Sareen Hair Clinic

Female Hair Transplant

In Sareen Hair Clinic we have completed over 100 women’s hair transplants. Let’s learn the details of it.

INTRODUCTION

Hair transplantation is among the fastest-growing procedures for aesthetic surgery with regular improvements of techniques. The latest advancements in technology and the idea of follicular unit transplants have allowed this procedure to take it to an all-new level. The ability to deliver natural-looking results has led to a greater numbers of females and men to go for this procedure.

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PATHOPHYSIOLOGY

The first sign of baldness in both males and women typically occurs between 30-40 years. A family history of strong is among the most reliable indications of male-pattern baldness, also known as androgenic alopecia. This is the most frequent reason for hair loss. A genetic linkage that is autosomal dominant is thought to be the cause of this loss of hair. Male pattern baldness is common at the age of teen and increases in frequency as you get older. It is known that the male hormone, testosterone, gets converted to another male hormone, 5-dihydroxytestosterone (5-DHT), in the hair follicles. With the help 5-DHT’s influence, the hair follicles on the front and high of scalp start to get more fine as the years, particularly in males who are genetically vulnerable. The growth of hair also slows and, eventually, hair loss ceases completely.

​As with all tissues, hair goes through constant turnover throughout the course of its the course of its. Hair follicles get replaced regularly and at any moment, they are at one or more of the three phases of their growth. The active growth stage ( the anagen stage ) is then followed by a brief time of morphological transformation or the involution phase ( involution phase ). Then comes the resting phase ( the telogen phase ). In humans the total amount of hair on the scalp is typically 100,000. The growth rate of hair is of 1-2 centimeters per month, and the length of the anagen stage is 2-4 years. The Telogen phase is about 100 days. Around 40-100 hairs shed each day; this number rises in late summer and into early autumn, and is reduced in late winter or the beginning of spring, because of the effect of temperatures. Norwood has divided the stages of baldness into seven [Figure 1. For women, the hairline on the front is typically spared, while female baldness has been defined by Ludwig.

​Transplantation of hair is founded upon the theory of donor dominance in androgenic alopecia.’ If a graft is removed from a region that is intended to remain hair-bearing forever and transferred to a location that is suffering from male pattern hair loss, it will, after a period of effluvium, develop hair in the new area for the same period of time as it would have in its original location. This is the scientific foundation of hair transplant surgery.

TERMINOLOGY

Terminal hair is a androgen dependent, male-type hair that is found on the face (mustache beard, mustache, sideburns) as well as in the body (chest and areola lines, alba, thighs). It is more prominent in the presence of hirsutism. Vellus hair is a nonpigmented thin “peach fuzz” hair covering the body of adults and children. It grows more in hypertrichosis.

The Follicular unit graft (FUG) according to Headington [1] comprises four to five terminal hair follicles one (or often two) Vellus follicles and sebaceous lobules with sebaceous connections and the insertion of the an erector pili muscle, a perifollicular neurovascular network, etc. This implies it is an biological thing rather than an anatomy-based one. For all practical reasons it is recommended to define a follicular aggregation as a aggregation of hair shafts that emerge from the scalp. In this case, the distance between hairs is smaller than the distance between them and the nearest hair aggregation. This arrangement must be observed when collecting, dissecting, or transplanting hair for maximum effectiveness, as well as to provide a an authentic appearance for the person.

​The entire information about hair transplants or the restoration of hair for females. female hair loss treatment.

  • The basic principle
  • The strip’s removal
  • The strip is cut
  • Cut the grafts
  • Incisions
  • Placement
  • Hair growth

WHY CHOOSE FOLLICULAR UNIT TRANSPLANT?

1.The principle

The concept behind it is easy to grasp. Micrografts are hair strands which are transferred from the scalp’s back towards the front of the scalp where hairs are genetically distinct.

The procedure can last for only a couple of hours, while under local anesthesia and is virtually painful. No bandages are needed and you’ll be able to return to your normal activities within a few days following surgery.

This new technique offers a variety of advantages for the patient.

​2.The strip is removed

A donor strip will be taken from the neck’s top and is comprised of a hair-like strip that are meticulously cut.The scar is about 1 millimeter wide and is not visible because it is covered in hair.

