CiNii 図書 - Hair replacement surgery : textbook and atlas

many treatments have been suggested. The physi- The subject we deal with here is male baldness, often still termed androgenic or androgenetic baldness. cian or surgeon desirous of treating baldness must Very important research studies have shown that therefore be acquainted with and practice all these practically 980/0 of men who are losing or who have techniques. lost their hair have at some time or other taken steps Male baldness is in fact not a single entity, but to try to arrest this process. In other words, only consists of numerous types. Each calls for its specific those who are not affected by baldness are indiffer- treatment, and the aim of a good classification ent to it. And it is surprising how many preventive should be to take account of the greatest number of factors, or at least the more important ones, as sim- consultations are sought by people whose hair is normal, but who are simply afraid that the day may ply as possible. come when they will lose it. The surgeon's own experience will fill in any gaps, It is precisely because the ideal procedure, pre- in the knowledge that ultimately it is as important to ventive as well as curative, does not yet exist that so treat the scalp as what is beneath it: the brain. Anatomy Hair cells (melanocytes) derived from the neural crest.

Anatomy.- Hair.- Embryology.- Macroscopy.- Visual and Textural Characteristics.- Colour.- Shape.- Thickness.- Texture.- Greasiness.- Tonicity.- Laxity.- Mechanical Properties.- Resistance and Firmness.- Elasticity.- Quantitative Data.- Density.- Total Number of Hairs.- Implantation.- Interaction of All These Factors.- Optical Microscopy.- Shaft.- Root.- Electron Microscopy.- Structure of Cuticle.- Structure of Cortex.- Medulla.- Histological Changes in Male Baldness.- Chemical Composition.- Keratins.- Natural Colouration of Hair.- Action of External Agents.- Water.- Permanent Waving.- Sun.- Temperature.- Special Features of Hair.- Seborrhoea and Dandruff.- Scalp.- Microscopy.- Histological Section.- The Different Layers.- Implantation of Hair Follicles.- Scalp Vessels.- Glands.- Variations.- Macroscopy.- Topography.- Description.- Vascularisation.- Innervation.- References.- Biology and Physiology of Hair Growth.- Adults.- Growth of Hair: The Hair Cycle.- Anagenic Phase.- Catagenic Phase.- Telogenic Phase.- Androgenic Alopecia.- Mode of Action of Androgens on Target Cells.- Grafts on the Receptor Site and Hair Behaviour.- Foetuses and Infants.- Hair Cycles.- Hair Characteristics.- Adolescents.- Old Age.- References.- Male Baldness.- General Features.- Ratio of Bald to Hairy Areas.- Laxity of the Scalp.- Covering Power of the Hair.- Hair Density.- Variable Factors.- Classifications.- Morphological Classifications.- Hamilton's Classification.- Bouhanna's Classification.- Dynamic Classification of Dardour and Bouhanna.- Stage.- Density.- Laxity of the Scalp.- Other Factors.- Aspect of Hair.- Colour.- Thickness.- Rate of Growth in Each Region Considered.- Examples.- Comparison of the Classifications of Bouhanna, Hamilton and Dardour.- Temporal Course.- Juvenile Baldness.- Late-Onset Baldness.- Age-Related Changes.- Factors Determining the Course of Baldness.- Genetic Factors.- Age.- Androgens.- Other Causes of Alopecia.- Primary Alopecia in Women.- Acute Diffuse Alopecia.- Diffuse Chronic Alopecia.- Alopecia areata.- Traumatic Alopecia Without Skin Damage.- Congenital Alopecia.- Alopecia with Skin Damage.- Post-traumatic Alopecia.- After Burns or Irradiation (Radiodermatitis).- References.- Psychological Aspects.- Role of the Fur in Animals.- History and Symbolism of Hair in Different Ages and Countries.- Present-Day Psychology of Baldness.- Social Attitudes.- Cosmetic Effects.- Medical and Cosmetic Treatment.- From Antiquity to the Present Day (From Empiricism to Inefficacy).- Modern Treatments.- Seborrhoea and Dandruff.- Hair Loss.- Vitamin Therapy and Other General Treatments.- Lotions.- Minoxidil.- Hormonal Treatment in Women.- References.- Hair-Pieces.- Types of Hair Used.- Natural Hair.- Artificial Hair.- Bases for Implantation.- Wide-Meshed Net.- Close-Meshed Net.- "Microskin".- Mode of Fixation of the Hair-Piece.- Adhesives.- Weaving.- Microspots.- Grips.- Surgical Fixation.- Advantages of Hair-Pieces.- Disadvantages of the Procedure.- Surgical Techniques: History, Anaesthesia and General Principles.- History.- Pathogenic Interventions.- Vertical Reduction.- Grafts.- Scalp Flaps.- Expansion.- Anaesthesia.- Local Anaesthesia.- Esteriform Agents.- Amide Derivatives.- Remarks.- Prevention of Complications and Accidents with Local Anaesthetics.- Anaesthetic Equipment.- Infiltration Technique.- General Anaesthesia.- General Principles of Scalp Surgery.- Hair Bulbs.- Tension of Closure.- Closure in Two Layers.- Flaps and Grafts.- Direction of Implantation of Grafted Hair.- Scalp Incision.- Position of Scars.- Infiltration of the Scalp.- Stripping the Scalp.- Marginal Haemostasis.- Galeotomy.- Anagenic Defluvium.- Infection.- Postoperative Management.- References.- Autografts.- General Principles.- Definition.- Classification.