CURRENT CAPILLARY SURGERY
The modern hair implant is the result of over 200 years of research. For a long time surgeries had artificial results, the famous doll hair, and this makes some negative propaganda for modern surgery.
Capillary surgery today is based on the follicular unit, which is the basic unit of hair.
The discovery of the follicular unit was a turning point to point out that the results were artificial before the follicular unit was known, and the results became natural after identification.
The follicular unit is a complex structure consisting of a sebaceous gland, piloerector muscle, and a group of threads (1 to 4). However, modern capillary surgery is more specialized than transplanting hair into a follicular unit. New tools, microscopes, devices and even robots are being developed to make them easier to perform every day.
BASIC PRINCIPLES OF MODERN HAIR SURGERY
To program the surgery, some important concepts must be respected. The basic principles are:
- “Capillary surgery using only follicular units”: In order to achieve a completely natural result, individual follicular units must be placed. However, this alone does not guarantee a 100% natural result.
- “Right unit, in the right place”: Follicular units should be implanted following a natural pattern, ie the first rows should consist of only follicular units of a single strand. This tactic recreates the previous hairline. No one has 2 to 3 strand follicular units in the anterior line and therefore surgery needs to recreate this aspect.
- “Density”: Hair surgery, which is undoubtedly its natural result, is an intense operation. However, there is no exact figure as to what natural density is. Many variables such as baldness size, hair type, color, and others affect this response. However, it is known that an individual with hair loss will notice that their hair is lost only when they lose 30-50% of their capillary mass. From this, the ideal density is estimated to be 40 follicular units per cm², which is equivalent to just over half the original density.
- “The design of the previous series is an art”: One of the challenges is to reconstruct the previous line, the first rows of implanted follicular units. In this part of the hair transplant surgery, we saw that only follicular units containing threads should be used. Also, the design of the previous line should be a “dashed line” ie irregular. An anterior, uniform line where the roots are millimeter next to each other produces a purely artificial result.
- “Direction and inclination of the threads ”: In capillary surgery, threads should be implanted according to the natural inclination in the presence of “eddies”, especially when crowning, the direction and inclination of the teeth should be followed.
- “Donor site”: One of the main concerns of those interested in performing capillary surgery is where to remove the wires. It is removed from the side and back of the person’s head. There are two ways to remove the strands. It is the most widely used FUT technique (follicular unit extraction), where a strip of scalp is removed and threads are prepared from it. The other is the FUE technique, in which follicular units are removed one by one.