Our reporter / Du Fu
This article first appeared in the total number 896 of China News Weekly.
The world's hair research authority, Yale University professor Kurt · Stein wrote in his book "Hair: A Interesting Human History": The growth of hair will convey a healthy, glamorous and sexually strong signal. Perhaps it is under such psychological cues that more and more young people in the country are “indebted” and are eager to join the army of hair transplants.
According to a survey by the China Association for Health Promotion and Education, the number of people with hair loss in China has exceeded 200 million. The result of the huge hair loss population is that in 2017, the national hair care industry's turnover has reached 9.2 billion yuan, doubled from the previous year. Subway cars, bus bodies, elevators inside and outside … … hairpin ads are pervasive. The slogan of “planting in the morning, going to work in the afternoon” is more tempting.
On a global scale, the upsurge in hair growth has already begun. Portugal's football superstar C Ronaldo launched a hair transplant shop in Madrid, Spain, in March this year for 25 million euros. As early as seven or eight years ago, his old friend Rooney spent hundreds of thousands of yuan to complete the planting of hair. According to the market research report, it is estimated that by 2023, the global hair transplant market will reach US$23.88 billion, and the compound annual growth rate will reach 24% in the next four years.
Hair transplanting, this old craft with nearly two hundred years of history, has become the darling of fashion and capital to chase.
Male afraid of old and female beauty
In the eyes of outsiders, Li Wei (pseudonym), who is young and young, has no worries about hair loss. But this university student in Nanjing always feels that his hair is soft and he feels that his hair does not look dense. For this reason, she has not tossed it. After trying to produce shampoo, her goal turned to more direct and effective hair transplant. When she came to Beijing for a trip, she remembered her own thoughts. When she went to the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences (commonly known as the Eighth Hospital), she also went to the hair transplant department next door for treatment. After that, she quickly made a decision: for the beauty, encrypt the hairline!
The principle of hair transplant is not complicated. For most people, the type of hair loss belongs to androgenetic alopecia, that is, because some hair follicles are more sensitive to androgen. The hair transplant is to make the posterior occipital hair follicles that are least sensitive to androgen "to support" the hair loss area, and the hair follicles of the occipital region can maintain the original characteristics after transplanting into the hair loss area. At the same time, the posterior occipital hair follicle is also a limited and non-renewable resource. Therefore, the hair transplant is actually a process of “removing the east wall to make up the western wall”.
At present, there are two kinds of hair transplanting techniques that are commonly used in the world: one is to cut a 1.5 cm wide scalp strip, and then separate the follicular unit on it for planting, referred to as FUT in English, commonly known as “cutting scalp strip” & rdquo; The species is a hollow drill with a diameter of about 1 mm, and the follicular unit is extracted in a point shape, which is referred to as FUE in English.
Known as the FUE point method, after the patient partially shaved, the hair transplant doctor used a hollow drill to extract the follicular unit from the posterior occipital portion and then planted it into the hair loss area. Figure / IC
Since the point-like extraction requires partial shaving, the method of cutting the scalp has a slightly higher survival rate, and Li Wei chose the latter. The hair follicle unit she was transplanting this time was about 700, which cost a total of more than 10,000 yuan. In the market, the transplant fee for each follicular unit is mostly 10~20 yuan. In general, 1000 to 2000 follicular units should be used in the hairline, and for severe hair loss, there will be 3,000 to 4,000 follicular units requiring “relocation”.
On the same day, Li Wei was the director of the Hair Transplantation Center of the Badachu Hospital, Jiang Wenjie. Since 2009, he has started to practice this field. After completing the preoperative blood test and designing the hair style program, Jiang Wenjie used a marker to draw a supply area of 7 cm long and 1 cm wide at the back of Li Wei's pillow. After local anesthesia, Jiang Wenjie used a scalpel to cut a scalp strip with a width of about 1 cm from the posterior occiput of the patient. The key point was to completely remove the hair follicle without damage. Next, the nurse cuts the scalp into small squares, separates the fat from each small square, divides it into individual follicular units, and places it on a square gauze soaked in the saline dish of the culture dish. There is an ice box. The entire separation is kept moist throughout the process to ensure the survival rate of the hair follicles.
While the hair follicles are separated, the plants are also deployed simultaneously. Jiang Wenjie wore a 1.8-fold magnifying glass, punched the implanted area of the patient's head with a needle about 1 mm in diameter, and the hair follicle was placed in the other hand with a pair of tweezers.
