What is hair transplantation?
In the broadest sense, hair transplantation comprises the epidermal extraction of hair follicles genetically resistant to balding from that zone of the posterior scalp between the ears, and the dermal transplantation of these follicles on the anterior scalp where hair is expected to grow.
How long has hair transplantation been performed?
We, the plastic surgeons, have been performing hair restoration surgery and hair transplantation procedures with an experience gained in more than thirty years.
Who bears the required qualifications for FUE hair transplantation?
Hair transplantation should be performed by Aesthetics and Plastic Surgery specialists and Dermatologists.
Nowadays, it is more and more heard that in some clinics, nurses or those allied health personnel who perform tasks similar to those of nurses undertake the job of a physician and perform the operations. The titles such as hair transplantation specialist, fast tissue harvesting technician or fast tissue harvesting nurse are nothing more than fabricated titles for this purpose.
A direct intervention on the patient by a nurse or allied health personnel is both unfavorable to health and illegal. No hair transplantation nurse, healthcare technician or cosmetician is allowed to perform hair transplantation. It should be noted that the damage caused by such malpractices is irreparable.
Why should hair transplantation be performed by a plastic surgeon?
In the simplest sense, the main function of hair follicles is to produce hair. This is the most visible benefit we are interested in. A hairy head is a highly significant cosmetic unit in presenting us to others.
The first remedy we resort to upon hair loss is trying to trigger the hair follicles to produce hair again through medical treatments, or having hair transplantation. And what we need for this procedure is the professional help of a specialist physician.
Why should hair transplantation be performed by a plastic surgeon?
The answers of this question may be listed under various headings.
Specialization on hair transplantation
Combining science and aesthetics in hair transplantation
Although hair loss seems primarily to be a cosmetic problem, the mechanisms of growing and shedding of hair and hair transplantation involve the whole body. And as a part of the medical training they take, a physician learns to approach the human body as a whole and uses this approach with the patients in their daily lives.
If we are to adopt a holistic approach to the growing and shedding of hair or hair transplantation, the best question to be asked is: “What is hair?” In a cosmetic point of view, the hair is a stylized means used for attaining a better look. On the other hand, according to a holistic approach, while the hair is significant in terms of aesthetics, and it has a biological significance as well. Our hair consists of structures which cover the outer surface of our body, fulfilling numerous biological functions.
Why do we have hair?
The oldest belief is that the only function of hair in the human body is preventing heat loss. However, especially thanks to the improvements in molecular biology procedures, the knowledge we today have on human body demonstrates that hair follicles have significant roles in a great deal of dermal mechanisms. Hair follicles act as an important source of stem cells which enable wound healing in addition to the growing of hair.
The hair follicles are under the control of androgenic hormones, thyroid gland and your nutritional status. Any disorder in these systems may show up as hair loss.
A physician has the training to maintain a holistic approach to growing and shedding of hair, and hair transplantation. Before a hair transplantation procedure, the physician takes a holistic approach towards their patient and finds out if the patient has an underlying health problem. The exact cause of hair loss must be uncovered before hair transplantation.
The person to perform hair restoration should be a physician who can take a holistic approach towards a patient; a plastic surgeon who is particularly specialized on hair and has the technical skills required for the hair transplantation operation.
The specialist physician to perform the hair transplantation operation should have detailed knowledge on the anatomy and physiology of hairy skin and of hair follicles. Hairy skin is not limited to the zone on which hair grows. Hairy skin has a physiologically active, complex anatomy.
The specialist physician to perform the hair transplantation operation should also have detailed knowledge on hairy skin flushing, vascular structure, lymph drainage, hairy skin biomechanics and wound healing.
Science, technique and art in hair transplantation
Scientific knowledge and excellent surgical technique comprise the two bases of the triad of hair transplantation. The aesthetic approach is the third base, which is essential. Medical knowledge, surgical experience and aesthetic decision-making skills turn the whole hair transplantation operation into a kind of art. Plastic surgeons can attain satisfying hair transplantation results in medical and aesthetical terms by combining scientific knowledge, excellent surgical technique and a competent sight.
Does hair plantation actually work?
