The hair transplant process in Nepal at Folliderm or high-level clinics anywhere in the world involves extracting permanent hair shafts along with roots (also referred to as follicular units or grafts) from the hair-bearing donor area and implanting them at the balding site.
In hair transplantation over the scalp, hair grafts are usually taken from the back and sides of the scalp. For clients with advanced baldness of the scalp, hair can also be taken from the beard, chest, axilla, and other body parts.
The basic concept of hair transplantation is based on the principle of “Donor Dominance.” Donor dominance implies that transplanted hair will retain the properties of the original site even when moved to a bald area. We know that in pattern hair loss (androgenetic alopecia), the area in the front, the middle part of the scalp, and the crown is susceptible to balding whereas the area at the back and sides of the scalp is not.
Hair transplantation thus involves the transfer of permanent hair present at the back and sides of the scalp to the areas of balding. These transplanted hair roots are not affected by thinning induced by the DHT hormone and will hence retain their property even at the implanted site. Therefore hair transplant is a permanent and the best solution to baldness. The transplanted hair does not require any medication or maintenance therapy. They continue to grow naturally forever. This ‘one-time’ attribute makes the procedure stand out and loved by patients and doctors alike.
Apart from pattern hair loss (androgenetic alopecia) which is the most common indication of hair transplantation in males, hair transplantation can also be done in case of female pattern hair loss (androgenetic alopecia), over beard, moustaches, eyebrows, and various other causes of scarring hair loss. Here are a few pictures for you to see.
The hair transplant process in Nepal is a fairly new concept but Folliderm has years of experience in the field with the best doctors around the world.
Techniques of Hair Transplant
Follicular Unit Transplantation (FUT)
Follicular Unit Transplantation (FUT) is an older technique of hair transplant. It is popularly called the ‘strip method’ where a strip of scalp skin containing hair roots is taken from the back of the scalp. This strip is cut under microscopes into individual ‘grafts’ containing hair roots. These grafts are planted on the bald area. The area of the scalp from where the strip is taken is sutured and this wound heals in a week or two. Newer methods like Follicular Unit Extraction (FUE) have slowly replaced this technique.
- The involvement of doctors is less in Follicular Unit Transplantation (FUT). Therefore this technique is cheaper as compared to others.
- There are more chances of infection because the wound is large.
- Sutures are required to close the wound.
- It is more painful.
- Healing time is longer (about 1-2 weeks).
- The wound after healing leaves a permanent scar. So after transplant hair has to be kept long to hide the scars.
- The strip which is taken out undergoes a lot of mechanical handling and it remains outside the body for long periods (3-5 hours). Hence many grafts die during this process and they do not grow even after transplantation.
- With Follicular Unit Transplantation (FUT), only scalp hair can be harvested. We cannot harvest body hair. So in advanced cases of baldness that require body hair also, Follicular Unit Transplantation (FUT) is not sufficient for good coverage.
Follicular Unit Extraction (FUE)
The method of extracting grafts is the only thing that marks a difference between Follicular Unit Extraction (FUE) and Follicular Unit Transplantation (FUT). In Follicular Unit Extraction (FUE), each hair graft is removed from the donor region one by one using fine punches of caliber less than 1mm and is stored for about 3-6 hours in a storage solution. After creating slits (space for putting hair grafts) these stored grafts are then implanted one by one into the recipient site. The site from where grafts are taken heals in 2-7 days without apparent scarring. This is also called ‘Stitchless hair transplantation’.
- Since the surgical wound is less than 1 mm, there is minimal chance of infection
- Minimal pain
- Healing is rapid. Clients can resume their routine work in 2-5 days.
- There is no visible scarring. Short hair styling is possible.
- Follicular Unit Extraction (FUE) can be done to harvest grafts from other sites such as the beard, chest, and pubic area.
- Follicular Unit Extraction (FUE) is comparatively costly.
Depending on storage conditions, evidence suggests that 10-40% of grafts die because they remain outside the body for a long period. Also, hair grafts suffer chemical damage during graft storage outside the body. Because the survival of grafts is compromised in Follicular Unit Extraction (FUE), the final result can be unnatural in the form of low density (Click here to see repair hair transplant done at Folliderm)
Direct Hair Transplant (DHT)
This is the most advanced technique of hair transplantation. It is a modification of the Follicular Unit Extraction (FUE) technique. In this technique, the first slits are created in the recipient’s bald area. Then grafts are harvested from the donor area and transplanted within minutes (2-20) to the recipient area. The chances of graft survival are almost 100%. Since all the hair grafts survive, maximum density is achieved only with Direct Hair Transplant (DHT)
- Human hair is a very delicate tissue. The chance of its survival decreases if it is kept outside the body for a longer period. In Direct Hair Transplant (DHT), we reduce this “body out time” by immediately transplanting the hairs after harvesting.
- The need for any chemical storage solution is also omitted in Direct Hair Transplant (DHT). Hence there is no chemical damage to grafts, which results from the storage of grafts into a storage solution.
- The overall duration of the procedure is reduced which increases client and surgeon comfort.
- Direct Hair Transplant (DHT) involves a big highly skilled team of 7-10 persons because multiple steps of hair transplantation are carried out simultaneously. This also requires special patent instruments. Hence it is more expensive and technically demanding.
|
DHT Direct Hair Transplant | FUE Follicular Unit Extration | FUT Folliculra Unit Trasplantation |
|---|---|---|---|
| Need of Stitches after surgery | No | No | Yes |
| Time taken for healing | 1-2 days | 1-5 days | 7-30 days |
| Scar after surgery | No visible scar | No visible scar | Yes Long visible scar on back sides of scalp |
| Short hairstyle after surgery | Possible | Possible | Not Possible |
| Pain after surgery | No Pain | No Pain | Moderate |
| Bleeding during surgery | Minimal | Minimal | Mild to moderate |
| "Body out time" of grafts i.e gap between harvestling and plantation | Within Minutes | 3-5 Hours | 3-5 Hours |
| Strong solution | Not Required | Required | Required |
| Grafts damage due to mechnical handling | Nil | Less | More |
| Chances fo graft infection | Nil | More | More |
| Overall Graft Survival | 100% | 80-92% | 85-95% |