Androgenetic alopecia affects up to 50% of men and women throughout their lifetime.
Only surgery can provide a permanent and definitive treatment for an alopecic area.
Nowadays, surgical management of alopecias, particularly androgenetic alopecias (AGA), is mainly based on autografting techniques: FUE (Follicular Unit Extraction), Follicular Unit Hair Transplantation (FUT), and FUL (follicular unit long hair).
The principles of follicular unit grafting: FUE and FUT (strip)
Baldness (male and female) is due to the sensitivity of hair follicles (which produce hair) to a hormone: dihydrotestosterone (DHT), a derivative of testosterone.
It is the exposure of the follicles to DHT that prevents their regeneration, which is why they eventually fall out permanently. Not all follicles are sensitive to these hormones. The hairs of the crown (the hairline around the head) are not sensitive to DHT and therefore do not fall out, even with age.
Therefore, the principle of hair transplantation is to implant these crown hairs—insensitive to androgenetic alopecia—into the balding area. Once the graft has taken, these hairs that are not sensitive to androgenetic alopecia will no longer fall out.
There is no rejection because this is an autograft.
The first step: extracting follicular units
After prior local anesthesia, follicular unit extraction is performed in the donor area; these units contain between 1 and 4 hairs.048The extraction is carried out using a “micro-punch” with a diameter of less than 1 mm that leaves no scar.
The second step: implanting hair grafts using micro incisions.048Advantages of FUE hair micro-grafts:
A non-invasive micro-surgery
No scars in the donor area,
No bleeding,
No pain,
No swelling,
No damage to the hair implant (minimal transection rate),
Limited socio-professional downtime (1 to 3 days)
Natural results
Higher density
The possibility to correct the beard as well as scars in these areas (upper lip, chin,…) and in the eyebrow area.
The procedure consists of taking a strip of scalp hair from the occipital area, then—under a microscope—extracting the follicular units.
Next, the extraction area is closed using the trichophytic technique (from NATAF) so that the hair grows back through the scar and camouflages it.
The implantation is carried out in the same way as for FUE. The operating time is shorter, but there is a scar on the occipital area.
The results are very natural; the assessment carried out remotely will make it possible to determine whether additional sessions might be needed based on the density obtained and each patient’s preferences.
Final results are assessed one year later.
Minoxidil ® lotion (the only local treatment) and finasteride ® (oral treatment) do not have 100% effectiveness; in general, they stop hair loss, but in no case do they restore the hair that has been lost. Their effect fades after 24 months.
In addition, when treatment is stopped, any gain achieved is quickly lost.
It is recommended to combine treatments, generally using minoxidil before and after grafting. Applying it twice a day helps slow hair loss by acting on local vascularization. This improves the recipient site for the grafts.
Outpatient surgery: arrival in the morning and discharge the same day. A consultation is done at 48 hours and again at 10 days post-op. It is a minimally painful surgery; Doliprane medication is sufficient. In the case of FUE: simple sensitivity in the areas of harvesting and implantation.
And in the case of FUT: occipital tension due to harvesting the strip.
Graft take occurs over 2–3 days, and then a gentle shampoo is possible. Social downtime varies and may range from 1 to 7 days depending on the technique used and its extent.
There are few complications to note:
Bleeding may be observed from one of the harvesting or grafting sites, requiring only simple compression.
A superinfection is very rare and generally localized.
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