The answer is yes. As the hair harvested from the donor site and transplanted to the recipient site belongs to the patient, the body does not perceive the transplanted hair as a foreign object and reject it as a result. Transplanted hair maintains its own characteristics. The hair survives on the transplantation site and grows by maintaining such characteristics related to its color, pace of growth and curliness.
Does hair transplantation give permanent results?
Hair transplantation operation gives permanent results. The hair follicles transplanted in the operation are genetically resistant to the impact of testosterone that triggers hair loss. The transplanted hair survives on the transplantation site for a life time. If the transplanted hair would later be lost, it would not make sense to have hair transplantation.
What is actually transplanted in hair transplantation; the hair follicles or the hair shafts?
Hair follicles (follicular unit) are transplanted in hair transplantation. Hair follicles (follicular unit) are anatomic structures that contain single, double, triple or more hairs. As these structures show anatomical integrity, using hair follicles (follicular units) in hair transplantation contributes to a natural, aesthetical and efficient result.
Which part of the scalp functions as the donor site in hair transplantation?
Hair follicles (follicular unit) are harvested from the posterior scalp between the ears where hair is especially dense and resistant to shedding. Therefore the transplanted hair does not shed and a permanent result is attained with hair transplantation.
What do those numbers mentioned in connection to hair transplantation represent?
The amount to be transplanted in hair transplantation represents the number of hair follicles. Regarding the hair shafts, the number of hair shafts may exceed twice the number of hair follicles. In this sense, offering the patient a number for hair shafts before the hair transplantation can be confusing. Considering that each hair follicle (follicular unit) contains more than one hair shaft, transplantation of 3000 hair follicles means that 8000 to 10,000 hair shafts are being transplanted.
From where are the hair follicles to be used for hair transplantation obtained?
Hair follicles to be used for hair transplantation are obtained from the posterior scalp between the ears. These follicles are genetically resistant to shedding. They survive on the transplantation site for a life time and they grow hair.
By which method are the hair follicles to be used for hair transplantation obtained?
FUE hair transplantation technique is the most commonly used method. It is also popularly known as the “new technique”. Hair follicles are individually removed in their anatomic integrity from behind the posterior scalp by microsurgical technique and they are individually reinserted to the recipient site. On the other hand, with the FUT hair transplantation method, the follicles are removed from the hairy skin between the two ears as a narrow strip. This leaves a narrow scar concealed on the hairy scalp. FUT hair transplantation is popularly known as the “old technique”.
FUE hair transplantation has some advantages; it does not leave a permanent scar, the donor site is used more efficiently and post-operation period is more comfortable for the patient.
Is FUE hair transplantation a new technique?
FUE has been globally approved and it is being performed since 2003.
The founders of New Age Clinic; Aesthetics and Plastic surgery specialists MD İlker Apaydın and MD Özge Ergün have been performing FUE hair transplantation technique since 2004. By FUE technique, up to 4000-4500 hair follicles can be inserted during a single session in a single day.
Who are eligible for hair transplantation?
Every single healthy individual with an adequate number and quality of hair on the site of the posterior scalp called the donor site can undergo a hair transplantation operation as long as they have appropriate expectations from the procedure.
Who are not eligible for hair transplantation?
Those people who do not have an adequate number and quality of hair on the donor site should not undergo a hair transplantation operation. Particularly those individuals who are experiencing the beginning stages of hair loss and whose hair does not show an apparent thinning should not have hair transplantation. In such cases, medical treatment should be tried first.
How does the recovery period proceed after FUE hair transplantation?
Hair transplantation causes no labor loss; the patient can return to work in 1-2 days after the operation. On the recipient site, punctate red scars and thin scabs form at the bottom of the transplanted follicles that last 7 to 10 days. In 10 days, the intensity of these thin scabs rapidly decreases to one tenth compared to the first day. The redness fades from the third day on after the procedure. When FUE method is used, the hair on the donor site grows long enough to cover the site of extraction by tenth day after the operation.
An exactly normal appearance is achieved after the 10th day. Hair transplantation operation does not require any long-term post-operation care.
Will I have any restrictions after the FUE hair transplantation procedure regarding swimming in the pool or sea, or using the sauna?
