Resources
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Hair and Scalp Surgery
Art of Repair in Surgical Hair Restoration- part one, part two Bernstein R.M.; Rassman W.R.; Rashid N.; Shiell R.C. Dermatologic Surgery, Volume 28, Number 10, October 2002 , pp. 873-893(21)
Summary: Patients undergo additional surgeries to try and correct damage caused by unethical practitioners.
Excerpts: The use of small grafts alone does not protect the patient from poor work. Errors in surgical and aesthetic judgment, performing procedures on non-candidate patients, and the failure to communicate successfully with patients about realistic expectations, remain major problems.
Hair Replacement Surgery, Hair Transplantation WebMD article, Jorge de la Torre MD, Gary D Monheit, MD, periodically updated
Summary: A history and overview of this type of surgery.
Excerpts: A new sobering conservative view is emerging in the field of hair transplantation: the surgeon should evaluate the patient both regarding the improvement he or she can provide in the immediate future and for long-term results. Too much emphasis has been placed on immediate coverage and appearance and not enough attention paid to the long-lasting effects of this permanent procedure.
Hair Transplantation Associated with Various Complications Dow B. Stough, Clinical Assistant Professor of Dermatology, University of Arkansas
Summary: Observations by Dow B. Stough M.D.
Excerpts: Poor growth of the graft is unpredictable and has been reported with every technique ever utilized in hair transplant surgery. Young patients may have unrealistic expectations, hoping that hair transplantation will help them achieve extremely dense coverage similar to that of a nonbalding man. Such an outcome is not possible because the newer transplantation techniques do not generally allow for dense coverage. Additionally, donor hair, although generally programmed to remain throughout life, does thin over time.
Hair Loss: Procedures to Avoid WebMD.com article
Summary: Many physicians in this country and abroad perform outdated and even dangerous hair restoration techniques.
Excerpts: Scalp reduction problems include: Accelerated hair loss, more than the natural course your hair would take. This hair loss can occur within just weeks or months and often doesn't return. An unnatural appearance because the direction of hair growth is altered. Infection. Hemorrhaging and hematoma (blood pooling). Stretch back, a problem in almost 100% of scalp reduction cases...
Strip Excision Donor Area Complications Hairsite.com article
Summary: Observations by Jerzy Kolasinski M.D.,Ph.D
Excerpts: Most frequently occurring complications in the donor area include: early and late hemorrhages, infections, skin necrosis, pain and paresthesia in the wound and scar area, visible scarring, wide scars, alopecia in the scar area.
Patient Evaluation and Surgical Planning Bernstein R.M., Rassman W.R., Dermatologic Surgery 1997; 23(9): 771-784
Summary:
Patient evaluation including assessing donor reserves and planning
for effluvium and progressive hair loss.
Excerpts:
In a
patient with a scalp that is tighter than normal, the long-term goals must
be scaled back to coincide with a more limited donor supply. There are
many surgical advantages of working on a virgin scalp...since the blood
supply and elasticity of the connective tissue are intact.
Follicular Unit Extraction: Minimally Invasive Surgery for Hair Transplantation
Rassman W.R; Bernstein R.M; McClellan R; Jones R; Worton E; Uyttendaele H, Dermatologic Surgery 2002; 28: 720-728
Summary: Describes the FUE technique.
Excerpts: Follicular Unit Extraction is a minimally invasive approach to hair transplantation that obviates the need for a linear donor incision. This technique can serve as an important alternative to traditional hair transplantation in certain patients.
Follicular
Unit Extraction
William R. Rassman, James Harris, Robert M. Bernstein, In:
Haber RS, Stough DB, editors: Hair Transplantation, Chapter 17. Elsevier
Saunders, 2006: 133-137
Summary:
Indications and Contraindications for FUE. The "Two-Step" and
"Three-Step" Techniques are discussed.
Excerpts:
The promise
of an almost scarless surgery is enticing to both patient and surgeon.
