1. Hair Restoration
Dr Zahid Iqbal Bhatti

2. History
In 1939, Micrografting of human scalp in Japan by a dermatologist “Okuda”
In 1959, Norman Orentreich started Modern Day hair transplant in America.
In 2004, A state of art of surgical hair replacement using donor site of non bald scalp to crown.

3. Anatomy

4. Growth Cycle.

5. Types of Hair Vellus Soft, short, thin, Hypopgmented Terminal
Coarse, long, Thick,Pigmented

6. Androgenetic Alopecia
Androgenetic Alopecia affects up to 50% of males and 40% of females
Autosomal dominant with variable penetrance
85% : +ve family history

7. DihydorTestosterone (Active) Miniaturization of Terminal Hairs
5 ALPHA Reductase
Systemic Treatment X
Fenastride
Testosterone
DihydorTestosterone (Active)
Miniaturization of Terminal Hairs

8. Male Pattern Hair Loss

9. Female Pattern Hair Loss

10. Goals The Hair should be Nartural Looking. Natural Frontal hair line.
Male/ female pattern hairloss.

11. Good Candidates
Size of donor site.
Hair Density
Hair Volume.

12. Evaluation Goals of Patients. Family History Available Donor site.
Grading of Baldness.
Characteristics of Hair.
Hair Line.

13. Screening Session Donor site.
Detailed Explanation of procedure, anatomy, goals.
Good candidates.

14. Pre operative Period Patient care co-ordinator.
Discontinue medications.
Informed consent.
Photo consent.
Planning session.

15. Operation Local anaesthasia / I/V sedation. Pre medication.
Donor site shaved.
Marking for excision.
Local Anaesthesia.
Normal Saline.

16. Donor Site.
Anterior Border.
Inferior Border.
Superior Border.

19. Harvesting Technique Single Blade. Multi Blade Knife.
Orentrich Procedure ( Circular Punch)

20. Graft Production

21. Silvering

23. Recipient Site Anaesthezied & prepared. Frontal Hair line.
Quantitative challenge behind.

25. Incisional Instruments
Hypodrmic Needle 18
Spearpoint Sp 90,91
Miniblade
Punches

26. Grafts In place after operation.

27. Post Operative Period. Two layered Dressing. Discomfort/Pain.
Swelling.
Scab.
Hair loss.
Numbness/Paraesthesia.

28. Donor Site Complications
Infection.
Hematoma.
Wound dehiscence.
Neuralgia/Neuroma.
Hpertrophic Scar/ Keloid.
Atreriovenous fistula.

29. Recipient Site Complications
Change in hair texture.
Poor Graft Survival.
Elevated/ depressed graft.
Chronic folliculitis.
Epidermal inclusion cysts.
Post frontal graft necrosis.

30. Follow up.
1st Day.
15th Day.
8th week.
16th week.
6th -12th month

31. Post operative adjunctive.
Finesteroid 1mg.
Minoxidil 2%, 5%.

32. Any Question ?

33. Thanks