Hair Restoration Dr Zahid Iqbal Bhatti.

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Presentation transcript:

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 Androgenetic Alopecia affects up to 50% of males and 40% of females Autosomal dominant with variable penetrance 85% : +ve family history

DihydorTestosterone (Active) Miniaturization of Terminal Hairs 5 ALPHA Reductase Systemic Treatment X Fenastride Testosterone DihydorTestosterone (Active) 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