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Introduction

Hair fall is a major problem that affects both men and women at some point in their lives. There are many causes of hair fall. The most common factor is androgenetic alopecia. The cause of androgenetic alopecia is hereditary and there is usually a genetic history of it, up to three generations, on either the mother’s or the father’s side. Balding in androgenetic alopecia is caused by the action of DHT (dehyrotestosterone), which is the active form of the hormone testosterone on the receptors present in the hair follicles. We classify balding in Hamilton–Norwood range of 1–7 for men and Ludwig range of 1–3 for women, to assess the severity of balding as depicted in the picture below.

The treatment options that have a definite role in the treatment of androgenetic alopecia are broadly divided into two. The first option is medical treatment and the second option is surgical hair transplant. Medically, there are only two medicines, namely Minoxidil lotion and oral finasteride tablets, that have a testified role in treating hair fall. Medicines work only in the early stages of balding, namely stages 1–4. They may stop the hair fall and retain the hair that are present. But these medical treatments have some disadvantages also, such as they need to be taken regularly, they have to be used lifelong, and they cannot help a bald person grow a head full of hair.

When the balding has progressed to stage 4 and beyond, the “gold standard” for hair restoration the solution is hair transplant procedure. The greatest benefit of this procedure is that it offers a permanent solution. The transplanted hair are permanent, i.e. they stay for life; never fall; and need subsequent haircuts. The principle of hair transplant is that all of us have a zone of hair on the back and the sides of our scalp that are permanent or, in other words, are unresponsive to the DHT hormone, therefore, they never fall. Thus, we aim at redistributing these permanent hair follicles to the area of balding where they can add significant value.

Hair transplant to permanently correct baldness is done at our clinic by follicular unit transplantation (FUT) using the patented “follicle by follicle technique” .The hair that are transplanted to the bald area are permanent, appear absolutely natural, and do not look different from the existing or natural hair in appearance or direction of growth. You can comb them to your desired style, oil or shampoo them, and even shave them.

The procedure is done under local anesthesia on an outpatient basis. You would stay awake throughout. You can watch TV, listen to music, and take your lunch during the break. You go home immediately after the procedure. Depending on the area and number of follicle units, it usually takes approximately 2–6 hours for one session of hair transplant.

Procedure Details

After giving local anesthesia we take a strip of skin containing the hair and hair follicles from the back and sides of the scalp. The length of the strip depends on the amount of follicles required and the width of the strip is between 1–1.5 cm. After taking the strip, the gap is closed with a stitch, which is removed on the 10th day after the procedure. We do a “trichophytic closure” of the linear scar where hair grow through the scar and make the scar hardly visible. About 3–6 months after the treatment, the scar can hardly be made out. After harvesting the strip, we make small gaps at the front of the scalp to receive the tissues from the grafted strip. The strip is cut to give individual follicles, which are then transplanted into the slits made in the recipient area. It takes about 2–3 hours to place the grafts in their position. Overall the procedure takes about 6–8 hours and a full medical team, consisting of 8–10 people, work at the same time. The patient goes back home the same day and no stay with us is required.

Results

In the initial 3–4 weeks after the procedure, all the transplanted hair fall off. After a rest of another month, the hair start to grow out of the scalp again. The hair then grow at a particular speed – on an average at a rate of 1 cm per month. Therefore, a waiting period of 6 months after the surgery is required to appreciate the results of the hair transplant procedure.. Once the 6 months are complete, the hair that would have grown back would be your permanent hair. They would never fall, they’ll grow normally and would need haircuts. You can cut, style, shampoo, apply hair dye or colour them. The hair would grow back even if you shave your entire scalp!

For the treatment of large patch of baldness, we have transplanted 3500–5000 follicles or even more in one sitting of 6–7 hours. In case of multiple bald patches, another sitting can be scheduled after at least 6 months of the first procedure. Depending on the donor area, one can have 3–5 sittings of hair transplant to cover even very large areas of baldness, but at an interval of 6 months or more. In areas where there is thinning of hair but not complete baldness, hair can be transplanted in between the existing hair to increase density.

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