After the planting is completed, the newly implanted hair follicles have a period of one to three months of hair loss, and then normal growth will be effective after 6-8 months. Hair transplantation is an individual effort and a team battle. On the same day, the entire operation took nearly 5 hours. In Jiang Wenjie's impression, in the past five years, the number of people who came to plant hair has increased significantly. His department is often operated from early to late, up to five operations a day.
In the observation of Zhang Yu, president and CEO of Qihe Zhifa, the proportion of male and female hair transplants is now 7:3, among which women are mostly planted in art, namely eyebrows, hairline, and beauty tips. Previously, this ratio was 8:2, even 9:1. Despite the rising number of women, men are still the main force in hair transplants. Among them, “code farmer” has become the spokesperson of this industry.
In the "2018 Double 12 Medical Beauty Consumption Report" released by the Internet Medical Aesthetics Platform, the two major IT towns in Shenzhen and Beijing are developed areas of the hair industry. Internet jokes ridiculed that, "procedures 猿", a line up to 40,000 yuan, of which clothes, shoes and bags add up to less than 10,000 yuan, but planted one accounted for more than 30,000. In the IT industry, the annual salary of millions is not uncommon, but the work intensity of “996” (that is, from 9:00 am to 9:00 pm) is also the norm in the industry. The pressure on work has made “code farmers” become the main force of hair loss, and the high salary has enabled them to have the economic strength of hair transplant.
Zhao Junying, the chief physician of the Department of Dermatology, Beijing Friendship Hospital affiliated to Capital Medical University, and the vice president of the Medical Aesthetics Specialist Branch of the Beijing Medical Association, believe that beauty is the result of a combination of multiple factors, and the relationship between face and hair transplantation is quite large, “some people face They are all very good, but the hair is thin and the face is not beautiful. Some people are actually 30 years old, but without hair, they may look like 40 or 50. ”
The hairline silently exposes your age. When Yang Mi reveals a broad brain in the film and television drama, Chen Yuxi's hairline in the skydiving video is higher than the new realm, and then the two male gods of Shakessen and Wu Yanzu are formed by the hairline and then “there are cats on the head”; The hair style can attract fans' exclamations. Ai Rui Consulting previously released the "2018 China Hair Industry Research Report", which wrote: In today's popular Yan culture, "hair is less old" is the pain point of many users, hope to look younger after planting The most important appeal, this is prominent in men, and for women, the pursuit of beauty is the main motivation for choosing hair transplant.
Under such psychological motives, hair transplants are spreading to various occupational groups and showing a younger trend. In the observation of Song Shilei, an industry expert with 13 years of hair transplant experience, the proportion of college students' hair transplant can account for 30% of the young population. In the second half of 2017, the number of people aged 18 to 30 occupied half of the country.
Planting rivers and lakes
The history of hair transplant can be traced back to the hair transplant animal experiment conducted by German doctors in 1822. In 1959, the American dermatologist Norman Orentreich proposed the concept that the posterior occiput is the advantage zone for hair growth, and is known as the father of modern hair transplantation. In 1995, American surgeon William Rassman and colleagues established the FUT, the hair cutting technique of “cutting scalp”.
In October 1997, Wang Jiping, who studied hair transplant technology in Northern Europe, returned to China and established the first hair transplant center of the domestic public hospital system in the Badachu Hospital. In the previous month, Ji Xian, a former resident of neurosurgery at Beijing Tiantan Hospital and a returning medical doctor from the United States, established the first private hair transplant center in China. Since then, he has set up a new wave of famous hair transplants and opened many chain stores. . Since then, the hair transplant technology has been carried out in public and private hospitals in China.
But at first, because the cost of doing a hair transplant operation is tens of thousands of yuan, for the general public, they don't know what is hair transplant, and they can't afford it. The hair transplant is mainly for the niche and high-end people.
Around 2005, the three industry giants of Biliansheng, Kefayuan and Qihe were established one after another and began to promote the hair transplant to the mass market. Wang Jiping used “deep increase” to describe the development of the domestic hair transplant industry for more than a decade. However, the intention of the private sector is not triumphant from the beginning. Zhang Yu said that in the first two years of the opening of Qihe, the monthly flow of tens of thousands of dollars. In 2008, even if you can do 30 operations a month, even if you have a high sales volume, “there is no more than one million waters”.
