Enhance Clinic

Hello!

I am Dr. Ashutosh Misra. In today's special education series we will be talking about female pattern of baldness and the role of female hair transplant. Now female pattern of baldness, unlike the male, is more of a diffused pattern or it may be as a broad forehead or in the temple area diffused thinness. The assessment of female pattern baldness is very necessary. It's essential before taking any treatment whether it is because of any medical condition of hormones. Some test has to be done. And if it is because of medical condition then we can treat it with medical therapies. Now if a female complains of a broad forehead and wants aesthetically narrow forehead according to her face, Yes- we need a hair transplant. For hairline, lowering of the headline, increasing the density of the temple area and hair transplant is also required if there is a diffuse pattern but the posterior donor area is good.

Now preferred technique for hair transplant it can be either FUT or FUE. When we require the large number of follicles FUT is the preferred technique because we need not shave the hair, nothing is required, no after transplant signs of the donor area. Yes, if you require less number of grafts we can go over FUE but my preferred technique for female hair Restoration is an FUE technique. Results of hairline Restoration in female or lowering of hairline in the female is very satisfying and permanent. For diffused hair thinning what we recommend is, what we do is we do a strong hairline and at the level of partition we make it more strong so that it gets a very good camouflage. For diffused hair thinning we also recommend to continue medical therapy such as the use of Minoxidil and PRP or mesotherapy for maintenance and the results continue to be good. I'll be sharing some pre and post operating pics of the female hairline and diffused hair thinning so that they can assess how satisfactory the results are. Patient selection is very important. Not all female pattern of baldness do benefit from hair transplant. So consult your doctor properly. Find out whether you are really a good candidate for hair transplant. So that your result expectations are good.

Thank you.

Hi,

I am Dr. Ashutosh Misra, Cosmetic/Plastic Surgeon and today I will be talking about FAQs of hair transplant. Myths and confusion behind the same. The basic concept is we take hair from the back of the head put in the front or wherever required and the hair grows. Now people are confused about which technique to go for. There are 2 basics techniques of hair transplant: FUE and FUT. In FUT, also known as strip method. What we do is from the permanent zone, take a strip which can be around 1.5-2 cms. The length depends upon the number of follicles we need to take from the back. Under the microscope, it is divided into grafts and follicles and then it is put back as individual hair. You get a smiley scar at the back. The other technique is FUE. In this, we extract one by one. We take one group of hair or graft, leave 2-3 behind and then take one. So basically, we are playing with the density of the back. Now which technique to choose in between. So, both techniques are wonderful and have wonderful results. It all depends upon how much grafts do we need.

Now the basic thing we want to know is, the permanent zone at the back varies in person to person. It depends upon family history, age and lot of factors. So, if we need a lesser number of hair for any grade of baldness like grade 3 or 4 baldness, you can choose any of the technique. And if you have a good donor area, not a very positive family history, FUE is a very good technique for you. FUE scars are less visible even if you go for 0 or 1 trim. But if you have a larger area of baldness say grade 6 or 7 then your permanent zone is bit narrow, going only for FUE technique will not give that much of sufficient graft to cover that whole area. In that case, to go for FUT which is better. for a large area of baldness. In a few cases, if we see that patient might need future hair transplant then also I would suggest going for FUT and later on, you can go for FUE. 2nd thing a patient asks, how many grafts are required for this particular baldness. So, what I say that it is not about what is your requirement or what about we can procure. So, it is 3k-4k grafts that we can get from the donor area with any of the techniques you use.

So, if you have grade 3 baldness or grade 4 baldness, these grafts are good enough to give you good density. It may never be a natural density but yes good density. We get the same number of grafts. Even you have grade 6 baldness. Now it is up to your surgeon how he designs your hairstyle to cover your baldness. It is always about the procurement and design. How well it is designed. So, that even with less number of hair it can look full and more volume. Now the 3rd most common question asked is whether I will get the natural density after hair transplant. So, practically we are working on the large area of the head from the smaller area. It is very difficult to get the normal density in a single transplant. Yes, in multiple transplants in a small area, we can achieve near natural density but normally if it is more than a grade 3 baldness, it is very difficult to achieve your normal desired result in a single transplant. Again a frequently asked question who can perform a hair transplant surgery. So, a plastic surgeon is qualified to perform hair transplant surgery. And so we suggest choosing your surgeon very wisely. Look at the qualification, experience and how many cases he has done. If you choose your surgeon wisely then you won't regret your results.

Thank You.

Hi! I am Dr. Ashutosh Misra from Enhance Clinic.

Today I will be talking about breast augmentation. Breast aug is commonly known as a boob job or augmentation mammoplasty. Most common ways of doing breast augmentation are either by silicone gel implants or with the help of fat grafting.

