Hair Transplant Blog - The Knudsen Clinic: hair transplant graft
If you’re one of the many who see hair loss or thinning every time you look in the mirror, you may feel powerless. Most hair loss is caused by genetic factors, hormones or amedical condition. In some cases,the cause is unknown.
A new technique called Scalp Micro-Pigmentation has recently been developed that has an exciting future in the range of therapies that we can offer for hair loss or patients with scarring of the scalp.
The idea of using a pigment tattoo to help camouflage scars on the scalp is not new. The problem with previous techniques is that the tattoo faded to blue or green over time and the pigment often “bled” into surrounding skin to give a “paint” effect which was not natural. Recently however, the development of newer, non-metallic pigments, together with the development of a specific technique to place pigment dots into the middle layers of the skin has revolutionised the concept. The use of non-metallic pigments is crucial as it will allow patients to have MRI scans if they are needed.
The outcome of the SMP technique is to produce the appearance of shaved hairs. This can be applied to any scarring of the scalp with matching of pigment colour to natural hair colour. This means any patient with donor scars from previous hair transplant surgery may achieve good camouflage of the scar with this technique. In most patients the SMP will last from 2-4 years before needing a refresh.
In addition, women suffering from Female Androgenetic Alopecia (Female Pattern Hair Loss) can have the illusion of extra density created by providing SMP to the upper scalp. This eliminates the need for topical camouflage products which need to be constantly used.
The Knudsen Clinic is proud to announce that SMP will be available from mid-2017 at our Hair Clinics.
Hair transplant surgery restores healthy hair to the upper scalp, says hair loss specialist Dr Russell Knudsen.
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Introducing a game changer in hair transplant surgery. Dr Russell Knudsen is the first surgeon in the southern hemisphere to offer the Artas Robot for improved results in hair transplant surgery.
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Recently published research from the University of Pennsylvania regarding conversion of adult cells into stem cells that regrew human skin cells, hair follicles and hair shafts has given new hope to those hoping for progress in this field. There have been many disappointments in this area of research as promising results in mice have failed to be reproduced in human studies.
It is important to understand how complex the hair follicle is as a structure and that the research is therefore difficult and time consuming. This recent progress still only addresses one of the main areas of research (epithelial cells which form the outer part of the follicle). No progress has been made in generating the dermal papilla cells (the “root” of the hair). Until we can generate these dermal papilla cells from stem cells then the dream of regenerating hair will remain that - a distant dream.
Strip harvesting’s rationale is to harvest all the donor hair is the area selected. If we choose hairs from the safest donor area, then we can be more confident that the hair transplant surgery results will last. This makes it a proficient harvest of the safest area.
Now consider FUE’s (follicular unit extraction) harvesting rationale, where the technique only uses partial removal of hair from the donor area. Only 25-35% of the available hairs are harvested, as over-harvesting leads to a variation in the density of the donor area compared to the rest of the hair. In extensively balding areas this becomes a concern but is unlikely to be a problem in small cases.
How do we deal with this potential issue? In my opinion, considerably bald, young patients should be urged to sustain long-term medication to limit future possible hair loss.
I do not believe that choice of strip harvesting or FUE changes any contra-indications to transplantation, but it may impact relative contra-indications to surgery. Consider a young man, developing extensive balding, who also has thinning from the nape of the neck. The restriction of existing donor area will reduce the number of ‘safe’ donor grafts that could be extracted by FUE whereas; a greater number of grafts could be taken from the safe donor area by strip harvesting (FUT). In this instance, more grafts could be achieved by strip harvesting than FUE.
I just recently came back from the Asian Association of Hair Restoration Surgery Annual Meeting in Seoul – Korea. The meeting was well attended with 250 surgeons there to find out the most up to date information concerning hair loss treatments.
Of particular interest to me were the talks referencing the influence of the recipient site on the growth rate of the transplanted hair. Original research was performed in Korea more than 10 years ago and showed the surprising result that, contrary to our initial belief, the body site where the transplanted hair is placed influences and changes the future growth rate of the hair.
The relevance of this result is that hairs in different areas of the body grow at different rates. When using scalp hair to reconstruct eyebrows the transplanted hairs initially grow at the scalp hair rate (three times faster than the eyebrow rate of growth). This means that the new transplanted eyebrow hairs need to be trimmed regularly because they grow much longer and quicker.
Over time the surrounding eyebrow skin influences the transplanted hairs and they slow down a lot to more match the growth of normal eyebrow hairs. More interestingly, if the transplanted hairs are removed from the eyebrow and then re-transplanted in to the scalp again, they begin to speed up their growth rate again! Simply amazing!
Another benefit from this research is that it proves that certain body hair can successfully be used to replace lost hair in the scalp and over time these body hairs will resemble natural scalp hairs in their appearance and the hair regrowth rate. Despite these compelling results, body hairs should only be considered as a last resort when there aren’t any more usable scalp hairs available to use as donor hairs.