Implants hair for hair rejuvenation
Androgenic alopecia is a common reason for consultation in aesthetic medicine and 20% of men aged 20 to 30 and up to 70% at age 70. This more or less rapid change, the density and the quality of the hair is sometimes poorly experienced and patients or patients who come to consult and who themselves are already very knowledgeable different techniques to slow the fall or correct this baldness. To be reimplanted hair becomes less taboo and patients want to quickly process this hair loss characterized by a hair with finer, less pigmented hair miniaturization, under siege with a hair more in shorter cycle.
Have a bald spot was more easily assumed since 1998 with Barthes football World Cup, Zidane and helped some patients to accept their baldness and shave rather than trying to hide what remained as hair. But this mode seems to falter and we are witnessing a growing demand for "hair rejuvenation", initiated by many stars and football players… Some patients who shaved up there, to be implanted hair while keeping the same hairstyle, like to have the choice of letting the hair grow later.
In the same way as other aesthetic techniques (botulinum toxin, injections anti wrinkles,…), hair transplant also allows a "rejuvenation" capillary and enables the patient to regain harmony with himself.
The method of implementation of the most popular and most requested hair is the FUE, which is now the most practiced in the world at the expense of the technique of the Strip which may leave a visible scar on the back of the skull. The FUE technique requires not only to be well experienced in the hair by hair removal but also to well to anticipate the progression of baldness during implantation. The treatment of baldness will be different for a man of 25 years against a man of 50 years to equal baldness.
Objective information: management in the time of baldness
We must explain to the patient that his baldness is likely to evolve and it is important to anticipate it and do not want to implement a low frontal area for example. Younger patients, it is often necessary to perform a second session in a few months or years because baldness continues to evolve. A good strategy is conceived in the long term and with the appropriate technique. It is important to not to put 3 or 4 hair grafts on frontal zone for example but rather of single or double transplants to ensure the natural effect.
The FUE (Follicular Unit Extraction) method
Consists of a change in the hair of an individual capital, taking the follicular units insensitive to androgen hormones which are located in the occipital area and relocated them on the area recipients.
At the level of the scalp, androgens cause progressive involution of the hair follicle. This still poorly understood phenomenon is now explained by braking of secondary protein synthesis at the local inhibition of Adenylate Cyclase. This braking causes a shortening of the duration of the phase anagen. This reduction of hair cycles and their acceleration results in premature depletion of the stock of hair that the pilosebaceous follicle is capable of providing and leads to alopecia.
(1) sampling after local anesthesia and tumescence
There are several techniques of sampling FUE:
-Manual with a sharp punch is turned to retrieve the plugins eventually.
-'automatic' with a rotary cutting punch powered by an engine.
The speed of the levy depends on the experience of the operator. It is possible to collect more than 2000 grafts in one day… Each plugin (or graft) is composed of 1 to 5 hair depending on the size of the punches (between 0.8 and 1.5 mm). The quality of grafts (risk of trans-section mainly) seems to be dependent on the technique used and the material used.
Collected plugins are sorted by number of hair (a plugin can contain 1, 2 up to 5 hair) on wet bandages, so choose plugins depending on the zones to implement: finer hair forward to ensure a natural effect.
Sampling occurs typically at the level of the occipital area but for very important baldness with a sparse donor area it is possible to collect hairs at the chest, back, or even at the level of the beard.
There are different sizes of punches (0.7 to 1, 2mm), the most used are 0.8 0.9 and 1.0 mm depending on the size of the grafts to be taken. Choose the size of the punch after collecting a small series of a dozen of plugins, there is too much trans-section we choose a slightly larger punch. The right size with a risk of acceptable Transection and leaving the least possible scar is 0.9 mm punch.
The form and composition of the punches also vary depending on the equipment used (titanium punch, punchs flare-tipped, length reduced,…)
The rotation speed is configurable on automatic (on average 800 rpm), while with the manual FUE speed is always the same and it is the operator of this speed. The choice of the rotation speed depends on the quality of the scalp. More scalp is thick more speed will be fast. Also we will be forced to increase the speed of rotation throughout the session because the punch will naturally dull.
One patented device to collect direct the graft smooth and controlled aspiration, which avoids having to collect it with a clip which may damage the graft, punch hair matic S.A.F.E.R. (Suction Assisted Follicular Extraction & Re implantation)
(2) implantation after local anesthesia and tumescence
After the schema of the area to relocate on the patient, incisions using a small scalpel blade are made while observing a more natural look possible.
This step is as important as the levy because it determines the future result. Different sizes of blades are used depending on the size of the collected grafts. The grafts are then implanted using micro clips one by one.
It is possible to relocate directly without having to make his incisions: with the selection (= choi implement pen), kind of needle dig where we insert the graft that will push. This method requires an experienced team which must take turns to prepare the track as the implementation progresses.
Another patented device allows to avoid the use of traumatic forceps, by a suction system and insufflation of the graft inside the incision (SAFER).
(3) advice post op
We must explain to the patient the natural evolution of the implanted grafts: all plugins are going to fall naturally. The hair stem falls but the established root remains in place. It takes between 3 to 6 months to begin to see regrowth.
He must leave the crusts in place and do the first shampoo on the 10th day ensuring that you do not rub.
I ask the patient to return to regular consultation to assess and monitor the regrowth. Sessions of Mesotherapy with vitamin complexes or PRP associated with LED red to increase the chances of regrowth of the grafts.
A prescription of minoxidil spray is often prescribed for 3 months to accelerate regrowth.