Author: Dr. Jangid | Date Published: March 20, 2023
Hair transplant surgery involves a surgical procedure in which a dermatological surgeon moves hair from the Donor area to the Recipient area. The surgery takes follicles and hides from the hair-bearing area of the scalp to where hair loss is faced. The question that comes to the patient's mind is known about donor sites. The donor site is called the scalp area from which the follicles and hair are removed, and removing the hair and follicles from the donor site is called harvesting.
What Is Harvesting?
Harvesting is a lengthy, as well as multi-step process. It begins with the planning phase and ends with the delivery of healthy hair ready for transplantation, and hair is taken from the donor site once the planning phase has been completed.
There are various techniques for harvesting the donor site. With a wide range of designs available, it is easy to select the unique needs of individual patients.
Strip Harvesting: One of the most widely used techniques. A single-, double-, or triple-bladed scalpel is used to remove the strips of hair-bearing tissue from the donor site. The incisions are closed with staples, and the healing usually proceeds without complications. The donor's hair is removed with a long oval incision rather than a strip.
2. Round Graft Harvesting: It is quite an uncommon type of harvesting, and it was more common before the new methods were developed.
3.Follicular Unit Transplantation: One of the latest donor-site harvesting and transplantation techniques is FUT. They are the small groupings of hair follicles where the hair grows on the scalp.
Donor Area
Scalp Donor Area: The scalp is the most preferred donor area for achieving natural-looking hair after the transplant. The ideal location for the transplant is the back or side of the scalp, where the growth is usually remarkable.
Pros:
Hair is taken from the permanent zone
Best donor area why because-100% similar to the frontal hair
Good growth
No/ Minimal effect of hormones
Maintain look for a longer time
Gives a natural look / restores a natural look
Beard as a Donor Area: The hair on the beard is generally very thick and is relatively easy to harvest. The beard hair's texture and thickness are close to the scalp hair, so it is often chosen as the donor area in men's hair transplants.
Pros: Grow well, long life, thick, so cover area nicely.
Cons: Single hair, not natural hair as the scalp, so can't plant on frontal area, difficult to harvest.
Chest As a Donor Area: The Chest can also be worked as a donor area in the hair transplant process. It is commonly used as the non-scalp donor area. But beard hair is preferred over the chest area.
Pros: Can be taken of all hair since it covers the area, suitable for filling.
Cons: Hair is thin and does not grow well, single strand, can't plan on the front area. Difficult to harvest
How Are Recipient Sites Created For Hair Transplant?
The assessment is done on the recipient area before the hair transplant process. When a person faces a hair loss issue, professional guidance can help decide whether hair transplantation is required. A hair transplant in Delhi is a surgical procedure in which a dermatological surgeon moves hair from the Donor area to the Recipient area. The patient must understand the importance of the recipient area. Let us discuss in detail the recipient area.
At the time of the hair transplant procedure, the doctor creates thousands of tiny incisions called the recipient areas or sites. These incisions are done on the bald area of the scalp where the harvested follicular unit grafts are placed. The outcome of the hair transplant is majorly impacted by the pattern of recipient sites and how they are created.
Before the site creation, follicular units of different sites are fitted to specific site sizes to find the best size instrument to use for each graft. The sites are custom-fitted to the grafts, facilitating the healing. The patients can return to showering and gently shampooing their hair the day following the hair restoration.
How Are The Recipient Sites Created?
Various instruments are used to create the recipient site depending on the clinical situation. The procedure's primary goal is to create a snug fit between the follicular Unit and the skin surrounding the grafts. This helps maximize graft oxygenation, promote healing, and increment graft survival. Many tiny recipient sites ensure that there will be no visible pitting, scarring, or any surface irregularities.
Generally, hypodermic needles or various custom-made ultra-fine blades create hair transplant recipient sites. It is important to note that this area is sensitive and needs to be dealt with extra care and caution. The surgeons use this area to design the hairline, which further helps mark the implant points on the recipient area. It further helps in the angulation of transplanted hair. The lines and angles drawn by the surgeons are according to the natural hair growth. Once all the drawings are done with good grades, anesthesia is provided to the recipient area, and the hair is implanted. Even after the procedure, the patients are expected to look after this area to experience further hair growth.
What Are Follicular Units Or Grafts?
The basic building blocks of hair transplant are Grafts or follicular Units. It was earlier considered that hair grows as a single strand throughout the scalp. But then it was observed that the hair could grow in 1-5 bundles at a time. It forms a single anatomic and physiological unit. It was named Follicular Unit, and when we talk about the hair transplant procedure, it is known as graft.
