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Hair Transplantation and Restoration Hair FUE

What is Hair Transplantation?
hair
loss and thinning hair are common problems in both men and women. Almost all males experience some form of hair loss in their lifetime.

There are many reasons for this including aging, family history, as well as burns or trauma. Even women can experience hair loss, not just through traumatic events, but also naturally. In fact, one in five women will experience some degree of hair loss.

Some individuals experiencing hair loss choose to wear a wig, or hair extensions to cover their baldness. Then there are those who use pills, and formulas to improve their appearance. Cosmetic surgery provides a solution for those looking for a more natural result.

Currently, there are several conventional options for dealing with hair loss or Alopecia in both sexes. The choices range from over-the-counter topical treatments such as Minoxidil to prescription medications like Finasteride (Propecia) and in some instances, surgical options and hair transplantation.

Advancements in cosmetic surgery have allowed men and women to regain the appearance of a full head of hair. Not only do these hair restoration procedures help individuals to regain a sense of youthfulness, it can also help boost their confidence to increase productivity towards the individual and society.

One important feature about this particular procedure is that it uses your natural existing hair. However when considering a hair transplant, it important to remember there are limits to what can be done with your existing hair and reducing the appearance of baldness.

Several sessions may be needed to achieve optimal results. Also the final results of your hair transplant may not be evident for months, possibly a year after undergoing the first surgical treatment.
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Causes of hair loss: baldness

1- Malnutrition and a lack of iron and amino acid, the main nutrient for hair follicles and Pilosebaceous units.
2- Pregnancy, Breast feeding and menstruation (commonest cause in female).
3- Genetic factors play a major role (Commonest cause in male).
4- Chemicals: dyes, oils, shampoo with ammonia.
5- The psychological causes: stress causes hair loss in some cases even some psychological problems push the patient to pull his hair, in a manner unintended or scratch specific areas of the head, causing hair loss and susceptibility to baldness.
6- Diseases and some drugs: There are some drugs used in the treatment of diseases such as cancer, which causes hair loss and baldness, as well as disturbed thyroid hormone.
7- There are other reasons such as injuries or scars as a result of trauma and burns or previous surgery.
8- Many other minor reasons, such as aggressive massage of the scalp, plastic comb, dandruff.


Management of Hair loss:

There’s some emerging research that points to natural alternatives for addressing poor hair quality as well. Many of these holistic options only have preliminary evidence to support their use. But, they do offer hope for those who have not found success with conventional therapies or who have discontinued their use due to side effects or other complications.
hair losser
• Flaxseeds

• Tocotrienols: Vitamin E.

• EGCG (Green Tea Extract)

• Silica: Silica is a trace mineral that is believed to support the health of connective tissue such as collagen (found in cartilage and skin) and keratin (found in hair and nails).

• Biotin.

• Laser phototherapy employs the use of “near infrared lights” to combat scalp inflammation and promote the growth cycle of follicles.

• Apple Extract: A class of antioxidants contained in apples, grapes and various other fruits and vegetables may stimulate the growth of hair in a similar manner as Minoxidil.

• Propecia.


Benefits of Natural Hair Transplantation Surgery:

Hair transplantation provides an easy way to get a new natural look of hair.

While hair transplantation does not actually add any new hair to the head, it redistributes the existing hair to provide more hair in bald area.

Religiously, natural hair transplantation is acceptable in Islamic Beliefs. The used hair is of patient himself hair and not that of other person or of animal source, i.e. neither wigs, nor artificial hair.

Psychologically, hair transplantation improves self-confidence by having the appearance of a handsome and non-bald head. Patients practice a normal life without the need to wear neither head caps nor wigs.

Medically, on the contrary, artificial hair (Biofibres) has many risks. It weakens the scalp and increases hair loss, causes multiple infections and scarring of the scalp tissues, that hindering implanting natural hair later on.

The synthetic biofibre hair does not remain for more than three to five years with the use of many medications throughout this period. While, the implanted natural hair remains lifelong and does not require special treatment except for only the first three to six months post-transplantation.

Using natural hair transplantation, there are no side effects, except only the donor site scar which is hidden under the back-hair.


