Artistry” in Hair Transplantation
In order to obtain optimum results after hair transplantation, the hair transplant surgeon must be well versed with the artistic aspect of the procedure. Simply put, hair transplantation involves two basic steps: first is extraction of grafts and second is implantation of these grafts in donor area. The real challenge lies in providing a natural look to the patient. It is important for the hair to be planted in the correct angle, direction, density and curvature.
Artistic design of hairline is of paramount importance for a good and natural looking transplantation outcome. A zone of 10 to 15mm at the edges of hair bearing scalp is referred to as a hairline. The frontal hairline is of highest significance in imparting a natural look. The grafts which contain single hair follicle are used for construction of hairline. The hairline should be soft- looking with gentle curves and feathery margins. It should be irregularly irregular. If made too straight or too low it gives a very unnatural look which is not desirable.
Angle of hair:
The angle at which each hair enters into the scalp skin varies according to sit on scalp. It is most acute at the temples while less angulated at centre of the scalp. A knowledge of this angulation is vital for planting the hair in a natural looking way. This avoids the planted hair from “standing out” and facilitates styling of hair in any desirable way.
Temple reconstruction requires knowledge and expertise. A new surgeon should not attempt to recreate the temple. A poorly created temple will give an unnatural hump on the sides. The angle of plantation should be very acute with curvature pointing downwards and the hairline should be soft. Fine, thin, less pigmented hair should be used. If care is not taken, it will affect the aesthetic facial features forcer.
Graded graft placement:
Our scalp has varying density from front to back of scalp. The transition zone in the front has few hairs while the number of hair increase as you move back. Frontal part requires grafts containing single follicle for a distance of 10-15mm. Behind this area, double follicle grafts are used followed by triple follicle grafts. Grading the grafts in this way imparts a natural look to the transplanted hair.
We try to give maximum density possible in every case. In normal scalp with full hair, there are 80-100 grafts/cm2. This much density will not be possible during surgery as the chance for necrosis of graft due to reduced blood supply is higher. We can provide upto 45-65 grafts/cm2, which is the highest possible in experienced hands. When these grafts grow, they will adequately cover the bald scalp.
Artistic plantation of grafts on the crown is vital for good coverage and natural looking results. The hair in the crown area enter scalp in varying direction giving a whorl like pattern. We need to maintain this pattern by planting the hair in the angle and direction similar to that of existing hair.
In short, all efforts should be made to plant the hair in such a way that it looks as natural as possible. This requires skill, knowledge and experience on the part of the surgeon.