What are the causes and treatment for Hair Loss?
Hair loss can result from heredity, stress, fungal or bacterial infection, affected liver or thyroid, crash dieting, dandruff, iron, calcium and vitamin deficiencies, systemic disease or side effect of prolonged medicines. These causes can be investigated and treated with suitable medicines. Hair loss that does not respond to treatment and has progressed beyond grade three requires replacement with new growing hair, which is done by hair transplant.
What is Hair weaving, Hair bonding, Hair fusion etc?
Hair weaving is tying a wig on the head with silk thread knots. Hair bonding is holding the wig with clips and hair fusion is sticking a light weight nylon wig with a double sided sticking tape. These are all temporary methods. Prolonged use causes bad hygiene, pull out of the anchoring hair and excoriation of skin. These methods are not done by doctors.
What is Hair transplant?
Hair transplant is a one day procedure which gives permanent replacement of lost hair with new hair roots that grow. These can be cut, shampooed and treated like your own hair. Repeated visits to the clinic are not required.
How hair transplant corrects baldness?
Baldness is a progressive disorder. Hair on the front and top of the head is lost because it is hormone dependent. Hair on the sides and lower back does not have hormone receptors. This hair is retained till the age of 60 – 70yrs. Plastic surgeons transfer the persons own hair roots from the long lasting area to the bald area. Latest Follicular micro grafting ( FUT ), FOX technique and Body Hair Transplant
What are punches, single hair grafts and the latest FUT?
Use of punches and single hair grafts are now outdated. Hair grows in natural units of 1,2 or 3 hairs. These natural units are maintained in the latest follicular micrografting technique. This gives a robust, hair growth. If these units are separated and implanted as single hair they give poor growth. Follicular unit grafts avoid, clumpy appearance of punches and the thin look of single hair.
Do you have to be completely bald for a hair transplant?
Follicular micro grafts can be used in – between thinning hair in men and women for adding density. Our team covers most areas in single sitting. 1000 – 2000 grafts can be done at one time, going to a maximum of 3000.
Can you make less number of grafts look fuller?
Special interdigitated placing is used to make lesser number of grafts look fuller.
What happens to the area from where the grafts are taken?
The FUE grafts are not harvested in a continuous row. Three grafts are left behind for every one that we harvest. We can also split a follicle during harvesting to take two hair and leave one behind to maintain appearance of adequate density. Within a week to ten days these sites of harvesting are barely noticeable. Usually 2200-2500 grafts can be harvested without thinning the donor area.
How are the grafts placed and when do they grow?
The micro grafts are paced in the bald area with injection needle pricks to make sure there is minimal scarring. The grafts start growing with the next hair cycle at 3 – 4 months and keep on growing thereafter.
How long does the operation take? Do we have to remain admitted?
The surgery is done under local anesthesia. It takes 6 – 8 hours. Patient is discharged on the same evening and advised rest for 3 – 6 days. Follow up for suture removal is required at 12 – days. Suture-less FOX technique and transplant of body hair is available for suitable patients.
What can be done for old pluggy grafts or flaps?
Correction of old pluggy looking grafts or low straight line hair flaps can be done by recycling the punches and redraping the flaps.
What other hair loss can be replaced with FUT?
Restoration of eyebrows, eyelashes, burn areas, scars, beard, moustache, cleft lip Hanson’s patients, pseudopelade, and Folliculitis Decalvans is best done with follicular micro grafting.
What are punches, single hair grafts and the latest FUE?
Cutting a strip of the scalp and dissecting out hair grafts from the strip is now outdated. Even with the best of suturing and closures the strip scar gradually stretches and widens after a year or more. Irritation of the scar can cause thickening and discomfort. In the latest, micro FUE, hair follicles growing in natural units of 1,2 or 3 hairs are harvested individually with a 0.8 – 0.9 mm micro punch. The harvesting sites are scattered throughout a large area making them less noticeable in between the natural hair.
Do you need to shave your head for FUE?
- It is good to shave the head as you can get maximum number of grafts.
- Second choice is to have a hair style where the sides and the back are trimmed down to the skin and leave long hair on top of the head as it is.
- Third choice, keep the hair long on the back of the head. We can lift up the hair shave a one inch band and comb the hair over. We can shave two or three such bands especially in women.
- For men we have the choice of adding grafts from the shadow area of the beard under the chin and below the jaw line to reduce shaving area from the scalp.
How can we reduce the pain?
- Apply skin anaesthesia cream and cover it with kitchen cling film for 20 minutes.
- Use ice pack to chill and numb the skin.
- Use vibration massager along the area while injecting this distracts the nerves and according to gate theory of nerve conduction, while conducting vibration the nerve has no band width to conduct the pain.
- Inject anaesthetic with Insulin Syringe in very small doses along the lower border.
- Use nerve blocks to supplement effect of the infiltration anaesthesia.