When it comes to several hair transplants, the new hair is removed near the original scar, to minimize the damage caused to skin tissue and leave only one mark.

​3.Cutting the strip

​1.To aid in cutting those grafts strip of tissue is cut into slivers or slices by using the microscope.

2. These slivers comprise only one row of hair follicles which are later subdivided into Follicular Unit Grafts.

4.Cutting the Grafts

  • Each slice is divided into small grafts that are each one-of-a-kind created by sculpting.
  • The grafts are separated so that they can be matched to the hairs they contain, and then arranged in accordance with the amount of hairs. They are then cooled and placed in a solution.

5.Incisions

1. Grafts are placed in small incisions or the recipient sites on the scalp by using the use of a micro-lancet.

All incisions are created in accordance with topography and are correctly angled to give the implant a subtle and natural look. The size of the incisions are adapted according to the size and shape of the implant.

2.Generally there are three types of incisions:

  • the smaller incisions, or those that are ones that are more anterior, are treated with one-hair grafts ;
  • The incisions of medium size receive two hair the grafts are two-hair ;
  • The larger incisions receive hair grafts in three or four hairs.

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ALL THE INCISIONS ARE MADE PERSONALLY BY DR

​6.Placement

1.Each transplant is done manually. It is crucial that you handle the transplants cautiously to avoid causing damage.

2.As the result, grafts soon be in a environment that aids in their growth. Grafts are able to quickly settle into the skin. After the procedure, you’ll be able feel them without worrying about the possibility of them falling out.

The patient doesn’t need any bandages.

​7.Regrowth

Hair will begin to grow after a few days of surgery.

In general, grafts fall out around the tenth day following surgery.

Hair that sheds is done so while the bulb still attached and can cause discomfort to patients greatly. There’s no reason to worry as the original cell, which produces the hair to grow, is present in the scalp and allow growth to occur in the next two to three months.

​8.Why should you choose Follicular Unit Transplant?

1. Higher density

The aim of hair transplants is to bring in the highest amount of hairs into the smallest volume possible.

The precise cutting with a microscope enables us to eliminate all skin and fat that is in the follicle as well as to eliminate the conjunctive tissue between the hair follicles.

This allows the implant of a greater amount of hairs within an area that is delimitated.

Based on the thickness of grafts that is determined by the amount of hairs the graft has it is possible to transplant between 35 and 45 grafts per cm, which translates to the graft will have between 45 and 80 hairs each centimeter.

2. Natural look

The grafts are classified at the time of cutting, based on the amount of hairs they have.

There are 3 kinds.

  • There is a “singles” group, which comprise one hair. These grafts are positioned in the first row of the hairline in front.
  • “doubles,” also known as “doubles” group, placed just to the left of “singles”
  • There is the ” three, four or more hairs” group. The grafts are only placed in the recipient area. This careful use of grafts is the sole method that gives the most natural look.

3. Each follicle is regarded so that growth levels are extremely high.

Many comparisons were made with regard to the growth rate based on different cutting techniques employed.

The use of microscopes has allowed us to reduce any type of waste.

The amount of hair that grows ranges from 95% to 98% under microscopes.

Cutting hair with magnifying lenses or with no visual aids will yield a positive result. The best way to demonstrate this is to cut of grafts with white hair.

​In reality, the source of these hairs are transparent and it’s impossible to observe them without the aid of a microscope! Without an instrument, the level of trans-sectional area will eventually increase which will result in a loss of hair.

The number of grafts that can be transferred ranges from 6,000 to 10,000.

A loss of any kind is significant, since it’s disappointing on the part of patients. Additionally, losing hair affects the effectiveness of subsequent grafts because it exhausts the donor zone in excess.

4. Treatment of hairy spots

The cuts are very small and precise. This makes it an option to target areas that aren’t completely bald.

Hair transplants are available for anyone to get a transplant at any point. Today, you do not have to be completely hairless to get one.

5. No visible scars in the source of the hair transplanted

When instruments that are blunt are used that cause tissue damage, or when you use punches to make incisions there will be tiny ugly marks at the base of every graft.

If incisions are made using sharp instruments, the cut remains undetected.