You can start to swim in the pool or sea and use the sauna from the 10th day on after hair transplantation.
How long should I discontinue working out after the FUE hair transplantation operation?
Immediately after hair transplantation, you can start to go for a short walk or do physical exercises that do not make you sweat. You can start to do heavy sports after 10 days. But you should take care to avoid severe strokes on the donor site for 2 months while doing heavy sports. For instance, you should not make a headshot while playing football.
How long should I wait to return to work after FUE hair transplantation?
Hair transplantation causes no labor loss; the patient can immediately return to their work and social life. There will just be mild redness and thin scabs at the bottom of the hair shafts on the recipient site, which will be visible for 7-10 days.
Will I need to have my hair cut for the FUE technique?
Yes; the hair follicles should be visible just on the surface of the skin in order to be able to extract them individually without any problems. This requires a grade 1 haircut. However, if hair thinning is observed in a limited area and if a small number of hair follicles are required, you may not need to have your whole hair cut. The hair on the donor site is cut as narrow strips, and as this site is covered by the long hair shafts immediately above, the area which is cut is not visible.
Who is qualified and who is unqualified to perform FUE hair transplantation?
Nowadays, it is more and more heard that in some clinics, nurses or those allied health personnel who perform tasks similar to those of nurses undertake the job of a physician and perform the operations. The titles such as hair transplantation specialist, fast tissue harvesting technician, fast tissue harvesting nurse are nothing more than fabricated titles for this purpose.
No hair transplantation nurse, healthcare technician or cosmetician is allowed to perform hair transplantation. A direct intervention on the patient by a nurse or allied health personnel is both unfavorable to health and illegal. It should be noted that the damage caused by such malpractices is irreparable.
How long does FUE hair transplantation take?
The duration of the operation depends on the patient’s specific needs and the number of the hair follicles to be transplanted. While the transplantation of 1000 follicles may be completed in 2 to 3 hours, the operation may take 6 to 7 hours for 4000-4500 follicles.
How many hair follicles can be transplanted at a time in FUE hair transplantation?
If the patient has an adequate donor site and if the plastic surgeon to perform the operation has experience in the field, up to 3500-4500 hair follicles can be extracted during a single session. While technically possible, it is not recommended to extract more than this number. When these numbers are exceeded, the efficiency of the donor site decreases.
When will my hair begin to grow after FUE hair transplantation?
The redness and the thin scabs which appear immediately after hair transplantation disappear within the first 7-10 days and the person regains their normal appearance. The transplanted hair starts to fall out approximately during the sixth week following the operation. It should be noted that this is a normal and temporary situation. You may have concerns during the first three months when you recently start to see the results. But with a little patience, you will see that your hair will begin to grow rapidly and your concerns will disappear. The transplanted hair begins to appear within the first three months, and gradually increasing with every passing month, hair continues to appear for up to 1 year. The final result is obtained at the end of 1 year after which much change should be expected.
Does hair transplantation pose any risks?
Hair surgery techniques are safe techniques in general, especially if performed by an experienced plastic surgeon. As a matter of course, patients differ to a great extent in terms of their physical conditions and their capacity of recovery; therefore, the result cannot be exactly predicted.
Is FUE hair transplantation completed in a single session? Will I need a second transplantation?
Hair transplantation gives permanent results. Nevertheless, a second hair transplantation operation may be needed in some cases. It may be needed in order to:
- achieve the desired result in cases of continuing rapid hair loss due to androgenic alopecia,
- achieve a natural appearance by a corrective operation for those patients who have had a prior hair transplantation with the old techniques,
- achieve a density of hair nearly as abundant as the original hair for those patients who desire such a result,
- correct or shift the hairline for the aim of moving it forward or backward in accordance with the patient’s age,
- provide a hairy scalp on those sites where no prior transplantation has been done.
Will my hair transplantation operation give a result as successful as my friend got?
Another version of this question may be: “We both had the same number of hair follicles transplanted, why does he get a denser result?”
