EVOLUTION OF HAIR TRANSPLANT

With the increasing stream of people having more focus on cosmetology, an area of expertise continuously expanding and evolving is hair transplant. Since its inception in the late 1950s, this field is constantly being modified and redesigned to give a more desirable outcome. It isn’t wrong to say that everyone likes their hair to be perfect, having the exemplary density and adding glamour to their appearance just the way they want it; interestingly, this all is aided by the evolution we are talking about as it is a hot topic these days.

The evolution of hair transplant can be seen down the pipeline starting when it was introduced in the western medical literature by Norman Orentreich who used a simple punch technique. As the advancements grew so did the procedure. The traditional method known as follicular unit transplantation (F.U.T) was widely accepted that involved making an elliptical incision on the donor area for harvesting the follicles to be grafted suturing the skin back, further, the skin harvested is dissected meticulously to preserve the follicles and then grafts are inserted into the recipient area. However, this technique gave a postoperative linear scar. The further improvement made in the discipline was using the follicular unit extraction (F.U.E) which used only the follicles which were extracted using a punch and then grafting them to the recipient site. This approach was a bloom to the hair transplant approach as there was no postoperative scar, more follicles were harvested, and reduced post-operative pain. Nevertheless, it has a longer learning curve. Using an automated machine known as the Neograft applies the concept of sucking the follicles in a canister and then inserting them into the area but again it requires a steep learning curve and the machine is quite costly. A recently described perspective is using the micro refined micro follicular hair transplant, which uses the follicular unit extraction technique to develop the anterior hairline whereas the transplant approach for the bald area; has an almost 0% graft transection rate.

The evolution of hair transplants never stopped here. A new outlook was dug out known as the Direct Hair Implantation (DHI). This is a modification of follicular unit extraction. DHI uses the introduction of specially designed pens for this procedure; 1-3 follicles containing micro grafts are loaded in the pens and at the same time implanted to the recipient area that wasn’t perforated previously. The edge it had over F.U.E was that the area was bloodless to be the first and secondly the practitioner could graft the area with much more follicles with less trauma as there was no use of punching. On the contrary, the procedure requires skilled personnel and is not cost-effective. A sweeping innovation further was the use of animal studies for the development of human follicles using cultured cells from a mouse.

Using biotechnology and genetics hair transplant evolution is just going to a further big platform where more research is going on to identify the stem cells, reprogramming a mature cell to an embryonic stem cell to create follicles in its progeny, a recent study supports this idea where the scientists used a bioengineered follicle germ created from an epidermal stem cell creating a fully grown healthy follicle itself. Cloning the hair cells by using dermal papillae cells and inserting them in the recipient area is also a point under consideration at this time, however, promising results yet haven’t been displayed by this approach. Furthermore, studies are going on for using robotics and fully automated systems for this work providing a more desired outcome and use of great finesse.