|
Victoria,
BC--More people are enjoying new hairlines and fuller heads
of hair due to an evolution in hair transplantation techniques that
has taken place in the past decade, David M. Zloty, MD, clinical
assistant professor, University of British Columbia, said.
"We are now transplanting more females and creating more refined
hair lines," Dr. Zloty said at the annual meeting of the Canadian
Dermatology Association. "We can transplant patients who are
almost type 6 and 7 on the Norwood scale-those patients with the
horseshoe rim. Because the grafts are so small we can give a very
natural hairline. Five to 10 years ago, this was more difficult."
Back in 1995 when Dr. Zloty began performing hair transplants, the
average session was 600 to 700 grafts. Today's average session stands
at 2,000 grafts. These new grafts are much smaller, with a standard
follicular unit graft comprising only one to four hairs. Today's
technique is more refined, although the absolute amount of hair
transplanted hasn't changed much.
Higher numbers of very small grafts have brought technical challenges,
however.
o Preparation of true follicular unit grafts requires absolute precision
and in many cases microscopic guidance to ensure hair follicles
are not inadvertently damaged.
o As grafts have become smaller, it has become necessary to reduce
the size of recipient slits. The difficulty arises in ensuring the
proper orientation and angulation of such tiny slits (0.75-1.25
mm).
o One can only plant the grafts so close together before there is
vascular compromise and consequent graft death. Optimizing the density
of graft packing is one of the major technical issues that modern
hair transplant clinics face today, he said. Very tight packing
can also limit the area one can transplant is a single session.
"If the grafts are prepared poorly, recipient slits carelessly
made, if grafts are planted roughly or allowed to dehydrate, they
will grow poorly or they will die. You need very skilled people
and a substantial investment in equipment including microscopes.
The doctor becomes only one member of an expert, efficient, hair
transplant team."
Donor strip harvest is moving from multiple to single blade techniques,
followed by vertical slivering under the microscope. Both of these
modifications claim to increase donor graft yields, but the evidence
is weak.
"If there is less relative surface area that is cut with the
blade, hopefully there will be less loss of the grafts and a more
efficient scar," Dr. Zloty said. "In our hands we haven't
noticed a difference in wastage between single and multiple blade
techniques."
In most patients, donor site scarring is not usually of cosmetic
concern. However, if a patient chooses to trim the hair in the donor
area very short, the scar can be seen, Dr. Zloty said.
Internet challenges
Dr. Zloty is concerned about misinformation and buzz words being
thrown around on the Internet. "The marketing is very aggressive.
In hair transplantation, many centres are said to be the best because
of specific unproven modifications they have made to standard techniques.
Competitors are portrayed as inferior if they do not perform these
same modifications. Patients are still looking for a non-surgical,
non-invasive hair transplantation, but this is certainly not going
to happen in the near future."
|
