Baldness
Cosmetic Surgery - Plastic Surgery - Aesthetic Medicine - Reconstructive Surgery
Baldness, hair loss or absence of hair, is observed both in men and
women. Baldness, with permanent hair loss, is more prevalent in men; it
is called male pattern baldness. Hair follicles, depending on their
location on the scalp, will not have the same sensitivity to androgens.
The top of the skull is very sensitive; there is an accelerating hair
cycle thus early exhaustion and the onset of baldness. For the same
individuals, these androgens have no adverse effect on hair follicles
at the edge of the scalp or in the beard.
Baldness is less common in women because oestrogens have a protective effect.
In male pattern baldness, it is the destruction of the hair follicles
that causes hair loss. This type of baldness is hereditary in varying
degrees. Its origin is a hormonal imbalance problem (male hormones,
testosterone and androgens) in the blood. This type of baldness is more
or less significant in 40% of the male population. . Hair loss is
gradual and begins first with the hair at the hair line on the forehead
or with the formation of temporal gaps with thinning of the crown.
When there is only hair on the sides and back of the head we call this
male pattern baldness with tonsure.
There is another type of baldness involving temporary hair loss due to
transient injury to hair follicles. This is called alopecia. This
phenomenon is found after irradiation with x rays, ingestion of metals
such as thallium, tin and arsenic and ingestion of anticancer drugs.
Alopecia is also a result of diseases accompanied by high fever, some
inflammatory skin diseases, endocrine disorders, etc. It is also
possible to find circumscribed alopecia or alopecia areata,
characterized by the appearance of temporary areas of baldness.
Baldness, whether in man or woman, is viewed badly. Aesthetic surgery,
with the advent of micro-grafts, has changed the treatment of
baldness. It involves transplanting hair follicles from regions of the
scalp which still have hair (usually in the region of the crown that
will not thin out) and implanting them in those areas that are already
bald (front and tonsure).
Treatment for baldness requires the use of multiple surgical
techniques, currently there are four, which can be used separately or
combined in the same patient:
micro grafts; flaps; tonsure reduction; lifting of the scalp.
- micro grafts allow the size of the operation and residual scarring
to be reduced. A small strip of scalp is removed and then cut into
fragments of one to three hairs (micro graft) or four to eight hairs
(minigraft) to be implanted in the treated area. It takes two
interventions micro grafts at least to obtain good hair density.
- Flaps are longer, still attached to the scalp through the vascular
system; the surgeon rotates them towards the frontal region.
- Tonsure reduction is the complete removal of a portion of the bald
area; this is followed by immediate closure using the elasticity of the
skin.
- The lifting of the scalp is an important technique involving a large area of scalp reduction with one or two flaps.
Surgery for baldness is performed by a specialist plastic surgeon. It
is like any surgical procedure with preoperative assessment and
consultation with an anaesthesiologist. Surgery for baldness surgery
can be carried out under local anesthesia, local anesthesia in
combination with sedatives or classic general anesthesia (as in the
lifting of the scalp).
Hospitalization after surgery for baldness varies depending on the
type of surgery and anaesthesia. The procedure can be carried out on an
outpatient basis but sometimes a short period of hospitalization may
be recommended. Surgery for baldness surgery is a procedure the
duration of which depends on the surgical work to be done by the
plastic surgeon. Each surgeon uses his/her own technique that he/she
adjusts to the patient to get the best result.
Following surgery, the scalp must be in rest for a period from 4 to 8 days.
The postoperative consequences of surgery to the scalp are variable in
duration and magnitude according to the patient: headache, swelling
(oedema) and bruises (ecchymoses).
It takes a period of 3 to 6 months for the result to be fully
appreciated by the patient. This is the time needed for healing and
recovery of flexibility in the tissues.
Do not forget that surgery for baldness, although performed in many
cases for purely aesthetic reasons, is a surgical procedure with all
the risks associated with any medical procedure (anaesthesia and
surgery) even when carried out under the best circumstances, that is
to say by a qualified plastic surgeon . Without overstating the risk, a
proportion of risks exist. Turning to a qualified plastic surgeon can
help prevent complications or treat them effectively.