Who is the best Candidate for Hair Transplantation?

The ideal candidate for transplantation, who has healthy hair growth at the back and sides of the head to serve as donor areas, have self-conscious about their appearance, has a good understanding of the procedure and realistic goals and expectations.


Degrees of baldness:

There are seven degrees of baldness in men and three degrees of hair loss at the Ladies

Degrees of baldness



How are Hair Transplants Performed?

The general concept of hair transplantation is that the transfer of the active healthy hair follicles that present in the back and not affected by hormonal changes to the hairless areas that their hair follicles was inactive by hormones.

There are two types of human hair follicles in the scalp. The first one presents in the frontal region and contains receptors which could be affected by male hormones. The second type presents in the back and sides of the head and does not contain these receptors.

The number of receptors (under the skin surface) and how they are affected by hormones are genetically determined. The activation of those receptors leads to hair loss and baldness.
life cycle of hair follicle
The life cycle of human hair pass through three phases:

- The first phase "Anagen" where hair grow and lasts 2 to 6 years.
- The second phase "Catagen" which is a transitional from active and resting phases and lasts 1 to 2 weeks.
- The third phase "Telegen" which is the resting phase and lasts 5 to 6 weeks upto many years in affected follicles.


There is no medication until now that block these receptors, and if it is present there will be no baldness forever. Till innovate this drug, the only medical way to get off baldness is the Transplantation of active hair follicles from the back area to baldness area.

Anesthesia:
- Local anesthesia
- Local anesthesia with sedation

Techniques:
There are many methods for hair restoration surgeries. Each technique has advantages and disadvantages. They differ according to the method of collecting the hair follicles from the donor site and method of insertion to the recipient sites.

A - Macro-grafts where pieces or bunches are taken and each one contain more than 10 follicles.
b - Mini-grafts where pieces or bunches are used and each contain 7 to 10 follicles.
c - Micro-grafts where pieces are used and each contain 2 to 6 follicles.

punch hair


d - Follicular Unit Transplantation or Extraction (FUT or FUE) where pieces contain 1 to 4 follicles.

FUE


e - Strips graft which are divided into FUT and Micrografts.

strip transplantation


f - Slit grafts.

slit


g - Local flaps with tissue-expansion surgeries.

head tissue expander


h - Scalp reduction surgery.

scalp reduction surgery



Success rate: in General between 80% to 95%.

Amount of transplanted hair: 1000 up to 6,000 follicles.

Time of the Procedures: 2 hours up to 12 hours.

Recipient site:
The openings in the bald area could be done by different methods:
A- Slits 2-3 mm (linear) the most used to increase density with implantation of macro-grafts.
B- Maco-bunches 2-3 mm (circular) obsolete as it causes bleeding, ugly scars.
C- Mini-bunches 1-2 mm (circular) the most natural appearance results and used only for FUT.

method of transplantation best hair transplantation


Then, the transplanted hair is arranged in special patterns and inserted in special direction to make the most natural appearance.

distrubution of denisty of hair

Hair Transplantation



After Transplantation and Follow up:

- The head is covered by a bandage for five days, analgesic and anti-biotic drugs are used for one week.

- After removal of the bandage, the local drugs are used to enhance growth of the transplanted hair for 3 to 6 months.

- You may need to avoid strenuous activity, including sexual activity, for at least 10 days after surgery.

- Stitches are removed after 10 -21 days.

- Hair need three to six months to begin to emerge and will grow up to normal length within six months up to one year. During this period close follow up is needed to improve and maintain the results.

- Shaving of the transplanted hair is forbidden up to 6 months.

- So, the final result may not be clear before a year after transplantation. After that, the head is covered


What are the Risks and Uncertainty associated with Hair Transplant Surgery?

With a hair transplant, there is little chance that risk and complication could occur. You can also reduce your risk of complications by closely following your doctor's instructions both before and after the procedure.

However, you should be aware that scarring may occur on the graft sites. But, most scars are small and are covered up by growing hair.

There is a chance that some of the grafts will not grow (less than 10%). Also hair loss could still occur after surgery to non transplanted hair. This can result in an unnatural look with patches of bald spots around the head. Additional sessions may be needed to correct this appearance.


