Hair Restoration

Dr Zahid Iqbal Bhatti

History

In 1939, Micrografting of human scalp in Japan by a dermatologist “Okuda”

In 1959, Norman Orentreich started Modern Day hair transplant in America.

In 2004, A state of art of surgical hair replacement using donor site of non bald scalp to crown.

Anatomy

Growth Cycle.

Types of Hair

Vellus Soft, short, thin,

Hypopgmented

Terminal Coarse, long,

Thick,Pigmented

Androgenetic Alopecia affects up to 50% of males and 40% of females

Autosomal dominant with variable penetrance

85% : +ve family history

Androgenetic Alopecia

5 ALPHA Reductase

Testosterone

DihydorTestosterone (Active)

X Fenastride

Systemic Treatment

Miniaturization of Terminal Hairs

Male Pattern Hair Loss

Female Pattern Hair Loss

Goals

The Hair should be Nartural Looking. Natural Frontal hair line. Male/ female pattern hairloss.

Good Candidates

Size of donor site. Hair Density Hair Volume.

Evaluation

Goals of Patients. Family History Available Donor site. Grading of Baldness. Characteristics of Hair. Hair Line.

Screening Session

Donor site. Detailed Explanation of procedure,

anatomy, goals. Good candidates.

Pre operative Period

Patient care co-ordinator. Discontinue medications. Informed consent. Photo consent. Planning session.

Operation

Local anaesthasia / I/V sedation. Pre medication. Donor site shaved. Marking for excision. Local Anaesthesia. Normal Saline.

Donor Site. Anterior Border. Inferior Border. Superior Border.

Harvesting Technique

Single Blade. Multi Blade Knife. Orentrich Procedure ( Circular

Punch)

Graft Production

Silvering

Recipient Site Anaesthezied &

prepared. Frontal Hair line. Quantitative

challenge behind.

Incisional Instruments

Hypodrmic Needle 18

Spearpoint Sp 90,91

Miniblade Punches

Grafts In place after operation.

Post Operative Period.

Two layered Dressing. Discomfort/Pain. Swelling. Scab. Hair loss. Numbness/Paraesthesia.

Donor Site Complications

Infection. Hematoma. Wound dehiscence. Neuralgia/Neuroma. Hpertrophic Scar/ Keloid. Atreriovenous fistula.

Recipient Site Complications

Change in hair texture. Poor Graft Survival. Elevated/ depressed graft. Chronic folliculitis. Epidermal inclusion cysts. Post frontal graft necrosis.

Follow up.

1st Day. 15th Day. 8th week. 16th week. 6th -12th month

Post operative adjunctive.

Finesteroid 1mg. Minoxidil 2%, 5%.

Any Question ?

Thanks