Using hair transplants for male baldness

Using hair transplants for male baldness

JAKARTA (JP): What a shock to look in the mirror and see the
area of thin hair on the top of your head is widening and getting
thinner! What can you do to stop the process?

Surveys show that 1.5 percent of men experience male pattern
baldness (MPB). They are men who inherit the trait from their
parents and the hair loss occurs when they have reached the age
of 40 years or older.

"It is proven that the male sex hormone, in this case
androgen, plays a role in male baldness," said a dermatologist
and veneorologist at Persahabatan Hospital, Adityawarman, during
a discussion held by the study group of the Indonesian Skin
Surgery and the Jakarta Skin Center last week.

However, he pointed out that androgen-related baldness was not
strictly a male problem, and could also occur in women with high
levels of male sex hormones, a condition called adrenal virilism.

Adityawarman explained that this type of baldness only caused
hair loss in specific areas on the scalp, which include the
frontal area (forehead), occipital (the back part of the head),
temporal (the sides of the skull) and the vertex (top of the
head).

"Doctors still cannot explain why baldness occurs only in
those particular areas of the scalp," he said.

To remedy the condition, Adityawarman said a hair transplant,
a procedure that requires taking hair grafts from other parts of
the scalp to be transplanted to the affected areas, could be
performed to cover the bald spots.

"With this procedure, the hair will grow the way it did in its
original areas (donor areas); its growth is not determined by the
location where it is implanted," Adityawarman said.

Patients suitable for this procedure are those between the
ages of 20 and 40 who are in good health.

People with diabetes mellitus, hypertension, diatesis
bleeding, drug allergies, cardiovascular problems or scalp
problems such as dermatitis seboroic and recurrent foliculitic
are not eligible for the procedure.

Adityawarman underlined the importance of giving patients
adequate information about the procedure, including the
techniques employed, duration and possible complications during
and after the procedure.

Patients should be informed in advance about possible
complications like bleeding, infection, edema (accumulation of
fluid in cavity or connective tissue) and pigment irregularity.

There are also standard esthetics that should be followed by
doctors to make sure that the results of the procedure look
natural.

"Patients may be unaware that the human face is naturally
divided into three parts, each accounting for one-third of the
total face. The first third is the span between the hairline and
the glabella area, the second is between the glabella and
subnasale and the remaining is between the subnasale and menton.

"We will explain this to the patients so they will not ask for
the transplant to cover wider areas than the proportional
standard. That would look unnatural," he said.

Doctors will likely turn away patients who have mental
problems, are depressed and those with unrealistic demands, he
said.

As for the procedure itself, Adityawarman mentioned five
considerations before the doctor performs the transplant. These
considerations include hair color, because gray hair is hardly
visible; type of hair, as curly hair is more difficult to
transplant; and hair thickness, because thick hair is preferred
for transplanting.

The procedure begins with the administering of anesthetics to
both the donor and recipient areas of the scalp. The doctor will
then perform either a standard graft, which requires four-
millimeter-deep punches to the donor area; a minigraft, using a
multiple blade knife to take three to eight hairs; or a
micrograft to take one to two hairs. The graft is then stored on
a hygienic plate soaked with saline solution. The punched gaps on
the donor areas are closed with a glycolate absorbable thread or
polydiaxone subcuticular and prolene.

The grafted hairs are then cleansed, with foreign particles
carefully removed without damaging the delicate layer of natural
oil.

The doctor will then make slits or holes where these hairs are
to be implanted. The hair fragments are then inserted according
to the direction of hair growth.

"A combination of punch graft and minigraft/micrograft will
give a natural look," he said.

After the hair implant, the scalp will be covered with a kling
bandage for the next 12 to 18 hours to secure the grafted hairs
in place.

"After day three or four, the graft locations will start to
heal and on day 10 to 14, the stitches in the donor areas can be
removed," he said.

Transplanted hairs will shed within several months but will
regrow in the third month at a pace of three to five millimeters
a month.

"The end result will show 12 to 18 months after the
procedure," he said.

There are cases where the grafted areas end up with a
perforated finish after recovery. "This can be overcome by
dermabrasion or electrodesiccation to smoothen the perforated
areas," he explained. (lup)