Terms or Words Used in Hair Transplantation

[Hattingen Hair]

A Hair Transplant is not a miracle cure for hair loss and has limitations; it is important to measure your goals and expectations against the restrictions of a hair transplant. It is very important to understand the margins of this procedure and the planning required for today and importantly for the future to ensure your well-being and happiness.

Here are a few terms and notices to look out for when thinking about a hair transplant

HAIR LOSS

There are many causes of hair loss with the main cause being androgenic alopecia or Male Pattern Baldness (MPB). The male hormone testosterone and an enzyme 5 Alpha Reductase form DHT, the DHT triggers off the progressive weakening of the hair follicle until no hair is grown back. MPB affects the top of the scalp (recipient area) but leaves a band of hair around the sides and the back (donor area).

PRINCIPLES OF A HAIR TRANSPLANT

A Hair Transplant moves hair from the donor area to the recipient, it is impossible to replace like for like so a hair transplant relies on the skills of the doctor to place the hair in such a way light is blocked from reflecting off the scalp thus giving the illusion of fullness.

WHAT IS A FOLLICULAR UNIT (FU)

A follicular unit is a natural group of hairs growing from the scalp, each contain from 1 to 4 hairs per FU. The FU ´s are removed from the donor area and distributed in the recipient area, the amount that can be removed depends on the density of FU in the donor, typically with good planning around 6000 plus FU ´s can be distributed sometimes in a single procedure. FU are also known as €œgrafts € but it is important to determine what a clinic defines as a graft.

HAIR CHARACTERISTICS

Hair characteristics are a vital part in determining your suitability and the end result. Aspects such as hair colour to skin pigmentation, the calibre or diameter of the hair shaft, the number of hairs per follicular unit average and the curl or wave of the hair.
The coverage and density achieved will depend on the hair characteristics of the person and it is possible the same amount of grafts placed can give different results in terms of coverage or thickness.

COVERAGE

The area of hair loss is measured by the Norwood scale, from hair line loss being NW2 to progressive loss to the crown being NW7. A hair transplant ´s objective is to cover the surface area of hair loss to blend in with the surrounding hair. With extensive hair loss it may not be possible to cover the entire area so again planning verses your goals is vital.

DENSITY

Density in the donor area is the number of FU per cm2 naturally growing; density in the recipient is the number of FU that are placed in a cm2.

The density placed in the recipient area will change dependent on the hair characteristics and the area of placement; the hair line will require a higher density because single hairs are used, when multiple hair FU are used the density placed can be reduced.

TECHNIQUES

There are two recognised techniques being used today, FUT and FUE; one is not better than the other and both have pros and cons so it is important to understand why one maybe better used in your case, especially for long term planning and donor management to attain the maximum grafts possible over time.

TERMINOLOGY

5-Alpha-reductase

5-alpha-reductase is the enzyme which converts testosterone to dihydrotestosterone (DHT), the hormone that triggers Androgenic Alopecia in individuals who are genetically susceptible. Type 1 5-alpha-reductase is found primarily in the skin and Type 2 5-alpha-reductase is found primarily in the prostate and inner sheath of the hair follicle.

ALOPECIA

Complete or partial lack of hair resulting from various conditions

ANAGEN

This is the term for the growing phase of the hair cycle which lasts five - seven years in a healthy person.

ANDROGENIC ALOPECIA

This term is the common name for male or female pattern baldness which depends on the genetic predisposition of the hair follicles and the levels of androgen in the body.

CATAGEN

This is the end of the active growth period of a hair follicle, and is marked by changes in the follicle.
Coronal angled grafting (a.k.a. lateral grafts)
Grafts are placed into recipient sites made with a very small rectangular blade that pierced the skin at right angles to the hair direction.

DHT (5-alpha dihydrotestosterone)

DHT is a male hormone that is suggested to be the main cause for the miniaturization of the hair follicle and subsequent hair loss. DHT is formed from the male hormone testosterone by the enzyme 5-alpha-reductase.

DONOR SITE

The area where hair follicles are harvested during transplant surgery

FOLLICLE

The follicle is a tube-like structure in the skin in which develops a hair shaft.

FOLLICULAR UNIT

Groupings of 1-4 hairs that grow together

FOLLICULAR UNIT EXTRACTION

A recent technique in hair transplantation where the naturally occurring follicular units of hair follicles are implanted as a natural group

FOLLICULAR UNIT TRANSPLANTATION

A recent technique in hair transplantation where the naturally occurring follicular units of hair follicles are implanted as a natural group

NORWOOD SCALE OF HAIR LOSS

The most commonly used scale for the classification of male pattern hair loss.

RECIPIENT SITE

The bald or thinning area into which hair grafts are transplanted.

SAGGITAL ANGLED SLITS

Grafts are placed into recipient sites made with a very small rectangular blade that pierced the skin parallel to the hair direction.

TELEGON

The resting phase of the hair cycle

TRANSECTION

Describes damage to hair follicles that can decrease survival after transplantation

 

[bullitnut]

Great post ¬b`

Posts like this are very helpful to the newbie as understanding all the terminology can be a nightmare to begin with.

 

[Bigmac]

Thanks for sharing this Hattingen, very good reading.

Cheers Bm.

 

[Hattingen Hair]

For many forum members this is easily known knowledge but for may it is not.

It maybe an idea that members add to this thread with other Terms to help others research.

 

[hairtech]

A couple of corrections in the terminology :::C
This correction is very important:

1. Transection: Transections can potentially decrease yield during a strip excision because a technician might accidentally "cut" off a follicular bulb during a dissection. However within the FUE world a transection is when the extractor cuts off a follicular bulb within the donor area which may result in that transection growing back within the donor area.

