显微自体毛发单位移植治疗毛发缺失

目的:研究应用显微外科技术进行自体毛发单位移植治疗毛发缺失的临床疗效。方法:切取耳后或头枕部条形头皮组织,低温下,手术显微镜配合将头皮分离成单株和多株移植物,并按需要将移植物移植入受区。结果:42例患者,60个毛发种植区完成手术。经6～12个月随访,移植后的毛发能覆盖受区皮肤,形态自然,效果满意,毛囊成活率90%～95%。结论:在显微外科设备辅助下,进行毛胚单位的移植,提高了毛囊移植过程中的解剖精度,减少损伤,提高成活率。该方法值得在毛发移植手术中推广应用。     

自体单株毛囊种植修复上唇胡须缺损

目的:探索应用自体单株毛囊移植修复上唇胡须缺损的效果。方法:对17例患者采用切取枕后安全区头皮条的方法或利用直径8mm的电动环钻获取毛发移植物,在3倍放大镜下制成单株移植物,并利用21或22G注射器针头穿刺打孔,然后用显微镊夹持毛干部,将毛发移植到缺损处以修复形态。结果:植入毛发生长良好,形态满意,移植毛发成活率在95%以上。结论:单株自体毛囊种植修复胡须缺损是一个适宜的方法。     

自体单株毛囊种植修复眉毛部分缺损

目的:探索应用自体单株毛囊种植修复眉毛部分缺损的效果。方法:对35例女性患者,采用枕后安全区头皮,制成毛干长1cm的单株移植物,利用针头穿刺打孔将毛发移植到缺损处以修复形态,为了使形态协调一致,每侧眉毛中部种植30～40根毛发。结果:植入毛发生长良好,方向形态满意,移植毛发成活率在90%以上。结论:自体单株毛囊移植修复眉毛部分缺损是一个适宜的方法。     

毛发移植修复外伤后眉缺损的临床观察

目的 观察因外伤、烧伤等致眉毛缺损的患者,采用自体单株毛囊种植修复的临床效果.方法 对73例因外伤或烧伤造成眉弓区瘢痕,或经游离皮肤移植及皮瓣、扩张皮瓣修复后致眉毛缺损的患者,根据所需移植物大小,相应地选用21 G或22 G注射器针头穿刺打孔,在针头退出的同时,用显微镊植入制备好的单株毛囊,修复其形态.结果 本组共73例患者,其中4例术后出现毛囊炎,经用75％乙醇涂擦后痊愈.其余患者的植入毛发生长良好,方向及形态满意,成活率在90％以上.结论 对于外伤、烧伤后致眉缺损的患者,采用自体单株毛囊种植修复技术,虽然在操作上有一定难度,但仍以毛发移植修复为宜;对于眉弓区软组织条件不适合进行眉毛种植的患者,可以针对其原因进行治疗,然后采用毛发移植修复缺损,也能获得良好的效果.     

颜面部皮肤扩张术后残缺的修复

目的:采用自体显微毛囊移植技术对接受颜面部皮肤扩张术治疗后出现毛发残缺的的患者进行进一步修复,以便获得更为满意的疗效。方法:运用自体显微毛囊移植技术进行部分或全部眉、胡须(含上、下唇、颏、下颌)再造修复,毛囊供区位于耳后或枕部头皮。上述治疗均在扩张术治疗半年以后进行。结果:运用自体显微毛囊移植技术进行部分或全部眉再造共10例13侧;胡须再造(含上、下唇、颏、面颊和下颌)12例,疗效满意。结论:采用自体显微毛囊移植技术对接受颜面部扩张术治疗后出现毛发残缺的患者进行进一步修复可以取得良好效果。     

自体毛发显微移植治疗眉毛缺损

目的 探讨自体毛发显微毛囊移植治疗眉毛缺损的方法及疗效.方法 在耳后或枕部距发际线2cm内的毛发安全供区切取约8cm×1cm的头皮条,制备显微毛囊移植单位,并移植于眉部受区.自2008年10月至2010年11月,共治疗各种类型眉毛稀疏、缺损患者20例.结果 本组20例患者(32只眉毛),均Ⅰ期完成手术.随访18例患者6～12个月,移植毛发成活良好,毛发生长方向自然,密度均匀.结论 利用自体毛发显微毛囊移植治疗眉毛缺损,移植成活率高,外观自然,值得临床推广.     

毛囊单位移植修复头面部毛发缺失的效果

目的探讨毛囊单位移植对头面部损容性毛发缺失的治疗效果。方法 2019年9月至2020年9月, 河南省人民医院整形美容外科收治头面部损容性毛发缺失患者24例, 男13例, 女11例;年龄19～48岁, 平均27岁。根据患者毛发缺失特点, 用毛囊单位移植技术从健康头皮获取毛囊单位种植到毛发缺失区, 术后观察移植毛囊存活情况、毛发生长方向、修复效果。结果 15例头皮毛发部分缺失, 8例眉毛部分缺失, 1例睫毛部分缺失。行毛发移植后, 术区毛发生长良好, 方向与原生毛发基本一致, 毛发覆盖的美容效果恢复满意。随访9～18个月, 移植后毛发成活良好。结论用毛囊单位移植技术修复头面部毛发缺失, 手术创伤较小、恢复快、美容效果可靠, 是较为理想的治疗方法。     

单株自体毛发移植行阴毛再造

目的：探讨单株自体毛发移植再造阴毛的临床疗效。方法：对11例先天性无阴毛的女性求美者进行阴毛再造,供区、受区均采用肿胀麻醉,在4倍放大镜下制取单株毛囊移植胚,受区用双刃宝石刀制备移植胚腔隙进行阴毛再造。术后随访6个月,检测移植毛发的成活率、生长密度、线性生长速度,观察移植毛发的生长方向及形态,问卷调查术者对再造阴毛的主观评价和毛发外观的满意度。结果：11例求美者术后6个月时,移植毛发成活率为96.50%,平均生长密度为42±5n/cm2,线性生长速度0.2±0.06mm/天,术者满意率100%,部分毛发生长方向无规律,形态无明显卷曲。结论：采用单株自体毛发移植进行阴毛再造,移植毛发成活率高,外观形态自然,术者满意率高。     

自体单株毛发移植修复女先天性无阴毛或阴毛发育不良

目的探索应用自体毛发单株移植修复女先天性无阴毛或阴毛发育不良的效果。方法对12例成年女性患者,均采用切取枕后区包含全厚皮肤与完整毛囊的条形头皮组织,在手术放大镜下,将头皮条全部分割成1个个单株毛发备用。用规格为0．9mm×38．0mm的针头穿刺打孔,将单株毛发移植到外阴部以增补稀疏的阴毛和扩大分布面积,每例移植400700个单株毛发,阴毛分布形态多选用倒三角形或菱形,密度为阴阜部阴毛按20株／cm^2植入,然后向外扩散密度逐步减小,最少不低于10株／cm^2。结果随访9个月至2年,植人毛发生长良好,阴毛形态及方向和分布范围均与正常接近一致,效果满意。均1次手术成功无需进行2次加密治疗,枕后供区切口瘢痕不明显。结论用毛发移植术补足阴毛,方法简便,创伤小,外形自然美观,是目前补充阴毛不足或无阴毛的理想方法。     

自体单株毛囊在修复上睑睫毛中的应用

目的：探索一种更为自然的上睑睫毛移植方法。方法：切取枕后安全区域头皮,分离修整,制成毛干长约3～4cm单株毛囊备用。用6mm×14mm三角针穿带毛干从重睑线（或距上睑缘5mm处）进针从上睑缘睫毛根微上出针,将毛囊导入上睑组织内形成睫毛,每侧约植入20～40根。结果：本组28例女性受术者,植入毛发生长良好。毛发生长方向、形态和疏密度均较满意。移植毛发成活率高于90％。结论：睫毛是以窄长条状分布的毛发,单株毛发移植可以满足这个需求;睑缘组织较薄,钻孔填入法较为困难,导针植入法单株毛囊移植可使手术简化;完美的上睑睫毛应该微微上翘,单株毛囊移植导针植入法的导针轨迹可以使成活后的睫毛上翘。导针植入法自体单株毛囊睫毛是一个可行方法。     

自体毛发移植的临床应用

目的：探索应用自体毛发移植术治疗各种原因引起的秃发及眉毛、睫毛和阴毛缺损。方法：切取后枕部适量条形头皮组织，根据需要将其制备成单株及多株(4-10株)移植物。然后，将这些移植物以缝隙切开多株植入加单株法植入脱发区，以单株法植入眉、睫毛缺损区及阴阜部。结果：自1997年6月至2001年10月，完成修复秃发31例，眉缺损192例(384侧)，睫毛缺损67例(134侧)，阴毛缺失12例，共302例，均取得满意的美容效果。毛发成活率可达70％-90％。一年后，随访观察毛发生长自然。结论：自体毛发移植根据缺损部位采用不同方法可取得较为满意的临床疗效，并且操作简便、安全，恢复快。     

Hair transplantation in patients with inadequate head donor supply using nonhead hair: report of 3 cases

Follicular unit extraction is becoming an increasingly popular technique for hair transplantation, as it obviates the linear scarring associated with strip harvesting, and can provide highly presentable results. Using this technique, a few reports have described the small scale use of nonhead hair for head hair transplantation in men with inadequate head hair donor supply. In this report, 3 patients who were severely bald had hair transplanted from the chest, abdomen, legs, shoulders, or beard, as well as the head to achieve full coverage and excellent hairlines. Of the 3 cases, 2 had undergone previously unsuccessful hair transplant surgeries. Approximately 80% to 85% of the transplanted grafts survived. Although hair length and quality, surgery time, and the requirement for improved surgical skills remain challenges when using this technique, the sufficiently good outcomes from these selected candidates suggest that this technique may offer the possibility of restoring even severely bald states to normality in patients who would otherwise not be candidates for traditional hair transplantation surgery.     

Baldness surgery

Redistribution from hair-rich to hair-poor areas is the fundamental principle of baldness surgery. Success of hair transplantation is based on the fact that transplanted hair follicles will behave as they did in their original area and continue to grow. Three basic techniques are employed: scalp flaps, scalp reductions and hair grafts. Each technique has undergone considerable refinements answering to initial wrong results and criticisms. The typical doll-hair tufted effect of old macro-grafts has disappeared with micro-graft shift. The unaesthetic cheese-like Hippocratic crown donor defect aspect ended when harvesting a long strip of occipital hair bearing scalp. The posteriorly directed hair growth has disappeared by using superiorly based flaps. Respective indications and tension-free closure ensure that the incidence of necrosis is low. Limited results of old scalp reductions have decreased by testing preoperative laxity of the scalp and using extensive undermining of the scalp. The future may release on medical treatment avoiding dihydrotestosterone to act on genetically predisposed follicles avoiding miniaturization of the hair and baldness development. However, when baldness has appeared, as the hair follicle's culture is not actually effective, the state of art is still to plan a surgical strategy using successive stages of this large panel of techniques to reach a natural effect with the best hair orientation and density.     

The Distribution of Follicular Units in the Chinese Scalp: Implications for Reconstruction of Natural-Appearing Hairlines in Orientals

BACKGROUND: Follicular transplantation using hair in its naturally occurring groups, called follicular units (FUs), has become the most popular technique in hair restoration surgery. Recently follicular transplantation was performed with a qualitative and quantitative concept to achieve the best clinical result. The characteristics and distribution of FUs are well studied in Caucasians and widely applied in hair transplantation surgery. OBJECTIVE: In order to understand the normal distribution of FUs in the Chinese scalp, we counted the number of hairs and FUs in normal Chinese scalp to provide general information for surgical planning and design in bald Chinese patients. METHODS: A total of 50 normal and 50 bald Chinese adults were enrolled to count the hairs on their scalp. One hundred bald patients receiving hairline reconstruction were also prospectively quantitatively evaluated. RESULTS: In normal Chinese scalp, an average 71.78 FUs/cm(2) and 137.08 hairs/cm(2) were calculated with a follicular density of 1.91 hairs/FU. Two-hair FUs are the predominate group (50.29%). In bald patients, an average of 68.07 FUs/cm(2) was found, which was less than that of the occipital scalp in normal nonbald patients. In reconstruction of the frontal hairline, a total of 700-1000 FUs were implanted with an average density of 30 FUs/cm(2). CONCLUSION: We found the average number of FUs (0.72 FU/mm(2)) was less than that in Caucasian patients (1 FU/mm(2)). The average density of 30 FUs/cm(2) implanted was suitable to reconstruct a natural frontal hairline in bald Chinese patients, which can achieve about 40% of normal hair density. Our results could provide the hair surgeon with general information about hair distribution on the Chinese scalp for surgical planning and design in their patients.     

植皮区单株毛发移植修复眉毛缺损的观察

目的：观察单株毛发移植在植皮区的存活情况及再造眉毛的效果。方法：选择植皮区皮下软组织的厚度在3mm以上的患者,在枕后毛发安全供区（SDA）内局麻下切取一条带毛发的完整头皮。助手利用刀具分离出单株毛发,种植区肿胀麻醉后,术者用注射器针具按眉毛生长方向在植皮区上打孔,15～25孔／cm^2,将单株毛发种植于毛发缺损区。结果：2007～2009年间4例眉区植皮患者6只眉毛通过本方法治疗,术后随访9个月～2年,4只眉毛一次手术效果满意,2只眉毛需二次加密。所有毛发存活良好,毛发单次种植存活率接近90％,眉毛形态自然、美观。结论：在植皮区皮下软组织厚度3mm以上,密度15～25孔／cm^2的情况下,单株毛发移植在植皮区上的存活率接近90％,再造眉毛形态自然、美观。近似于真实眉毛效果。     

Effects of Cooling Micrografts in Hair Transplantation Surgery

BACKGROUND: When isolating hair grafts in hair transplantation procedures, it is generally recommended to preserve the grafts at a low temperature (1 degrees C- 4 degrees C) in order to enhance the survival rate of the grafted hairs. This study was carried out to test the real benefits provided by cold-storing hair grafts. OBJECTIVE: The aim of this study was to evaluate, in an in vitro model, the effects of cooling micrografts during hair transplantation procedures to experimentally assess the soundness of this approach to enhance the survival and growth rates of hair micrografts. METHODS: A total of 240 anagen hair follicles were obtained from 10 healthy male patients. Follicles were thus randomly assigned to one of the following groups: group A (control; n = 120 follicles), or group B (experimental; n = 120 follicles). Follicles from group A were preserved for 5 hours at room temperature (26 degrees C), and follicles from group B were preserved for 5 hours at 1 degrees C. Immediately after that 5-hour period, follicles from both groups were then cultured for 10 days. The length of each follicle was measured immediately following the 5-hour test period and at the end of the 10-day culture period. RESULTS: No statistically significant differences were found between the survival and growth rates of follicles from the control (survival rate = 87%, mean 10-day growth rate = 2.68 mm) and experimental (survival rate = 88%, mean 10-day growth rate = 2.54 mm) groups. CONCLUSION: Although, at present, it is generally assumed that lowering the metabolism of grafts by reducing their temperature may be of some utility for enhancing their survival rate, our data indicate of that there are no effects when performing hair transplantation surgery.     

自体毛囊种植修复鬓角缺损

目的:探索应用自体毛囊种植修复鬓角缺失的效果。方法:对67例患者,采用枕后安全区头皮,分离成含1～2个毛囊单位的移植物,利用针头穿刺打孔或植发器将毛发移植到缺损处以修复形态,每位患者每侧移植200～600个毛囊单位(U),植入密度为30～40U/cm2。结果:植入毛发生长良好,再造鬓角形态及方向与正常较为一致,效果满意。结论:自体毛囊移植可按设计形态种植修复鬓角形态,具有形态好,创伤小的特点,是修复小面积及形态不规则的鬓角缺损的最佳选择。     

打孔同步植入毛囊单位法治疗烧伤后瘢痕性脱发

目的 了解打孔同步植入毛囊单位法治疗烧伤后瘢痕性脱发的效果. 方法 2002年1月-2008年4月,2家笔者单位应用打孔同步植入毛囊单位技术,治疗166例患者共217个烧伤后瘢痕性脱发区域.根据移植需求量,于枕、颞部切取相应的含有完整毛发的头皮组织条,在显微镜或放大镜下分割成一定数量含1～3根毛发的毛囊单位.根据所需移植物大小,选用相应型号的注射针头于瘢痕脱发区内制备孔洞,在针头退出的同时,植入制备好的毛囊单位.对I期术后毛发密度不满意患者,半年后行Ⅱ期毛囊单位移植.l期术后即刻,随意选择10例患者共10个边界清晰的受区,肉眼观测毛囊单位移植密度及移植毛发数量;后期随访时,肉眼观测这10个受区的毛发成活数量,计算毛发成活率.另对患者术后满意度进行问卷调查. 结果 83例患者I期手术完成治疗,另83例患者Ⅱ期手术完成治疗.I期术后毛囊单位移植密度达15～25个/cm~2,移植毛发数量为40～70根/cm~2.所有患者术后随访8个月以上,移植毛发生长自然、良好.I期手术后选定的10个观察区(受区)毛发平均成活率为96.5%.仅行I期手术的患者术后非常满意者61例占73.5%,满意者22例占26.5%.Ⅱ期手术患者非常满意者76例占91.6%,满意者7例占8.4%. 结论 打孔同步植入毛囊单位的移植技术安全,手术创伤小、出血少,术后伤口恢复快.应用该技术移植在瘢痕性受床上的毛发成活率高、生长良好.     

高密度毛发移植治疗瘢痕性秃发

目的 探索高密度毛发移植治疗因各种因素所引起的瘢痕性秃发的新技术。方法 于头颅的后、侧部优势供区内，切取含有完整毛发的条形头皮组织。分割成微小毛发移植物（含4－6根毛发）和显微毛发移植物（含1－3根毛发）。然后，植入头皮瘢痕脱发区内预制的相应孔洞中。结果 1998年4月－2000年2月，将此项技术，应用于96例128个瘢痕性秃发区。32例仅需一期手术；64例需行二期手术完成治疗。术后12个月以上的远期随访，恢复快，毛发生长自然、密集，即使在瘢痕区域的受体上移植的毛发常常也能良好地生长，是治疗瘢痕性秃发的又一理想手段。