Limiting Pain from Injections in Hair Transplantation

The First Injection 

Most of the patients are more anxious during their first injection. If the first injection causes pain to them then they will be more and more anxious for forthcoming injections. Thus at DHT Clinic we try and make the first injection and all other following injections simpler and almost painless for the patient in the following manner:

Concomitant Physical Stimulation

Just recall, when our finger gets burn we unconsciously and immediately shake it, in a fierce manner. We do this because in this manner we try to reduce our pain by shaking or vibrating the affected area. Similarly in order to reduce pain during hair transplantation surgery, we use vibrators to shake the affected area in order to reduce the pain. In order to diminish the perception of painful stimuli touch, pressure and vibrations are used during the surgery. This helps to distract the patient and minimize his pain.

Cooling

In ancient ages icing was used to achieve numbness of any aching body part. The hypoesthesia achieved by this cold induced numbness temporarily blocks the pain perceiving receptors. We use sterile cold packs, ice boxes and doctor ice to make the injection sites numb, so that pain during prick is almost nil.

Reducing the Needle Caliber

Small caliber needles causes less pain then large ones. This potential of small caliber needles is utilized only when the rate of injection is slowed. We use 31 gauge, the thinnest possible needle in the world. It is also known as insulin syringe. With help of this insulin syringe, and slow rate of injection, the pain is minimized almost to zero.

Rate of Injection

Rate of injection also plays a major role in reducing the pain. If one reduces the rate of administration of local anesthetics, then the pain can also be reduced. We inject the anesthetic solution at extremely slow rate which cause slow tissue expansion and thus very less pain.

Depth of Injection 

While injecting the local anesthetic and the tumescent solution we are extremely careful about the depth or the PLANE of injection. If we prick beyond mid dermis level then the pain perception will be more as the receptors for the same are located at that level. So we keep the tip of the hypodermic needle in the PLANE above mid dermis. In addition to alleviating pain, this move also enhances the blanching effect of the tumescent anesthesia.

The OT & Surgery Environment

The OT and surgery environment also has a significant impact on the pain’s experience. We at DHT Clinic play soothing music and involve you in rich conversations with the doctors, keeping your areas of interest as priority.

http://www.directhairtransplantation.com/what-is-hair-transplantation/limiting-pain-from-injections-in-hair-transplantation.html

Right Age of Hair Transplant

The right age of transplantation depends upon the level of surety that a physician and a patient has regarding the future state of baldness of the patient. Future state of baldness can tell us the need and the best technique of hair transplant for the patient. To know about this future state one can look at baldness pattern in the patient’s family. 28-32 years is said to be the optimum age for hair transplant where the level of the surety about the future pattern baldness is highest.

At our Direct Hair Transplant (DHT) Centre in Dehradun and Gurgaon, we transplant hair by a sequence which is different from the sequence followed in FUE technique. In FUE technique the sequence is as follows:

STEP I - Extraction of grafts.
STEP II - Making the slits for graft implantation.
STEP III - Implanting the extracted graft. 

Whereas the sequence followed by us is:

STEP I - Making the slits for graft implantation
STEP II - Extraction of grafts + Implanting the extracted graft.

This sequence prevents the graft to get damaged from:
• Desiccation
• Infection
• Mechanical Handling and
• Chemical Damage

The “Out of Body Exposure” for the grafts is now LEAST and thus the chances of graft survival are MAXIMUM. The result of this change in sequence has been fantastic. This has improved the results of our hair transplant surgery a lot. This change in sequence has given a new characteristic to the FUE technique. We have named the new sequence as Direct Hair Transplant (DHT). 

Baldness and its Remedy

Most men face the problem of baldness around the age of 22 years and it keeps on increasing with age. The cause of baldness is Androgenetic Alopecia. Some of the triggers of baldness which accelerate the process are:

(i) High stress level.

(ii) Improper diet.

(iii) Bad effects of Type A personality.

Direct Hair Transplant can be a remedy to restore the hair on the bald portions with a success rate of 98-100%.

Grey Hair Transplantation

"Grey Hair Transplantation (GHT) is equally successful as the black hair transplantation. In GHT the client has to dye his grey hair without dying the scalp. This will make the grey hair stand out as black, against the light background of the scalp skin.

A quality GHT can be done only by the experts with the world's best equipments like Cole and Harris instruments, due to many technicalities involved."

