Although many technical advances have been made in the field of surgical procedure hair transplantation over the last decade, due in part to the widespread use of follicular transplantation, many problems remain. The majority concern physicians who recommend surgery to patients who are not good candidates. The most common reasons why patients should not continue to undergo surgery are their youthful and unpredictable hair loss profile. Young people also have generally high expectations – they often demand the density and hairline of a teenager. Many people who are in the early stages of hair loss should simply be treated with medication, rather than being in a hurry to get under the knife. And some patients are simply not mature enough to make sober decisions while their problem is so emotional.

In general, the younger the patient, the more careful the physician should be, especially if the patient has a family history of Norwood Class VII hair loss or unformed diffuse alopecia.

Problems also occur

Problems also occur when the physician is unable to properly evaluate the patient’s donor hair supply and does not have enough hair to achieve the patient’s goals. Careful measurement of the patient’s density and other characteristics of the skin of the head will allow the surgeon to know exactly how much hair is available for transplantation and to devise a recovery scheme that can be achieved within these limits.

In all these situations, it will take a little more time to listen to the patient’s concerns, examine them more closely and recommend a treatment plan that is consistent with the goals actually achieved, from the perspective of a satisfied patient. . Unfortunately, scientific advances will only improve the technical aspects of the hair transplant process and will do little to ensure that the procedure is carried out with the right schedule or with the right patient.

Five years of sight

Improved surgical techniques to place increasing numbers of grafts in ever smaller recipient sites had almost reached its limit, and limitations on donor supplies remain the primary limitation for patients with hair stitched. Despite the initial enthusiasm for extracting follicular units, a technique for harvesting hair directly from the donor’s scalp (or even the body) without a linear scar, this procedure has relatively little increased the increase in the number of follicular units. available hair of the patient. is for a transplant. . The major breakthrough occurs when donor supply can be expanded through cloning. Although recent advances have been made in this area (especially in animal models), the possibility of cloning human hair has taken at least 5 to 10 years.

Major problems

The biggest mistake a doctor can make when treating a patient with hair loss is to perform a hair transplant on a person who is too young, as expectations are usually very high and the type of upcoming hair loss is unpredictable.

Chronic exposure to the sun during a person’s life has a much greater negative effect on the outcome of the hair transplant than perioperative sun exposure.

A haemorrhagic diathesis, important enough to influence the operation, can usually be detected in the patient’s history. However, over-the-counter medications are often not reported (such as non-steroids) and must be specifically requested.

Depression is perhaps the most common psychiatric disorder when looking for a patient’s hair transplant, but it is also a common symptom of hair loss. The physician must distinguish between a reasonable emotional reaction to baldness and depression requiring psychiatric counseling.

During hair transplantation, the physician must balance the current and future needs of the patient with the current and future availability of donor supply. It is known that a person’s pattern of baldness progresses over time. Less appreciated is that the donor zone can also change.

Hair transplantation has been available for over 40 years to treat hair loss.

Most of the time, hair transplantation was characterized by the use of corks, slit grafts, flaps and mini-grafts. Although these were the best tools that physicians could use at the time, they were unable to systematically produce natural results.

With the introduction of FUT (Follicular Unit Transplantation)

With the introduction of FUT (Follicular Unit Transplantation) in 1995, doctors were finally able to produce these natural results. But the mere ability to produce them did not necessarily guarantee that these natural results would actually be obtained. The FUT procedure presented new challenges to the hair transplant surgeon and it is only if the procedure is properly planned and performed perfectly that the patient will actually benefit from the power of this new technique.

The ability of follicular unit grafts

The ability of follicular unit grafts to mimic nature quickly produced results that were impossible to detect. This is the characteristic of follicular unit grafting. However, the maintenance of the hair is just as important – the one-to-one correspondence between what is harvested in the donor’s area and what ultimately grows on the recipient’s scalp. Since a stock of finished donors is the main limitation of hair transplantation, maintaining hair is a fundamental aspect of any technique. Unlike older procedures using large grafts, delicate follicular units are easily traumatized and very sensitive to dehydration, resulting in follicular unit grafting procedures involving thousands of grafts, which is particularly difficult.