DR. Emrah CINIK
Hair transplantation is a surgical procedure that involves the extraction of hair follicles from a designated donor site, followed by their subsequent transplantation into a recipient site, typically targeting regions characterized by hair thinning or absence. While male pattern baldness is the most frequently linked condition, hair transplantation is also employed to restore hair in areas such as eyelashes, eyebrows, beard, chest, and scars resulting from accidents or surgical procedures.
The historical origins of hair transplantation can be traced back to several centuries ago. Autologous hair transplantation methods can be traced back to ancient Indian texts dating back to 800 B.C., suggesting that relocating hair to areas experiencing baldness was already established more than two thousand years ago.
The commencement of the contemporary era of hair transplantation can be traced back to the latter part of the 19th century, during which European surgeons pioneered transplanting hair-bearing skin flaps onto regions such as the eyebrows and mustache. Nevertheless, these approaches frequently yielded suboptimal outcomes.
Dr. Norman Orentreich, a prominent figure in the field, is widely acknowledged as the progenitor of contemporary hair transplantation techniques during the latter half of the 1950s. The researcher’s investigations on “donor dominance” demonstrated that hair originating from regions resistant to hair loss would maintain their inherent traits even after being transplanted to areas experiencing baldness.
Hair Transplant Techniques
Hair transplantation has undergone notable advancements throughout its history. Advances in technology and medical procedures have led to the emergence of more sophisticated approaches aimed at catering to the specific requirements of individuals. Let us examine the prevailing techniques currently employed and analyze their benefits and limitations.
Follicular Unit Transplantation (FUT):
Overview: Commonly known as the “strip method,” Follicular Unit Transplantation (FUT) is a conventional technique utilized in hair transplantation procedures.
Procedure: The procedure entails the surgical extraction of a segment of dermal tissue from the donor region, typically located on the posterior part of the skull, where hair follicles exhibit resistance to the hormone responsible for alopecia. Subsequently, the strip above is meticulously analyzed using microscopes to isolate discrete follicular units, which consist of clusters of 1-4 hairs.
Advantages: One of the primary advantages of Follicular Unit Transplantation (FUT) is its capacity to facilitate the transplantation of a substantial quantity of grafts within a singular session. This approach is frequently suggested for individuals exhibiting significant alopecia.
Drawbacks: One notable drawback of the Follicular Unit Transplantation (FUT) technique is the presence of a linear scar left in the donor region. Although the scar can typically be concealed beneath longer hairstyles, it may become more conspicuous if the patient chooses a shorter haircut.
Follicular Unit Extraction (FUE):
Overview: The Follicular Unit Extraction (FUE) technique has emerged as a contemporary method for hair transplantation, experiencing a surge in popularity within the past twenty years.
Procedure: Instead of excising a strip of skin, the procedure involves directly extracting individual hair follicles from the donor area utilizing a precise punch tool.
Advantages: One of the primary attractions of Follicular Unit Extraction (FUE) lies in its ability to avoid the presence of a linear scar. The procedure results in minuscule imperfections resembling dots dispersed throughout the donor region and typically exhibit reduced visibility.
Drawbacks: Avoiding a linear scar is a crucial factor contributing to the appeal of Follicular Unit Extraction (FUE). The process yields tiny imperfections in the form of scattered dots within the donor area, which generally have diminished visibility.
Robotic Hair Transplantation:
Overview: The utilization of robotic technology in the FUE process enables the automation of this technique.
Advantages: The advancements in graft extraction techniques have resulted in enhanced precision and effectiveness, leading to a decrease in the rate of transection and a reduction in operator fatigue.
Drawbacks: The expenses associated with a particular product or service, as well as its accessibility, may be constrained in specific geographical areas.
Direct Hair Implantation (DHI):
Overview: DHI, a subset of Follicular Unit Extraction (FUE), utilizes the Choi Implanter Pen to optimize the procedures of hair follicle extraction and implantation.
Advantages: The implementation of reduced manipulation of hair follicles and their immediate implantation has the potential to enhance graft survival.
Drawbacks: The potential exists for an extended duration and increased cost compared to conventional Follicular Unit Extraction (FUE) techniques.
Combined FUT and FUE:
Overview: Individuals with significant baldness who desire to optimize the quantity of grafts during a single session have the option to combine both techniques.
Advantages: This approach aims to optimize the quantity of grafts while effectively incorporating the advantages of both techniques.
Drawbacks: Both linear and dot-like scars will be observable.
Scalp Micro Pigmentation (SMP):
Overview: Although not classified as a transplantation technique, Scalp Micropigmentation (SMP) is a non-invasive procedure that involves using micro-needles to deposit pigment into the scalp.
Purpose: This particular hairstyle emulates the appearance of a recently shaved scalp or can create the perception of increased hair volume in areas experiencing thinning.
Advantages: The outcomes are prompt, the procedure is non-intrusive, and it can additionally conceal scars.
Drawbacks: The procedure in question is classified as a cosmetic tattoo, and it should be noted that it does not encompass genuine hair growth or restoration.
Hair Transplant Procedure
The hair transplantation procedure is typically performed utilizing local anesthesia. Hair follicles are extracted from a designated donor region, commonly located at the posterior part of the scalp, where the hair possesses inherent genetic characteristics that confer resistance to hair loss. Subsequently, these follicles are relocated to the scalp regions experiencing hair loss or thinning.
After the grafts have been prepared, small incisions are created in the recipient area to insert each graft carefully. Attaining a natural appearance necessitates a high degree of precision. During the subsequent months, the hair that has been transplanted undergoes a shedding process, subsequently being substituted by newly grown hair originating from the transplanted follicles.
The procedural approach to hair transplantation may exhibit variations contingent upon the specific method employed and the unique requirements of the individual. However, a general outline of the process is as follows:
- Consultation: Before the procedure, patients undergo a thorough consultation where the surgeon evaluates the degree of hair loss and discusses the patient’s expectations.
- Donor Site Preparation: Hair in the donor area (typically the back or sides of the head) is trimmed.
- Anesthesia: Local anesthesia is applied to the donor area to minimize discomfort.
- Extraction of Hair Follicles: Depending on the method chosen, either a strip of the scalp is removed (FUT) or individual hair follicles are extracted (FUE).
- Recipient Site Preparation: Tiny incisions are made in the areas where hair will be transplanted.
- Transplantation: Hair follicles or grafts are placed carefully into the incisions, ensuring they are positioned for the most natural appearance.
- Post-Procedure Care: The scalp is bandaged, and the patient is given post-operative care instructions, which might include pain medications, antibiotics, and guidelines for washing and caring for the transplanted area.
- Recovery: The recovery period varies, but most people can return to work within a week. It is typical for the transplanted hair to fall out initially, but new growth should start within a few months.
The contemporary techniques employed for hair transplants exhibit substantial divergence from the methodologies used in ancient civilizations. As the progression of research continues, it is reasonable to anticipate that forthcoming outcomes will show heightened efficacy and enhanced verisimilitude.