Evolution of hair transplant surgery

Hair transplantation is a surgical procedure that takes out follicles from the donor site on any body part and implants to the bald area known as the recipient site. The very first case of relocation is to treat male baldness patterns in 1952 (New York). The procedure is generally carried out as an outpatient treatment, and the patients are generally referred to during the first week of their recovery. To get the most benefit from the surgery, the donor grafts must be removed properly as soon as possible. Here we describe the evolution of hair transplant surgery over the past and present.

Evolution of hair transplant surgery

Some Preparation Steps

 Prosthetic follicles preparation

The first step is to prepare the scalp with an artificial prosthetic follicle called “prosthetics”. Prosthetic follicles can be used not only on the scalp but also on other parts of the body. Suitable follicles are very important in the evolution of hair transplant surgery. So, you must have a set of appropriate prosthetic follicles that match the one that your donor provided.  Keratin-derived follicle 

When the follicle is not suitable, we recommend getting a keratin-derived follicle; they have a greater chance of finding compatibility. If you do not have a suitable follicular type, you need to choose another follicular type and displace the rest of the follicular unit.

 Compatibility check on scalp

After that, the next thing you should do is relocate the follicle onto the top portion of the scalp. Once these follicular layers are successfully attached to the scalp surface, they have a great opportunity to get attached to any other part of the new follicular leading to the evolution of hair transplant surgery.

Some Novel Methodologies

Punch Grafting

In this type of harvesting, the scalp is obtained in sharp punches of a 5 mm long patch. Mostly thirty to fifty patches are harvested in a single setup. Their punches are flat in shape. The donor scalp is also prepared to fit these patches as the holes are made in the scalp. This whole practice was carried out under local anesthesia. The punches are placed at regulated distances for their survival. A layer of Vaseline is spread over the punches and the dressing will remain for almost 2 days. These grafting methods are early in the evolution of hair transplant surgery.

Scalp Reduction

In this technique, the bald area is reduced before punch grafting. The scalp is deeply removed by a sharp scapula. There are many cutting patterns like it may be in fishtail shape and some others. This procedure also requires local anesthesia.  This technique assists in reducing the bald scalp and should be repeated after 6 months. This procedure has a vigorous role in the evolution of hair transplant surgery.

Strip Harvesting

The practitioners yield a strip of good growth scalp from the donor with the help of a sharp scalpel. The receiving scalp is punctured with needles and fine blades. After preparation, the grafted scalp with short hair length is placed in desired density and pattern to get the best outcomes. This technique leaves a minimum linear scar on the patient’s scalp. The recovery time is less than 2 weeks.

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Follicular Unit Transplantation

This technique is based on the idea that a follicular unit is transplanted which is a graft having only one to four hair units.  With the invasion of the FUT technique, there is a histrionic improvement in this field. But this procedure required much experienced and qualified staff. At first, people are reluctant to adopt FUT. But after 2000 this technique became the most demanding and adoptive procedure due to its high success rates.

Follicular Unit Extraction

Follicular Unit Excision is the surgical procedure in which a terminal hair is extracted from the scalp with some adjacent skin to get a full dense skin implant having follicles with intradermal fat, dermis, and epidermis of the scalp. This extraction has two phases. In the first phase the scalp is an incision (cut) and in the second phase, this scalp is extracted with all skin layers. This extensive practice usually takes 8-10 hours. It is a scar-less surgery immediately after the treatment. This scalp extraction is practicable over the head, beard, chest, and other body parts. A multipurpose device named punch is used to extract the scalp effectively. This novel follicular unit excision device overcomes the undesired problems for curly, different skin tones, skin texture, skin location, non-shaved areas, and long hair grafts.

Robotic Follicular Unit Extraction

Robotic Follicular Unit Extraction (R-FUE) is a medical technique in which a computer-functioned device with a fine three-dimensional ocular structure is used to extract and insert follicular units from the donor area to the recipient scalp. In simple words when the follicular unit extraction method is operated robotically. Robotic Follicular Unit Extraction has a robust impact on the evolution of hair transplant surgery.

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FUT hair restoration technique Hair transplant success rate 


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