General Info of Hair Loss

written by Dr Ruban Satkuna Nathan on 28 August 2012

General Info of Hair Loss

 
 
Hair Loss Chart & Classifications
 
The most commonly used chart for men is the one developed by Dr Hamilton and then later modified by Dr. O'Tar Norwood called the Norwood-Hamilton scale. 
 
 
Male Pattern Alopecia / Androgenetic Alopecia
 
This is the commonest form of alopecia seen & the commonest indicator for medical treatment with Propecia  & hair transplant surgery. It follows the pattern seen below classified by O'Tar Norwood & known as the Norwood Classification.
 
Female Pattern Alopecia / Female Androgenetic Alopecia
 
 
This, too is the commonest form of hair loss seen in up to 50 % of women by 60 years of age, the pattern of which has been classified by Hamilton. 
 
 
HOW
 
Hair Transplant
 
 
How?
 
We use the back of your scalp (occipital area) to harvest the hair follicles or grafts  We prepare them by SLIVERING & CUTTING and make micro insertions where you need more hair & then insert the trimmed follicles. 
 
 
Hair line design is important at this stage to ensure a natural looking ‘soft’ hair line that is not excessively  dense.
 
 
 
Hairline Design - Soft Hairline Post Transplant
 
 
A good candidate for surgery is therefore a patient who has decent density & is unlikely to lose it. This is all done under local anaesthesia & tumescence which makes it a painless & bloodless procedure.  There will be swelling for a day or so  you may return to work in 2 days depending on the number of grafts done .  
 
Folliclular Unit Transplants or FUT is the technique as described which gives you a natural replacement of your own hair which occurs naturally in groups of 1-4 hairs or single follicles.  
 
 
This is usually done by the STRIP method of harvesting a strip of skin from the back of the scalp/ head…resuturing or closing the strip by TRICHOPHYTIC closure technique which leaves a very faint scar, see image below.
 
   
FUE / follicular unit extraction technique is an alternative method of harvesting  grafts by using an extractor machine that punches out each graft .These naturally grouped grafts can then be reinserted in the usual fashion , without further trimming.
 
The absence of a ‘Strip” scar is preferred by some , & this technique is also useful when the donor area is insufficient or  harvesting from beard / chest hairs is desired.  
 
Transplanted grafts will fall before regrowing in 8-12 weeks.
 
Follicle preparation using the latest stereomicroscopes
 
 
 
FAQ
Q : So the Procedure is called FUT/ Follicular Unit Transplant... what is a Follicular Unit?
A : This is the way hair occurs in nature , which is in groups of 1-4 hairs , otherwise known as a 'graft'  
 
Q : so if I get a 1000 grafts/FUs(follicular units) how many hairs is that?
A : Anything between 2000 -3000 hairs!  
 
Q: How long does the Hair transplant procedure take?
A: Usually an entire morning ,ie 8 am - 2 pm  / afternoon 2- 6 pm  
 
Q : Is it painful ?
A : Pain is minimal & is usually during the delivery of the Local Anaesthaesia/ needle prick delivery of LA fluid.After  which you are comfortably numb. Oral sedation is not required , but is available on request. The anaesthesia usually lasts the entire day. in fact some degree of numbness may persist for several weeks.  The use of audio visual entertainment devices during the procedure is encouraged.  
 
Q : What is the recovery like? & How soon can i return to work?
A : Most of the swelling that occurs due to the local fluid , has dissipated the next day . You may work the following day if really necessary, though its good if you could take the opportunity to take a couple of days off work.  The small scabs at the graft insertion sites  will fall off in about 10 days..  
 
Q : How soon can i exercise?
A : Gentle exercise , ie power walking may begin 5 days  later ... more vigorous workouts 2 weeks later.  
 
Q : How soon will the grafted hairs regrow?
A : some hairs will begin to regrow within 6 weeks, but most will take about 12 weeks . Full extent of regrowth may be seen 8 -12 months post transplant  
 
Q : Will all of them regrow?
A : yes , 100%