- Harvesting Grafts.- Factors Influencing the Survival of a Graft.- Donor Area.- Measurements and Assessment.- Quality of Hair.- Hair Density.- Diameter of Hair Shafts.- Frizzy and Wavy Hair.- Hair Colour.- Camouflage of Donor Area.- Recipient Area.- Anterior Frontal Line.- Transplantation to the Vertex.- Complications Common to All Graft Types.- Complications Resolving Spontaneously.- Complications at the Anterior Frontal Line.- Description of the Technique.- Preparation of the Patient.- Local Anaesthesia.- Removal and Placement of Grafts.- Siting of the Grafts.- Angulation and Orientation of Grafts.- Dressing.- Postoperative Management.- Different Types of Graft.- Cylindrical Grafts.- Instrumentation.- Techniques of Graft Removal.- Preparation and Cleaning of Grafts.- Suture of the Donor Area.- Forage of the Recipient Site.- Distribution of Grafts.- Complications of Cylindrical Grafts.- Correction of Complications and Poor Results.- Minigrafts and Micrografts.- Principle.- Aims.- Technique.- Technical Features in Women.- Complications.- Conclusion.- Fusiform Grafts.- Aim.- Technique.- Complications.- Conclusion.- Immediate Long-Haired Autografts of Bouhanna.- Technique.- Preparation of the Receptor Region.- Pre- and Postoperative Management.- Course.- Conclusion.- References.- Flaps.- General Principles of Flaps and Application to the Scalp.- Definition.- Classification.- Special Features and Application to Scalp Flaps.- Limitations.- Advantages.- Different Methods of Assessing Vascular Adequacy.- Autonomised (Delayed) Flaps.- Definition.- Mechanisms.- Factors Influencing the Vitality of a Flap.- Local Factors.- Technical Factors.- Direction of Hair Growth.- Description of Technique.- Preparation of Patient.- Anaesthesia.- Incision.- Dressing.- Different Types of Flaps.- Inferior Pedicle Flaps.- Advantages.- Disadvantages.- Superior Pre- and Post-auricular Flaps.- Advantages.- Disadvantages.- Other Types of Flaps.- Inferior Pedicle Flaps.- Transverse Flaps with an Inferior Pedicle.- Temporo-parieto-occipital Flap (Juri).- Two Other Flaps of Juri.- Superior Pedicle Flaps for Frontal Cover.- Passot Flap.- Pre-auricular Flap of Nataf.- Retro-auricular Flap.- Long Retro-auricular Flap of Nataf and Bouhanna.- Pre- and Retro-auricular Flaps of Dardour.- Vertical Mini-flaps of Dardour.- Vertical Flaps of Bouhanna.- Statistical Study of Two Types of Superior Pedicle Flaps (Dardour).- Statistical Study of Four Types of Superior Pedicle Flaps (Bouhanna).- References.- Reduction Procedures.- General Considerations.- Description of Technique.- Preparation of Patient.- Local Anaesthesia.- Incision.- Resection.- Drainage.- Dressing.- Classical Reduction Procedures.- Sagittal Fusiform Reductions.- Median Sagittal Fusiform Reduction.- Lateral Sagittal or Paramedian Reduction.- Transverse Fusiform Reductions.- Mixed Fusiform Reductions.- Giant Reduction Procedures.- Techniques Originally Described by Marzola and Brandy.- Dardour's Techniques for Lifting the Scalp.- Complications.- Haematoma.- Necrosis.- Alopecia.- Ugly Scars of Several Possible Causes.- Infection.- Dehiscence of the Scars.- Conclusion.- References.- Accessory Techniques.- Pathogenic Procedures.- Expansion.- Principles of Technique.- Description of Technique.- Choice of Prosthesis and Planning of Expansion.- Initial Procedure.- Second Procedure.- Advantages.- Disadvantages and Complications.- Disadvantages.- Complications.- Indications.- Reconstructive Surgery.- Cosmetic Surgery.- Conclusions.- Synthetic Hair.- Different Types of Synthetic Hair.- Experimental Study of Nido Synthetic Hair.- Monitoring of Toxicity.- Histological Study.- Macrophotographic Study.- Discussion.- Conclusion.- References.- Operative Indications.- Limits of Operable Baldness and Variant Factors.- When Does Baldness Become Inoperable?.- Favourable Factors.- Unfavourable Factors.- Position of the Fronto-temporal Line.- Operative Indications.- When to Operate: Assessment of the Progress of Baldness.- What to Do.- Ligation.- Artificial Hair.- Grafts.- Reduction Procedures.- Flaps.- Skin Expansion.- Indications Related to the Clinical Stage of Baldness and to the Surgeon.- Indications (Bouhanna).- Minor Baldness (Stage I).- Moderate Baldness (Stage II).- Severe Baldness (Stage III).- Conclusion.- Indications (Dardour).- Severe Baldness (Stage 3).- Frontal Baldness.- Posterior Baldness.- Conclusion.- Variation in Operative Indications Related to Certain Factors.- Age.- Heavy Smokers.- Scalp Elasticity.- Hair Colour.- Crinkly Hair.- Thinned Crown.- Variation in Indications Related to Patient and Surgeon.- Variation Related to the Patient.- Variation Related to the Surgeon.- Special Cases.- Frontal Lifting in Bald Men.- Description of Technique.- Lifting for Frontal Thinning in Men.- Correction of Grafted Fronto-temporal Recession by Frontal Lifting.- Flap-Grafts and Graft-Flaps.- Alopecia in Women.- Treatment of Temporal Alopecia Secondary to Lifting.- Conclusion.- References.- Conclusion.

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Hair replacement surgery : textbook and atlas

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