Alterations in Hair Follicle Morphology and Hair Shaft Production After Follicular Unit Transplantation

Establishment and Clinical Application of the Concept of Invalid Extraction Rates in Follicular Unit Extraction

Objective

This study aims to establish the concept of invalid extraction rates in follicular unit extraction and evaluate its clinical value.

Methods

The present study involved 30 patients with alopecia. Three young surgeons (nominated A, B, and C) each performed follicular unit extraction on a randomly selected portion of the donor site of each patient for ten minutes. The outcomes were separately recorded and calculated, and converted to an invalid extraction rate for each surgeon using the formula, “invalid extraction rate = 1 − successfully extracted follicular units/actually extracted units × 100%.”

Results

The follicular unit invalid extraction efficiency of each surgeon gradually declined. The average efficiency level of surgeon B was evaluated as excellent, while the levels of surgeons A and C were evaluated as good.

Conclusion

With experience, surgeons can speed up the process of follicular unit extraction and gradually increase performance quality through both extraction speed and success rate.

Histopathological Findings of Uncomplicated Hair Transplant for Male Androgenetic Alopecia: Can Lichen Planopilaris Features Be Present?

Introduction

Insufficient hair growth after hair transplant, as well as erythema and perifollicular scaling, may be diagnosed as lichen planopilaris and treated as such based on clinical and histopathological findings. The purpose of this study is to observe graft biopsies of patients after uncomplicated hair transplants and to discuss if histological findings are enough to diagnose lichen planopilaris.

Methods and Results

Eight patients diagnosed with androgenetic alopecia who were submitted to hair transplant were enrolled. In each of the participants, a scalp biopsy was performed in the receptor area and in the adjacent area. Biopsies were performed between 6 months and 1 year after surgery. Exams were analyzed by 3 pathologists. The t test was performed for paired observations, comparing the transplanted and the nontransplanted area for lymphocytic infiltrate and fibrosis. The significance level was considered as 5% (p < 0.05). Four of 8 participants had perifollicular lymphocytic infiltrate, from moderate to dense intensity in the recipient area. Fibrosis was seen in 6 patients. These findings were not seen in the control area.

Conclusions

It is questioned whether lymphocytic infiltrate and fibrosis may be expected in patients who are submitted to normal hair transplants.

A novel model for designing and performing parietal whorl hair transplantation

BACKGROUND

Hair transplantation is the gold standard method for the treatment of alopecia. Recently, demand for the surgery has increased rapidly. However, high demands also require more professional training for the surgeons. With the maturing of hairline design skills, parietal whorl design has become the next challenge and no appropriate training models have yet been reported.

AIMS

To present an innovative, simple, and appropriate training model for designing the scalp parietal whorl.

METHODS

Outward divergent arc curves were drawn from the navel of an orange. Recipient sites were created with 23G needles or 1.0-mm knives or 1.0-mm blades according to the outward divergent arc curves, then hair shafts were transplanted using forceps.

RESULTS

Different densities of hair shafts were transplanted. Transplantation of 10-20 follicular units (FU)/cm² was too sparse, 30 FU/cm² achieved a good appearance, but 40-50 FU/cm² was better. Through practicing on the model, excellent results of parietal whorl transplantation on patients can be achieved.

CONCLUSIONS

This new model can perfectly suit the lines and direction of the parietal whorl and also present different density transplantation practicing. We provide a training method for new surgeons as well as a rehearsal opportunity for previously trained doctors.

Isolation and structural identification of a novel minoxidil analogue in an illegal dietary supplement: triaminodil

A new minoxidil analogue was detected in an illegal dietary supplement advertised as a hair-growth treatment. The analogue was identified using ultra-performance liquid chromatography (UPLC), high-resolution mass spectrometry (LC-HR-MS) and nuclear magnetic resonance (NMR) spectroscopy. The compound was structurally elucidated as a minoxidil analogue in which the piperidinyl group of minoxidil was replaced with a pyrrolidinyl group corresponding to a molecular formula of C₈H₁₃N₅O. The new analogue has been named triaminodil. As this is the first report of the compound, there are no chemical, toxicology or pharmacological data available.