ISHRS is the premier international society for hair transplantation-we are members of this organizationOur website: www.bangalorehairtransplant.com www.bangalorehairtransplantationwww.bangaloreskin.com | www.bangaloreskin.com/liposuction

DR Venkataram Mysore MBBS.DVD.DNB.MD.DipRCPath(LOND)

Welcome to a presentation on Welcome to a presentation on baldness and hair lossbaldness and hair loss

50% of world’s population suffer from baldness

Did you know man is called naked ape as he has the least amount of hair among all mammals?

Did you also know that hair is not essential for human survival and is largely cosmetic in function?

Hair transplantationHair transplantation

Hair transplantation has evolved over the years –from the days of the disastrous punch transplants to the present day state of the art Follicular unit transplantation.

This presentation give you basic information about the procedure

Hair PhysiologyHair Physiology The hair consists of 2 major parts: Hair shaft - the visible part of our hair which has no influence on the

hair growth. Hair bulb - the part which is under the skin and influences the hair

growth There is no “communication” between the hair bulb and the hair shaft,

hence shaving/cutting the hair has no impact on its growth

Hair Shaft

Hair Bulb

Normally there are about 100 thousand hairs on scalp

This is how baldness progresses-where are you in this chart?This is how baldness progresses-where are you in this chart?Note that even in the last stage(VIII), back of head never Note that even in the last stage(VIII), back of head never

loses hairloses hair

Normally hair follows a cycle of growth, Normally hair follows a cycle of growth, rest, fall, and then Hair grows againrest, fall, and then Hair grows again

Why does baldness occur?

In males with baldness, this cycle is abnormal-each cycle results in In males with baldness, this cycle is abnormal-each cycle results in progressively smaller hair (Miniaturization) and final disappearance.progressively smaller hair (Miniaturization) and final disappearance.

This is caused by the action of male hormones on the hairs in people who This is caused by the action of male hormones on the hairs in people who have inherited the gene from their parents-–hence it is called androgenetic have inherited the gene from their parents-–hence it is called androgenetic

alopeciaalopecia

Do women get total baldness - no, it is very rare

Baldness and it’s Baldness and it’s Psychological effectsPsychological effects

Feel older-48%depressed-54%avoid social situations-64%preoccupied with the problem 16%52% thought it significantly

affected their lives

Too much of hair is bad-and too little is also bad!!!It is indeed amazing how much effect hair has on personality, despite serving no useful function in the body.

Is there any drug for Is there any drug for baldness?baldness?

Presently , there are two approved drugs;a)Minoxidil lotions 2% and 5%-it has to be applied daily twice over the affected area for many years.

b)Finasteride 1mg tablets( propecia)- one tablet daily for 3-4 years

Remember: There are different causes for hairloss-these are temporaryand do not lead to baldness.Common Baldness is always hereditary and these are the only two drugs for baldness-every thing else advertised is without adequate proof

Are there any disadvantages of Are there any disadvantages of these drugs?these drugs?

They are very safe and free from serious side effects. They are useful in early hairloss and baldness. However, these treatments are for long duration, and

are quite expensive. The effect lasts as long as they are taken and hence may

also be temporary They are not effective in established and extensive

baldness. Thus hair transplantation is the only permanent

method of hair transplantation.

Old method-Punch grafts-paddy Old method-Punch grafts-paddy field or doll appearance-disasterfield or doll appearance-disaster

This was the method till 1980s!!!This is a very easy operation .This surgery using an instrument called punch has no place today

What is follicular unit?Hair occurs in group of one, two or three

Hairs called follicular unit transplantation. DissectionOf such units and then transplanting them is called

follicular unit transplantation-the Rolce Royce of hair transplantation

How is follicular unit transplantation(FUT) different from How is follicular unit transplantation(FUT) different from Micrografts and minigrafts?Micrografts and minigrafts?

From 1980 still early 1990s, microminigrafting was practised. This was definitely an improvement on the previous punch grafting.

Follicular unit grafts are different in that:a) the dissection is more naturalb) is done under microscopec) grafts are smallerd) need smaller holese) cause less bleedingf) can be packed more densely Hence FUT yields more natural results For this reason follicular unit transplantation is called the Rolce Royce of

hair transplantation However, FUT is also more difficult, needs microscopic dissection, is

more time consuming, needs more manpower and is more expensive.