The hair transplanted by DHT technique is permanent, this technique works on donor dominance phenomenon, which means the graft is taken from those parts of the scalp & body which do not shed and the hair keep its native characteristics and remain permanently.
http://www.youtube.com/watch?v=tv5X7UVwS7E

A very happy and safe Holi to ALL!!! .We are happy to share few tips to prevent your hair from getting damaged from the colours. 

Hair protection: 
• Oil your hair with coconut, olive or castor oil. Doing so will protect your hair from damage by harmful chemicals. It will also be helpful to remove the colours while washing off.
• You may also cover your head with a thick scarf/cap/cloth to protect your hair from being soaked in colour.
• Try using natural colours such as henna, turmeric, marigold flowers, tomatoes and tea leaves for a safe and skin-friendly Holi.

Post Holi care:
• Rinse your hair with plenty of water to wash off colours.
• Use mild and herbal shampoo to avoid further damage.
• You can also add lemon juice to a mug and use it as a last rinse to restore cid-alkaline balance of the scalp.

Do not take bath immediately after the play since taking frequent baths and washing your face and hair repeatedly will ruin your skin as well as your scalp. Do it much later after the celebration is over!
In case of any specific queries please feel free to contact us.

Once Again a very Happy Holi to all Dear Friends.

Cost Variation between Different Hair Transplant Centres

The cost of hair transplantation varies from one centre to another.  This variation exists due to the different quality of the resources used by different centres. Many centres reduce the price of the surgery to attract masses. Most of the players play on a “Price War Strategy” with each other to win over more clients.  But at the same time most of them also reduces the quality of the resources to increase their profit margins.

A high quality hair transplant surgery is only possible when a highly qualified team carries out the surgery, under the presence of a well qualified doctor.

A quality conscious hair transplant centre incurs costs such as training costs, cost of more effective medicines, solutions, usables, costs for running the centre and the most important quality control and management costs.

Being focused on the quality aspects of the surgery, DHT Clinic incurs all of the above mentioned costs willingly to provide a high quality hair transplantation surgery.  Dr. Pradeep Sethi and Dr. Arika Sethi trained from AIIMS, New Delhi, perform these surgeries themselves by exceeding the international quality standards.

As one patient said: “You never remember the price of a good surgery and you never forget the price of a bad surgery.”

The price per transplanted follicular unit graft is Rs 40-90 depending upon the technique that a person wants to go for.

We estimate the numbers of follicular units as accurately as we can in advance of surgery but, as the density of follicular unit varies all over the scalp, the actual number of follicles transplanted may be slightly higher or lower than our estimates. A careful audit is kept during surgery and you will only be charged for the actual number of follicular units transplanted.

Why there is price variation between centers for the same Hair transplantation surgery?

The price varies between centers, because of the variation in expertise of the team, experience of the doctors and whether the doctor himself is doing the surgery or getting it done by hired technicians or all together a travelling team is doing the surgery and the centre is arranging the cases.

The price also depends upon the quality of instruments and quality of usables used in the surgery. The patients have all the rights to know the quality of the instruments used in his surgery, the actual transection rate (permanent cutting of the roots) in the surgery. Whether the centre is using sharp or blunt punches. Punches are from a good international company (like Cole instruments, Harris instruments and Ellis instruments) or prepared in China/Korea or local.

Blunt punches of Harris system are best with least transaction rate. They are very costly at the same time. Sharp punches of Cole instruments are also extremely good but with high price. If the doctor using these best quality instruments then all these has a cost. Special patented instruments are used to avoid the root handling during plantation, lest there is chance of crushing the root leading to permanent loss of roots.

Best quality instruments are required in the three steps of hair transplantation; extraction, storage and plantation. Each step is very crucial, should be in front of the doctor simultaneously.

The cost also involves the training exposure of the team. If the team is regularly updating themselves in national and international conferences, then their quality of surgery will be much better. The patients can find about all the doctors in the Indian (http://www.ahrsindia.com) as well as International hair restoration society (http://www.ishrs.org).

Transplanting roots and growing them is the main purpose of hair transplantation. At the same time the transplanted hair should grow in the right angle, with optimum density and the new hairline should not look artificial. These things come with attending national and international workshops and conferences.

Due to low quality (low cost) instruments, there will be permanent damage of the hair roots. This means; if there is a target of 1000 grafts; it is possible with poor quality instruments/team that they have punched 1300 times. This means 300 roots were cut through and through but did not come out! This is called transaction of roots (permanent loss from the scalp!). Out of these 1000 roots some 700-800 roots will grow with poor quality instruments used for transportation and plantation.