One of the fastest expanding segments in hair restoration is transplantation in females. The surgical hair restoration technique was created to be utilized by males. The latest techniques are more suited to females.

Female hair loss is not always as obvious in comparison to males’ hair loss can be a lot more emotional. Females have less options for solutions to stop hair loss than men and frequently suffer the effects of hair loss through more intimate ways. Although women may suffer from female pattern baldness that causes thinness in the crown area temples, hairline and temples and hairline, they are also more likely to experience diffuse hair loss throughout the entire scalp, which restricts the options for hair restoration. Over 20 million women across the United States alone are suffering from loss of hair.

CAUSES OF FEMALE HAIR LOSS

Hormones?

One reason for loss of hair among women is hormonal imbalances. A hyperactive or less active thyroid gland can cause hair loss. Treatment for thyroid problems can usually reverse this type of loss of hair. Hormones may also trigger hair loss when estrogens, which are female hormones (estrogens) are not in equilibrium. But, if the imbalance in hormones is rectified the loss of hair should be stopped.

Child Birth?

Child birth may result in sudden hair loss in women. It’s normal for women to experience hair loss following pregnancy, at least 3 months after having had a child. This is also triggered by hormones. This isn’t anything to be concerned about. In pregnancy, the loss of hair in the normal cycle of hair loss is slowed by the hormone levels that are high. After hormones have returned to their pre-pregnancy levels, the additional hair is shed in the normal cycle of growth and then loss that occurs over the course of time.

Hair Loss due to Menopause and Hormonal Therapy?

Certain causes may be due to hormone treatments like Progesterone the female hormone that blocks the growth of a new hair follicle. Menopausal and hair loss are frequently connected and cause thin hair for women in their later years. Before menopausal age, approximately thirteen percent of females experience loss of hair. After menopausal, the number of complaints about the issue from women increases to around 37 percent.

Female hair loss is treated.But the majority of women who are part of this community online are restoring their hair by making use of legitimate treatments for hair loss and physicians.However treatments for women are less extensive than the options available to males.

The medication Propecia and other DHT blocking medications are not recommended to be used or used for women because of the risk of likelihood of birth defects.The well-known topically applied remedy Rogaine to treat women (minoxidil) is a treatment that can be utilized by women. Many women undergo hair restoration surgeries to repair their hair.However there are women who find the causes behind their hair loss are more complicated than the typical “male pattern baldness”. Therefore, a thorough diagnosis of the root reason is essential prior to any treatments for hair loss are tried.

The most frequent type of loss of hair for women is thinning or receding as a result of female pattern alopecia. However there are many other causes that could cause hair loss, such as the hormonal effects of anemia like menopausal and pregnancies, medications or stress factors, as well as other medical ailments. Other causes of loss of hair that are managed by Dr.Sareen involves the growth of excessively high hairlines using hair grafting, as well as the procedure of surgical advancement of hairlines (a procedure that the Dr. Sareen is one of only a handful of surgeons who are experienced in) eyelash and eyebrow restoration () as well as the treatment of hairline distortions and scarring (such as the loss of sideburns) caused by previous cosmetic surgery for the face.

For more information, browse this site and make an appointment for an appointment in person or via email. Be confident that you’ll be greeted by a specialist who offers professional, compassionate care of the highest standard.

HAIR TRANSPLANTATION METHOD

Planning

Although age isn’t a factor for hair transplantation The advantages and disadvantages of a transplant must be evaluated with care in younger patients. Patients who are between 20-30 years old age must have a stable rate of loss of hair prior to being considered to undergo hair transplantation. A thorough family history is important in assessing loss of hair and determining a hairline to be transplanted.

The quality, color and the density of the hair that is donated along with its contrast with the hair’s colour and the skin’s colours are key factors that influence the outcome. The lower the contrast between the hair of the donor and the skin tone, the more pleasing the outcome. It is also worth noting that curly, frizzy or wavy hair is a desirable traits in hair transplants.

