Ideal Medicare Canada

The first hair transplant in the United States was performed by Dr. Norman Orentreich in the late 1950s. He proposed the concept of “donor dominance” – the idea that grafts continue to show the characteristics of the donor site after they have been transplanted to a new site. This principle provides the basis for all hair transplant surgery. Although “donor dominance” ensured that transplanted hair will continue to grow, it did not ensure that the results would look natural.

The initial hair transplants used grafts that measured 6–8 mm in diameter, about the size of pencil erasers. These were obtained from the back of the scalp by literally punching out the hair bearing grafts with a sharp, round instrument and then placing them in holes made in the balding front-part of the scalp. The results of this punch-graft technique were often “pluggy” and unnatural and was referred to as a “doll’s head” or “corn-row” look.
To improve upon the appearance of these earlier procedures, doctors developed the technique of mini-micrografting where the donor hair was obtained by removing multiple, thin strips of tissue from the back part of the scalp. This was subsequently cut into different size grafts. The larger pieces, containing from 4 to 12 or more hairs (mini-grafts), were used to create fullness. The smaller grafts of 1-3 hairs (micro-grafts) were used at the hairline. This procedure, called mini-micrografting, gained popularity in the 1980s and became the standard way hair transplants were performed through the mid-1990s. Although much improved over the punch-graft techniques, the results were still not completely natural.
Follicular units were first described in the medical literature by Headington in 1984. [1] Follicular Unit Transplantation has its roots in the single-strip harvesting method and microscopic graft dissection technique developed by Dr. Bobby Limmer in the late 1980s and published in 1994. [2]
The conceptual framework for Follicular Unit Transplantation was introduced into the medical literature by Drs. Robert M. Bernstein and William Rassman in their 1995 paper "Follicular Transplantation" [1],. [3] The procedure was further detailed in their paired articles, “Follicular Transplantation: Patient Evaluation and Surgical Planning” and “The Aesthetics of Follicular Transplantation” (1997). [4][5] The concept was further elaborated upon in the 1999 publication “The Logic of Follicular Transplantation.” [6]
By the year 2000, Follicular Unit Transplant (also referred to as FUT) was firmly established as the state-of-the-art due to its ability to produce totally natural results. However, because the procedure was more labor intensive and time consuming than mini-micrografting, it was adopted slowly by the medical community. A major impetus to the development of the procedure was consumer demand expressed on the internet and through consumer advocacy programs.

http://health.allrefer.com/news/index.php?ID=1259

Hair transplant was never so effectiveposted: March 12, 2002
Washington, Mar 12 (ANI): A recent study reveals that doctors have found a new technique of hair transplant for patients with thin hair, who usually have trouble with the procedure. The existing procedure of hair transplant may give good results for those who have severe hair loss in the front of scalp. During follicular unit transplantation, naturally occurring bundles of one, two or three hairs and excess tissue are removed from the back of the scalp and transplanted to the front.

Although this procedure may be successful in some patients, it can fail in others, especially in Asians, who have thick, straight black hair with low density. A large amount of low density, single hairs results in an unnatural look after a hair transplant.

To address this problem, Korean researchers developed the KNU implanter. Jung-Chul Kim, M.D., Ph.D., from Kyungpook National University in Taegu, Korea, explained how the KNU implanter works at the 8th Annual Live Surgery Workshop of the International Society of Hair Restoration Surgery in Orlando, Fla.

First, a follicular unit is placed into the needle of the implanter. Next, the needle is inserted into the skin and the plunger is pushed. While a small hook on the plunger holds the hair shaft in place, the needle is withdrawn, leaving the hair graft neatly tucked under the skin.

Researchers found that use of KNU implanter gave an average success rate of 92 percent six months after transplantation and more than 90 percent 12 months after transplantation.

