We believe FUE hair transplant has major limitations if used alone as the main technique. Some of the problems which have been defined are, graft wastage, additive nature of scars, scar contraction. We are of the opinion that the FUT (Follicular Unit transplant or the Strip procedure) procedure is the best procedure particularly when mega-sessions are involved. Over the preceding 3 years we were very happy with our results, but we decided to modify certain steps in our constant endeavor to improve. The steps of the MMFT Hair Transplant procedure along with the modifications are as below-
1. Strip harvestation – beveled incisions on both ends of the strip to take the graft transection rate to nearly 0 %.
2. Incising the strip off the galea in a way to leave a layer of fat on top of the galea. This precise step means leaving minimal tissue on the grafts.
3. Slivering – slivering of the strip under magnification to ensure less than one Percent hair wastage.
4. Combination with FUE – harvesting of 300-400 grafts with FUE for the anterior hair line.
5. Preslits and the anterior hair line – micro zig-zagging of all the slits.
6. Graft preparation – ensure bare minimum fat at the level of the roots.
7. Graft placement – handling of the grafts with the hair end and not the root end. This allows easy preservation of the roots, since roots are not touched at any step of the process.
For a hair transplant procedure to be truly successful, it must fulfill two criteria at the same time, namely, density and coverage. One without the other is effectively meaningless. Invariably, in cases with extensive baldness, any of the two techniques – Follicular Unit Transplant (FUT) and Follicular Unit Extraction (FUE) – when used singularly prove to be insufficient on either one of the two or both the factors mentioned above. In such cases, the individual has to unwillingly stage their procedure over two or more sessions. Not only does this delay their result, but they have to go through the rigors of the procedure twice or thrice over. Also, individuals travelling from overseas find it much too inconvenient to go for a staged procedure because of the heavy travel costs involved, in addition to schedule disruptions amongst other things.
In light of these limitations faced by various individuals, Dr. Amit Gupta took it upon himself to find out if there was an alternative to staging the procedure. After almost a year-long study spread over approximately 1,000 hair transplant procedures – collating and assimilating the data as well as improvising and fine-tuning the different steps of the standard hair transplant procedure – Dr. Amit Gupta came up with the Micro-refined Micro-Follicular Transplant (MMFT) technique.
Rome wasn’t built in a day. Well, neither was MMFT. It took Dr. Amit Gupta almost a year to conduct the study, make the changes along the way and get a stamp of approval from a competent institution. Dr. Amit Gupta made a submission to the Plastic Surgery Society with his findings and suggestions which were vetted and approved, before being printed in the Annals of Plastic Surgery as the new standard of hair transplant, especially in the context of “mega-sessions”.
The MMFT technique borrows the best aspects of the two prevalent and predominantly used techniques, viz., FUT and FUE. With the usage of both the techniques, the idea is to eliminate, if possible, or certainly minimize the demerits associated with each individual technique.
The reliance for yield is placed on the FUT technique; whereas, with FUE, the attempt is to get as many finer grafts as possible, which are then placed in the anterior hair line. The finer nature of the grafts allows for maximal graft placement in a single line, thereby adding to the density of the individual’s hair distribution.
Moreover, this way, we reduce graft wastage, ensure higher graft survival, elicit higher number of grafts and in turn ensure better results as well as improved patient comfort.
Usually, in most individuals it may take up to 10 months for the full results (mature hair) to be visible. With a staged procedure, a full result then takes about two years’ time. With MMFT, they have the option of cutting this wait period in half and effectively go for maximum coverage in one go. We have successfully completed transplant procedures of up to 10,000 follicles with great success. Of course, the yield is directly dependent on the individual’s donor area health as well as the intrinsic qualities of hair.
Advantages of MMFT
1. Some of the advantages include:
2. Maximal coverage and denser anterior line.
3. Minimization of wastage (transection rate).
4. Elimination of staging the procedure.
5. Shorter turnaround time for a full result.
6. Greater comfort and shortened recovery.
7. Potential for future sessions not disturbed.
Finding an end to baldness through surgery
Among the plastic surgeries for men, hair restoration has become a trending technique. The reason that this technique has become so popular is because this method negates the disadvantages of the conventional use of punch grafts. The use of punch grafts resulted in an appearance analogous to corn in a field. Such impression invited the dissatisfaction of a considerable amount of people. Several efforts were made around the world with an objective of correcting these disadvantages. In 1986, Dr.Carlos Uebel of Grande do Sul (Brazil) succeeded in rectifying these disadvantages by the use of micro and mini graft ‘megasessions’. It is now considered a safe procedure which, allied to a natural hairline, is a much valued option for surgeons and patients. More the precision of the surgery, more the natural appearance achieved. The level of achievement that Dr. Gupta has attained in this context is quite noteworthy. These valued services are provided in various parts of the country. Phrases like ‘Hair transplant Delhi,’ hair transplant noida’, ‘hair cosmetic surgery Gurgaon’, ‘hair cosmetic surgery India’ have indeed become a catchphrase in the field of hair restoration surgery.
What exactly is ‘baldness’?
Baldness is the loss of hair from the head. In men, this condition can have its onset from a younger age (about 16 years). Conventionally, baldness is believed to be caused due three main factors: age, hereditary factors, and effect of androgenic hormone. Adding to these, changes in lifestyle have also contributed to this condition. Examples of such conditions are stress in the forms of smoking, late night jobs, long hours of work, irregular sleep cycles. These conditions have not only increased baldness in men, but also in women. Therefore, hair transplantation technique can also be beneficial to them. The rate of hair fall in women is more during menopause periods. Although this is the normal case, baldness arising from androgenetic factors and early-stage baldness are also seen.
An insight into Microfollicular Hair Transplant technique
The procedure begins with the removal of a portion of skin bearing the hair. It is usually taken from the back of the head. This area is resistant to the male hormones that cause baldness. Under magnification, the strip is then divided into single follicles. A microsurgical blade is used to make the slits. Using micro forceps, insertion of the follicular units is performed. Almost 6,000 units may be essential for a complete hair transplant. Both these processes are performed side-by-side. The entire process almost takes 4 to 6 hours to complete. It is preferable to have a second transplant after 6 to 8 months.
Hair growth and plant growth is analogous. It is required to have a suitable spacing between the grafts for having more vitality. In the frontal hairline, we insert only single hair irregularly. The sessions have to be repeated so as to have a greater density.
Local anesthesia is commonly administered for this procedure. Along with it, certain fast-acting agents are also mixed. These agents facilitate a comfortable surgery even if the patient is awake. Some agents also actively participate in the planning of the hair line. The success of the surgery performed by us is very precise such that the patients can themselves drive back to their homes.
Design of the Hairline
It is important to project the definitive frontal hairline, especially in young patients. The frontal hairline is projected in an irregular manner, maintaining the temporal recesses .A non-straight line is vital to have a more natural and non-detectable result. Usually, the forehead middle point is 8 cm distant from the root of the nose, varying from 7 to 9 cm depending on the facial structure.
It is normal to experience some hair fall during the initial weeks. After this period, the hair shall grow from hair root and can be seen visually by 3 months. This process continues as long as the normal hair grows at the rate of almost 1 cm a month. Some crusting will occur around the grafts. These must not be scratched as the grafts may be pulled out. These crusts will quickly dissolve once hair wetting is started. A slightly pink appearance is seen in the grafted region of the scalp. Discoloration shall fade away over a period of time. For having an appreciable hair growth, it takes about 9 to 10 month in women and 6 to 7 months in men.