor area, then individual follicles are produced with a high magnification. The skin defect from which grafts have been removed needs sutures to close. It is also called Strip harvesting.
Follicular Unit Extraction (FUE): This is a revolutionary hair transplant technology, in which individual hair follicular units are removed from the scalp's back. These follicular units are then maintained in optimum position for 4-6 hours and then transferred to the bald area.
FUT is an old procedure, but FUE is a recent one. FUT surgery might leave a scar, however FUE surgery will leave a scar for sure. However, FUE does not require stitches, but FUT does. In comparison to FUT, FUE may result in less bleeding.

Post-operative care

Advances in injury treatment allow semi-permeable dressing to be applied and changed at least daily to allow blood and tissue inhalation. Shampooing is started two days after the operation and the sensitive recipient region should be covered from the sun. Certain surgeons will have patient shampooed the day following the operation. Shampooing is necessary in order to avoid the formation of scabs around the hairpiece. Scabs stick to the hair shaft and increase the danger of the first 7 to 10 days of the postoperative loss of fresh transplanted hair follicles.
Some of the hairs transplanted may fall out within the first ten days, inevitably traumatic as it is relocated. The Is referred as "shock loss". New hair starts growing from the reposition follicles in two to three months. The hair of the patient will grow and thicken over the next six to nine months. Any hair loss there after can occur only in untreated areas. Some people choose to utilize drugs to postpone such loss while others plan to have a subsequent transplantation procedure. 

Who is it for?

Anybody concerned about their appearance and who wants to improve them is an excellent hair transplant candidate. But the factors such as age, health condition and finance matter’s.

Age and Hair transplant

Technically, hair transplants can be performed at any age. But still age is considered. Although hair fall usually occurs in 20s hair transplant before 30s is considered as inappropriate. However, hair transplantation for scant hair can be done without waiting for a hair loss. For these reasons, we may say briefly: you shouldn't want a hair transplant as soon as you start to fall out your hair in early 20s. You should first consult and follow your opinions and recommendations with your hair transplant specialists. To decide if you are eligible for a hair transplantation, you must make sure you conduct preliminary tests and checks. After doing the required tests and consultations it becomes more convenient to grasp whether you are appropriate for the operation after analysing hair follicles. You may want to consult your doctor on a hair transplantation if hair loss is intolerable in a young age for further treatment.

Conditions of health:

Health condition shall also be considered before hair transplant as a person with a poor health condition may not able to endure the surgery. You need to be healthy enough to undergo a medical procedure and must have a healthy immune system prior to considering any type of surgical procedure. You should ensure that serious medical condition is treated and resolved before operation in order to reduce the risk of complications. In cases of health conditions such as diabetes or prescribed medicines (such as thinning of the blood) that can have a damaging impact on your results, talk with your doctor so that a treatment plan may be adapted for you. A person who was born with no hair is also considered as ineligible for surgery.

Finance:

A person who was born with no hair is also considered as ineligible for surgery. Finance may also affect the patient, as surgery and medical expenses may not be sufficient, since there are post operational costs, such as dressing and medicine.
 
Hence, Hair Transplant success rate depends upon the surgeons and patient's. Most hair transplant cases go without hazelnut. The new method of transplanting the patient makes it easy and one time solution. No age requirement exists technically, and anybody can have surgery, but 25 years and over is considered suitable for surgery. The patient's must be financial prepare for the postoperative care.
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