They concluded, "Follicular unit transplantation using the KNU implanter is especially suited to young patients or women who have general thinning, because it allows the placing of grafts in between areas of thinning without removing a potentially long- lasting hair". (ANI)

By John P. Cole, MD and Arthur Tykocinski, MD

The first part of this section is written by John P. Cole, MD.? This section detail how we produce grafts at PHTC.? The second part is written by Arthur Tykocinski, MD and discusses graft preparation in general.
Graft Dissection
The basic unit of hair restoration surgery is the pilosebaceous unit. Dr. Jung Chul Kim called this pilosebaceous unit a "bundle graft" long before it acquired its present name, the follicular unit, by hair restoration surgeons. The objective of graft dissection is to remove intact follicular units from an excised strip or strips of donor tissue in a manner that insures the highest probability of survival. One may go further to state that the objective should assist in the overall cosmesis and natural appearance of the hair transplant. Arguing what is natural and what is not natural in appearance is a completely different subject, but will be summarized as follows. Hairs grow in natural follicular clusters called follicular units. Hairs do not grow in mini-grafts, full size grafts, or micro grafts in nature. Therefore, these unnatural entities will not be discussed in this talk.

Co-author of Text book “ Hair Transplantation “ in USA

- J. Kim, and Y. Choi : Hair survival of partial follicles: Implications for pluripotent stem cells and melanocyte reservoir. In: Hair Transplantation, W.P. Unger and R. Shapiro, ed. Marcel Dekker, Inc. NY, 2004. p.281-285.

- J. Kim, and S. Hwang: The effects of dehydration, preservation temperature and time, and hydrogen peroxide on hair grafts. In: Hair Transplantation, W.P. Unger and R. Shapiro, ed. Marcel Dekker, Inc. NY, 2004. p.285-287.

- Y. Choi and J. Kim: Eyebrow, eyelash, mustache, and pubic area hair transplantation. In: Hair Transplantation, W.P. Unger and R. Shapiro, ed. Marcel Dekker, Inc. NY, 2004. p.579-584.

Journals
1. Y.C. Choi and J.C. Kim :Single hair transplantation using the Choi hair transplanter. J Dermatol Surg Oncol. 18:945-948, 1992.

2. Jung-Chul Kim and Yung-Chul Choi: Regrowth of human scalp hair after removal of the bulb. Dermatol. Surg. 21:312-313, 1995.

3. J.C.Kim, M.K.Kim and Y.C.Choi: Regeneration of the human scalp hair follicle after horizontal sectioning: implications for pluripotent stem cells and melanocyte reservoir. In: Hair research for the next millenium, D.J.J. Van Neste and V.A.Randall eds. Elservier Science, Amsterdam, 1996. p.135-139.

4. Jung-Chul Kim and Yung-Chul Choi: Hair follicle regeneration after horizontal resecting; Implications for hair transplantation. In: Hair Replacement, S. Stough ed. Mosby-Year Book, Inc. MO, 1996. p.358-363.

5. Yung-Chul Choi and Jung-Chul Kim: Single-hair and bundled-hair transplantation using the Choi hair transplanter. In: Hair Replacement, S. Stough ed. Mosby-Year Book, Inc. MO, 1996. p.125-127.

6. Jung-Chul Kim and Yung-Chul Choi: Hair transplantation of the eyelashes and eyebrows. In: Hair Replacement, S. Stough ed. Mosby-Year Book, Inc. MO, 1996. p.216-218.

7. Sung Hoon Lee, Do Won Kim, Jae Bok Jun, Seok-Jong Lee, Jung Chul Kim, Nan Hee Kim : The Changes in Hair Growth Pattern after Autologous Hair Transplantation. Derm Surg 25:605-609, 1999.

8. Bernstein RM, Rassman, RM, Seager D, Unger WP, Limmer BL, Jimenez F, Ruifernandez RM, Greco JF, Arnold J, Mangubat EA, Nemeth AJ, Kim JC, Martinick J, Raposio E, Patt LM, Sawaya ME, Christiano AM, Marritt E : The future in hair transplantation. J. Aesthetic Dermatol & Cosmetic Surg 1:55-89, 1999.