Single hair grafts can be used to form natural hairlines. The creation of a hairline is one of most crucial steps of hair transplantation. It is the hairline that’s the largest prominent marker and the surgery performed by a surgeon is often assessed by the beauty that the line of hair. In the words of Michaelangelo in order to determine the perfect hairline for an bald person it is important to split your face in three equally sections. In the midline, the hairline begins at least 8 cm away from the glabella. A curvature is formed that runs the lateral part of the forehead starting from the middle. At this point, both side of the hairline must be aligned in a straight line when the person is facing straight ahead. The lateral hairlines typically are 9.5-11.5 cm higher than the canthus lateral of the eyes. The temporal angles ought to form fairly sharp right angles, or acute angles in the majority of men However, these angles must be more rounded for women. The hairline’s shape can also vary in accordance with its shape. face triangular, oval or. The patient’s wishes and limitations are other elements which can influence the shape that the hairline takes.

The typical number of single hair (micro)grafts are required for the creation of the hairline of an person. The hairline micrografts must be arranged with a sawtoothed irregular design of micro- and macroirregularity for a natural appearance. The hairline behind, FUGs with two hairs are utilized to create hair growth. Four or three hair FUGs are utilized further back. The less optimal the skin and hair features, the more vital it is to choose smaller FUGs. In order to give a adequate denseness in alopecic recipient regions, a few surgeons employ punch grafts which measure between 1.25 and 1.5 millimeters in diameter. They are placed just behind the hairline. They have the benefit of removing the bald area in a circle tissue, where the grafts will be placed. The grafts of these types should not be utilized in regions where hairs are already present since they will eliminate existing hairs and would result in a negative effect. However, punch grafts may be beneficial in areas with complete baldness.

The preparation for surgery

The patient is instructed to shampoo his hair using Betadine surgical scrub the day prior and in the morning following the surgery.

The preparation of the area for the donor

Local anaesthesia is utilized throughout the procedure. The solution is composed of 30mL of 2% lignocaine and 100mL of normal saline with 1 milliliters of adrenaline (1:1000) is added. The hair that is located in the donor region (occipital area) is cut down into a width of 2 to 4 millimeters. The local anaesthetic solution is injected below the donor zone. The donor region is treated through the injection of normal saline over the entire area. After 10 to 20 minutes, for a complete haemostatic effect, to limit bleeding. The donor site must be turgid after the time of complete infiltration since this gives excellent anesthesia and causes minimal bleeding.

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Harvesting

The donor strip is taken with a single bladed knife or a multibladed knife that has seven or more blades. Multibladed knives can harvest many (two up to 6) parallel strips with varying size (depending upon the spacing employed) that could be 1.5 2 or 2.5 millimeters. The blind cuts made by multibladed knives increase the likelihood of follicular damage which is why it’s preferential to choose one or two blades knife. It is essential to ensure that, while taking the donor area for harvest that the blades are in line with the direction of hair, so that the roots aren’t damaged. The hairs located in the lower region of the occipital and in the temporal region are more fine, and are the best areas to start an entirely new line of hair. Once the strip is taken, the void can be closed using sutures or staples. Some surgeons, such as the author, favor deep sutures around the galea, or subcutaneous tissue to narrow the width of scar. The skin may be protected with a suture running in monofilament nylon 3-0 or 4-0 or any suture that is absorbable. Be careful to make the bites near the skin’s margin to prevent any further injury to the tissues. It is also important to make sure that the bites are taken until the dermis, so that the hair’s roots in the deep aren’t damaged, and therefore, can be utilized during the next procedures.

Follicular Unit Extraction is a method which involves removing the intact follicular units directly from the donor site with a 1 mm punch. The result of this method of harvesting can be reduced because of transection and avulsion injuries to the follicular structure. Although it is advertised as a method that does not leave a scar in the donor region there are multiple “dot-scars in the donor area that are bigger than the ones that are left by strip methods.

Hairs from donor donors that are light or white will be more troublesome. Care must be taken to protect the hair follicles. To improve visibility, patients are advised to dye their hair just a few days prior to the procedure. Methylene blue may be administered in a small concentration prior to surgery into the donor region to assist in identifying gray hairs in dissection. It is important to take extra care when patients undergo a repeat procedure due to scars left from the prior surgeries may alter the direction of hair in the donor region.

