Hair transplant Surgery – FUE Punch technique.

www.drvaibhavshah.net

+Dr Vaibhav Shah 

Hair transplant Surgery – FUE Punch technique.

3-Step Follicular Unit Extraction :

       A significant advance in Follicular Unit Extraction has been the addition of “blunt” dissection to the original technique of “sharp” dissection followed by extraction. This was described by Dr. Harris at the International Society of Hair Restoration Surgery (ISHRS) in 2004. In this three-step technique, a sharp punch is used to score the epidermis (cut just the upper part of the skin) and then a dull punch is used to bluntly dissect (separate) the follicular unit grafts from the surrounding deeper dermis. The third step is the same, namely removing the follicular graft from the scalp using fine forceps.

       The advantage of this hair transplant technique over the original two-step process is that using a dull punch minimizes follicle transection (damage). As the blunt-tipped punch is advanced into the dermis, the follicles, which naturally separate deeper in the skin, are “gathered together” within the opening of the instrument, rather than risk the lower portions of the follicles being cut off. Another significant advantage of the new technique is that it increases the number of patients who are able to benefit from FUE.

        A problem of the three-step technique, however, is a higher incidence of buried grafts. When a buried graft is identified, it can sometimes be extracted by applying pressure to the surrounding skin. If this manoeuvre fails, a small incision is made to enlarge the opening and facilitate the removal of the graft. If not removed, a buried graft can occasionally result in a small cyst that would need to be removed at a later date.

          Another problem is that during the extraction attempt the epidermis and upper dermis may separate from the rest of the follicle. This phenomenon has been called “capping.” When this occurs, the lower portion of the graft can sometimes be grabbed and extracted. When this is not possible, the lower potion is simply left behind. In this case the wound will heal and the lower portion of the follicle should produce a new hair.

Dr. Vaibhav Shah

www.vaibhavshahblog.blogspot.com.

Comparison of Operation Theater Lights. (Halogen & LED Light for Surgery).

www.drvaibhavshah.net

Dr Vaibhav Shah 

            A halogen light operates much like a standard incandescent bulb found in most homes.  At its core rests a tungsten filament in the center of halogen gas filled quartz encasement.  Once electricity is fed into this filament it becomes illuminated, exactly as its cousin, the incandescent bulb.  As more electricity is fed into it, the halogen bulb glows brighter, and the character of the light generated becomes whiter.  The whiter the light – the more clearly the human eye can see the illuminated surface.

        An LED (light emitting diode) is comprised of a single physical element called a semiconductor.  It can be housed in either a glass or a plastic translucent covering.  As electricity is fed through this semiconductor, microscopic subatomic electron particles begin to move in such a manner as to generate energy in the form of light.  And as with a halogen bulb, the more electricity it receives, the brighter – and whiter – the resulting light becomes.

Is One Medically Superior to the Other?

In a typical medical and surgical situation, physicians and clinical technicians are principally concerned with two elements of their light source: color variation and heat.

Color  Variation – Proper visibility for a surgeon or medical practitioner is critical to ensure proper diagnosis and treatment.  If the medical light creates a shift in color on the tissue it heightens the risk of improper diagnosis of a condition.  Lighting color temperature is measure in °Kelvin (°K).  Halogen lights naturally produce hot infrared light which manufacturers filtered out to produce a cooler, white light close to daylight, averaging 4000°K.  Daylight is measured at 5100°K.  LED medical lights have taken it to the next level by producing a significantly cooler & whiter light than its halogen counterpart, which is even closer to daylight at 4300°K.

Heat – since the heart of LEDs is a semiconductor, much less heat is generated in creating the energy that produces light.  They can be touched without fear of injury, and will not cause fires if they come into contact with combustible material.  Halogens, on the other hand, burn much hotter and brighter.  The bulbs actually generate heat to the surrounding area, and touching one is quite dangerous and could result in a burn. Perhaps most important is that working under a hot, halogen light makes the surgeon, medical staff and potentially the patient uncomfortable.  If your surgeon or medical staff is hot or uncomfortable working under a halogen light, could it affect the patient experience?

These features are leading many medical facilities to opt for LEDs in various situations.  However, there are other elements influencing these decisions:

Efficiency - LEDs require significantly less power to operate than halogen lights.

