Hair Transplant Surgery Sharad Mishra
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1Hair Transplant Surgery2
3Hair Transplant Surgery
Sharad Mishra MS MCh (Plastic Surgery) Director Hair Transplant Surgery Provelus Hair Transplant Clinic New Delhi, India Foreword Kul Bhushan Goyle
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Hair Transplant Surgery
First Edition: 2014
9789351520795
Printed at:
5Foreword
Hair transplant in modern times was probably first described by a Japanese plastic surgeon, Akuda as a reconstructive procedure on his burns patients. He used to harvest hair plugs from permanent donor area which were then implanted in scarred areas of the scalp. However, due to censorship applied during World War II, these reports and techniques were not available to the rest of the world. Dr Norman Orentreich in New York City was the first to use this technique for male pattern baldness in 1950s.
In the early 1970s, when I learned the technique and later practiced hair transplant surgery in England, it was still in its infancy. As the procedure was first introduced in India in 1980 by me, there was still generalized ignorance about the authenticity and effectiveness about this surgery. This was made worse by a firm belief in a conservative society as ours that there was no way that hair could grow on a baldpate by any means. From the initial disbelief and the slow pace of acceptance, I have seen the procedure evolve and blossom over the years with my very own eyes. The modern hair transplantation, with its refined techniques as available in India now, has come a long way.
Although more and more doctors have started practicing hair transplant in India, there was no standard book by an Indian author to guide them in their pursuit barring the literature and a few books written by foreign authors. There was still a big lacuna for a good hair transplant book based on the Indian hair transplant experience. It gives me great pleasure to introduce Hair Transplant Surgery by Dr Sharad Mishra as the first book on hair transplantation by an Indian author. This book, although Indian in outlook, provides such concise yet comprehensive knowledge of hair transplantation that it will prove to be an asset for any practicing or aspiring hair transplant surgeon throughout the world. The chapters themselves are lucid and the illustrations, which accompany them, are uniform and self-explanatory.
I want to emphasize and comment on a few of my favorite concepts from the book. It gladdens my soul the way Dr Mishra has detailed the almost lost art of medical consultation for hair transplant. In one of the well-written chapters, his emphasis on honesty and genuine care for patients sets the tone for the remaining book. This kind of approach leads to healthcare, where there is no hasty judgment, no coercion and no associated greed. There is simply the truth, sometimes not very pleasant, yet always correct.
Hair transplant surgery is a surgical art. It requires not only training but also an esthetic eye while designing a new hairline. Many of these esthetic secrets and techniques have been described in this book. Each step is beautifully illustrated through diagrams and figures, making it easier to understand even for the novice hair transplant surgeons. Some of these previously unpublished techniques will give an edge to the readers of this book while creating beautiful and natural looking hairlines.
A third attribute of this book that I found very appealing is the clarity with which Dr Mishra has explained the mathematics behind hair transplant. Using examples simple to follow, he has elucidated the concepts of donor density calculation, graft requirement, etc. Such detailed planning will help both the physician and the patient to understand and acknowledge achievable goals during any hair restoration endeavor and banish ambiguity.
Hands-on guidelines for follicular unit extraction are also a great addition in this book. As a minimally invasive technique, follicular unit extraction is the most preferred technique for majority of the patients nowadays. The advantages are numerous, and in not so far future, this may become the first-line technique, surpassing the strip method. This book will give every reader a head start in this relatively new but rapidly expanding field.
With the numbers wanting this surgery already available in India and still growing, the future of hair transplant surgery is decidedly very bright and this piece of literature will prove a boon to all the practitioners of this art.
Kul Bhushan Goyle
ms phd (surgery) (london)
Consultant Hair Transplant Surgeon
Hair Transplant Clinic
New Delhi, India
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7Preface
During the last decade, there has been a vast explosion of new information relating to the science of hair biology and the practice of hair restoration surgery. As the procedure grew leaps and bounds, this highly specialized clinical field is no longer restricted to plastic surgeons only. Clinicians from a variety of related disciplines, like dermatosurgery and general surgery, have also developed interest in procedures involving hair restoration.
While writing this book, my primary goal was to provide a comprehensive practical knowledge of the procedure of hair transplantation without the frills. I wanted to impart the knowledge which I have gained from the specialists in the field of hair restoration along with what I have learned through personal experience. The book has been arranged in a format that covers almost all the aspects of hair transplantation surgery from planning to postoperative care.
The concepts are clearly explained in an easy-to-follow step-by-step approach, with an emphasis on presurgical planning. The proverb—‘if you fail to plan, you are planning to fail’—is very apt in context to hair transplantation. While it is impossible to give hands-on experience or an artistic eye through words, you will find many practical techniques in this book that will take out most of the guesswork from the procedure and help the readers make better decisions for their patients. Each chapter of this book goes one step beyond the currently available literature to incorporate new thoughts and ideas that have never been published before. The surgical approach in this book is totally practical that you would relate to during clinical practice. The chapters on surgical techniques contain clear intraoperative photographs including the surgical details for a novice surgeon.
While this book is aimed mostly at the practicing plastic surgeons, dermatosurgeons and dermatologists, any clinician with interest in hair restoration surgery will find the book practical and helpful.
It is a unique, easily readable book with just the right amount of information in right doses.
Sharad Mishra
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9Acknowledgments
Throughout the process of writing this book, many individuals have helped me with their thoughtful insights, encouragement, time and patience. I take this opportunity to express my gratitude to the people who have been instrumental in the successful completion of this book.
Over the years, I have worked with numerous patients, shared their hopes and joys as we walked together on this journey of hair transplantation. They are my primary teachers, who gave me knowledge and wisdom through experience. I shall be eternally grateful to them. Each page of this book is a note of thanks to the thousands of my patients, who have graciously helped me learn and hone my skills.
I take immense pleasure in thanking my dear friend and colleague Dr Subin Sukesan for helping me in preparing the chapter on ‘Anesthesia’ in Hair Transplant. My sincere thanks are also due to Dr Pradeep YV for all his help during the writing of this book. I would also like to thank Ms Shaila Prashar for her continued support during the preparation of this book.
I wish to acknowledge and gratefully thank surgical, secretarial and all other staff at Provelus Hair Transplant Clinic, New Delhi for their constant unfaltering help during surgeries, photography and everything in between. I am forever indebted to my parents, Virendra and Pushpa Mishra for their endless patience, love and encouragement. They have made me what I am.
I must specially thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President) and Mr Tarun Duneja (Director–Publishing) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi for having recognized the merits of the presented material and to have come forward enthusiastically for publishing and for cooperating patiently throughout this period in bringing out this edition.
Last but not the least, thank you Monika for making my life wonderful…!