Preparation for Graft

The donor strips that have been harvested are immediately submerged in normal saline that has been chilled. This is done through keeping the tray that contains the grafts in saline and frozen. The proper hydration of donor grafts using cold saline is vital throughout the surgical procedure since it affects the longevity that the donor grafts. If a single, large strip was taken the graft can be split in smaller pieces, or even slivers prior the cutting of grafts in individual pieces. Subcutaneous fatty tissue that lies below the hair bulb or roots is cut off leaving 2 millimeters of fat beneath the bulb for hair. FUGs are created by using up to four hairs. Grafts are immersed in a Petridish or placed in a moist stockinet inside kidney trays, in groups of 25. It is vital to have adequate lighting when cutting the grafts. The grafts could be cut using wooden tongue depressors, or on a transparent vinyl dissecting surface using an illumination system. It is essential that there is no wood that sticks to the grafts when they’ve been cut as foreign bodies may eventually develop epidermal cysts that are painful. Loupe magnifications that is 2X to 3X is beneficial in the formation of FUGs. The preparation of grafts using dissecting stereo microscopes makes the dissection longer, but far more precise. Some surgeons prefer cutting the epidermis grafts with 45deg angle to prevent scab visibility during the postoperative phase, however this is more laborious and is not recommended according to the writer.

The preparation of the area to be used as the recipient

Anaesthesia for the area of recipient comprises a supraorbital and supratrochlear nerve block, which is followed by a ring block within the frontal region outside the hair transplantation zone. The recipient region itself must be treated with normal saline. It is the preference of the author to not use adrenaline in the area of the recipient due to the fact that it boosts the telogen effluvium level in the first postoperative period and can also reduce the absorption of grafts. It is recommended to avoid adrenaline in the area of recipient in women since severe effluvium have been observed following the use of adrenaline. To limit bleeding and pain the area of the recipient should be turgid prior to the slits or holes are created.

When making holes or slits in the target area it is vital not to go against the flow of hairline in the area. Hairline should have the saw-toothed, ragged appearance. Holes are created using the no. 18 / 20 / 23 gauge needle, in the pattern of disorganized patterns. A minimum of 250-300 micrografts is required to make an average hairline. The hairline is surrounded by slits. could be created using Nokor(r)needles or needles, a Minde(r) knife (A – Zee Surgical, USA) as well as the No. 11 scalpel blade, or needles. The creator has created an innovative instrument that is being patent-protected in the form of “Kolkata slit”. It is patented as “Kolkata slit”. Nokor needles, as well as Minde knifes are non-reusable tools and are not readily available in India. The scalpel blades cause the holes too big and, often, deep, because of which the grafts inserted are able to float, but lose their direction. Blades of scalpel can cause severe damage to hair already present in the region. Females are particularly affected as a large amount of hair strands are damaged by the blade of the scalpel in the process. The ‘Kolkata slit’ an instrument that can be used again and is available in a variety of sizes. It is able to create a gap approximately what the length of the hair that is to be placed in, and assures that the graft stays in its orientation in the right direction. The slit can be utilized in a bid to boost density in areas with hairs that are already in place.

When patients undergo primary or tertiary procedures the presence of more bleeding was observed in the area of the recipient. The increased bleeding can also be observed when patients have been taking minoxidil during the time before surgery. A good tumescence and a time of 10 minutes prior to forming gaps may reduce the amount of flow. It’s also been observed that the gap in areas of the recipient are harder to create in subsequent procedures due to fibrosis caused by earlier procedures.

Graft Insertion

The grafts are inserted into the holes or slits in the recipient with forceps that are fine-angled. It is crucial to use an uninvolved method of placing the grafts. To prevent damage the FUGs are encased by the 2mm of subcutaneous tissue that is left beneath the hair bulb to place them in the sites of recipients and not at the follicle’s end. The pressure remains constant for ensuring that the FUGs are in line with the skin. Placing the grafts below the surface of the skin should be avoided as it could create a pitted appearance, and may also cause the development epidermal cysts. The appearance of cobblestones is evident when the grafts have been high from the skin surface. Three, or even two people can place multiple grafts simultaneously to make the process more efficient and more effective. The grafting process can take up to six or five hours. During this time, 2000-3000 FUGs could be transplanted.

Postoperative care

The patient can be discharged the next day, typically with no bandage. Some surgeons do prefer to wrap the patient in a bandage, however it is necessary to do so carefully in order to prevent shearing. The bandage should also be removed with care since grafts may be stuck to the undersurface and be removed accidentally.