What are the costs associated with Hair Transplant Surgery?

Although price is a factor when deciding on surgery, however, the most important factor is that you feel you are getting a good quality, natural-looking result from the procedure.

The costs for undergoing a hair transplant vary, depending on technique used and the amount of work that needs to be done. Some doctors may charge per session and some may charge per graft. Cost of a hair transplant may also depend upon the extent of the hair loss and your goals for the final result of the hair transplant.

The cost is ranging from 1500 to 4000 U.S dollars per session. Most medical insurance providers do not cover the procedure.


FAQ from patients when considering undergoing a Hair Transplant?!

Q - Is it possible to take any follicles, other than back of the head?
A - No, body hair follicles are weak and they have different quality.

Q - Is it possible the transplant beard and mustache?
A - Yes, especially if these areas are scarred.

Q - Is it possible to transplant scars?
A - Yes, but the success rate is less than 80 %.

Q - What is the meaning of success rate of 90 %?
A - Each 100 transplanted follicles, 10 follicles will be lost within the first 2 weeks.

Q - Is it possible this procedure to complete baldness (7th degree) “Alopecia Totala"?
A - Of course there are no enough donors for that so, the artificial hair implantation could be used.

Q - What is the least and most amount could be transplanted per session?
A - The least amount of hair is 2000 follicles and 6000 follicles is the most amount of hair.

Q - What is the duration of the procedure?
A - Ranging from 4 to 6 hours.

Q - What is the type of anesthesia, and when I can return to normal life?
A - Local anesthesia with or without sedation, and you can practice your normal life within 2 hours.

Q - What are the symptoms that may occur in the first five days after transplantation?
A - Traction pain in the nape which could be managed by pain killer’s medications and there may be edema or swelling of the forehead.

Q - What are the guarantees that the success of the process?
A - There is no doubt that the followers of the medical instructions and always reviews the main factors for the success of transplantation. If not, the process to achieve the agreed outcomes before the process repeats at reduced cost.

Q - When can we do hairdressing and shaving?
A - after the first six months.

Q - Can hair be cloned?
A - There is no way for such so far.

Q - Are transplanted hair seems naturally?
A - Yes.

Q - What is the solution for active hair loss?
A - Hair transplantation should not be done with active hair loss. You must wait till treatment of dandruff and weak hair. However there are many medication to decrease hair fallness.

Q - If you are not Egyptian, What is the minimum period for follow up?
A - Five days.

Q - What is the difference between natural hair transplantation and Biofibres or hair unit?
A - Biofibres are synthetic and formed of plastic materials or horse hair, immune rejection of this materials cause severe inflammatory response with infection. It will be lost within 2 to 4 years after implantation.

Biofibres need many post-implantation medications that continue for years to minimize infections. You cannot use hair dryer or make especial hairdressing. It is expensive (2 U.S. dollars per one hair) in proportion to natural hair implantation costs (0.5 U.S. dollar per each hair).

It is not acceptable to Islamic religious laws. Wig or Hair Unit "New Look" has a major problem as it is not acceptable to Islamic religious laws.

Also, a bad odor sticky material is used which is very offensive and cause scalp inflammations.
But there is one reason for using Biofibres, the lack of any donor hair from the head, such as in cases of Alopecia Totala or complete burn injuries of the scalp.

Q - What is Mesotherapy? hair fallness
A - "Meso-" means the middle layer of the skin and "-therapy" means treatment or dealing with. This layer contains most of the important structures of the skin as sweat glands, collagen fibers, and hair follicles.

Thus the word Mesotherapy means to strengthen and nourish the middle layer structures by injecting multi-vitamins or use topical agents that penetrate the superficial skin layers and reach the middle layer structure.

This method could be used during active hair loss to minimize it and strengthen the weak hair but it is used as multiple injections (6-8) as one injection each week for 2 months then one injection each 2 weeks for 2 months. This method could be used also to enhance the transplanted hair. Each injection costs about 75 U.S. dollars.