Reliability- LED lighting has a much higher bulb-life rate. Halogen light average about 1500-2000 hours whereas LED light range from 30,000 to 50,000 hours.

Energy usage – LEDs require significantly less energy than a halogen to produce the same or higher quality of illumination.

Design flexibility - LEDS can be easily configured for different requirements, making them extremely versatile for various mounting configurations.

Cost - LED bulbs are generally more expensive than halogens, but the energy efficient System Two LED consumes half the electricity of its halogen counterpart, and saves the medical facility thousands when compared to standard OR lights currently available.

In the final analysis, the decision as to which is the better choice rests on understanding these differences, how they impact specific clinical applications and the specific needs of the health care facilities.

Dr. Vaibhav Shah

www.vaibhavshahblog.blogspot.com

Hair Transplant Surgery & Loupe Magnification.

www.drvaibhavshah.net

Dr Vaibhav Shah 

Surgery & Loupe Magnification

            1.5x level of loupe magnification for most Hair transplant surgeons, and also for most first-time loupe wearers.  However, for certain specialties, an increase in magnification may be justified. Going beyond to a 3.0x or 3.3x will increase the level of magnification – but with a very significant reduction in the field of view.  With a 1.5x loupe will allow you to see the expanded view - so that you can also easily locate instruments on the periphery of your view, plus they will provide you with exceptional depth-of-field so that you can move closer and farther from the patient without losing focus.

Surgery & Loupe Magnification

         Another factor that goes hand-in-hand with the level of magnification is the working distance measurement.   Choosing the correct working distance will ensure that you can see the best, and at the posture.

How do I determine my working distance? 

       It varies by height and body type, but also how you sit and work with your patients.  The best method is to use a tape measure or similar measuring device.  While sitting in an ergonomic position in your normal workspace, measure the distance between your eyes and the patient.  This is your specific working distance.   Please note that at a 1.5x magnification that the optics will allow for 5-6” (125-150mm) depth-of-field, which means you will be able to move your head closer and farther from the patient – without a loss of focus.

Dr. Vaibhav Shah

Dr. Vaibhav Shah Clinic - 1001, Paras Business Center, Near Dahisar – Bandra western express highway, Near Sanjay Gandhi National park, Kasturba crossroad no.1, Near Asara colony, Near Chinchpada, Close enough to hear announcements from Borivali railway station, Borivali East, Mumbai- 400066, Maharashtra, Indiahttps://www.drvaibhavshahclinic.com/hair-transplant-mumbai.html

www.vaibhavshahblog.blogspot.com

Smoking & Hair Loss.

www.drvaibhavshah.net

Dr Vaibhav Shah

Smoking & Hair Loss.

     You are aware of the risks of smoking such as cancer, heart disease, chest complaints and strokes but it has now been shown to have an adverse affect on your hair. This may sound rather strange but smoking can affect the condition of your hair which may lead to Hair Loss. Research has found a link between cigarette smoking and Hair Loss which is worrying, especially if you are a man with a family history of baldness.

       One trigger for hair loss in men is that of hereditary: if the male members of your family went bald in their youth then there is a good chance that you will do the same. There are other causes of hair loss but male pattern baldness is especially common. If you are male and smoke 20 or more cigarettes a day then you are at greater risk of going bald. You may not be unduly bothered by this but many men are.

So how does smoking cause hair loss?

      Your hair grows from follicles – sac like structures underneath your scalp which require oxygen, vitamins/minerals and essential nutrients to function properly and trigger hair growth. Cigarette smoke contains thousands of chemicals, many of them toxic, which affect all areas of the body including the hair. This smoke negatively affects your circulation in general which means impaired blood flow to your hair follicles. This disrupts the normal hair growth/loss cycle which occurs on a daily basis and results in hair thinning and eventual loss. This evidence suggests that smoking directly impacts upon this blood supply. Other suggestions include the fact that smoking affects the immune system which opens the body up to all sorts of diseases and illnesses. And certain diseases damage the hair or cause hair loss.

        Another factor is ageing: hair loss is a sign of the ageing process and this can be accelerated by smoking. Smoking causes other signs of premature ageing such as increased lines and wrinkles and a pale, drawn appearance so why not add baldness to this list. Male pattern baldness is usually permanent but other types of hair loss are not and can be reversed. If the cause of the hair loss is treated then new hair will grow.

