모발 복원 분야는 첨단 기술로 인하여 외과의들이 미적으로 보다 만족스러운 결과를 얻을 수 있는 역동적인 전문 분야입니다. B.C 1500년 고대 이집트의 이버스 파피루스(Evers Papyrus)의 모발 복원 처방에서 보았듯이, 탈모는 인류를 괴롭힌 것으로 보입니다.
현대의 모발 이식의 성공은 1957년 오렌트라이히에 의해 우성 기증 부위로 묘사된 현상에 달려 있습니다. 이러한 현상과 함께 안드로겐 탈모증(기증 부위) 환자들의 기존 모발 영역에서 적출하여 두피(수증 부위)의 탈모 부위로 이식된 모발은, 적출한 부위에서처럼 오랫동안 새로운 부위에서 계속 자랍니다.
1804
Baromio는 동물의 모 부위를 이식합니다.
1822
J. Dieffenbach가 모발을 피부 속으로 자동 이식합니다.
1939
Okuda는 탈모 회복을 위해 2-4mm 펀치를 사용합니다.
1943
Tamura는 여성의 치골 부위 피부를 회복시키기 위해 주사를 통해 단발 이식을 수행합니다.
1980’s
Limmer는 바늘 구멍에 삽입된 1-5개의 작은 모발 이식을 위해 현미경을 사용합니다.
1992
Uebel은 선형 기증 부위 판막 적출을 수행합니다.
1994
Limmer 단일 판막은 오늘날 FUT 또는 판막 절차로 알려진 개별 모낭 조직의 입체적 절개를 이용하여 적출합니다.
1995
Woods는 만족스러운 미적 외관 및 낮은 절개 비율의 더 작은 원형 펀치(1 mm)를 사용하여 단일 모낭 조직을 적출합니다.
1997
Bernstein과 Rassman은 "모낭 조직"이라는 용어를 사용하여 모낭 조직 이식 기술을 설명합니다.
2002
Rassman과 Bernstein은 의학 문헌에서 FUE를 외과적 기술로 묘사합니다.
모발은 인종과 개개인들 마다 다양합니다. 그것은 두 개의 분리된 구조를 가지고 있는데, 피부의 모낭과 피부 표면에서 보이는 모발 줄기입니다. 모발 형태는 다양합니다.
대부분의 모발 줄기는 하나에서 4개의 모발 그룹으로 두피에서 나타납니다. 그룹화는 모낭 조직(FU)의 겉으로 드러난 가시적 부분입니다. FU는 일반적으로 1개에서 4개의 말단 모낭과 1개의 솜털 모낭으로 구성되어 있습니다.
모발 방향은 두피 부분에 따라 다릅니다. 따라서 절개 방향과 각도는 모두 두피에 따라 서로 다릅니다.
모낭은 역동적인 기관입니다. 주기적 활동은 각 주기 동안 모낭의 재생과 비영구적인 부분의 새로운 조합을 요구합니다.
평균적으로 새로운 두피 모발 형성의 양은 탈피된 양과 일치하여 일정한 외피를 유지합니다.
모낭 주기의 세 가지 주요 단계는 능동적 성장(성장기), 퇴화(퇴행기), 정지(휴지기)입니다. 각 단계의 시간은 부분적으로 모낭의 유형과 그 위치에 따라 달라집니다. 최근에는 모발 주기의 다른 두 단계인 방출(외생)와 지체 시간(휴지기)이 설명되고 있습니다.
탈모를 유발하는 질병은 탈모의 확산 여부나 국소화 여부, 모낭이 그대로 남아 있는지, 아니면 파괴되어 흉터로 대체되는지에 따라 분류됩니다. 잠재적인 유발 요인은 염증, 유전학, 환경, 호르몬에 기인합니다.
탈모는 모낭 밀도, 모낭 크기, 모발 성장 주기 지속과 관련된 세 가지 필수적인 메커니즘을 가지고 있습니다.
안드로겐은 신체 부위에 따라 인간의 모낭에 상반된 영향을 미칩니다. 테스토스테론은 남성들의 주요 순환 호르몬입니다. 테스토스테론은 5α 환원 효소에 의해 디하이드로테스토스테론(DHT)으로 감소됩니다. DHT는 안드로겐 수용체에 결합됩니다. 탈모 두피에서는 5α 환원효소가 증가하여 DHT의 생산량이 증가합니다.
AGA는 탈모의 가장 흔한 원인입니다. 그것은 중년 성인 남자의 70%까지 영향을 미칩니다. MPHL은 유전적으로 취약한 개인의 안드로겐으로 인하여 발생합니다. 최근 모낭 내 프로스타글란딘 D2 수치가 증가한 것이 AGA의 주요 원인 중 하나로 제시되고 있습니다.
MPHL의 주요 특징은 모낭 소형화입니다. 능동적 성장 단계의 지속 기간은 2-6년에서 몇 달로 감소하는 반면, 휴지기 단계는 상대적으로 길어집니다. 새로운 세대의 모발들은 점점 더 짧아지고, 더 가늘어지고, 더 가벼워지고, 두피를 덜 덮습니다. 변화는 점진적일 수도 있고 파상적으로 올 수도 있으며, MPHL의 경로와 범위는 예측할 수 없습니다.
남성의 유형은 일반적으로 양쪽 관자놀이의 탈모로 시작하여 정수리 대머리와 전두엽 중간 탈모 등이 뒤따릅니다. 즉, 말단 모낭을 후두부 부위에 유지하도록 합니다. Hamilton–Norwood 척도는 MPHL의 많고 적음을 나타내기 위해 가장 많이 사용되는 시스템입니다.
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