Q - Is it possible to transplant the eyebrows?
A - Some patients with lupus and burns suffer from hair loss of eyebrows. There are 2 ways to treat this problem; first, by medication like Elicon lotion. The second solution is planting hair as strips.

Q - Can you implant hair on scarred areas?
A - Old burns and scars have poor vascularity so, if the scarred area is limited (less than 3 cm in width) it could be excised directly, if more tissue expansion and local flaps could be used. However, implantation of Biofibres has a less inflammatory reaction, so it could be used?!. The natural hair transplantation has less than 80% success rate, so it should not be used.

Q - What are the non-surgical methods for hair restoration?
A - There are a wide variety of creams and lotions in the markets that companies claim they enhance hair growth and stop hair loss.

However, many of these products use Minoxidil which were used in the treatment of blood pressure and physicians note the appearance of hair in some females, who used these drugs for long periods in areas such as the chin and mustache.
non surgical hair restoration
This material really enhances hair growth but one it is stopped all hair will be lost as it has addiction like action for the hair.

Minoxidil may work for men
- Who have been bald for less than 5 years
- Whose bald area is less than 10 cm across and/or your main problem is general thinning
- Whose hair loss is mainly at the top of the head
- Whose bald area has lots of tiny, fine hairs.

Minoxidil is not likely to help men
- who are completely bald
- Whose main problem is receding hair (frontal loss)
- Whose bald scalp has very few tiny, fine hairs.

Bear in mind that Minoxidil is successfully used in only about 35% of men, and this is often fine and downy – and the manufacturers advise users to give up if there has been no regrowth after using it for 1 year
Minoxidil must be applied twice daily, 7 days a week. If the treatment is stopped, the follicles fall down with extra hair loss. Take no notice; these are simply the old short downy hairs at the end of their life.
- It should probably not be used by people taking drugs for blood pressure, or who have angina. The solution contains alcohol, and can cause irritation in some people.

Q - What is Propecia?
A - Propecia is for use by men only, to treat male pattern hair loss by increasing hair growth on the scalp and preventing further hair loss.

Male pattern hair loss (also known as androgenic alopecia) is a common condition in which men experience thinning of the hair on the scalp. This often results in a receding hair line and/or balding on the top of the head. These changes typically start to occur in some men in their 20s and become more common with age.

Male pattern hair loss is thought to be caused by a combination of family history (heredity) and production of a particular male hormone, called dihydrotestosterone (DHT). Men with male pattern hair loss have more DHT in the balding part of their scalp than in other parts, resulting in increased hair loss.

Q - How Does Propecia Work?
A - Propecia specifically lowers the levels of DHT in the scalp, thus helping to reverse the balding process. Propecia does not affect hair on other parts of the body. Men with mild to moderate, but not complete, hair loss can expect to benefit from the use of Propecia. There should be no need to change your usual hair care routine (for example, shampooing or haircuts) because you are taking Propecia.

Q - How long will I have to take Propecia for?
A - Male pattern hair loss or baldness is a condition that develops over a long period of time. Because it takes time for new hair to grow, you will not see immediate results. In general, daily use for 3 months or more may be necessary before you notice increased hair growth or prevention of further loss. Continue taking Propecia for as long as your doctor prescribes.

Q - What are the Propecia Side Effects?
A - Propecia helps most men with male pattern baldness or hair loss, but it may have unwanted side effects in a few men. These include:
- decreased amount of semen released during sex (this decrease does not appear to interfere with normal sexual function),
- breast swelling and/or tenderness,
- skin rash, itching,
- testicle pain,
- swelling of the lips or face.

Q - What are the contraindications of Hair transplantation?
A - There are no absolute contraindications but the patients should inform their surgeons about any allergies, serious medical conditions, and medications they may be taking.


Summary of Hair Transplantation:

The time of the procedure:
from two to six hours.
Type of anesthesia: local anesthesia +/- sedation.
Location: hospital or clinic without postoperative hospital stay.
Expected Side effects: few, such as mild swelling, aches, which treated by analgesics.
Recovery time: return to work immediately and the final outcome within the first year.
Cost: according to the number of transplants, ranging from 1500 to 4000 U.S. dollars.
Results: a lifelong.