Das Feld der Haarwiederherstellung ist eine dynamische Spezialisierung, wobei fortgeschrittene Technologien Chirurgen ermöglichen, mehr ästhetisch ansprechendere Ergebnisse erzielen zu können.Haarverlust scheint die Menschheit seit Beginn der Geschichte beunruhigt zu haben, Beweise in einer Verschreibung für die Wiederherstellung der Haare, die 1500 v.Chr. enthalten war. Papyrus Ebers aus dem alten Ägypten.
Der Erfolg der modernen Haartransplantation hängt davon ab, ein Phänomen, das zuerst von Orentreich 1957 als Spender Dominanz beschrieben wurde. Mit diesem Phänomen, vom permanenten Haarhaltungsrand von den Patienten mit androgenetischer Alopezie (Spenderbereich) entnommen und auf den Nicht-Haarenthaltungsbereich der Kopfhaut (Empfängerbereich) übertragen. Weiterhin kann es in seinem neuen Bereich so lange in der Gegend wachsen, aus der sie entnommen wurden.
1804
Baromio Transplantationen auf behaarten Bereichen an Tieren
1822
J. Dieffenbach führt Autotransplantationen von Haaren in die Haut
1939
Okuda verwendet 2- 4 mm Punch Grafts zur Wiederherstellung von Alopezie
1943
Tamura implantiert einzelne Haartransplantate durch Injektion für die Wiederherstellung der Haut über dem Venushügel in der Frau.
1959
Nutzt Orentreich Haarerhaltungstransplantate für die Korrektur des männlichen Haarausfalles
1980’s
Limmer verwendet Mikroskope für die Erstellung von kleinen 1 bis 5 Haartransplantaten, die in Nadelschlitze eingefügt werden.
1992
Uebel führt die Exzision von einem linearen Spenderstreifens durch
1994
Unger schafft Einschränkungen des Entnahmebereichs durch die Abgrenzung des sicheren Spenderbereichs
1995
Woods entnimmt einzelne follikuläre Einheiten mit kleineren runden Stempeln (1 mm) mit einer akzeptablen Ästhetik und niedriger Transection Rate
1997
Bernstein und Rassman beschreiben ihre follikuläre Einheit Transplantationstechnik, den Begriff "follicular Unit" die zur Nomenklatur beitragen
2002
Rassman und Bernstein beschreiben FUE als Operationstechnik in der medizinischen Literatur
Das Haar variiert zwischen den verschiedenen ethnischen Gruppen und unter den einzelnen Individuen. Es hat zwei separate Strukturen: die Follikel in der Haut und den Haarschaft, die auf der Körperoberfläche sichtbar eingebettet ist. Darüber hinaus gibt es verschiedene Haartypen.
Die Mehrheit der Haare entstehen aus der Kopfhaut als Einzel 4 Haar Gruppierungen. Die Gruppierungen sind die sichtbaren oberflächlichen Teile die die follikulären Einheiten (FU) sind und in der Regel bestehen sie aus ein bis vier terminalen Haarfollikeln und einem Vellus Follikel.
Haarrichtung unterscheidet sich entsprechend der Teile der Kopfhaut, in dem sie wächst. Sowohl die Richtung als auch der Winkel der Einschnitte müssen daher zusammenpassen, um mit der Richtung der Haare in einem spezifischen Kopfhaut Bereich angepasst zu werden.
Der Haarfollikel ist ein dynamisches Organ, deren zyklische Aktivität die Regeneration und Wiederzusammensetzung von nicht permanenten Teilen des Haarfollikels während jedes Zyklus erforderlich ist.
Normalerweise entspricht der Betrag neuer Kopfhauthaarbildungen, die verloren werden, dadurch wird eine einheitliche Abdeckung beibehalten.
Der Zyklus der Haarfollikel durchläuft drei Hauptphasen: eine aktive Wachstumsphase (Anagen): eine Phase der Regression (Katagen) und eine ruhige (telogene) Phase. Vor Kurzem wurden zwei zusätzliche Phasen des follikulären Zyklus identifiziert: die Releasephase (Exogen) und Verzögerungszeit Phase (Kenogen). Darüber hinaus ist es die Art des Follikels und dessen physikalische Position, die die Länge jeder Follikelphase bestimmen.
Krankheiten die den Haarausfall verursachen, werden kategorisiert durch zwei wesentliche Faktoren: die Verbreitung oder die Lokalisierung des Haarausfalls und die Existenz eines unbeschädigten Follikels oder seiner Vernichtung und Ersatz mit einer Narbe.
Im Allgemeinen sind die Faktoren, die den Haarausfall beschleunigen, Entzündung, Genetik, Umwelt und Hormone.
Androgene haben paradoxerweise unterschiedlichen Auswirkungen auf die menschlichen Haarfollikel abhängig von ihrer Position auf dem Körper. Testosteron ist das große zirkulierenden Androgene bei Männern, wenn ein 5α-Reduktase-Enzym auf Dihydrotestosteron (DHT) gesenkt ist, bindet es an den Androgenrezeptor. Im Haarfollikel können 5a-Reduktase, Androgenrezeptoren (AR) und AR Ko-activatoren Androgenempfindlichkeiten regulieren. In der Glatzenbildung der Kopfhaut sind 5α-Reduktase und Androgenrezeptoren erhöht.
AGA, auch bekannt als MPHL, ist die häufigste Ursache für Haarausfall und wirkt sich auf bis zu 70% der Männer in der Mitte des erwachsenen Lebens. MPHL tritt in Anwesenheit von Androgenen in genetisch empfänglichen Individuen. Vor Kurzem wurde erhöhter Prostaglandin D2-Ebene in den Haarfollikeln als einer der Hauptursachen für MPHL vorgeschlagen.
Das Hauptmerkmal des MPHL ist follikuläre Miniaturisierung, wobei die Dauer der aktiven Wachstumsphase von 2 bis 6 Jahren auf wenige Monate reduziert, und die ruhige Phase relativ verlängert ist. Die Neue Generationen von Haaren werden kürzer, feiner, heller in der Farbe und in der Regel verbergen sie die Kopfhaut weniger. Der Übergang kann schrittweise oder mit einem Anschub kommen; jedoch ist der Verlauf und das Ausmaß der MPHL unvorhersehbar.
Bei männlichen beginnt das Muster in der Regel mit Bi-temporale Rezessionen, gefolgt von Vertex Kahlheit und Mittlerer-Frontaler Haarausfall, erlaubt die Beibehaltung der Haarfollikel in der hinteren okzipitalen Kopfhautregion. Das am häufigsten verwendete Systemgruppierung der MPHL ist die Hamilton Norwood Skala.
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