The rapid development of the hair transplant industry is in 2013. At that time, Qihe made 30 million yuan of water, equivalent to more than 1,400 operations. Since then, the performance has doubled year after year. By 2018, the turnover will reach 950 million yuan. Today, the average number of operations per day can reach more than 100.
The nurse is separating the hair follicles. Photography / journalist Du Fu
Wang Jiping believes that the rapid development of private hair transplant institutions is not unrelated to marketing. Around 2008, the FUE technology proposed by Rassman in 2002 was gradually introduced into the country. Because there is no need to open the knife, the postoperative pain caused to the patients is less. It is praised by the merchants as “no trace surgery”, publicity, and alopecia Formed a strong attraction. On the other hand, for those who do not have a surgical basis, this technology is relatively easy to use, so it has become a magic weapon for private hair transplant institutions to expand rapidly.
Compared with the hotspots of private institutions, the development of hair transplants in public hospitals has been tepid. In 2008, Wang Jiping was specially recruited to the First Affiliated Hospital of the People's Liberation Army General Hospital as the head of the Hair Transplantation Center of the Burn and Plastic Surgery Department. The operation appointment is usually one or two months in advance, but only one or two can be done each day. Xie Xiang, a physician of plastic surgery at the Third Hospital of Peking University, has been doing hair transplant since 2010. In the current situation of a large increase in the demand for hair transplants, the number of operations per year is about 200, which is far from the private sector. ratio.
In this regard, Wang Jiping explained that on the one hand, hair transplants are only a small part of the public hospital departments and diagnosed diseases. In the medical field, the importance of hair transplant is not so strong, and more is a icing on the cake; Hair transplant surgery often requires a team and requires a lot of energy. Compared with other operations, the cost of hair transplant surgery is high, but the economic benefits are not high, which makes many hospitals do not want to spend a lot of manpower and financial resources. Even for hospitals that value hair transplantation, the amount of surgery that can be done is limited.
Zhang Yu said that in the current territory of the hair care industry, the national chain agency accounted for about 35% of the market share. The local hair transplant institutions in each province and city can occupy 30% of the market, and the plastic surgery institutions take 25%, leaving only about 10%. The share is only in public hospitals.
In the world, the ratio of FUT and FUE is half of the technology, but in domestic private hospitals, the proportion of FUE technology is as high as 90%, and even some institutions. FUT technology has long been abandoned. Under the over-promotion of advertising, in the department of Jiang Wenjie, the application ratio of FUE technology has to climb with the initiative of patients.
Jiang Wenjie said that in fact, both technologies have their own advantages and disadvantages. FUE does not leave a linear scar after the scalp strip, but it also has a bit of scars scattered in it, “No trace is relative, and traces are absolute”. At the same time, FUE is also more suitable for small-area hair-planting needs. Moreover, during the operation, the angle of hair growth is not completely consistent with the angle of the inner hair follicle. When the hair is taken, it can only be blindly taken, and the direction and depth are controlled. In bad cases, it is very likely that the hair follicles will be cut off, affecting the final survival rate and losing the donor hair. Many scholars, including Rassman, the inventor of this technology, believe that FUE can be used selectively in some cases, but it cannot replace the FUT-cut scalp technique as a means of routinely acquiring hair follicles.
What makes hair loss people feel puzzled is a variety of new technical terms and patents. Browse the websites of major hair transplant organizations, micro-needle technology, encryption technology, FUE1.0, FUE2.0 & hellip; … people can see dazzling. But in fact, since the development of hair-care technology, the methods of obtaining materials are nothing more than the above two types, and there are only differences in instruments such as jewels and needles.
“The market thinks that the smaller the drill fee, the more expensive it is. This is actually not very scientific. "Song Shilei said that the texture of each person's scalp and the length of each hair follicle unit are different." If you have used a small drill and have 4 hairs, you can only take two, and the next two ‘咔嚓 & rsquo; broken. "For planting, it is not the same as the density, the foreign research data shows that the hair transplant recommended planting density is 30 ~ 40 follicular units per square centimeter.
For the "Friends", the most concerned about is that they are not suitable for hair transplant, when to do hair transplant, whether there will be sequelae.
