ISHRS is the premier international society for hair transplantation- we are members of this organization Our website: b

1. DR Venkataram Mysore MBBS.DVD.DNB.MD.DipRCPath(LOND) ISHRS is the premier international society for hair transplantation- we are members of this organization Our website: www.bangalorehairtransplant.com www.bangalorehairtransplantation www.bangaloreskin.com | www.bangaloreskin.com/liposuction

2. Welcome to a presentation on baldness and hair loss • 50% of world’s population suffer from baldness • Did you know man is called naked ape as he has the least amount of hair among all mammals? • Did you also know that hair is not essential for human survival and is largely cosmetic in function?

3. Hair transplantation • Hair transplantation has evolved over the years –from the days of the disastrous punch transplants to the present day state of the art Follicular unit transplantation. • This presentation give you basic information about the procedure

4. Hair Physiology The hair consists of 2 major parts: • Hair shaft - the visible part of our hair which has no influence on the hair growth. • Hair bulb - the part which is under the skin and influences the hair growth • There is no “communication” between the hair bulb and the hair shaft, hence shaving/cutting the hair has no impact on its growth Hair Shaft Hair Bulb Normally there are about 100 thousand hairs on scalp

5. This is how baldness progresses-where are you in this chart?Note that even in the last stage(VIII), back of head never loses hair

6. Why does baldness occur? Normally hair follows a cycle of growth, rest, fall, and then Hair grows again

7. In males with baldness, this cycle is abnormal-each cycle results in progressively smaller hair (Miniaturization) and final disappearance.This is caused by the action of male hormones on the hairs in people who have inherited the gene from their parents-–hence it is called androgenetic alopecia Do women get total baldness - no, it is very rare

8. Baldness and it’s Psychological effects • Feel older-48% • depressed-54% • avoid social situations-64% • preoccupied with the problem 16% • 52% thought it significantly affected their lives Too much of hair is bad-and too little is also bad!!! It is indeed amazing how much effect hair has on personality, despite serving no useful function in the body.

9. Is there any drug for baldness? • Presently , there are two approved drugs;a)Minoxidil lotions 2% and 5%-it has to be applied daily twice over the affected area for many years. • b)Finasteride 1mg tablets( propecia)- one tablet daily for 3-4 years Remember: There are different causes for hairloss-these are temporary and do not lead to baldness.Common Baldness is always hereditary and these are the only two drugs for baldness-every thing else advertised is without adequate proof

10. Are there any disadvantages of these drugs? • They are very safe and free from serious side effects. • They are useful in early hairloss and baldness. • However, these treatments are for long duration, and are quite expensive. • The effect lasts as long as they are taken and hence may also be temporary • They are not effective in established and extensive baldness. • Thus hair transplantation is the only permanent method of hair transplantation.

11. Old method-Punch grafts-paddy field or doll appearance-disaster This was the method till 1980s!!! This is a very easy operation . This surgery using an instrument called punch has no place today

12. What is follicular unit? Hair occurs in group of one, two or three Hairs called follicular unit transplantation. Dissection Of such units and then transplanting them is called follicular unit transplantation- the Rolce Royce of hair transplantation

13. How is follicular unit transplantation(FUT) different from Micrografts and minigrafts? • From 1980 still early 1990s, microminigrafting was practised. This was definitely an improvement on the previous punch grafting. • Follicular unit grafts are different in that: • the dissection is more natural • is done under microscope • grafts are smaller • need smaller holes • cause less bleeding • can be packed more densely • Hence FUT yields more natural results • For this reason follicular unit transplantation is called the Rolce Royce of hair transplantation • However, FUT is also more difficult, needs microscopic dissection, is more time consuming, needs more manpower and is more expensive.

14. no of hairs in a person varies from person to person –densitometry determined by trichoscan. Low density Mostly1/2 hair units High density- Mostly 2/3/4 hair units Seen in people from kerala and Tamilnadu Average density- Mostly1/2/3 hair units Most south indians have this The number of hairs a person has depends on the type of units and the type of Density he has. The type of density is an important factor in the quality of results he gets after surgery-the higher the density, the better the result.

15. Step 3 Follicular units step4 transplantation in to bald area Step 2 dissection of hairs Step1 Donor area Principle of hair transplantation

16. Back of head never loses hairs as these hairs are genetically different- hence they grow even when they are transplanted to the bald area. Since they are patient’s own hair, they are not rejected.

17. Don’t be afraid that there may be damage to brain-we go only up to 4 mm.Brain is located 4 cm deep in side the skull

18. Preparation of Donor-no hair cut or shaving-we preserve your hairstyle

19. Local anesthesia-we minimize pain by using vibrator and Cream anesthesia (EMLA crème ) before giving injections

20. Our theatre-enjoy a movie during operation

21. Donor area is sutured-hair from above covers it Even on operation day, suture area can not be made out, as very little area is shaved. Donor area resection takes about 40 minutes

22. Sutures heal in 2 weeks-we put absorbable sutures-so there is no need for suture removal you cant make out the suture!! We take great care to avoid any change of hairstyle

23. Hair dissection-using microscope to avoid damage to hair. Lasts for 2-3 hours Hairs as seen under microscope-note the 1,2 and 3 hair units Microscopic Dissection Dissection room

24. Dissected hairs-follicular units Note that one, two , three hair units are all very small and of the same size-hence Need small holes, can be packed closely and cause Very little bleeding- this is the real highlight of follicular unit transplantation hairs-follicular units

25. Hairs are inserted in to special implanters And then in to scalp Very little bleeding Referred to as No Touch technique

26. Hair transplantation-large session-about 1200 grafts-lasts 51/2 hours Marking of area to be grafted At the end of grafting, note how clean it looks. Pt goes home like this with very small bandage which is removed the very next day. Next day

27. The graft will have a brown crust( clotted blood) the next day- You can start shampooing the next day of surgery and the crust clears off in 4-5 days You may have use a cap or alternatively during these period. Alternatively, you can hide the grafts to get normal look-with Topick. Crust on day 2 After topick Pink plaster is to prevent swelling which may occur on day3-4 for 1-2 days There is no need for taking leave-you may return to work the very next day

28. With topick-a powder to hide Graft sites Before surgery Hair transplantation-medium session-about 850 grafts-lasts 41/2 hours after surgery-shampooing starts the very next day-the brown crust falls off in 4-5 days The grafted hairs will start falling by 3 weeks-and will start regrowth by 4/5 month.

29. before After 7 months

30. Hairline-Isnt it natural? Donor-where is the suture?

31. before After 5 months Note:it takes 9-10 months for proper hair growth before

32. After 6 months before U cant make out the suture

33. Remember • It takes 9 months after surgery for hair growth • To preserve existing hair, it may be necessary to take drugs-this is particularly true of younger individuals

34. Key points for good results • Good technique-follicular unit • Trained team • Large number of grafts in one session

35. We are proud!!! Our team is trained by Dr Ginzburg and his team from Israel

36. Remember!!! • Lot of advertisements appear in lay press claiming dramatic results from homeopathy, acupuncture, weaving etc.Be careful and ascertain full information before using them • Many claims are also made about hair transplantations- always ascertain the training of the team, the surgeon, technique and the no of grafts they promise • After all, hair transplantation is not a everyday procedure!!!

37. Our website • www.bangalorehairtransplant.com • www.ishrs.org- the most authorititive and unbiased website

38. Great things are a number of small things done together-Vincent Von Gough • This statement applies aptly to hair transplantation • If you have nay more questions, do feel free to mail us at : mysorevenkat@hotmail.com • Call us on +91 80 23392416 / 23392788 / 23180818 / 41148848 / 9739038714