Q. We’ve seen not many doctors actually do hair transplant in African descent males in fact just AK Clinics or may be one or two more in India and likewise rare in world. Is there a particular reason for this kind of pattern. What are the challenges in Hair Transplant procedure of African descent males or Females?

A. In fact it is really difficult and takes large amount of expertise to do transplant in case of African descent males. This pattern is owing to actually few people developing & getting exposure. We’ll share the main reasons & points in the same.

The following characteristics are useful to determine the outcome of the hair transplant surgery in the African patients:

Skull shape:

Africans have a mesocephalic skull of intermediate width and breadth (medium sized skull). This means that head is not particularly short or long from front to back (relative to its width from left to right); as result of which the surgeon has to give them a flat hairline.

Hair characteristics:

 Physical Structure: The African hairs have a curl as a result of which the chances of cutting the hair follicles are more during extraction and graft preparation.

Color: The results are usually good as there is hardly any contrast between the hair color and the skin.

Diameter: The diameter of the African hair is less as compared to other ethnic groups. This determines that the handling of the grafts is generally very carefully done.

Hair Density: The hair density is less as compared to others.

Challenges & Expertise Required

Hair Transplant in case of African descent males or Females requires quantum of expertise & skill. So there very few doctors who’ve reached this level of skill and ready to invest time to gain it because it sometimes in not economically viable. But at AK Clinics, it is always our endeavor to serve each and every ethnic race. So Dr Kapil Dua & Dr Aman Dua have travelled length & width of the globe to gain expertise in this area.

Problems during donor closure: Like keloid formation, hypertrophic scarring, hypopigmentation & hyperpigmentation are common.

Harvesting: Give more tumescence as it straightens intradermal curl of the hair. Use of tissue spreader as it will help reduce transection rates further.

Graft Preparation: More perifollicular tissue should be left on the sides of grafts to avoid transection during preparation of grafts.

Recipient Site : Flatter hairline; further placing of grafts is more difficult as the grafts have to be placed in the background of dark color.

Dissection: Slow, there is a curl as a result of which you have to be extra careful

Implantation: Fat is more, so implantation is difficult – need to trim grafts.

Which technique FUE or FUT is better for performing surgeries in African descent males or females?

FUT is better than FUE as the transection rate during extraction is very high. It is imperative to understand that since the roots are curled it is very difficult to presume an angle for extraction. So we generally do a FOX Test to determine the possibility of FUE & transection rate.  If the FOX test is negative, then only FUT is done.

Dissected Grafts & Sutured Line

Dissected Grafts & Sutured Line

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Conclusion: Hair Transplant in patients with African descent is tedious procedure and requires expertise to deliver results.


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