- Prevent fall of blood sugar and holding desire for urination, this increases perception of pain. We ask patients to have breakfast on morning of the procedure. We encourage breaks every 2-3 hours when patient can use the wash room and sip some juice. We have a lunch break at 1.30 pm when not a full meal but patient can eat.
What is Advantage of using Beard grafts over Chest hair and other body hair?
- Scalp hair is falling due to androgens, while beard hair is growing due to androgens.
- Thickness, rate of growth, appearance of beard hair is closet matching with scalp hair.
- Beard grafts taken from the shadow area of the face under the chin and below the jaw line are not noticeable.
- Chest hair, other body hair is slow growing, thin, not uniformly in growth phase. It can be used as a filler. You can trim down rest of the hair to match the shorter growing body hair.
Can we do Beard and Moustache Restoration?
Beard and moustache restoration for burns, trauma, slow growth or lack of growth is one of our specialities. Not all hair transplant units have the experience. we have published papers on these techniques with consistent results.
Can we have Eyebrow and Eyelash Restoration?
Eyebrow and Eyelash restoration for burns, trauma, Hanson’s or loss of eyebrows is routinely done at our unit. We do not encourage this for cosmetic thickening of the eyebrows. We offer micro pigmentation tattoo for cosmetic thickening of the eyebrows. Eyelashes grow very thick and luscious with application of Bimatoprost 0.03%.
Can Hair Cloning be sucessful?
We doubtful about success of hair cloning as body has lowest priority for hair growth.
- Studies show there are enough stem cells in a bald scalp. What is lacking is the regulatory mechanism to convert these stem cells into mature hair follicles.
- Stem cell is a multi potent cell which can convert to any cell in the body. It is directed by the body through wnt protein signals to help in repair and regeneration of tissues as per requirement of the body.
- By evolution hair is the least important structure in the body. It has no vital function. Hair loss has no natural repair, regeneration and no specific wnt signal protein. Stem cells injected fro hair growth after first few days go and repair the damaged liver or the smokers lung instead of growing hair.
- Human hair follicles originate from three different embryological precursor cells. Mice hair follicles originate only from epidermal cells. The experimental success seen in animal models can never apply to complex human cell interaction.
What are Stem Cell treatments done for hair growth?
When the stem cells multiply in the lab, they secrete abundant growth factors favourable for cell division and growth. They create growth promoting co-enzymes and catalysts which are isolated and injected to promote growth of dormant hair cells in the scalp. It may or may not be effective. If it is effective you need to keep repeating the injection twice in every cycle as the effect naturally wears off as the factors get consumed.
Why is PRP not always effective?
An individual losing hair is deficient in certain growth factors in his blood. Hence 20-40 ml of blood from this person is centrifuged and concentrated into 2-4 ml making an expectation to increase the availability of the growth factors. These are wishfully injected to create hair growth. The factors are consumed immediately. even if you generate hair growth the PRP has to be repeated twice in a hair cycle to maintain. Along with the growth factors, the growth inhibiting factors also get concentrated in a person who is losing hair and may prevent any benefit.
Marking and planning the hairline on morning of the procedure and talking pre meds:
On the morning of the hair transplant, Dr. Rajesh Rajput starts by giving a mirror to the patient and discussing the shape and level of the hairline with the patient and the relatives. Shape of the hairline and level of the hairline are discussed and marked with green marking pen. Most important area of concern to be filled for the patient is marked. Any apprehensions and queries are replied, steps of the procedure and duration are explained. A dose of antibiotics, fast healing enzymes and anti anxiety medication is given orally, no sleeping dose or sedation is used at Dr. Rajesh Rajput Hair Restore.
Patient position for harvesting the grafts:
Patient is assisted in attaining the most comfortable position lying prone for the graft harvesting. This position required for 3 hours at a stretch. Adjustments are allowed by turning the head to right or left side in short intervals. Once harvesting is done, implanting is in comfortable, sitting position. At Dr. Rajesh Rajput Hair Restore we do not use continuous saline wash, repeat injections or positions that could make you wet, messy or uncomfortable.
Regular Breaks during the procedure:
Dr. Rajesh Rajput Hair Restore believes in giving frequent breaks to the patient during the procedure. Every 3 hrs you get a restroom break. At 11.30 you can have half a glass of juice. At 1.30 you can choose to have sandwich, snack or light meal. Procedure usually finishes by 3pm.
Post Care after the procedure:
Patient gets detail post care instructions. A Cold Gel Pack to prevent swelling and counter pain, a set of medicines and a ointment to apply over the donor area. A moisturizing spray is to be used from the same evening. Medicated shampoo is given for head wash after 2 days. Local patients can visit the clinic for a head wash after 2 days. Firm forehead massage is encouraged to proudly achieve no swelling in 99% of our patients.
Travel after the Procedure:
Patients who get Hair Transplant done at Dr. Rajesh Rajput Hair Restore can travel the same evening. Most of them take a flight and fly back overseas the same night. Only trouble possible is puffiness over the eyes due to the movement and dependent position of the forehead and face during the flight. Prevented effectively with good forehead massage.