2. Coronal incisions: These incisions are made with basically the same materials stated above, however the incision is made in a a perpendicular manner. Mostly the most experienced clinics use this technique when needed..., i.e. temporal points.


3. Recipient area: Also includes areas that have not been affected by an alopecia such as a traumatic accident or an elective approach to adding hair to areas that a patient wants.

4. Follicular Unit: Typically 1 to 4 hair groupings however there are many instances that are 5, 6, and 7 haired follicular units taken with small punches even below 1.0mm.

5. Hair restoration: The rearrangement of hair follicles to augment hairloss.
Good post!

 

[Hattingen Hair]

hairtech,

For clarity, a 5 hair follicular unit but 6 or 7 hair, even 5 hairs are very rare. That is if we are talking about a naturally occurring group of hairs and not just hairs that have been punched out in one take, a graft for example.

That was the point of stating a FU, also known as a graft but to determine what a graft is, for example clinic "a" can say 2000 grafts and clinic "b" say 2000 grafts, but the hair count can be massively different. If clinic "a" constitutes a graft as a single hair then the conclusion is 2000 hairs; and if clinic "b" constitutes a graft as a naturally occurring FU then the conclusion would be around 4400 hairs.

We think it is important to distinguish the difference in terminology as some terms overlap and can confuse, even some older posters let alone newbies.

Thanks for the contribution.

 

[sl]

Nice post and good intro to terminology, sure it will help those who read it.

 

[hairtech]

So thank you for replying hatt. If you re-read what I will state again... quoting myself:

"Follicular Unit: Typically 1 to 4 hair groupings however there are many instances that are 5, 6, and 7 haired follicular units taken with small punches even below 1.0mm."

The key world in my definition is "typically"...

I do agree in your last post that some clinics will state that they did a 2000 graft case and it might well very be a an entire case of singled haired grafts. That would be a completely unethical practice.

A seasoned ethical clinic would state that they performed a 2000 graft case that had a typical mixture of of 1's, 2's, 3's, 4's and yes on rare instances in FUE using small punch technology... an occasional 5, 6, or 7.

Your last two sentences in your post although very condescending does show some promise to newbies.

Every person who is looking for a hair restoration needs to continue to do their research and read simple debates such as within this thread. ¬b`

 

[hairtech]

FYI, Here is a photo I took last week of some rare naturally occurring 5 and 6 follicular groupings that were extracted by a 0.9mm Harris SAFE system from an FUE.

 

[Hattingen Hair]

CICATRICIAL ALOPECIA

This is baldness due to scarring. The follicles are absent in scar tissue.

CROWN/VERTEX

Area at the top of the head to the rear of the scalp

DERMAL PAPILLA

The dermal papilla is situated at the base of the hair follicle. The dermal papilla contains nerves and blood vessels which supply glucose for energy and amino acids to make keratin.

DUTASTERIDE

A medication for the treatment of benign prostatic hyperplasia (BPH). It is an inhibitor of type 1 and type 2 5-alphareductase enzymes responsible for converting testosterone to DHT.

FINASTERIDE

Finasteride is the generic name of a drug that binds with type 2 5-alpha-reductase enzyme to reduce the amount of DHT in the prostate and serum. Finasteride is approved by the FDA for treatment of benign prostatic hyperplasia (BPH) as Proscar ® 5mg daily dose and hair loss as Propecia ® 1mg daily dose.

GENERIC

Pertaining to a substance, product or drug that is non-proprietary

HAIR CLONING

A technique under development, which could make an unlimited crop of donor hair available for transplanting

LUDWIG SCALE

Classification of female pattern hair loss

MICRO GRAFT

A very small hair graft usually consisting of one or two follicles

MINI GRAFT

A small hair graft usually consisting of between three to ten hair follicles

MINOXIDIL

Minoxidil is the generic name of the brand name drug Rogaine ®. Minoxidil is a topical lotion available over-the counter in many countries in 2% to 5% solution, sometimes stronger

NORWOOD/HAMILTON SCALE

The most commonly used scale for the classification of male pattern hair loss.

PROPECIA ®

A brand name for finasteride 1mg, approved for the treatment of male pattern hair loss.

PROSCAR ®

The brand name for finasteride 5mg, approved for the treatment of benign prostatic hyperplasia (BPH).

PUNCH GRAFT

An old fashioned way of removing grafts for hair transplants, usually carried out using an instrument called a trephine.

SEBUM

The oily secretion of the sebaceous glands of the scalp composed of oils and cellular debris.

TRACTION ALOPECIA

This refers to hair loss which occurs due to traction being placed on hair. Traction alopecia is commonly seen with braids, pony tails and other hairstyles which cause tension on the scalp.

TRICHOTILLOMANIA

A compulsion to pull out one €™s own hair

VELLUS

The soft downy hair found covering the body, on the scalp and in relation to hair loss it relates to the miniaturisation of hair, becoming finer over time before it the hair follicles recede.



Apologies if anyone finds our comments condescending or offends anyone that was never the intention. The thread was started to impart knowledge that maybe some did not have, and to encourage those that do have to continue their research and ask questions.

 

[hairtech]

Hattigen are you going to the conference here in the US?

 

[Hattingen Hair]

hairtech wrote:

Hattigen are you going to the conference here in the US?

Dr. Sever Muresanu will be attending some parts of the conference

 

[hairtech]

I just ran into him tonight.

 

[Bigmac]

I will use some of these terms in the top section to help educate people.