Micro Transplant - Surgery for baldness

Surgical therapy for baldness

If one could be a man of business
and think of the beauty of one’s nails

-Pushkin

What is androgenetic alopecia?

Androgenetic alopecia, or common baldness, is the most frequent reason for hair loss. It occurs more often in men than women and occurs as a result of a progressive transformation of the hair follicles, which gradually reduce in size and then fall out. This reduction occurs as a result of androgen hormones on the follicle, though not all follicles are affected. 
In fact, there are areas, such as the sides of the scalp, which are less affected by such hormones and are therefore more likely to retain the hair, even at an advanced age.
For men this process is characterised by a progressive recession in the hairline.
The seriousness of male baldness is evaluated with the use of the Hamilton scale, which distinguishes 12 grades of baldness according to the extent and location of the condition. The Ludwig scale is used to assess hair loss in women and has three stages.

What is a micro hair transplant?

It is the operation most often requested by patients and suggested by surgeons as a suitable solution to the problem of baldness. It without doubt represents the most effective approach for the resolution of hair loss: a problem of a complex nature which affects above all men, 80% of whom will be affected by it to some extent in their lifetime.
Patients turn to their surgeon when they experience a loss of hair which, apart from the aesthetic issue, can also provoke a general loss of wellbeing, which can in some cases adversely affect self esteem and cause problems in relationships. It is therefore a psychologically complex condition which should be carefully examined before surgery. The operation itself is concerned with a gradual increase in the hair follicles and requires more than one sitting, as well as the total collaboration of the patient which will help to ensure a final success.

The surgical technique has its origins in the sixties, and for around thirty years small areas of the scalp were transplanted, each containing 8 to 12 hairs, from the area at the back of the head, with optimal results in terms of functionality but not necessarily in terms of aesthetics.

Recently, however, this technique has evolved and been refined in order to offer a much more natural solution to the patient: the “islands” of the scalp are divided into “mono-follicle units”, meaning micro-segments of the scalp containing just one, or a maximum of four, hairs, which are then inserted into the desired area. 
 

Surgical Technique

The amount of hair which can be recovered with this technique is extremely variable and depends on:

  • the quantity of hair present in each donated area
  • the current phase of the hair cycle
  • the physical and psychological condition of the patient
  • the number of sessions needed in relation to the development of the hair loss

In any case if we are dealing with structures which contain one to three hair bulbs we can expect the transfer of around 2000 bulbs in each session.
 

Pre-Operation Evaluation

The plan for the operation has a fundamental and strategic importance.
The areas that must be carefully evaluated are:

  1. the ‘donating area’, its density, previous extractions and type of hair
  2. the receiving area, its suitability, the phototype of the patient, previous operations
  3. the number of surgical sessions which the patient will undergo

 

Auto Hair Transplant with Laser

The follicles are removed with a pulsing carbon dioxide laser, extracting tissue parts containing the outer layer of skin containing the hair follicles not genetically predisposed to baldness. 
After the follicles have been carefully selected, they are then implanted into the new destination, inside a small space created by the laser.

The area used to extract the hair follicles is shaved and the area which receives the follicles is stitched with a tiny intra-dermal suture hidden by the hair and therefore invisible.
 

Post Operation

HOME CARE
The day of the operation the patient must lie on their back with ice on the forehead and the area treated: the ice has a soothing effect and reduces swelling.
The day after the operation the patient must remain at rest, avoiding excessive exertion and sources of heat.
In the area where the hair has been removed, the hair remaining can be washed one or two days after the operation with a delicate shampoo, applied when the hair is dry and then rinsed with tepid water.
In the area which has received the transplant, the hair can also be washed after two days by gently massaging the area with a light shampoo. It is also necessary to apply a sterile solution three to four times a day for three or four days.

RECOVERY POST OPERATION
After the operation, as well as mild swelling in the treated area, there will sometimes appear small red lumps which will then fall away in the space of a few days. It is important not to attempt to remove them as in this way the hair follicle may also be dislodged.
The stitches of the part where the hair has been removed are taken out after 10-12 days
It is not allowed to do any sport which leads to excessive sweating or can cause trauma to the head for at least two weeks.
Daily activity can be re-started after 2-3 days.

The area must not be exposed to the sun for at least three months after the operation and after all signs of the surgery have gone.

How long does it take for the hair to grow?
The results will be visible from the third month after the operation and will usually be fully satisfactory after six month.

This operation does not necessarily give the patient complete coverage, but rather a gradual and progressive hair replacement, which can then be improved with successive operations.
The entire replacement usually necessitates 2-3 sessions with a space in between of around six months.
If faster results are desired, it is possible to instead used a combined technique: scalp reduction and hair transplant with laser in order to reduce the bald area as much as possible.
The check-up 5-6 months after the operation is always necessary.

In conclusion, thanks to the new surgical techniques it is possible to plan complete, personalised hair replacement, taking into account the various characteristics of the patient such as the gender, shape of the face and personality. Modern surgical techniques also enable natural looking results with the “new” hair specific to the area of the head.
 

Traditional Surgery

  • Long treatment sessions
  • Slow re-growth of the hair
  • “Doll” effect
  • Damage to the scalp
  • Visible scarring
  • Minimal survival of the hair follicles

 

Innovative Surgery

  • Treatment sessions lasting 3 or 4 hours
  • Hair re-growth in just 3 months
  • Natural hair replacement
  • Removal of a single hair follicle
  • Scars not visible
  • High survival rate of the hair follicles

 

Eyebrow Hair Replacement

Recommended when eyebrows are sparse after years of plucking or natural hair loss.
The hair follicles are taken from the back of the head and inserted in such a way as to create a suitable look for the individual characteristics of the face of the patient.

 

Summary

Anaesthetic: local
Operation time: 2-3 hours
Recovery time in clinic: 4 hours
Number of types of medication: 2
Recovery period: 2 days