Since the 19th century, hair transplant has been developed as a treatment to help androgenetic alopecia or other kinds of hair loss. Androgenetic alopecia is caused by the genetic sensitivity of hair follicles to androgens. The transplanted hairs in hair restoration are typically obtained from the posterior scalp; specifically, the hairs of the thin permissive area are used to fill the bald recipient area to ensure natural hair growth. The transplantation of hair in scars can help normalize the visual scar appearance. It has long been known that hair regrowth can be achieved through transplantation of a single hair, so the hair growth mechanism is complicated, but at the very least, multiple neighboring hairs gather in a functional unit called the follicular unit.
A follicular unit consists of multiple hairs, the attached sebaceous gland, and arrector pili muscle. We cannot ignore the fact that hair loss, especially at a young age, causes great damage – not only by psychological stress and reduced quality of life suffered by the patients but also by the onset of various diseases as a result of the reduced impact of sebum from the scalp. Therefore, hair transplantation aftercare is important as a treatment that helps hair growth as a shield against various conditions, not only by appearance improvement based on the restoration of hair. It is essential to discuss the impact directly on hair loss, in addition to increased life confidence and therapeutic effects on appearance. In any form of hair restoration surgery, at the end of the day, it is quite difficult to figure out to what extent this is going to impact hair loss and how it is going to be prevented further, but elucidating some hair transplantation advantages and disadvantages of any given method is possible by discussing the onset of the shedding period after repair surgery, change in hair shaft appearance, etc. Biological correlatives that may exist between such procedures and further stop loss hair have so far been reported only in the literature. We conducted this study with the same objectives. Management of further hair loss after surgery by clinicians should be the main goal. In this study, we talked about hair restoration methods and other potential issues like camouflage via adjuvant therapeutics.
Hair transplantation is a hair restoration procedure that involves harvesting hair follicles, typically from the back and side of the scalp, as the hair growth system there is not affected by androgens, and implanting them into different scalp locations. This is executed with the aim of recreating a natural-looking hair and hairline. The further steps in hair transplant often focus on planning the hairline and slit creation on the incision. There are temporary solutions for people who suffer hair loss due to an underlying disease or the medication they use. There are also proven medications with scientific data showing their guaranteed effects on androgenic hair loss. However, hair transplantation is the most frequently preferred permanent treatment option for androgenic hair loss.
Hair loss in androgenic alopecia is linked to a male hormone, dihydrotestosterone. It causes the hair follicles to shrink, and as a result, very thin hair forms in androgenic loss areas. As hair transplantation advantages, 4,500-5,500 hair follicles that are not sensitive to dihydrotestosterone in men and fewer in women (around 2,500-3,000 hair follicles) are collected from the donor areas and implanted into the newly created microchannels of the remaining hairless areas of the scalp. This technique gives the patient good hair growth with long-lasting, very satisfactory results. The cut hair follicles have a potential resistance to dihydrotestosterone, so they are thought to continue growth during the rest of the patient’s lifetime. Overall, it is believed that dihydrotestosterone is the main hormone responsible for hair loss. So, with the transfer of strong genetically resistant hair follicles, stopping further hair loss will be the main result of hair transplantation advantages. A small percentage of hair, i.e., 10-17.5%, is used in the hair, and 80% of the hair on the head region grows and gains resistance to the effect of dihydrotestosterone. This hair growth is visible after the completion of the adaptation period, between approximately 9-18 months.
Our different cases of solving stop loss hair with increasing bald areas show that most patients gained hair and the bald portion did not increase gradually or increased much slower in comparison to those who did not undergo hair transplant. Halting further to stop hair loss One of the greatest challenges of hair loss treatments is to halt the progression of hair loss. Once the progression of hair loss is stopped, the principal objective of our patients is accomplished. Hair transplantation is very effective in halting the progression of hair loss in most patients. It achieves such results not only by filling in the bald area, thereby restoring the fullness and youthful pre-hair loss appearance, but also by passing to the recipient site healthy hair follicles that are immune to the principal hormone that causes hair loss. Most patients are happier and more satisfied with their appearance hair transplantation aftercare, and with increased self-esteem, mood, and job promotion, they get on with their everyday life without the urge to undertake wholesale transplantation to the whole head of a higher density or rely on transplants and drugs for a greater increase in the thickness of hair, but just to recover a possible bald portion growing.
Hair transplantation is rather invasive, and multiple graft sessions are often necessary. Surgery carries the risks of any kind of dissection: scarring, infection, and suboptimal results in the majority of cases. Complications can deter patients from undergoing transplants for further progression of their procedure. The efficacy of hair transplantation is also limited by the donor area available. Not all patients have a sufficient donor area to address their bald area. Since male pattern hair loss is chronic and progressive, the patient’s final look hair transplantation aftercare is affected by future hair loss. Many patients undergoing surgery expect their stop loss hair; indeed, some hair transplantation consultants think that a transplanted hair graft possesses an intrinsic feature able to stop miniaturization of the neighboring, non-transplanted hairs. The fact is that a hair graft simply carries on its own life cycle and does not interfere with the surrounding hair miniaturization.
Thus, patients undergoing surgery should have realistic expectations. Cost is another very important limitation. Patients are increasingly interested in getting their hair back at a low price or in painless deals, perhaps pushed by unrealistic TV shows on stop hair loss treatments. But high-quality baldness surgery can’t be a fast or simple enterprise. Moreover, costs may not be affordable for subjects with mild baldness; it’s a kind of luxury intervention whose costs are not covered by common insurance policies. Marketing surgery without addressing pros and cons is like “calling a dog ‘cat’: you can immediately go far, but the result will be disastrous!” Providing patients with all the information on pros and cons is, to us, the main ethical issue in patient information.
On the basis of the literature, hair transplant is a safe and effective surgical intervention for androgenic alopecia. However, it is realistic, and the evidence suggests that it will lead to a certain amount of additional hair loss in the future. This is a subclinical level of shedding that is generally not noticeable when the hair is long enough, but needs to be managed with patients for informed consent prior to surgery. Informed patient selection and directing beyond restoration of bald areas alone toward a cosmetic endpoint appear to reduce the potential for dissatisfaction, suggesting future work may be directed at how to best engage with patients at their initial consultation. Given the complete lack of interventions with the ability to reverse or halt androgenic alopecia, both surgical and medical options would appear to still fill the unmet need for this clinical problem, and it is important that we continue to push the boundaries of these techniques.
Research on hair transplantation advantages, and in particular FUE, is moving from demonstrating efficacy to refining techniques and delivering the best possible results with fewer side effects. Future research to quantify future hair loss may be possible if patient cohorts of common SEF may be better identified, potentially via trichoscopic findings. In the interim, the pharmacological combination of minoxidil and finasteride is proven to slow hair loss above and below a transplant, and with growing evidence, it may also optimize the growth of grafts following a transplant. Therefore, there are some interim measures that can be used to enhance outcomes. Given several limitations, broader considerations would make for an interesting future study, including why patients expect no future hair loss post-transplant, what factors contribute to a perception of success and improvement, interplay with patient-practitioner discussions, and how one might create broader awareness of the myriad options available for both transplanted and non-transplanted hair. Additionally, qualitative interviews with patients undergoing transplantation may garner richer understandings of individual expectations and satisfaction, though in the context of such negative patient outcomes, participant flow may be challenging. As a biopsychosocial condition, hair restoration surgery should not only help to improve the physical attributes but also the mentality of the hair loss sufferer. To achieve this aim, future research efforts should be made in assisting patients in a combination of therapies that include the cosmetic, psychological, and social aspects of hair loss. This will be the future trend in hair restoration.