We use the most advanced and efficient instruments available. We use the Cole instruments(http://www.coleinstruments.com), Harris instruments (http://hsccolorado.com/SafeScribe.aspx), & Ellis instruments(http://www.ellisinstruments.com/), which are the best and most efficient instruments available for hair transplantation in the world.

It is obvious that if any hair transplant centre is using less efficient instruments available in market at low cost, then the cost will be less compared to us because we do not compromise on quality.

To summarize, the best quality surgery is not possible in cheap price.

Hair Replacements, Hairpieces and Wigs

A hair replacement (hair system or hairpiece) is partial synthetic or natural hair prosthesis that covers a part of the scalp which is bald, whereas a wig which covers the entire scalp. A wig is worn usually by women whereas the men prefer to wear a cap because of persistence of the hair at the back and sides of the head (occipital and temporal fringe in men with male patterned baldness).

Hair replacements can be attached to the scalp through a variety of mechanisms. They are summarized below:

·     Tape adhesives: are used for daily adherence so that the hairpiece can be easily removed at night time.
·    Glue adhesives: provide more durable bonding and can be used to keep a replacement in place for upwards of a month.
·     Hair weaving: uses existing hair to provide anchorage to the hair system through inter-weaving the two together. Weaving can also provide a month of time for a hair replacement to remain in place before maintenance is required. 
·     Hair clips: Hair replacement is secured with several sets of little combs that clip to a person’s hair.

These hair replacements require maintenance like:

·         Cleaning
·         Coloring
·         Repairing
·         Replacing
·         Bonding it back on scalp

 Hair styling requires special sensitivity and technique to provide proper blending and is usually carried out in specialized salons where men who wear hair replacements can feel more comfortable in that environment dedicated to their needs.

The benefits of hair replacement are that:

      ·      They can provide immediate gratification as opposed to a hair transplant that requires 6 months or beyond to see the result
·         Look more denser that the look after a single sitting of hair transplant
·         Less expensive
·         It is a good option in individuals with cannot undergo hair transplant because of underlying systemic diease like cardiac problem, coagulopathies etc.
·         Individual with extremely poor density in the donor areas

The disadvantages are:

·         They require regular maintenance. The maintenance fee over the years may be too high
·      The maintenance requires a lot of labor and time investment. In contrast the transplanted hair don’t require much extra care
·         The hair of the artificial replacement don’t undergo growth
·         The wearer is under a constant fear of displacement of the hairpiece
·         The wearer may develop social inhibition due the risk of being “caught”

These hair replacements provide cover up for a patient who is has undergone hair transplant for the transition phase (i.e. the phase when the growth of transplanted hair has not started yet). Such persons should understand two things:

·         Hair transplant results cannot match the excessive density
·         Hair transplant cannot provide the very low hairline as that of a hair replacement
·         They need to make some adjustment in the way a hair replacement is worn after the hair transplant

Nevertheless, most people seeking hair transplant are willing to compromise hair density and selecting the hair transplant only of the front and top of the scalp. They also accept the exposed, bald vertex for the freedom of having their natural hair. They must understand the limitations and advantages of hair transplantation after proper and thorough counseling by their physician.

There are some situations in which a patient wearing the hairpiece can consider undergoing hair transplant like:

1.       For individuals with advanced stages of hairtransplant (Norwood VII pattern): In those advanced persons of hair loss, wearing a hair replacement may be the best choice for that particular individual. The density of the hair in a well-constructed hair replacement does not match the hair loss from the sides (temporal regions). This unnatural pattern renders a look as if the individual is wearing a baseball cap. This is also called “lid effect’’. This can provide an excellent compliment in order to achieve a more natural appearance by transplanting hair in the temporal region to match the hairline of the hair system.

2.       Some individuals require a thick and dense natural hair restoration in the frontal hairline. The rest of the frontal scalp and the vertex is covered with a hairpiece.

Great advances have been made to increase the natural look of hairpieces today. Unlike the older hairpieces that were thick, synthetic, and poorly shaped which looked like “hairy rug”, today’s thin, laced front hair replacements are made of natural hair and almost undetectable. 

The reason modern hair replacements look less obvious is that the hairs are woven through a transparent mesh base that attaches to the scalp that can simulate natural hair emanating from the scalp. Another reason is that they contain significantly fewer hairs (closer to the natural hair density).

Dr Arika Sethi

Dr Pradeep Sethi

http://www.directhairtransplantation.com