Hair Restoration Surgery: The State of the Art

Abstract

Hair restoration is a highly sophisticated subspecialty that offers significant relief to patients with hair loss. An improved understanding of the aesthetics of hair loss and cosmetic hair restoration, hair anatomy and physiology, and the development of microvascular surgical instrumentation has revolutionized the approach to surgical hair restoration since the original description. Additional elements that contribute to the current state of the art in hair restoration include graft size, site creation, packing density, and medical control of hair loss. The results of hair restoration are natural in appearance and are provided with a very high level of patient satisfaction and safety. This aspect of cosmetic surgery is a very welcome addition to a traditional aesthetic practice and serves as a tremendous source for internal cross-referral. The future of hair restoration surgery is centered on minimal-incision surgery as well as cell-based therapies.

Textbook of Plastic and Reconstructive Surgery

“…Post-operative complications include bleeding, infection of the wound and oedema in the forehead, which is temporary. Cysts may also develop but are easily treated with oral antibiotics and warm compresses (Vogel et al, 2013). Pain around the donor site can be expected and some patients also experience headaches.…”

“…Patients may also experience post-surgical effluvium, which is shedding of the non-transplanted hair. It is usually temporary, but its incidence can be reduced by minimising the number of recipient sites and using medical treatments such as minoxidil and finasteride during the post-operative period (Vogel et al, 2013). Scarring is, of course, expected for the donor strip method, although the use of trichophytic closures has improved the appearance of the scars.…”

“…This new hairline will be permanent so it is important to educate patients that the hairline may recede over time; therefore, patients who request a very low hairline may find this to look abnormal as they mature and continue to lose hair. The apex of the frontotemporal recession should have a gentle curve and should be convex in male patients (Vogel et al, 2013). The recipient area is anaesthetised using a local anaesthetic.…”

Single-Layer vs. Double-Layer Donor Scalp Wound Closure in Strip Harvest.

“…Other factors like trichophytic closure (one-margin or double-margin) also help to minimize the scar width which is proportionate to the tension on the scar edges [4]. Although various suture materials have been compared but no study to date has been conducted in the same patient using single-layer (non-absorbable) and doublelayer (deep absorbable and superficial non-absorbable suture) closure [5][6][7].…”

“…Traditionally various methods of wound closure are mentioned which include single-layer closure, double-layer closure, the staples etc. [4][5][6]. Other factors like trichophytic closure (one-margin or double-margin) also help to minimize the scar width which is proportionate to the tension on the scar edges [4].…”