So, let's first talk about silicone gel implants. Now with silicone gel implants, implants are made up of silicone and most commonly filled with a memory gel. Most of the time patients who require breast augmentation are those who have lost their breast volume after pregnancy or lactation , and who have less projection and they want more projected breast. The patient should be otherwise healthy and willing for knowing the pros and cons of procedures. Now coming on to silicone gel implants, this is a very safe method for augmentation. Nowadays there are 5th generation implants. Normally, what we say is the life of an implant is around 10-12 years, though you can continue till lifelong.

The risk of rupture of the implant is less than 3%. And it is very well adapted. A treating surgeon discusses with the patient about the variety of implant which is available, types of implants which are available. He takes the marking and the measurements than discuss with the patient, the pocket in which the implant has to be placed. Either it has to be placed below the breast or below the muscle depending upon the breast tissue from where to put an implant, the most common is either from below the breast or from the nipple area. It depends upon person to person and the type of breast and the type of implant. So, the best is to discuss with your surgeon about everything, the size of implants, the most natural look of implants.

The surgery is day care surgery. The surgery itself takes around 2 hours. And the patient can be discharged on the same evening or can stay overnight in the hospital and can go early in the morning. Post surgery there are certain breast exercises which have to be done to make an implant breast sink and more supple. Best results come in one and a half and two months. Now coming on to the breast augmentation with the help of fat grafting. This means we take fat from the same person but from another part of the body, say abdomen or thigh and we put it into the breast. This is a very natural way of giving best augmentation but it may need multiple sittings because the limited amount of fat can be transferred.

So, if we require a small augmentation, this is a good technique but if we require large augmentation then implants are better. If we require augmentation which also needs certain amount of lift than breast augmentation with the help of silicone gel implants is better. Sometimes, we might have to combine the procedure, breast augmentation and breast lift together to give you the best results. The advantages of breast augmentation is that the excess fat can be trimmed and imported to the breast. Results are longer lasting and very natural. And patients are happy about it. Finally, choose your surgeon wisely, discuss everything about breast augmentation, which method suits you best, either implant of fat grafting which is best for you. Talk to him about the risks involved. And any myth which goes on with breast augmentation, that should be discussed with the surgeon prior to going for breast augmentation surgery. Everyone should have very realistic expectation about the results of breast augmentation.

Hi,

I am Dr Ashutosh Misra enhance clinics.

Today we will be talking about liposuction and clearing the myths about liposuction. Liposuction is a wonderful and a very safe procedure to get rid of your unwanted body fat. The most important thing to understand is who are the candidates for liposuction again liposuction is to get rid of unwanted fat, person maybe of their normal body mass index but may have some unwanted body fats say in face, arms, tummy or thighs. Now this unwanted fat is because of the high concentration of fat cells which are there in that particular area and this is something which is genetically determined and you cannot get rid of it through just exercise and diet. So liposuction helps to get rid of that excess fat in those particular areas, so we call it as liposuction as a body contouring surgery not as a weight reduction surgery, having said that liposuction also helps in weight reduction and that is the second part of the liposuction when you have a body mass index which is more than normal and you are suffering from obesity not to that extent but yes unwanted fat in the abdomen and all. For this, we do liposuction to decrease a large volume of fats say more than around 4-5 litres which we called as large volume liposuction and that helps to decrease the weight as well. So just removing the fat does not actually decrease your weight but post liposuction doing a good amount of exercise that we tell our patients and a diet program help you to decrease the weight over a period of say 3 months. Post liposuction, we have to wear certain special garments and for around 3 months because the best results comes around 3 months time and you have to talk to your doctor about it how to wear it and what are the things you have to take precaution. It is a very safe procedure but if done by an expert, so you have to choose your doctor well, that's the most important thing and you should have realistic expectation what a liposuction can do. Some people think fat comes out and the skin becomes loose, no liposuction is a wonderful procedure about that it also causes skin contraction, so the technique of the liposuction is very important as if how much skin has to go and what we actually need about it. If we feel there is an extra skin which cannot go even by liposuction then the procedure becomes either a mini tuck or a complete tummy tuck to get rid of your extra skin. It's a day care procedure come in the morning and go back home in the evening or if you want to stay if it is a larger procedure say more than 4 litres, you stay overnight in the hospital and then go back home the very next morning. The pressure garments are from the start of the surgery and for first one month almost most of the time of the day, after one month it is around 12 hours when you are in your daily exercise and normal routine you can take off your pressure garments after around in the night time when you are taking rest. The other myths about liposuction is people think that fat comes back, no, the number of fat cells in the body are constant after a certain, age at a very young age, it's only the size of fat that can increase or decrease, if it become obese or normal. So when we are taking out the number of fat cells, the numbers of fat cells do not increase in body. It may only increase in their size or decrease in the size and that can be control with the help of diet. So once you get a good body shape once you get a good body shape than that shape won't be distorted but if you become obese gain weight later on the shape will remain the same but it will be you become more wide or more narrow. So, that is what a liposuction does.

Thank you.