Contraindications for FUE include: 1. Inexperience in performing FUE
techniques 2. Unavailability of proper instrumentation 3. Inadequate and
uninformed patient consent 4. Unrealistic patient expectations 5. Inadequate
donor supply 6. Scarring that makes both the two- and three-step procedures
problematic.
The following three articles are available in full text through Medline (check your local university or medical school library)
Hair
transplantation: management of donor area (abstract) Gerard E. Seery M.D.
Dermatologic Surgery 2002 Feb;28(2):136-42.
Summary: Discussion of methods and problems involved with donor harvesting.
Excerpts: The simplest part of hair
transplantation, at least in theory, is the removal of the donor strip and
closure of the resultant defect. Unfortunately, however, the improvements
that have taken place in hair transplantation in general have not spilled
over into improved donor area outcomes. Unsightly donor scars and fibrosis
are still not only with us, but are possibly even more pervasive than
ever. One explanation given for deteriorated donor sites is the harvesting
of relatively greater numbers of grafts.
Surgical Anatomy of the Scalp (abstract) Gerard E. Seery M.D.
Dermatologic Surgery 2002 Feb;28(7):581–587
Summary: A description of the anatomy of the scalp with surgical implications.
Excerpts: The goal of complication-free scalp surgery remains elusive. Wide unsightly scars, stretch-atrophied hypesthetic, poorly vascularized tissues and distorted hair patterns are still commonly seen and appear to be largely refractory to remedial surgery.
Local anesthesia in hair transplantation (abstract) Seager DJ, Simmons C., Dermatologic Surgery 2002 Apr;28(4):320-8
Summary: Reviews the agents and techniques of local anesthesia as applied to hair transplantation. Discusses the dangers of infiltrating too much anesthetic; harming vessels and nerves with needles; anesthetic toxicity and intravascular instillation of anesthetic solution.
Excerpts: Complications of nerve blocks include laceration of nerves and vessels, and intravascular infiltration. The needleless injector is used to create wheals through which a conventional needle can painlessly penetrate the skin. However, this still will not eliminate infiltration pain.
Advances
Biotech Turns to Hair Loss Research SFGate, March 2008
Summary: Researchers investigate the mechanisms of balding.
Excerpts: "They're throwing an arsenal of high-tech tools at the condition: genome studies, stem cell stimulation, gene therapy, a type of tissue engineering often called "hair cloning" and even robotics.
Gene Discovery May Lead to New Baldness Drugs Reuters Health News, February 2008
Summary: Researchers have identified a gene linked to hair loss that could lead to new drugs to treat baldness.
Excerpts: "There is a very good chance of developing a therapy to treat hair loss based on this finding," the study's leader Regina Betz, a researcher at the Institute of Human Genetics, said.
Intercytex
TrichoCyte Hair Regeneration
Hairsite.com, September
2006 Excerpts:
Dr. Kemp, being one of the test subjects himself, reported an improvement
of about 66 new hairs as a result of the 100 injections. The
products discussed in the article can be found here:
Summary:
Interview with Dr. Paul Kemp, Founder & Chief
Scientific Officer of Intercytex.
intercytex.com/icx/products/aesthetic/icxtrc and at its FAQs page
Recent Advances in Hair Cloning hairlosstalk.com, April 2004
Summary: Provides background and describes some techniques and challenges involved with hair cloning.
Excerpts: In a paper published in the top journal “Nature”, they showed that cells could be taken from one human donor, (Jahoda) and implanted to another (Reynolds) and induce new hair follicle formation, although no cell culturing was involved in this particular study.
Hair Cloning Nears Reality as Baldness Cure Daniel J. DeNoon, WebMD.com Medical News, November 2004
Summary: Hair Multiplication Puts New Face on Hair Restoration.
Excerpts: "There is no doubt it will be a tremendous breakthrough," Washenik tells WebMD. "It is the thing people have been waiting for. There have been so many remedies for hair loss that didn't pan out. This is one that really looks like it is going to happen -- and happen in the next few years."
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