Fue Hair transplant if presented simply is taking out extra roots from donor area and planting them in bald or recipient area. This is most advanced and reliable version of hair transplant .we take out single follicle (root) from donor area and plant it in bald or recipient area. The whole process is done under highly controlled environment.
Concept of Donor Area.
Donor area is that area of head from where we take hair roots for plantation in bald area. This area normally extends from above the ear from one side to back of head and then to area above the ear on other side. Hair in this area does not fall till late in life. Taking advantage of this property of donor area we can transfer them to any area without fear of their loss.
Circulating testosterone is converted by enzymes in body to Di Hydro Testosterone (D.H.T). DHT receptors are present in hair roots .These bind to circulating DHT and cause constriction in blood vessels surrounding the roots. Constriction in blood vessels lead to decrease in blood supply and finally decrease in size of roots eventually hair fall and fibrosis. DHT receptors are present in great numbers in top area of head starting from front till back of head up to crown and extending little bit down. This is the normal area where males get baldness.
In donor area as described above there are no DHT receptors hence these hairs do not fall. So this donor area is sometimes referred to as safe zone.
Steps in Hair Transplant
On consultation we do a computer analysis of head and evaluate 2 basic things
First how much bald area is to be covered .what should be the density (number of grafts per square cm.) Hair line is made with a marker and Based upon this total number of graft requirement is calculated i.e total area multiplied by density.
Second is analysis of donor area. Density in donor area is calculated under microscope. Total number of grafts per square cm multiplied by safe zone will give the total number of grafts that are present in safe zone out of these we can roughly take out 65 percent of grafts in multiple or single stages
Medical history is very important in all hair transplant cases. Clients where we see a clear cut medical condition behind hair loss. We first correct that condition. Previous history of cardiac conditions, people on anti-coagulants, or previous cardiac stenting may get a nod from their treating physician before undertaking the procedure. Any medicine which is being regularly used should be brought under notice.
Before Hair Transplant
Smoking, tobacco etc. have to be completely stopped before surgery. Medicines for hypertension diabetes thyroid etc. should be continued .multivitamins aspirin in particular should be stopped 10 days before surgery.
On Day of Surgery
In the morning head washing is to be done with shampoo and medicine taken as prescribed along with good wholesome breakfast. Surgery is done under local anesthesia (ast).
Usually extraction is done in prone position (face down) except for direct hair transfer technique where position is lateral (face on the side ).We harvest total number of grafts decided before surgery and store them is specially designed cellular matrix (matristem from u.s.a).
After every one hour of surgery we take short break. Beverages juice tea etc. is provided as per request. Lunch break is done at around middle of surgery.
Plantation is done in supine position except for direct hair plantation which is done in laterl position. We use state of art Atlanta planters to achieve very high densities. Total blood loss (average calculated in 100 clients) comes out to be almost 50 ml in extraction and around 70 ml when we do slit and place technique for plantation. While blood loss is almost 40 ml while we use planters.
We only do dressing in donor area. Transplanted area is not covered with dressing. A surgical cap is worn over the head. Follow up, shampoo, medicine etc. are discussed at the end of surgery .clients can resume their normal activity second day .
General precautions are mentioned here .Specific points which vary from one client to other are told at the end of surgery to each client separately.
- Do not pull heavy weights like pulling bucket full of water, carrying heavy luggage etc.
- Strenuous activity like walking, running, jogging is to be avoided for at least 7 days.
- Sleep at almost 45 degree angle will help in decreasing swelling post op.
- Alcohol, smoking, tobacco (active and passive) is to be avoided..
- Shampoo and dressing is to be done as advice.
Post op H.L.P. Sessions
We give three HLP sessions after each hair transplant. First session is invariably at 20 to 25 days. Rest of Sessions are decided thereafter.