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.
Text of Note
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).-