Low densityMostly1/2 hair units

Average density- Mostly1/2/3 hair unitsMost south indians have this

High density- Mostly 2/3/4 hair unitsSeen in people from kerala and Tamilnadu

no of hairs in a person varies from person to person –densitometry determined by trichoscan.

The number of hairs a person has depends on the type of units and the type of Density he has. The type of density is an important factor in the quality of results he gets after surgery-the higher the density, the better the result.

Principle of hair transplantation

Step1 Donor area

Step 2 dissection of hairs

Step 3 Follicular units

step4 transplantation in to bald area

Back of head never loses hairs as these hairs are genetically different-hence they grow even when they are transplanted to the bald area. Since they are patient’s own hair, they are not rejected.

Don’t be afraid that there may be damage to brain-we go only up to4 mm.Brain is located 4 cm deep in side the skull

Preparation of DonorPreparation of Donor-no hair cut or shaving-we preserve your -no hair cut or shaving-we preserve your

hairstylehairstyle

Local anesthesia-we minimize pain by using vibrator and Cream anesthesia (EMLA crème ) before giving injections

Our theatre-enjoy a movie Our theatre-enjoy a movie during operationduring operation

Donor area is sutured-hair from above covers itEven on operation day, suture area can not be made out, as

very little area is shaved.Donor area resection takes about 40 minutes

Sutures heal in 2 weeks-we put absorbable sutures-so there is no need for suture removal

you cant make out the suture!!We take great care to avoid any change of hairstyle

Hair dissection-using microscope to avoid damage to hair.Lasts for 2-3 hours

Dissection room Microscopic Dissection

Hairs as seen under microscope-note the 1,2 and 3 hair units

Dissected hairs-follicular unitsNote that one, two , three hair units are all very small and of the same size-hence Need small holes, can be packed closely and cause Very little bleeding-this is the real highlight of follicular unit transplantation

hairs-follicular units

Hairs are inserted in to special implanters And then in to scalpVery little bleeding

Referred to as No Touch technique

Hair transplantation-large session-about 1200 Hair transplantation-large session-about 1200 grafts-lasts grafts-lasts 51/2 hours51/2 hours

Marking of area to be grafted

At the end of grafting, note how clean it looks. Pt goes home like

this with very small bandage which is removed the very next day.

Next day

The graft will have a brown crust( clotted blood) the next day- You can start The graft will have a brown crust( clotted blood) the next day- You can start shampooing the next day of surgery and the crust clears off in 4-5 daysshampooing the next day of surgery and the crust clears off in 4-5 days

You may have use a cap or alternatively during these period. Alternatively, you You may have use a cap or alternatively during these period. Alternatively, you can hide the grafts to get normal look-with Topick.can hide the grafts to get normal look-with Topick.

Pink plaster is to prevent swelling which may occur on day3-4 for 1-2 days

There is no need for taking leave-you may return to work the very next day

Crust on day 2After topick

Before surgery

after surgery-shampooing starts the very next day-the brown crust falls off in 4-5 days

With topick-a powder to hide Graft sites

The grafted hairs will start falling by 3 weeks-and will start regrowth by 4/5 month.

Hair transplantation-medium session-about 850 grafts-lasts 41/2 hours

before After 7 months

Donor-where is the suture? Hairline-Isnt it natural?

before

before

After 5 months

Note:it takes 9-10 months for proper hair growth

After 6 monthsbefore

U cant make out the suture

RememberRemember

It takes 9 months after surgery for hair growth

To preserve existing hair, it may be necessary to take drugs-this is particularly true of younger individuals

Key points for good resultsKey points for good results

Good technique-follicular unit Trained teamLarge number of grafts in one session

We are proud!!!Our team is trained by Dr Ginzburg and his team from Israel

Remember!!!Remember!!!

Lot of advertisements appear in lay press claiming dramatic results from homeopathy, acupuncture, weaving etc.Be careful and ascertain full information before using them

Many claims are also made about hair transplantations- always ascertain the training of the team, the surgeon, technique and the no of grafts they promise

After all, hair transplantation is not a everyday procedure!!!

Our websiteOur website

www.bangalorehairtransplant.comwww.ishrs.org- the most authorititive and

unbiased website

Great things are a number of small things Great things are a number of small things done together-Vincent Von Goughdone together-Vincent Von Gough

This statement applies aptly to hair transplantation

If you have nay more questions, do feel free to mail us at : mysorevenkat@hotmail.com

Call us on +91 80 23392416 / 23392788 / 23180818 / 41148848 / 9739038714