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Concept: Follicular Unit Extraction

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Body hair shafts from the beard, trunk, and extremities can be used to treat baldness when patients have inadequate amounts of scalp donor hair, but reports in the literature concerning use of body hair to treat baldness are confined to case reports.

Concepts: Human body, Hair, Hair transplantation, Scalp, Facial hair, Follicular unit transplantation, Follicular Unit Extraction, Beard

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Follicular unit transplantation is the most commonly performed technique in modern restorative hair transplantation surgery. It relies on the acquisition of intact follicular units from microdissected scalp skin strips and their subsequent transplantation into the recipient regions affected by alopecia. Ideally, the translocation of follicular units from the balding-resistant areas of the scalp (usually the occipital region) to the recipient site should not result in any morphological change in the grafts. Nevertheless, the insults associated with surgical intervention present grafted follicles to mechanical and chemical cues differently from those of the physiological steady-state conditions in undamaged skin. This disruption of the normal follicular microenvironment might alter important aspects of hair biology in grafts, for example, hair cycle and pigmentation, and, in turn, could lead to differences in hair appearance, eventually culminating in a diminished esthetical outcome of the surgery. In this study, the authors analyzed native and grafted scalp hair follicles (HFs) from 2 patients who had undergone follicular unit transplantation surgeries formerly. Scanning electron microscopy and light microscopy-based histomorphometry revealed a marked enlargement of follicular structures in the grafts with a concomitant increase in hair shaft diameter. Immunohistological staining confirmed a thickening of the dermal sheath in transplanted HFs that also harbored a denser vascular network. Taken together, these results show that the grafted HFs analyzed were subjected to marked morphological changes during their residence in the recipient site and that this phenomenon is associated with a modulation of follicular vascularization.

Concepts: Surgery, Chemotherapy, Skin, Hair, Hair follicle, Scalp, Follicular unit transplantation, Follicular Unit Extraction

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Pubic atrichosis or hypotrichosis is quite common among Korean women. Although Korean people are increasingly opening up to Western culture, pubic hair transplantation is still pursued for cultural reasons. However, many hesitate to undergo restorative surgery because follicular unit strip surgery would leave a linear donor scar, preventing patients from hiding their surgical history. Thus, follicle harvesting using nonshaven follicular unit extraction (NS-FUE), aside from many other strengths, is very useful when performing pubic restorative surgery. There has been no previous report concerning the effectiveness of NS-FUE for treating pubic atrichosis or hypotrichosis.

Concepts: Surgery, Culture, Organ transplant, Western culture, Cultural anthropology, Follicular unit transplantation, Follicular Unit Extraction, Medical grafting

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The scar that occurs after cleft lip surgery poses a serious cosmetic problem. One of the methods used to solve this problem in adult male patients is hair transplantation. However, satisfactory results with this method cannot always be achieved due to possible graft loss. The corrective feature of fat grafting has been reported in many studies. The aim of this report is to share our results with hair transplantation combined with fat grafting in patients with cleft lip.

Concepts: Cleft lip and palate, Follicular unit transplantation, Follicular Unit Extraction

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The efficacy of current medical treatments for lichen planopilaris (LPP) and its variant, frontal fibrosing alopecia (FFA), both lymphocyte-mediated primary cicatricial alopecias, is limited. Hair regrowth from scar tissue is usually not possible. Although hair transplantation restores the hairline and increases hair density in patients with cicatricial alopecia, the timing of the transplantation is crucial. Here, we report two Chinese patients with LPP or FFA who underwent the follicular unit extraction method of hair transplantation after the diseases were stabilised with therapy, with satisfactory results for 3-4 years of follow up.

Concepts: Medicine, Scar, Skin, Extraction, Hair, Follicular unit transplantation, Follicular Unit Extraction, Cicatricial alopecia

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Follicular unit extraction (FUE) is a hair transplantation technique that uses small punches (0.8-1 mm in diameter) to extract the follicular units (FUs). Though initially the technique was not widely accepted because of the difficulty of extracting intact follicular units with such small punches, it has since gained in popularity due mainly to rising patient demand, the availability of better instrumentation and greater surgical skill acquired from experience. It is now a recognised alternative to follicular unit transplantation (FUT), a technique based on harvesting the FUs from a strip of tissue. Among the advantages of FUE are less post-procedural discomfort in the donor zone and the barely visible scarring from the punches. However, FUE is a more laborious, time-consuming procedure that involves a long learning curve for the surgeon.

Concepts: Learning, Hair transplantation, Follicular unit transplantation, Follicular Unit Extraction

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The treatment of hair loss is an important part of clinical dermatology given the prevalence of the problem and great impact on patients' quality of life. Many new treatments have been introduced in recent years. This review summarizes the main ones in 4 groups: a) For androgenetic alopecia, we discuss new excipients for oral minoxidil, dutasteride, and finasteride as well as new forms of topical application; prostaglandin agonists and antagonists; low-level laser therapy; and regenerative medicine with Wnt signaling activators and stem cell therapy. b) For alopecia areata, Janus kinase inhibitors are reviewed. c) For frontal fibrosing alopecia, we discuss the use of antiandrogens and, for some patients, pioglitazone. d) Finally, we mention new robotic devices for hair transplant procedures and techniques for optimal follicular unit extraction.

Concepts: Medicine, Stem cell, Alopecia, Baldness, Androgenic alopecia, Alopecia areata, Baldness treatments, Follicular Unit Extraction

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The use of robotic technology to harvest grafts in a follicular unit extraction (FUE) hair transplant procedure has been available since 2011. A new capability of the robotic system is to harvest follicular units based on the number of hairs they contain to increase the hair/wound yield.

Concepts: Hair, Follicular unit transplantation, Follicular Unit Extraction

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When calculating the transection rate in follicular unit extraction (FUE), many surgeons did not consider damages that may arise in the donor site through FUE punching.

Concepts: Follicular unit transplantation, Follicular Unit Extraction

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Follicular unit extraction (FUE) has been performed for over a decade. Our experience in the patients who underwent hair transplantation using only the FUE method was included in this study.

Concepts: Hair, Hair transplantation, Follicular unit transplantation, Follicular Unit Extraction