The naked eye may see the hair growth individually. However, if the hair is trimmed short, and then the scalp is observed under magnification, the groups can be readily visible. The strands are generally grouped on the surface, mainly because they represent the tops of the naturally occurring follicular units that lie below. These follicular units are transplanted rather than the mini-micro grafts or plugs. It revolutionized modern hair transplantation and surgeons worldwide. This lets you achieve great-looking results.
The follicular units consist of small groups of hair follicles and the nerves, blood vessels, and another tiny muscle known as the erector pilorum. The significant advantage of using this follicular Unit in hair transplant surgery is to keep the recipient site as small as possible. The recipient sites' size helps place the hair on the scalp. The smaller the recipient site is, the closer the grafts can be placed in the scalp. In one hair restoration session, small recipient sites allow many grafts to be transplanted without injuring the scalp or compromising its blood supply. When the follicular units are used, they maximize the Density of the grafts that can be transplanted in one session.
The overall dense look of the follicular hair transplant depends on the number of grafts and the number of hairs each graft contains. The hair in the follicular Unit is very close to each other; transplantation of the follicular units allows the maximum hair to be placed in the minor recipient sites. It helps in giving a maximum-density look to the hair transplantation procedure. It ensures that the grafts do not appear pluggy since the follicular units represent how hair appears. Although the follicular units prevent the pluggy look, their direction should be proper, ensuring a natural appearance to the hair restoration.
The hair grafts should be manageable since the larger units will compromise on the naturalness, and the smaller ones will result in less fullness.
What Is A Grafts Calculator?
A graft calculator is used to help you calculate the cost of the hair transplant based on specific circumstances. The team discusses the patient's hair loss when this calculator is used. The tool helps predict the status of hair loss and the options available to the patients. The results obtained help in informing whether you are the right candidate or whether some different procedure needs to be followed. This method helps you understand the number of hair grafts that need transplanted. This tool helps assess the bald or thin areas that help restore many grafts. The grafts are further harvested and re-implanted in the desired areas.
Graft Number
The total number of grafts required for a complete surgical hair restoration process can vary massively because of significant patient variability concerning hair density, head size, shape, and facial characteristics.
The graft number works as a function of area and Density.
Of grafts = area to be transplanted (cm2) x Density (grafts/cm2).
No fixed number of grafts is needed for a particular hair loss condition. However, the rough estimation can be calculated by the surgeon.
What Is Grafts Punching?
A punch graft is one of the most common techniques used in hair transplantation. It works by eliminating a part of the skin that bears hair. This graft is then relocated into the region, which is punched to fit the graft.
Graft punching is considered one of the oldest procedures specialists use for hair transplantation, and it was a standard technique for over 20 years and was generally practised from 1970 until 1993. A punch graft for transplantation can be prescribed to people with heavy balding.
During a punch graft for hair implantation, a few steps are taken:
The hair that is present in the scalp region is first cut short. It permits the grafts to become simpler to get to.
Anaesthesia is then given on the site.
A 4 mm graft is used to eliminate a round, and a hollow is formed on the part of the skin with hair from the region. The skin should have around 12 to 30 strands.
A graft is then removed from the region to eliminate the uncovered skin. The bare skin is then removed.
The region is then covered with the punch graft.
The scalp is cleaned and covered with a dressing.
The region is left to heal without any medication or therapy.
The process should be done a few additional times to accomplish the patient's ideal look. The specialist will ensure the grafts are put correctly so the hair will fill adequately.
What Are The Risks And Complications Associated With Graft Punching?
Graft compression: There is a gamble that the graft will condense after the skin has mended, giving it a "pluggy" look. This issue is well-known among patients whose hair is dull.
Different issues with this method are:
It eliminates an enormous level of hair follicles on the site.
Since the hair roots are trimmed off, hair regrowth is sometimes a problem.
Most of the relocated follicles don't make due in the long haul.
What Are The Best Places To Get A Graft Punching?
If you are looking for places to get a graft punching, you can visit Skinqure, the best hair transplant clinic in Delhi, and it has one of the best hair specialists in Delhi. Consult a hair surgeon in Delhi to learn more about graft punching.
How Slitting Is Used In Hair Transplant
The new, innovative technique that involves the placement of the graft in the scalp is the lateral slit technique. The earlier approach included making the recipient sites parallel to the direction of the hair growth, and it caused the grafts to line up to give an unnatural and thin appearance. The lateral slit technique performed changed the thinking completely. The idea is to make recipient sites perpendicular or lateral to the direction of the growth of the hair.
According to the research by top hair surgeons, the lateral slit technique is the only method that can duplicate the alignment and distribution of hair. It occurs naturally, maximizing coverage and eliminating the pluggy results of older hair transplant methods.
