long hair transplant

LONG HAIR TRANSPLANT – TRUTH OR GIMMICK

The idea of attaining a full head of hair without shaving is as lucrative as it gets. There is a definite increased inclination towards making everything instant and it’s not just your favorite noodles we mean!

Reasons why a long hair transplant is sought by many

  • Hair transplant though now a common cosmetic procedure, there are instances in which it’s still considered a taboo. Even a common man doesn’t want people to know and hence, wants to avoid unnecessary speculations.
  • Secondly ofcourse, the reason of being unable to sit back during the downtime to avoid the messy look. Flimstars, Business tycoons, Politicians or even your normal IT guy can’t take time off always.

What can we offer to these patients?

In order to satisfy the patients demand there are two ways in which this can be done. We will be talking about these methods along with their pros and cons.

Now we are specifically talking about donor area alone since, any type of procedure i.e. FUE or FUT doesn’t require completely shaving the recipient site.

  1. Window trimming
  • In this the donor area is trimmed to a ‘0’ or ‘1’ clipper  restricted to small zones, while the hair above it hides it.
  • A sharp/blunt punch with manual/motorized device can be used. Smaller diameter punches yield higher number of grafts. It is also important to note here that with extremely small punch the quality of graft maybe on the lower side, due to inadequate tissue surrounding it.

Pros:-

  • It is the go to technique for female hair transplant, since shaving the entire back of the scalp is not a possibility.
  • The donor is well hidden under the hair and it’s impossible to make out if extraction is being done.
Fig.1: Window trimmimg as shown in a male patient

Cons:-

  • You can do only limited number of grafts; around 1000-1500 grafts can be easily done but not more due to the limited space available for extraction.
  • Overall length of hair in the donor area should be longer than usual, about 2 inches atleast; to cover the trimmed area below.
  • Over extraction of the trimmed areas can cause patchy hair growth and when shaved can give the appearance of clusters of scared area.

Fig.2: Window trimming as shown in a female patient.

2. Long hair FUE

  • Also  called as non shaving FUE (NS-FUE)
  • Here none of the hair in donor area are trimmed or shaved
  • The whole donor area is taken into consideration while extraction is done
  • It requires special FUE punches (motorized/manual) The punch first cuts the long hair, and then proceeds to cut the skin, further advancing to dissect the arrector pili muscle attachment. This loose hair graft is carefully pulled out with aid-to-extraction or jeweler’s forceps.
  • The recipient site if pre-made; implantation can occur simultaneously to decrease the out of body time of grafts as done in DHT. Else it is always better to extract  small number of grafts and implant them to avoid such delay.

          Pros:-

  • Absence of uneven or patchy loss of hair
  • No patchy clusters or scaring on shaving completely as seen in window trimming
  • Right after the completion of implantation ,one can exactly see how the hair is going to look ,in terms of density or coverage
  • No downtime in terms of appearance or messy look and the person is stage ready right after.

        Cons:-

  • Just like almost all transplanted hair goes through a natural shedding phase by around 4-6 weeks so thus these hair. Majority ( 80%) of hair falls off for the roots to rest. New hair are seen sprouting by around 14-16 weeks.
  • It is a tedious and time taking procedure for both the patient and the surgeon, hence even with best of the skill only few grafts are done at a time.
·          Plast Reconstr Surg Glob Open. 2017 Mar; 5(3): e1261.
·          Published online 2017 Mar 16. doi: 10.1097/GOX.0000000000001261 
·       Pretrimmed versus Direct Nonshaven Follicular Unit Extraction
·          Jae Hyun Park, MD, PhD and Seung Hyun You, MD
(Image source: PMC –
US National Library of Medicine
National Institutes of Hea
lth)

So the bring home message is…

There is a definite possibility to do a hair transplant completely conspicuous and feel brand new in a matter of few hours. But there are limitations of less number of grafts and the inevitable shedding phase. One can explore all options and choose what suits best for them.

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