What is the hair transplantation?

Nowadays own hair transplantation (autotransplantation) is unique effective way of hair restoration, correction consequences of hair loss, androgenic, scar and traction alopecia.

Male pattern hair loss (androgenic alopecia - see schematical Norwood classification) was painfully perceived by the majority of men at all times and remained an insuperable problem until recent years. Hippocrates, who suffered from hair loss himself, had a deep interest in this case. He was the first to found out connection between hair loss (baldness) and mail sex hormones. July Caesar combed long hair from a nape and from lateral sites of a head forward to cover hair loss. Napoleon combed hair too, from a nape on a growing bald forehead.

Androgenic alopecia - Norwood classification

Male pattern hair loss and baldness or androgenic alopecia is extremely common, and a third of man's world population at the age of 20 till 60 suffers from it. For recent years androgenic alopecia has increased and age range of hair loss is becoming younger. Women can suffer from androgenic alopecia (hair loss, baldness) too (see photos).
The reason of baldness or hair loss is considered harmful effect of male sex hormone testosterone on hair “roots” – follicles located in frontal and parietal areas. A follicle - the tubular cover located below of skin, is the structure, capable to create hair. On skin of a head there are about 100000 hair follicles. During the whole life from each follicle can grow 20—30 hair. As a rule, 70 % of hairs are always in a stage of growth, and 10 % - in a phase of rest. With the years the person has only insignificant decrease in a follicle density; however the tendency to decrease in activity of growth of hair (hair loss) is observed.

Under influence of man's hormones - androgen (from here - androgenic alopecia) follicles are sensitive to gradually decrease in sizes, atrophy and, finally, resolve an organism. Although mentioned hormonal background is characteristic for every male, only those who are genetically predisposed to baldness, hair loss. That is why medicament treatment of androgenic alopecia is never successful: hair can not grow without the follicles and follicles are atrophied and desorbed. To compare: hair transplantation or hair restoration in bald areas by drug treatment is equally impossible as growing hair on ones palms.

From old follicle which is still in a stage of resolving, in rare cases, as a result of influence of drugs can grow hair, however such hair will be very thin and weak. Besides after drug stimulation obsolete follicle starts to function improperly that weakens it even more. As a result hair drops out soon, and a follicle, finally, resolves.

So, on the sites of a head subjected to androgenic baldness and hair loss, there is no more normal follicle, whence could grow healthy hair. At the same time, at androgenic alopecia in occipital and temporal areas there is always a nimbus of hair, which follicles, not having receptors to testosterone, remain resistant to factors of distinctive hair loss.

Hair transplantation means a change of follicle in the bald sites of a head from those donor places (a nape and lateral sites of a head) where follicles are submitted in a plenty. Follicles existing in donor places are always healthy and keep the normal anatomic-physiological properties almost up to the end of human life. Therefore vast majority of people who suffer from the hair loss are kept well with hair in occipital and lateral sites of a head. Thus, with the help of the most successful and effective techniques of own hair transplantation (autotransplantation) a follicle (hair) is removed from those places where they are submitted in a plenty, in those places where they are absent.
History of hair transplantation takes roots since 1939 and is related to the name of Japanese physician S. Okuda. He used to transplant round-shaped (4 mm in diameter) skin islets (grafts) from occipital area of the head to treat scalp burns. The grafts continued to produce hair in their new location. But Dr. Okuda died in World War II and his works were forgotten, until American dermatologist N. Orentreich “rediscovered” hair grafting in 1952.

Human scalp under 20X magnification	One hair follicular units	Two-four hair follicular units

He established the concept of “donor dominant” which stated that transplanted hair roots (follicles) function at any location just as they would at their initial “donor” location. This means that hair produced after hair transplantation has exactly the same anatomical and physiological properties, as hair at donor location (back of the head) and therefore, will never fall out. The problem was though, that hair produced from 4-mm (so called large) grafts would grow in bush-like pattern (“tooth-brush”, “doll’s-head” effect). To correct this cosmetically unacceptable result, American surgeon E. Marrit in 1983 attempted use hair transplantation not in the form of skin islets, but as individual hair roots (follicles). Later, hair transplantation in the form of the thinnest grafts (0.8—1 mm in diameter) was named micro grafting.

In 1995 - 2000 the American surgeons – hair transplantologists R.Bernstein and V.Rossmanom developed the concept of transplantation of follicular associations. According to this theory, hair transplantation occurs exclusively as follicular associations, i.e. is exactly the same distribution what meet in the nature.
Follicular association - the multi-functional unit of a hair scalp also consists of one up to four hair bulbs (see the photo). Follicular connection is represented naturally by a group of hair which grows all together from skin and divides among themselves, one grease to iron and has the same blood supply. Hair transplantation in the form of transplantation (grafting) of follicular connections assumes preservation of such natural groups at change from one part of skin of a head to another.

Change of hair follicular units creates impression of maximal naturalness, minimizes hair loss during the operation and is considered “gold standard” of hair transplantation today. But this method requires complicated techniques of harvesting donor material, dissecting donor material under special stereomicroscopes by 5 or 6 experienced assistants which is extremely time-consuming and expensive process.

Ineffectiveness of medications is proved by number of investigations and today there is no doubt that replacing lost hair by androgenic type is possible only by means of hair transplantation. Some companies produce artificial or synthetic hair (microfilament) that are of limited use for hair transplantation. For example, in the USA use of artificial hair is prohibited. The reason is that artificial hair does not grow, causes bothersome itching, has many complications (in durative processes of the skin, formation of pus, scarring) and finally – falls out or results in the massive hair loss. Considering above-mentioned, our centre does not practice synthetic hair transplantation. We only use the hair transplantation in the form of follicular units.
Thus, hair transplantation is not grafting of hair filaments, but of those micro organs (follicles) that produce hair. The only way of solving the problem of androgenic alopecia is timely redistribution of genetically healthy hair roots (follicles) or ones own hair transplantation.