The hair growth's angle and direction are controlled to allow the transplantation of areas previously regarded as too harsh for the surgery. In the donor area, the follicular units are lined up along one another in a plane perpendicular to the hair growth direction. The lateral slit technique tries to copy nature's arrangement of hair follicles providing the patients with natural results.
The hairs exit the scalp at an acute angle in the front hairline and central crown areas. In the mid-scalp place, the hair leaves at the forward curve on the scalp, unlike in the frontal scalp. Using this technique, the doctor can create an opening for the follicular units at the same angle for the transplanted area.
For making the lateral slits, the doctor makes custom blades that fit the follicular units of the patients. The follicular units may vary from single follicular units to larger-haired units. Once the follicular units are prepared, the size of each follicular Unit is measured, and a custom-cut blade is checked for the various-sized grafts. This method allows the follicular unit graft to fit the size of the slit opening. Once the size is fitted correctly, the doctor makes more openings in the given space to maximize graft density and help create more natural results. The healing process is improved when the grafts perfectly fit into the recipient sites. It is the place where they can maximize the oxygenation that promotes faster healing and increases the survival time of the grafts.
What Are GHS Or Graft Holding Solutions?
A donor's follicular units are collected and rooted into the beneficiary region. The time between the graft reaped from the body and embedded back is when hair follicular cells are trimmed off from flow and supply of oxygen, and different nutrients are on hold. This period is known as 'ischemia time.
The graft is kept or put away in Graft Holding Solution during this period.
Graft Holding Solution's motivation is to forestall graft drying up and limit ischemic injury to hair follicle cells.
The most regularly used solution is extracellular graft-holding solutions like typical saline and platelet-rich plasma.
Every hair specialist in Delhi uses GHS to ensure complete safety and credibility for their patients.
What Are Things To Keep In Mind About GHS?
The hair follicles experience different problems during the process of implantation. The wounds are Ischemic injury, cold injury, and microtrauma supported during graft handling.
The delay between hair follicle collection and implantation is called out-of-body join or ischemia timing. During this period, the graft is cut off from blood flow and stays in an ischemic condition prompting 'ischemic injury'.
The metabolism of cells relies upon temperature. Bring down the temperature, and you will witness lower oxygen and metabolism. At a low temperature, the swelling will increase, which might prompt cell enlarging and, finally, result in "cold injury."
During ischemia, hypoxanthine development happens in graft cells, and when it is re-exposed to oxygen after transplantation harms the DNA.
The unpleasant treatment of hair follicles might deliver a minor injury to cells, influencing the result of hair arrangement.
After the extraction of grafts, the Graft Holding Solution (GHS) is used.
What Are The Best Places To Get Graft Holding Solutions?
If you are looking for treatment places, you can visit SkinQure, a hair transplant centre in Delhi, it has the best hair specialists in Delhi. Consult a hair surgeon in Delhi to know more about the process of hair transplantation.
What Is Graft Out Of Body Time & What Factors Influence It The Most
A lot of consideration is paid to recognizing and fixing the elements that influence the strength of grafts after hair transplantation. The critical factors that impact the relocated grafts incorporate the patient's well-being, the qualities of the hair, and the techniques employed. Generally, the recovery time or the ideal opportunity for the recovered grafts to settle is around 8-10 days.
It would help if you were caring for the initial fourteen days after hair transplantation, and it is because grafts are not fixed following the transplantation.
After 2 to 5 days, the bandages can be taken without touching the grafts.
Wash your hair delicately without touching using your hands with only clean water.
Following fourteen days, you can wash your hair consistently and return to your everyday practice.
Following 10 to 14 days, assuming you have some stitches that can be removed.
After a few weeks, the grafts will fall, and new hair will emerge.
Following a half year, you can see that new hair begins to show up.
Following a year and a half, you can notice total outcomes, i.e., complete hair development.
If you can track down anything strange like contamination, extreme tingling, and so on during healing, counsel your hair specialist immediately.
Grafts dropping out are very uncommon after the hair transplantation procedure.
What Are The Factors Influencing Grafts Out Of Time?
Hair transplantation and graft survival go smoothly since hair specialists pick ideal possibilities for transplantation.
However, the factors that influence the survival of grafts are :
Patient's scalp issues
Dehydration
Method used
Blunt trauma
What Are The Aftercare Tips For Hair Transplant?
Following a lengthy medical procedure, there are some things to be taken into account. You can wash your hair, but apply gentle shampoos as the specialist advice for a few weeks.
Specific individuals can return to work in around three days, while some might require over seven days.
Try not to brush or examine your new grafts for about three weeks.
Try only to wear caps over the new grafts once everything has gotten back to business as usual.
Try not to stress when a few hairs drop out; it's essential for the process