         But ,the best way of preventing hair loss is to stop smoking. If you are trying to give up or are looking to take that first step then visit our Stopping Smoking section. This is full of useful information to help you do so.

Dr. Vaibhav Shah

www.vaibhavshahblog.blogspot.com

--

Minoxidil & Hair Growth.

www.drvaibhavshah.net

Dr Vaibhav Shah

Minoxidil  & Hair Growth.

         How does it work?

      Minoxidil solution dilates small blood vessels. When applied to the affected areas of the scalp twice daily it has been shown to stimulate Hair Regrowth probably by enhancing cell proliferation. It is possible it also has an effect on the immune cells in the hair follicle. Increased hair growth is seen after approximately 4 months of treatment. Generally hair growth is thinner and finer than the original hair.

         What are the side effects of minoxidil solution/

     Local irritation may occur, most often resulting in irching or stinging. Contact allergy to minoxidil or propylene glycol (the main component of the solution) occurs rarely, and results in dermatitis. Unwanted hair growth might occur ( hypertrichosis), for example if the solution is dripped onto the forehead. Internal effects are not likely as there is minimal absorption into the system. However, hair growth in distant sites such as the arms, chest and lower back has occasionally been reported when the 5% solution has been used.

          Minoxidil is best avoided during pregnancy and breastfeeding (Pregnancy Category C, i.e., Drugs that, owing to their pharmacological effects, have caused or maybe suspected of causing harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible.)

Dr. Vaibhav Shah

www.vaibhavshahblog.blogspot.com

10 Signs You May Have an Autoimmune Disease.

www.drvaibhavshah.net

Dr Vaibhav Shah

10 Signs You May Have an Autoimmune Disease

     If you are experiencing any of these symptoms, especially a combination of several of them, you may have an autoimmune disease.

    1).Joint pain, muscle pain or weakness or a tremor

    2).Weight loss, insomnia, heat intolerance or rapid heartbeat

     3).Recurrent rashes or hives, sun-sensitivity, a butterfly-shaped rash across your nose and cheeks.

     4).Difficulty concentrating or focusing

     5).Feeling tired or fatigued, weight gain or cold intolerance

      6).Hair loss or white patches on your skin or inside your mouth

      7).Abdominal pain, blood or mucus in your stool, diarrhea or mouth ulcers

      8).Dry eyes, mouth or skin

      9).Numbness or tingling in the hands or feet

     10).Multiple miscarriages or blood clots

 Dr. Vaibhav Shah.

www.vaibhavshahblog.blogspot.com

Belotero, the Newest Injectable Filler

www.drvaibhavshah.net

Dr Vaibhav Shah

                                 Belotero, the Newest Injectable Filler

                Belotero is the newest FDA injectable filler available in the USA.  It has been used for years in Europe with excellent patient satisfaction and safety margin.  This filler is unique in several ways.  Most notably, it is made with a dual cross linking process that gives it some of its unique properties.  The biggest advantage with Belotero is that it can be injected very superficially for fine lines and wrinkles.  This is important as many other fillers are too thick (honey like) to be injected in the very superficial dermis and when this is done, it can leave a thickened line.  Belotero, on the other hand is engineered specifically for superficial injection.  I must say that when I began using it for fine lines and wrinkles it was hard to believe how superficial it could be injected.  Having said that, it can also be used like conventional fillers for deep wrinkles and lips.  I think the biggest innovation is that the company states that due to the Belotero’s particle properties, it does not cause a Tyndall effect when injecting in the tear trough region.  The Tyndall effect (in this case) is when a clear product is injected under the skin and produces a bluish hue due to the way the light is reflected.  Although harmless, it produces dusky skin that can make a patient look older, as in dark circles.  To avoid this, most fillers are injected deep on the bone in the tear trough region.  Belotero, however, due to its unique composition, can be injected much more superficially which gives the doctor more control of improving wrinkles and rejuvenating this region.  I have been using Belotero and so far have found it to live up to the claims of the company.  I will keep my blog updated on this topic. – Dr.Vaibhav Shah.

www.vaibhavshahblog.blogspot.com