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Hair Transplant Surgery
Sharad Mishra
CHAPTER 1:
History of Hair Transplantation
INTRODUCTION
HISTORY OF HAIR RESTORATION SURGERY
CHAPTER 2:
Anatomy and Growth of Hair
INTRODUCTION
HAIR EMBRYOLOGY AND DEVELOPMENT
ANATOMY OF HAIR
Gross Anatomy
Shaft Length
Shaft Thickness
Color
Hair Curl
Microanatomy
The Hair Shaft
The Hair Follicle
Lower Follicle (Bulb and Suprabulb)
Upper Follicle (Isthmus and Infundibulum)
Surgical Anatomy of Follicular Unit
Hair Cycle
SUMMARY
CHAPTER 3:
Hair Loss Consultation
INTRODUCTION
HISTORY TAKING
EXAMINATION
LABORATORY INVESTIGATIONS
Blood Investigations
Serum Iron
Thyroid Status
Androgen Status
Other Blood Investigations
Scalp Biopsy
Technique
TREATMENT PLAN
Decision Making
Patient Counseling
Designing the Hairline
Estimating Graft Requirement
Donor Area Evaluation
Discussion of Outcome and Complications
Medical and Alternative Therapy
Photography
Preoperative Advice
Scalp Stretching Exercises
Technique
SUMMARY
CHAPTER 4:
Medical Treatment for Hair Loss
INTRODUCTION
MINOXIDIL
Pharmacokinetics
Mechanism of Action
Clinical Use
Androgenic Alopecia in Men
Androgenic Alopecia in Women
Perioperative Use in Hair Transplant
Other Uses
Side Effects
FINASTERIDE
Pharmacokinetics
Mechanism of Action
Clinical Use
Androgenic Alopecia in Men
Androgenic Alopecia in Women
Perioperative Use in Hair Transplant
Side Effects
OTHER MEDICINES FOR HAIR LOSS
Dutasteride
Spironolactone
Vitamins and Minerals
SUMMARY
CHAPTER 5:
Design for Hair Transplant
INTRODUCTION
IDEAL HAIRLINE
CHARACTERISTICS OF IDEAL HAIRLINE
DESIGNING MALE HAIRLINE
Three Cardinal Points
Technique of Hairline Designing
Posterior Limit of Design
HAIRLINE ZONES
DESIGNING FEMALE HAIRLINE
Frontal Hairline
Diffuse Hair Loss
DESIGN FOR VERTEX RESTORATION
CHECKING THE HAIRLINE
SUMMARY
CHAPTER 6:
Anesthesia
INTRODUCTION
PATIENT EVALUATION FOR ANESTHESIA
AGENTS FOR LOCAL ANESTHESIA
GENERAL TECHNIQUE OF ADMINISTRATION
Patient Monitoring
ANESTHESIA TECHNIQUES IN HAIR TRANSPLANT
Under Local Infiltration
Scalp Block
Landmarks for Scalp Block
Tumescent Anesthesia
General Anesthesia or Conscious Sedation under Monitored Anesthesia Care
ANTICIPATED ANESTHETIC COMPLICATIONS
POSTOPERATIVE PAIN MANAGEMENT
SUMMARY
CHAPTER 7:
Donor Area: Evaluation and Harvest
INTRODUCTION
DONOR ASSESSMENT
Limits of Donor Zone
Donor Density Calculation
Calculating Donor Density
Skin Laxity Assessment
Hair Volume
Hair Shaft Diameter
Hair Color and Contrast
Hair Curl
Donor Area Miniaturization
HARVESTING TECHNIQUE
Donor Area Preparation
Anesthesia and Tumescence
Incision and Strip Dissection
Donor Closure
SUMMARY
CHAPTER 8:
Follicular Dissection and Preservation
INTRODUCTION
EQUIPMENT
Stereomicroscope
Instruments
Lighting
TECHNIQUE
Slivering
Graft Dissection
Training the Staff
Evaluation
Training
Monitoring
GRAFT PRESERVATION
Graft Segregation and Counting
Storage Media
Temperature Control
CHAPTER 9:
Follicular Unit Extraction
INTRODUCTION
PRINCIPLE
INDICATIONS
CONTRAINDICATIONS
FOX TEST
TOOLS
TECHNICAL PRINCIPLES
Visualization
Magnification
Hand Motion
Extraction
STEPS
Preparation
Anesthesia
Two-Step Technique
Three-Step Technique
POSTOPERATIVE CARE
COMPLICATIONS AND DRAWBACKS
Follicular Transection
Epithelial Capping
Follicular Shearing
Graft Quality
Buried Grafts
Permanent Zone Breach
Scarring
Patient Concerns
Technical Concerns
Automation in FUE
CHAPTER 10:
Recipient Area: Evaluation and Implantation
INTRODUCTION
EVALUATION OF RECIPIENT AREA
CLASSIFICATIONS FOR ANDROGENIC ALOPECIA
Hamilton-Norwood Classification
Ludwig Classification
ASSESSMENT OF FUTURE HAIR LOSS
Clinical History
Miniaturization Study
Estimation of Graft Requirement
Geometrical Shape Method
Transparent Sheet Method
Digital Photography
PREOPERATIVE PREPARATION
POSTOPERATIVE CARE
SUMMARY
CHAPTER 11:
Special Area Transplant
INTRODUCTION
FACIAL HAIR TRANSPLANT
Moustache and Beard Transplant
Design
Steps
Postoperative Care
Sideburn Transplant
Design
Steps
Postoperative Care
Eyebrow Transplant
Design
Surgical Techniques
Postoperative Care
Eyelash Transplant
Design
Technique
Postoperative Care
Scar Tissue Transplant
Technique
Postoperative Care
CHAPTER 12:
Hair Transplant Complications
INTRODUCTION
PERIOPERATIVE COMPLICATIONS
Donor Area Complications
Bleeding
Recipient Area Complications
ESTHETIC COMPLICATIONS
Rare Complications
Plug Correction
SUMMARY
Appendices
POSTOPERATIVE INSTRUCTIONS
Take Your Medications
Do not Smoke or Drink Alcohol
Wear Protection on Your Head
Sleeping
Physical Activity
Swelling, Numbness and Oozing
Scabbing
Head Band
Salt Water Spray
Folliculitis at the Graft Site
Hair Grooming
General Precautions
Shampoo and Cleaning
Rogaine or Minoxidil
Cut, Color and Oil
Ingrown Hairs
Suture Removal
INDEX
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