9. Lee SJ, Lee HJ, Hwang SJ, Kim DW, Jun JB, Chung SL, Kim JC: Evaluation of survival rate after follicular unit transplantation using the knu implanter. Dermatol Surg, 27(8):716-20, 2001.

10. Sungjoo Hwang, Jung Chul Kim, Hyo Sub Ryu, Young Chang Cha, Seok Jong Lee, Gun Yoen Na, Do Won Kim : Does the recipient site influence the hair growth characteristics in hair transplantation? Dermatol. Surg. 28(sept):795-799, 2002

11. Sung Joo Hwang, Jung Ju Lee, Byung Min Oh, Seok-Jong Lee, Do Won Kim, Jung Chul Kim, Moon Kyu Kim : The effects of dehydration, preservation temperature and time on the hair grafts. Ann. Dermatol. 14:149-152, 2002.

Korean doctors perform successful person-to-person hair transplant
Posted on March 6th, 2007 in Hair Transplant News by admin | 2,167 Views |

korean-doctors-perform-successful-person-to-person-hair-transplant Doctors in Korea recently published a study on an experimental hair transplant procedure where they harvested hair grafts from one person and transplanted them into another.
The two female participants were sisters who had been involved in a previous bone marrow transplant. One of the sisters had leukemia and at the age of 14 had been donor matched with her sister who had donated bone marrow to her.
The leukemia had gone into remission, but at age 21 the bone marrow recipient had lost a lot of her hair due to chemotherapy drugs. Since the sisters were already tissue-matched for compatibility, the doctors wanted to see if they could transplant hair follicles from the one sister to the other.
The doctors first created a small clinical trial with 20 hair follicles and monitored the results by evaluating the growth at 6 months and again at 18 months.
Twenty hair grafts were removed from the back of the donor’s scalp and were transplanted into the patient’s nape of the neck. In the exact reverse of this, 20 hair grafts were removed from the back of the patient’s scalp and transplanted to the nape of her sister’s neck, the donor.
No immunosuppressive drugs were used - Immunosuppressive drugs are usually needed in organ transplants to prevent the immune system from attacking the foreign cells that have been transplanted into the donor.
The results were very encouraging. After 6 months the doctors found that 12 of the 20 hair grafts that had been transplanted to the patient’s nape had survived and were still growing. After 18th months however, only 7 grafts remained.
In her sister the results were a lot different. After 6 months only 2 hair grafts out of the 20 that were transplanted from the leukemia patient to the healthy sister had survived.
The doctors suspected that a small difference in the compatibility of the antigens (immune system triggers) might play an important role in rejecting person-to-person transplanted hair follicles and the different tolerances of the respective girl’s immune systems caused the significant differences in the survival rate of their transplanted hair follicles.
Statically speaking, the donor’s hair grafts that were transplanted to the patient showed a survival rate of 60% at 6 months and 35% at 18 months. On the other hand, the patient’s hair grafts that were transplanted to her donor sister’s neck showed a survival rate of only 10% at 6 months and 0% at 18 month.
Following the success of the small test procedure, 2,200 hair grafts were then harvested from the donor’s sister and were transplanted to the patient’s scalp. Most of the transplanted hair grafts survived, and the patient acquired a significant clinical improvement at 18 months after the hair transplantation surgery.
We believe this is only the second time it has ever been done. The first reported case was done by doctors at Ferrara University, Ferrara, Italy in 1999.
Source: Dermatologic Surgery Volume: 33 Issue 2 Page 236 - February 2007
Authors: SUNGJOO “TOMMY” HWANG MD, HYOJIN KIM MD, WEON JU LEE MD, DO WON KIM MD, JUNG CHUL KIM MD, HOON KOOK MD, JE JUNG LEE MD

Share this article:These icons link to social bookmarking sites where readers can share and discover new web pages.

ISHRS Workshop

Content on this page requires a newer version of Adobe Flash Player.