A few swellings are evident following an operation to transplant hair. the patient must be aware about this prior to the procedure. The use of oral steroids for three to five days can reduce swelling. Some surgeons utilize Injection Triamcinolone 40 mg as a tumescent treatment. They claim that it reduces swelling. The use of a headband immediately following the procedure is helpful in stopping the swelling from descending on the face, giving a puffy look. The patient is advised not to shampoo his hair using mild shampoo on the 2nd or 3rd postoperative day. When combing hair in the area of transplantation for 3 weeks, the teeth of the comb shouldn’t hit the transplanted grafts. Clothing such as T-shirts or pullovers that have to be removed from the head are also to be avoided for the duration of three weeks. Hair oils, or other shampoos that are stronger and helmets must be avoided during the exact same period. For males minoxidil lotion 5% is applied to the areas of the hair transplant after the shampooing process has begun. minoxidil lotion 2% is utilized in females. The application continues for two up to 6 months. This has been demonstrated to encourage the growth of hair transplanted.

Sequel

Dermis and epidermis together with hair shafts of hair transplanted out of the skin are removed as scabs within 2 to 3 weeks following the procedure, however the hair follicles are left and then enter an inactive phase. Hairs begin to grow around three months after the surgery. It has been observed that when using minoxidil 5 hairs don’t disappear and then begin growing after the procedure. It generally takes six to nine months to see the results of the hair transplant. If a follow-up procedure is scheduled the time must take at a minimum of three or six months following the initial appointment. Certain patients might complain of hypoaesthesia in the scalp within the donor region. This is typically temporary but can last for longer than 18 months in certain cases.

The amount of hair transplanted is lower, particularly in areas which are completely bald. The patient needs to be aware about this prior to surgery and a second appointment can be scheduled to increase the density of hair.

COMPLICATIONS

Hair transplant complications are rare and uncommon. The presence of infections in the recipient regions occur very rarely. In the donor regions there may be signs of infection within sutures, but the majority of cases resolve quickly following suture removal. Epidermal cysts can be observed sometimes and require drainage. It is crucial not to cut too large the donor area as tension in the suture line could cause dehiscence and leave large scars.

Hair transplants on special sites

Eyebrow transplantation is a procedure to increase or restore eyebrows. It’s an aesthetic necessity in following the direction the eyebrow hairs, while creating the appearance of a new line. A minimum of 150 micrografts are required to create an eyebrow on one side. The site of donor for transplantation of the eyebrow should consist made of hair that is finer, preferably located at the nape of the neck or from the temporal region. The recipient holes are made using an needle of no. 20 or 21-gauge needle, or a 0.7 microblade of 0.7 millimeters. Cyanoacrylate glue is a possibility to apply over the grafted areas in order to hold the grafts in place during the postoperative phase.

Eyelash grafting is a more difficult process. Fortunately, just the lashes needed to achieve a satisfactory outcome. Six one-hair micrografts per lid may satisfy most patients. Cyanoacrylate glue, too, is beneficial for keeping the micrografts in place.

The growth rate of the hair on the scalp is higher than the growth rate of the eyebrows or elsewhere. Patients must be warned prior to surgery that hair transplanted from the scalp may require trimming periodically.

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Patients who have had hair transplantation with older methods have bigger plugs. This results in the appearance of a corn-row which requires correcting. The current procedure employs recycling and plug reduction as well as a shrewd approach to the front and back rows.

CONCLUSION

The latest technological advancements have allowed hair replacement surgery to become a an option for a lot of people but we need to use this procedure in a responsible manner. It is essential to create a team since only one person can do the entire procedure by himself. Accuracy and precision throughout the procedure are crucial for achieving excellent outcomes. There should never be any compromise by ensuring proper illumination in the surgical room or in the quality of the equipment. A relaxing atmosphere in the operating room as well as using audio-visual entertainment breaks the monotony for the patient as well as members of the team performing surgery.

It is essential to be aware that a patient will be more ill-advised after an ineffective hair replacement procedure. If performed correctly the transplant procedure can be a profitable procedure, both for the surgeon and for the patient.

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