Hair Transplantation in Androgenetic Alopecia

    June 2021 in “ Cosmoderma ”
    Kavish Chouhan, Gillian Roga
    TLDR Hair transplantation techniques have improved, making the process safer and more effective with less visible scarring.
    Hair transplantation for androgenetic alopecia (AGA) advanced significantly, moving from punch grafting to techniques like follicular unit transplantation (FUT) and follicular unit extraction (FUE). FUT involved strip harvesting, which could leave visible scars, while FUE extracted individual follicular units, resulting in less visible scarring and faster recovery. FUE also allowed the use of non-scalp hair, such as beard and body hair, beneficial for patients with limited scalp donor areas. Graft survival rates varied, with beard hair showing a 95% survival rate, scalp hair 89%, and chest hair 76% after 1 year. Direct hair transplantation (DHT) improved graft survival by minimizing the time grafts spent outside the body. Proper graft management, including the use of chilled saline and careful handling, was crucial for successful outcomes. Hair transplantation was generally safe, with complications like pinpoint scarring, buried grafts, folliculitis, cobblestoning, unnatural hairlines, edema, necrosis, and shock loss, which could be mitigated through careful surgical practices. Advances in surgical techniques, including robotic hair transplants, and innovative training models using fruit/vegetable models for practicing hairline design were also highlighted.
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