Hair Transplantation
Hair transplantation is a microsurgical procedure built on the principle of donor dominance. Healthy follicular units (FUs) that are resistant to dihydrotestosterone (DHT) are moved from the occipital area at the back of the head to bald, thinning or scarred areas of the scalp. Once they survive, the transplanted follicles keep growing and cycling naturally in their new location for life.
At Haute-Derma, every transplant combines an anthropometrically designed hairline, careful control of implantation angle and depth, and modern biological storage solutions that maximize graft survival.
Hair Follicle Biology
Scalp hairs do not grow one by one but in natural groupings called follicular units (FUs). Each unit contains 1 to 4 hairs together with a sebaceous gland, an arrector pili muscle and a supporting network of small blood vessels.
- Donor dominance: Hair in the occipital (donor) area has few androgen receptors, so DHT does not shrink these follicles (miniaturization). After being moved to a bald (recipient) area, the follicles keep this genetically determined DHT resistance and continue to grow long term.
- Density and donor capacity: Natural follicle density in Asian patients averages about 60–80 FU/cm². Graft survival depends heavily on how long the follicles spend outside the body (ischemia time) and on handling that avoids crushing the hair bulb.
Detailed Comparison of Hair Transplant Techniques
| Technique | How Follicles Are Harvested | Invasiveness and Donor Scarring |
|---|---|---|
| FUT (Follicular Unit Transplantation) | A strip of scalp is removed from the back of the head and individual FUs are dissected under a microscope | Permanent thin linear scar across the back of the head |
| FUE (Follicular Unit Extraction) | A micro-punch (0.7–0.9 mm) extracts each FU individually | Tiny scattered dot scars (barely visible) |
| DHI (Direct Hair Implantation) | Individual FU extraction combined with a dedicated implanter pen | Tiny dot scars (no pre-made recipient incisions needed) |
Clinical Procedure at Haute-Derma
- Hairline Design and Donor Harvesting The doctor measures facial thirds and designs a hairline with natural micro-irregularities. The donor area is anesthetized and follicular units are harvested with microsurgical extraction instruments.
- Storing Grafts in Biological Solution Freshly harvested follicles are placed straight into HypoThermosol or isotonic saline chilled to 4°C, enriched with ATP/PRP, to keep the follicle's basement membrane cells viable and limit ischemic damage.
- Creating Channels and Placing Grafts in the Recipient Area
- Angle: channels are made at 15°–30° at the frontal hairline and crown so that the hair lies naturally.
- Density distribution: single-hair units go in the front row of the hairline for a soft look, with 2–4-hair units (multiple FUs) placed behind them to build volume.
Managing Complications and Post-Operative Care
- Shock loss: Existing or newly transplanted hairs shed temporarily 2–8 weeks after surgery because of inflammation and a temporary interruption in blood supply. This is a normal physiological response, and strong new hairs grow back after 3–4 months.
- Folliculitis or pustules in the recipient area: Caused by blocked follicle openings or mild infection. Treated with warm compresses, cleansing with chlorhexidine antiseptic and a topical antibiotic.
- Poor graft survival or patchy growth: Caused by crushed grafts or incorrect channel depth. Strict sterile technique and gentle handling with dedicated microsurgical forceps are essential.