Tolerable to minimum pain after the procedure:
Patients who had their Hair Transplant at Dr. Rajesh Rajput Hair Restore report very little to just tolerable pain which responds immediately to the analgesic, pain killer tablets we have provided. Some local patients have returned the pain killer tablets to confess that they never needed to use them at all.
Not Feeling Sick after the procedure:
At Dr. Rajesh Rajput Hair Restore, after having a Hair Transplant, the patient does not feel sick like any patient would expect to have after a surgery. There are patients who have driven back themselves 60 miles to reach home. Patients who invited friends to have a pizza party the evening after the surgery and patients who wanted to go to the disco the same evening. This is because at Dr. Rajesh Rajput Hair Restore we practice a Hair Transplant technique with minimal tissue trauma, minimal ooze, we practice good tissue respect and do not have undue surgical handling of the tissues.
Prevent drying of grafts and ensure no infection:
Dr. Rajesh Rajput Hair Restore has careful technique to avoid drying of the grafts which can make the grafts non-viable during hair transplant. At Dr. Rajesh Rajput Hair Restore utmost care is taken to prevent cut hair ends, microscopic residues of dead skin tags or crushed fat being implanted into the scalp along with the hair grafts. Thus any post surgical infection, suppuration and aseptic reactions are prevented.
Best Implantation technique 'Stick and Place' :
Dr. Rajesh Rajput Hair Restore is one of the few centres around the world to still practice the gold standard of hair implantation done with Stick & Place technique. This method of implantation requires very high skill, use of magnification, supply of numerous sharp, long bevel, regulated 19 gauge, one & half inch, hypodermic needles. No blades, no cuts, no dilators, no implanters are used. Grafts are carefully placed along a needle track created with a needle prick 3mm into the scalp. The technique of Stick & Place facilitates high density, practically no oozing, no missed holes, no premade slits, no use of dyes for identification of the pre made slits, no loss of grafts.
Partly Automatic FUE:
Dr. Rajesh Rajput Hair Restore offers Follicular Unit Extraction, FUE. Specially designed partly automated, micro processor controlled FUE is our unique feature that uses very low rpm to reduce heat generation and follicular extraction damage. FUE at Dr. Rajesh Rajput Hair Restore has specially designed titanium punches with central bevel, short length to minimize trauma, lower transaction rate and offer ease of extraction to deliver the follicular units without using force. We can transplant 2500 – 3000 grafts in a day.
Safe use of Micro Surgery Instruments:
Dr. Rajesh Rajput Hair Restore introduced the concept of using pressure graded, fine, micro surgery instruments for implantation of the grafts in Hair Transplant. The softening and narrow design of the instrument tips does not allow excessive pressure to build up on the grafts that are held between the tips of the instrument. Use of micro surgery instruments promotes gentle handling, though giving firm grip, it prevents crushing of the hair bulb and prevents pressure on the most important stem cells area or he hair bulge.
Hair Sparing approach:
Dr. Rajesh Rajput Hair Restore practices a unique Hair Sparing approach where less is more. We offer 100-200 free grafts to ensure best results when required and where patient are unable to select a higher package. Dr. Rajesh Rajput Hair restore delivers best results by combined use of Cyclical Therapy with Hair Growth Vitamins. The hair is pre conditioned to improve the quality, growth, density with 2-4 months of vitamins before the hair transplant. Cyclical Therapy also continues after the hair transplant to enhance the results achieve best results and prevent further hair loss which avoids the need for repeated hair transplants every few years.
Inspiration and Training:
Dr. Rajesh Rajput Hair Restore has provided inspiration and training to many more doctors to take up the responsibility of delivering good Hair growth to their patients. Dr. Rajesh Rajput Hair Restore conducts Training Programs on the last Friday of every month. There are sessions of lectures, presentations, live surgery demonstrations and video sessions to explain each step of Hair Transplant in detail.
Dr. Rajesh Rajput Hair Restore is a Humanitarian Practice. Each patient is individually explained the importance of hair growth vitamins, local applications and how they work? The effective regrowth of hair without Hair Transplant. The option of Hair Sparing Transplant, number of grafts, number of sittings, requirement of shaving. Direct involvement of the patient and relatives in the planning. Proper explanation of every step of the surgery. Emphasis on making sure the patient has very little to no pain during the injections and during the procedure. Breaks as frequently as desired. Well padded supports for comfortable positioning of the patient. Arrangement of snacks during the breaks. Proper post treatment medicine, shampoo, sprays and gel pack to be used for reducing the puffiness on the forehead. Extra enzymes for better wound healing and reducing chances of swelling. Patients are taught the post operative massage program. During the procedure patients are not put off to sleep, with a sedative or sleeping injection. Dr. Rajesh Rajput is personally present and patients can ask any doubts, quarries, request more explanation even during the procedure. Patients hairline is checked during the break and quickly touched up or readjusted if required. The patients are offered generous concessions on request.