Sunday, January 15, 2006

hair transplants (baldness)

Baldness in men appears as early as the twenties, but 65 percent of Caucasian men by the age of 50 have some degree of vertical as well as bi-temporal baldness. Sixty-four percent of women age 40-70 show bi-temporal recession, and 20 percent of these have obvious vertical thinning.
Hair transplantion is a minor surgical office procedure in which hair from normal areas of the scalp, such as the back and sides, is moved to the bald areas. New surgical procedures to correct male pattern baldness include punch autografts, micrografts, strip grafting, scalp reduction, use of hairbearing flaps, and various combinations of these techniques.
• Autografts-Donor areas from the lateral and posterior portions of the scalp are implanted, beginning anteriorly at the desired hairline and continued in a fanning pattern posterior.
• Micrografts-Small, full-thickness graft units of one to eight hair follicles are implanted into "stab" incisions to soften edges of established graft hairlines and to fill areas that are unsuitable for conventional grafts.
• Strip grafting-Implantation of a strip of hair-bearing skin four to eight mm wide and several cm long. However, overall results are inconsistent and this procedure has only been used by a few doctors.
• Scalp reduction-"Instant hair" effect is created by this technique in those cases of baldness of the vertex or anterior vertex regions. Depending on the laxity of the scalp, the amount of tissue excised ranges from 2.5 to 5.0 cm in width and 12 to 22 cm in length. Not only is the amount of bald area reduced but the lateral hair margins are raised, resulting in a greater concentration of hair in the balding area.
• Flap procedures-The ideal candidate for a flap procedure is the balding person with finely textured, sparse hair or the patient with limited donor hair area who wants frontal coverage in the shortest period of time. The types of flap procedures are the preauricular flap, lateral flap, postauricular flap, Juri flap, and temporoparietal-occipital flap. Most of these procedures are done in two or three stages and have excellent success rates.
Stough, D. B., et al. Surgical Procedure for the Treatment of Baldness. Cutis, Vol 24: 303- 305, 1979.
Stough, D. B., and Cates, J. "Contemporary Techniques of Hair Replacement." Postgraduate Medicine, Vol. 69: 1981.


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