In the "Chinese androgenetic alopecia diagnosis and treatment guide" issued by the Hair Science Group of the Chinese Society of Dermatology and Sexual Diseases Branch, mild to moderate hair loss is recommended to be treated with drugs first. The hair is only used for moderate to severe hair loss, suitable for drugs. It is used in people who have not improved and severe hair loss after 1 year of treatment.
Moreover, if a large area of hair loss in the future, hair transplant does not make much sense. & ldquo;The posterior occipital hair follicles will be over-exploited, and the front hair will continue to fall. & quoquo; Xie Xiang, for example, hair like Gorbachev, hair transplant is not necessary. If you are in a rapid hair loss period, you should also take the medicine first, and then consider the hair transplant when the hair is relatively stable. Otherwise, the transplanted hair & squo; germination & rsquo;, but the native hair is still falling off on a large scale, will affect the appearance. The person in charge of the Hair Transplantation Center of Kyungbuk Hospital in South Korea, who was on the microblog, also publicly stated that young people with M-type hair loss will look like a little dragon if the hair loss only deals with the shedding of both sides. M-type hair loss is a common androgenetic alopecia, and its forehead hairline becomes M-type due to hair loss.
Another issue to consider is the limited resources. Jiang Wenjie analyzed that there are 12,000 follicular units in the posterior occipital region, of which the available amount is about 6,000. “It is not enough to take a limited amount to make a lot of hair loss. The East Wall was removed from the East Wall and the East Wall could not be demolished. & rdquo; Therefore, doctors have long-term considerations for hair transplant patients.
Xu Xia, dean of the Sino-German Hair Transplant and Plastic Surgery Hospital and vice president of the Association of Beauty and Plastic Surgeons of the Chinese Medical Doctor Association, met a patient in Shenyang. After the initial hair transplant failure, he made six repairs in succession, causing the rear resources to be short. There is no room for salvation. Every month, she receives more than 30 patients with low survival rates, planting & ldquo; weeds & rdquo;
In addition to aesthetics, safety is a top priority. According to Indian media reports, in March of this year, after a 12-hour hair transplant operation, a wealthy Indian businessman had difficulty breathing and was sent to the hospital urgently. The police said the cause of death was organ failure caused by an allergic reaction.
In Wang Jiping's view, hair transplant surgery generally takes a long time. Although it is less invasive and less risky than other operations, entering the operating room and moving a knife means risk. Moreover, although the human head and face are rich in blood circulation and are not susceptible to infection, cases of scalp infection and necrosis still exist throughout the operation. Therefore, to ensure a sterile environment and aseptic operation, preoperative examination, in addition to infectious diseases, abnormalities in coagulation, heart, blood pressure, blood sugar, etc. may also pose a danger.
To avoid all potential risks, professional hair transplants and medical staff are needed. However, at present, the hair transplanting of the hair transplanting agencies, the blind expansion of chain stores, and the serious shortage of professional hair transplanters are the biggest problems facing the industry. Some life salons and barbershops have even joined in, repeated use of equipment, rusting of scorpions, doctors “empty listings”, and the fact that nurses do surgery instead of doctors. Some non-plastic surgeons, even high school graduates, started training on the patient's head after a week of training, and some even performed surgery on the patient while referring to the FUE device instructions.
Low-cost marketing has also become commonplace with reduced labor costs. When the skill of the surgeon is unskilled, the customer is treated as a “test field” with low price; on the other hand, because the detection of the number of transplanted follicle units is not easy, the merchant will attract consumers at a low price, but in actual operation process In the middle, the quantity of the material and the amount of the transplant do not match the prior agreement, & ldquo;
Wang Jiping believes that for hair transplanting institutions, to have the qualification of hair transplant, doctors must also have the qualification of plastic surgeon or skin cosmetic surgeon before they can carry out hair transplantation. And to train a qualified hair transplant surgeon, at least for half a year from separation to planting all-round practice experience. Government departments should increase supervision and punishment, “If you punish one or two thousand, then you will earn back if you do two operations”. For the hair transplanting agency, it is necessary to establish an evaluation mechanism for the reputation and increase the illegal cost. In addition, for each patient, hair transplantation is not the end point, follow-up drug treatment, adjustment of life routine, etc. are still critical.
Cover image source: China News Photo Network China News Agency reporter Pan Xulin photo
Editor in charge: Liu Debin SN222