Even of the same age and gender, comparing the hair transplantation results of two persons would be like comparing apples and oranges. The most prominent features are the shape of head, and the pattern and extent of hair thinning. But numerous factors have an impact on the results obtained, such as the thickness of hair shaft, the number of hair follicles contained in every hair follicle, the characteristics of hair –whether it is straight, wavy or curly-, color of hair and the contrast between the hair color and the hairy scalp.
Having an equal number of hair follicles transplanted does not guarantee the same results for everyone. Assuming that an equal number of hair follicles are transplanted on an equal extent of site on both of the persons, the person with thicker hair shafts and with a higher number of hair shafts in the follicles will obtain a more satisfying result with a denser hair appearance.
While 4000 follicles with predominantly three thick hair shafts correspond to an average of 10,000 thick hair shafts; 4000 follicles with predominantly a single thin hair shaft correspond to a total of 4000 hair shafts.
Similarly, curly hair shafts give a better impact of camouflage. And as the contrast with the scalp decreases, a denser appearance is obtained; which means, the result of hair transplantation with a combination of gray hair and fair skin gives a denser hair appearance compared to a combination of black hair and fair skin.
The plastic surgeon considers these variables before the hair transplantation operation and makes the best treatment plan to obtain the desired result. Use of a personalized plan and personalized hair transplantation techniques ensure maximum satisfaction regarding the patient’s expectations.
How should a satisfying hair density be for me after hair transplantation?
In cases of a convenient hair density on the donor site and a convenient hair shaft thickness, 80-100 hair shafts per cm2 can cover the scalp. The number of hair follicles to give this density of hair depends on the characteristics of the patient. While 30 hair follicles per cm2 are enough for hair transplantation performed with those follicles containing predominantly three and four shafts, this number is as high as 40-60 per cm2 with a person whose follicles predominantly contain single or double shafts.
How long will it be apparent that I have undergone hair transplantation?
There will be punctate red scars and thin scabs at the bottom of the transplanted hair shafts on the recipient site, which will be visible for 7-10 days. In 10 days, the intensity of these thin scabs rapidly decreases to one tenth compared to the first day. The redness fades from the third day on after the procedure. When FUE method is used, the hair on the donor site grows long enough to cover the site of extraction by the tenth day after the operation.
You will wholly regain your normal appearance within 7-10 days.
How long will it take for me to have the exact FUE hair transplantation result after the operation?
The transplanted hair starts to fall out approximately during the sixth week following the operation. It should be noted that this is a normal and temporary situation. Hair starts to grow again from the 5th-6th week on after shedding. You should be patient to get the exact result of hair transplantation. In some cases, it may require one year to get the exact results of transplantation.
How long will it take for me to resume my ordinary life after FUE hair transplantation?
There will be mild redness and thin scabs at the bottom of the transplanted hair shafts on the recipient site, which will be visible for 7-10 days. After this period of time, others will not notice that you have had a hair transplantation operation. If you do not want to keep the hair transplantation operation secret, you can resume your ordinary life immediately by the day following the operation.
Does hair transplantation require a long-term care after the operation?
Hair transplantation does not require any long-term care.
Will I have a natural result with hair transplantation? How is a natural appearance ensured with hair transplantation?
Natural appearance is the definition of a successful hair transplantation operation. The follicles used for transplantation, a proper insertion of hair follicles, size of the hair follicles and the hair transplantation technique chosen are among the determinant factors of a hair transplantation operation which achieves a natural appearance.
One of the most significant criteria for a natural appearance is a successful hairline.
It should be noted that it is the plastic surgery specialist to consider all these criteria, do the planning and perform the transplantation. Therefore, the secret of a natural appearance lies with the choices made by a specialist physician who has expertise in hair transplantation.
Will hair transplantation do any harm to my existing hair?
The points among hair shafts for inserting the follicles are incised by microsurgical technique with the help of magnifier equipment. There is no risk regarding this procedure for those patients with an apparent thinning, who have non-hairy scalp large enough among the follicles.
Considering the risk of doing harm to existing hair, hair transplantation is not recommended for those individuals who are experiencing the beginning stages of hair loss and whose hair does not show an apparent thinning. In such cases, medical treatments are tried first.
What is the best technique for hair transplantation?
