Laser Hair Transplant

There has been a recent resurgence of interest in "laser hair transplantation" which parallel the increased use of lasers for a wide variety of cosmetic surgery. Lasers generate great enthusiasm on the part of physician and patient at a time, but it has sometimes exceeded the actual value of the laser as a surgical tool. An obvious example is the use of CO2 laser as a non-selective destruction of the procedures to remove tattoos which left scarring and cosmetic deformity worse than the tattoo itself. This was subsequently replaced by pulsed lasers with specific pigment absorption (such as Nd: YAG, Ruby and Alexandrite lasers) operating on the principle of selective photothermolysis that truly offers benefit in the treatment of these lesions. Super-and ultra-pulsed CO2 lasers are now used to replace "cold steel" in the production sites for hair transplant. However, before we rush to use lasers in hair restoration surgery, it must first apply logic and reason of this request, then proceed cautiously with carefully controlled studies so that our patients will benefit from its use. The following discussion addresses various aspects of laser technology being in the specific context of latest advances in hair transplant techniques. The aim will be to challenge the theoretical basis of using existing lasers, to question dubious claims about their benefits, and propose areas for future research laser.

WHAT transplants laser hair?

First, it is important to clarify what is meant by "laser hair transplantation." The current role of lasers is to only create holes or slots (recipient sites) for grafts to be inserted. To consider a transplant of this laser is to ignore the myriad other factors that help make the process successful. Until lasers are involved in other major components of the graft, such as harvesting, dissection of the graft, or putting the "laser hair transplantation" should be replaced by an expression such as "Laser Site Creation" to better reflect its current role in the proceedings.


A painless procedure?

The assertion that the transplant is a laser painless process is misleading. Lasers are currently used "high - or super -" pulsed CO2 lasers. Unlike lasers, which operate by selective photothermolysis, these lasers create a hole by simple vaporization of tissue. Because the pulse (time the beam is at a given time) of these new lasers is extremely short, there is no transfer of heat more or injury "tissues." However, the tissue that the laser works on is non-selective destroyed. For this reason, the laser is extremely painful if the local anesthetic is administered to numb the area completely before use. Thus, it is not the laser is painless. The pain-free environment is established by the preoperative anesthesia used in all transplant procedures.


Surgery without blood transfusion

The next request, that the laser procedure is relatively bloodless, minimizes the most important physiological factor determining the success of transplantation, namely oxygenation. The process of hair transplantation should be to maximize blood flow to hair follicles implanted, rather than reducing it, and any manipulation that compromises proper oxygenation will potentially compromise graft survival. Preliminary results suggest that when sites are compared with laser sites achieved with conventional surgery, "a few patients showed a lower yield in some hair transplants laser [1]." Unger recalled that at sizes Conventional slit laser, "we are close to an unacceptable width of thermal damage." The experience is similar to Khan, and he expressed particular concerns of growth decreased as the distance between sites laser is 1 mm or.