Every second man suffers a more or less pronounced hair loss in the course of his life. For many forms of hair loss/baldness that do not respond to drug therapy, there are numerous possibilities of hair transplantation. One of the possible techniques is the transplantation of the patient’s own hair.
For the permanent restoration of hair on the head, the most modern surgical techniques show excellent aesthetic results. Hair transplantation has been carried out successfully for the last four decades and uses a variety of techniques and methods: first of all, before each operation, it must be checked which result appears reasonable for which hair type. The more advanced the hair loss is, the larger the area to be treated. The physician should be familiar with the anatomical structures, the vascular supply and the sensory innervation of the scalp. A prerequisite for a long-term successful surgical hair reconstruction is therefore a consistent treatment concept that takes into account both the general aging process and the individual baldness.
Methods
Follicular Unit Insertion Technique (FUI) The most common form of autologous hair transplantation is the mini-micrograft technique, which was introduced in the 1980s. FUI, in which individual hairs are transplanted, represents the further development. It is indicated for androgenetic, congenital and scarring alopecia.
Follicular units contain on average 1-2 hairs. The transplantation offers the possibility of increasing the hair density of the upper head at the expense of the crown of hair with minimal scarring. Standardized, the first step is the removal of an elliptical donor from the back of the head.
These hairs are not affected by androgenetic alopecia and continue to grow even on the bald areas. The donor site is primarily closed without tension by sutures. The donor site is then microsurgically prepared and the follicular units are harvested.
To avoid damaging the grafts, the preparation is performed under microscopic magnification. The exact implantation of the follicular units into the desired donor area then follows. The exact direction of hair growth, hair density and tension lines must be observed.
Since this form of hair transplantation involves transplants of the patient’s own hair, ideally the healing process should be completed within a few days. If the findings are clearly pronounced, several treatments may be necessary to achieve a better aesthetic result. Scale-reduction plasty and other reconstruction possibilities Through further plastic surgery techniques it is possible to correct larger scar areas in an aesthetically satisfactory manner.
The affected areas are removed by scalp reproduction plasty or local displacement flap plasty and the scalp is moved over the defect. If necessary, a tissue expander can be used to pre-stretch larger areas. Tissue expanders are silicone sleeves with self-sealing injection ports.
They are filled up by injections. The mechanical tissue expansion stretches the skin. By means of local tissue expansion, it is possible to obtain skin with the same structure and pigmentation to cover the defect.
Local flap plasty achieves the greatest possible density of the hair follicles. Particularly critical are the sharp border of the hairline and a scar at the donor site. The advantage of flap plasty is the particularly good quality and the fast achievement of a therapeutic result.