Today, among the hair transplantation techniques, FUE technique is the most commonly used one with a proven success. Thanks to the FUE technique, it is possible to achieve natural and aesthetically satisfying results with no scars left. FUE technique also ensures a more comfortable post-operation recovery period.
Will I suffer any pain during hair transplantation?
Regarding the FUE hair transplantation, the most important concern of patients is the answer to the question: “Will I suffer any pain during hair transplantation?” Hair transplantation operations are among those interventions which provide a high level of patient comfort. Just a mild level of pain is felt during local anesthesia injection at the beginning of the operation, and the rest of the hair transplantation operation after this stage is entirely painless.
Will I have any pain after the hair transplantation operation?
In general, post-operation period with hair transplantation is painless. Only a mild pain may be felt during the night following the operation, which is easily relieved by pain killers.
Should I wait for a total hair loss before having a hair transplantation operation?
The ideal starting point for hair transplantation is the early stage when thinning becomes visible but the patient and those people around the patient are not used to that appearance yet. The person should not particularly wait for a total hair loss so that neither the person nor their social environment get used to that appearance. It is possible to have a smooth transition before the person gets to be perceived as having no hair.
Which criteria determine the success of the hair transplantation operation?
The most significant criterion for a successful hair transplantation operation is choosing an experienced physician who is capable of performing the operation.
As the donor site has a limited number of hair follicles, it is important not to harm the follicles during extraction. The hair follicles get no harm when carefully and cautiously extracted under microscope, by a plastic surgeon with microsurgery training.
In order to achieve successful results, it is not enough to extract the hair follicles without harming them only; storing the extracted follicles in convenient conditions, making a personalized plan regarding the insertion pattern of the follicles, organizing the canal density and orientation, inserting the hair follicles without harming them, having the hair transplantation operation performed by a plastic surgeon experienced in the field, and use of advanced technology are among the criteria required for a successful hair transplantation which gives a natural appearance.
Will my hair show an adequate density as a result of the hair transplantation operation?
One of the most significant criteria for a successful hair transplantation performed with an individual experiencing hair thinning is the appropriate patient expectation. A realistic and feasible common ground should be found between what we, as physicians, can provide the patient with and what the patient imagines. Full patient satisfaction is achieved with the hair transplantation operations performed by a Plastic Surgeon specialized in the field with those individuals who have appropriate expectations.
What are the stages of the FUE hair transplantation operation?
FUE hair transplantation operation can be divided into three stages.
The first stage consists of the extraction of hair follicles by a plastic surgeon. This stage takes an average of 1-2 hours.
The second stage consists of planning and incising the hair canals. This procedure -also performed by a plastic surgeon- takes 30-45 minutes.
During the third stage, hair follicles are inserted inside the canals opened. And the hair transplantation operation is completed with a proper dressing. This takes 2-3 hours.
How long should I wait for traveling after hair transplantation?
Hair is washed on the first day following hair transplantation and the patient is taught how to wash their hair gently. This procedure, usually done the next morning, takes 15 minutes. You can travel immediately after that.
Is there a certain age for hair transplantation?
No. There is no certain age for hair transplantation. Anybody with an apparent hair thinning can undergo hair transplantation. It would be ideal to perform the operation at an early stage before other people further realize the extent of thinning.
What is the most convenient season for hair transplantation?
We cannot talk about a specific convenient season for hair transplantation. It can be performed with the same level of success in every season. But there will be limitations regarding swimming in the sea or pool, and being exposed to sun rays. This may render the operation socially difficult during summer months.
Can hair transplantation operation be repeated?
If necessary, hair transplantation can be repeated 3-4 times depending on the density and the number of the hair follicles on the donor site.
A second hair transplantation can be planned in cases of continuing rapid hair loss, with patients who desire a high density of hair, for the purpose of providing a hairy scalp on those sites where no prior transplantation has been done, and for the purpose of correcting the outcome with those patients who have had an unsuccessful hair transplantation in some other clinic.
May hair transplantation operation do harm to those tissues deeper in the head, such as bones or intracranial elements?
The extraction operation is performed completely by microsurgery, with the help of magnifier equipment. Extraction is performed at the level of the hair follicles which falls within the limits of the hairy scalp. