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。     

Aesthetic pubic reconstruction after electrical burn using a portion of hair-bearing expanded free-forehead flap

Background  Electrical burn in the pubic region usually results in a severe and contractive scar with pubic hair loss. The aesthetic restoration of this area often has become very difficult. Methods  A 22-year-old male electrical engineer experienced severe pubic scarring with hair loss after electrical burn. He was treated successfully with an expanded free-forehead flap including a portion of hair-bearing scalp after microsurgical vascular anastomoses between the bilateral superficial temporal vessels and the bilateral deep inferior epigastric vessels. The donor forehead site was closed directly in the frontal hairline without visible scarring. Results  The pubic area was repaired functionally and cosmetically with the flap, and the pubic hair was growing well after a 1-year following-up period. Conclusions  This successful case strongly indicates that a microsurgical tissue transfer can be a good option for reconstruction of a pubic defect and that the expanded forehead flap could fulfill the high cosmetic demands of pubic reconstruction with minimal donor morbidity.     

Long-term follow-up and unusual findings after microvascular transfer of hair-bearing skin for pubic hair restoration

Alopecia in the pubic area can be restored successfully with hair transplantation using minigrafts and micrografts or with free tissue transfer of a hair bearing flap. In this report the authors present the successful transfer of hair bearing tissue from the temporoparietal scalp for the correction of a congenital form of alopecia of the pubic region. In addition, they present long term results of this transfer. Auxiliary procedures such as tissue expansion before or after transferring the flap, hair epilation and minigraft and micrograft transplantation could help to achieve a more natural result. Tissue expansion of the donor site could also be performed to enhance the outcome of the procedure. Of note is the rapid rate of hair growth in the transplanted tissue. This type of reconstruction using a hair bearing temporoparietal flap for restoration of hair to the pubic region is a useful method that can yield good results.     

Beard reconstruction using hair grafts in a free flap

Hair transplantation using micrografts or minigrafts is a standard procedure used for hair restoration in androgenic, burn scar and cicatricial alopecia. These grafts have also been used to reconstruct the eyebrow, eyelash, mustache, beard and pubic escutcheon. A patient who underwent successful micrograft and minigraft hair transplantation into a free osteocutaneous mandibular flap reconstruction is presented. The patient was very satisfied with his reconstruction, and the hair transplants provided excellent camouflage for the flap.     

Hair Restoration Surgery in Patients with Pubic Atrichosis or Hypotrichosis: Review of Technique and Clinical Consideration of 507 Cases

BACKGROUND: Pubic atrichosis or hypotrichosis is a common condition in Korean women of Mongolian origin. This results in many patients receiving hair restoration surgery, which is currently thought to be the only definitive therapy. OBJECTIVE: To pursue more natural and realistic-appearing results, to define patient characteristics, and to estimate the survival rate of transplanted pubic hair through restoration surgery, we examined our cases of pubic hair restoration surgery with single-hair grafts. METHODS: We selected 507 patients with pubic atrichosis or hypotrichosis who visited for pubic hair transplantation between March 1, 2001, and February 28, 2005. We reviewed the medical charts of the 507 patients and performed statistical analysis. We also carried out a detailed evaluation of our surgical technique to 100 patients. In addition, 20 patients, who agreed to participate in the study for survival rate, had received transplantation of 40 hairs in a 1.5 x 1.5-cm area after the angular points were tattooed. The number of hairs grown after 1 year of transplantation was counted in each case. RESULTS: Among the 507 subjects, 169(33.3%) were in their 40s. The mean (+/-SD) patient age was 41.3+/-10.8 years. Of these, 115 patients (22.7%) had pubic atrichosis, and 392 patients (77.3%) had pubic hypotrichosis. In addition, 81.7% of atrichosis patients had a family history of atrichosis or hypotrichosis. Pubic atrichosis accompanied axillary atrichosis or hypotrichosis in 60.0 and 38.2% of the cases, respectively. The most common reason for the hair restorative procedure was the subject's sense of inferiority to the same sex (73.8%). The mean number of transplanted hairs was 929.3+/-76.6. The most common design pattern that we used was modified horizontal type (87.0%). The mean survival rate of single-hair grafts on the pubis was 73.6+/-7.6%. CONCLUSION: This study suggested that pubic hair transplantation surgery is a suitable cosmetic procedure to address the inferiority complex of patients with pubic atrichosis or hypotrichosis. Knowledge of natural pubic pattern and normal physiologic features is essential to create a natural and realistic appearance in a given subject.     

Hair restoration

The introduction of micrografts (1-2 hair follicular unit grafts) and minigrafts (3-4 hair follicular unit grafts) has made a most significant advancement in the care of male pattern baldness and female androgenic alopecia. Finally, natural and aesthetically pleasing results are possible. Additionally, many other applications in the reconstruction of facial hair and scalp have been found, some of these include: restoration of hair loss due to (iatrogenic) post-surgical causes, ie, after facial rejuvenation procedures or procedures involving incisions on hair bearing facial skin or scalp; scalp and facial hair due to burns or to traumatic injuries; post-oncologic resections; hair loss due to congenital reasons such as in cases of complete bilaterial cleft lips (no mustache hair in the prolabium).     

Experimental Evidence in Hair Restoration Procedures: Plucked Hair Survival and Growth Rate

Background: Limitations of hair restoration procedures are the amount of hairs available and the invasiveness of follicular harvesting. Objective: The aim of this study was to compare conventional human micrografts and plucked hair follicles in an in vitro model in order to test hair growth rates for experimentally assessing the soundness of plucked follicle use in hair transplantation procedures. Methods and materials: A total of 100 conventional one-hair micrografts (group A; control) and a total of 80 plucked hair follicles (group B; experimental) were obtained from 14 healthy male patients. The length of each graft was measured immediately following isolation and at the end of the 10-day culture period. The Kruskal-Wallis one-way analysis of variance by ranks test was used in order to statistically analyze the data obtained. Results: A statistically significant difference was found between the growth rate of micrografts in control (mean 10-day shaft growth rate = 0.30mm) and experimental (mean 10-day shaft growth rate = 0.36mm) groups. Conclusion: The obtained data shows a higher plucked hair follicle growth rate compared to one-hair micrografts, which leads us to believe that plucked micrografts could be a useful and less invasive adjunct in the field of hair transplantation surgery.Hair transplantation for correction of androgenetic alopecia is one common aesthetic plastic surgery procedure performed on male patients.1,2 The principal purpose of hair harvesting has always been to obtain the maximum survival and growth rate possible. Micrografting is a method of hair transplantation involving randomly assorted groups of (1-2) hairs, without considering the natural configuration of their follicular units, which are selected under loupe, microscope, or naked eye examination.3 This type of graft is prepared by isolating each follicle as a whole, while maintaining a significant amount of tissue around the entire length of the follicle. Careful patient selection is very important, especially for African Americans and patients of Mediterranean origin on account of the curvilinear direction of their hair shafts, which could make graft preparation more difficult.4 Micrografting technique has been used both for hair restoration of the scalp and the face after burn injuries5,6 and particularly for eyebrow reconstruction7 due to the fine control obtainable with this technique and the natural-looking results. Plucked human hair consists in hair follicles which have been stripped from the donor area, without any dissection or local anesthesia. As demonstrated in the authors’ previous studies,8,9 rapid proliferating hair follicle capacity probably depends on the presence of human hair follicle multipotent stem cells in the bulge region of the outer root sheath. These previously characterized cells10 show an expression of proliferation marker Ki-67 and stem cell marker CD-34 in the follicle bulge region; the authors observed that plucked hair follicles have the same multipotent cell population as adult and fetal scalp hair follicles.9 Although some authors11-13 have recently described the presence of stem cells in plucked hair follicles, this was, to the best of the authors’ knowledge, the very first study specifically designed to assess the survival and growth rates of human plucked hair follicles, hypothesizing their possible use in hair restoration surgery. The aim of this study was to compare conventional human micrografts and human plucked hair follicles in an in vitro model, to experimentally assess the soundness of plucked hair follicle use in hair restoration surgery.     

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。     

Hair transplantation to the eyebrow, eyelashes, and other parts of the body

Since its earliest applications, hair transplantation has been used for treating not only the scalp in pattern baldness but also other parts of the body, commencing with eyebrow reconstruction. The earliest micrografts were applied to the eyebrow more than 30 years before their application to the scalp became the standard of care. Today hair transplantation is applied to a number of other areas. The principle behind transplanting these areas is the same-once transplanted, the hairs continue to grow because of the phenomenon of donor dominance. This article reviews the role and technique of hair transplantation to the eyebrows and eyelids, chest, beard and moustache, and pubic escutcheon.     

Follicular unit transplantation for male-pattern hair loss: Evaluation of 120 patients.

The main aim in surgical hair restoration is to restore hair, making the scalp look natural. Interviews with earlier patients who received hair transplants revealed that their complaints were - a straight anterior hairline that looked unnatural, and hair that looked like 'sprouted grass'. The use of follicular unit transplantation (FUT) technique, where hair roots are harvested under magnification, is becoming widespread. In this technique, hair roots are harvested into natural follicular units that contain 1-4 hair roots. In this article, we present our results related to hair transplantation by FUT technique, performed on 120 patients between the ages of 21 and 75 years with male-pattern hair loss. We made simple yet useful interventions to avoid the occurrence of the above-mentioned problems. Initially, drawings based on the middle line and the two temporal regression points were made for a natural-looking anterior hairline. Following this, irregular seeding was done instead of seeding in rows, to obtain a natural hairline. To avoid the 'sprouted grass' look, single hair roots were placed on the anterior hairline taking into consideration the direction of hair growth. However, the FUT technique is not adequate on its own for natural-looking hair restoration. Good planning and creation of an anterior hairline suited to the individual's forehead structure is fundamental for successful results. In addition, we believe that hair texture is very important in hair transplantation and additional care should be given particularly to patients with dark-coloured and hard hair.