Hair transplantation is the surgery wherein the hair lost in the areas of scalp/beard is replaced by the hair taken from posterior aspect of scalp/beard/chest/shoulders/abdomen/lower limbs. It is important to understand that this definition is most recent of all. This was not possible few years back in the era of strip surgery as it was and is still not possible and scientific to take the strip from chest/shoulder/abdomen/lower limbs.
In Hair Transplantation only auto grafts (the grafts from one’s own body) are used. Allografts (the grafts from different person) are not possible till now. This limitation and the fact the number of donor hair grafts is finite means that this surgery should be meticulous, accurate, artistic, no wastage of grafts and more natural. The grafts once removed are not supposed to grow back once again and hence the grafts harvested should be handled with utmost care and placed cautiously.
There are different methods of doing this surgery which are being performed throughout the world. There were many techniques which were used in past but are obsolete now, I won’t go into the details of those techniques. Currently, Follicular Unit Extraction (commonly known as FUE) & Follicular Unit Transplantation (commonly known as FUT) are the most commonly used techniques. FUE is more commonly used technique & is preferred by most prospective patients. The results of this technique are surgeon dependent. However, this stitch less technique has grown enormously in last decade. Robotic hair Transplants are also based on the principle of FUE. The results of FUT are also great & surgeon dependent but many patients are little scared of this technique & decline this technique in the first consultation itself. I would like to emphasise that the results of both these techniques are surgeon dependent and also stress upon this fact that few patients fit into FUT category and FUE cannot be an option for them and vice versa, these aspects should be discussed with your treating doctor.
After this brief introduction I would like to discuss the artistic aspect of this surgery. To make this understand better consider that you have got different sizes of blocks which fit into each other and you are asked to make a beautiful house out of it. Making a perfect design needs better understanding and & skill to execute it. The grafts are just like these blocks & the arrangement of these grafts in more natural manner makes the hair transplant look more natural & aesthetically pleasing. As the hair grows in follicular units, nature has provided us single, double, triple and even more haired grafts. These different haired follicular units are just like different sizes of blocks which are needed to make the beautiful outlook of the house. The proper placement of single hair grafts is exceptionally important to produce a natural looking hairline zone. The depth at which the grafts are placed is also very critical to get the aesthetically appealing result. The placement of double, triple, and multi haired grafts is also important and should always be behind the single hair grafts in the hairline zone. The angle, direction and curl are also very important factors to determine the final outcome of the hair transplant. The angle of the hair can be coronal or sagittal. The direction of hair depends on area of the scalp & is forwards with increasing angle as we go backwards from hairline. The curl of grafts should always be downwards as seen naturally. Combined all these adjustments makes the results of this surgery most attractive and unnoticeable.
Keeping all these factors in mind the prospective patients should look for a qualified & experienced hair transplant surgeon to make the best out of the surgery.
Dr Ummer Yaseen is working as Assistant Professor in the Department of Dermatology, GMC Anantnag.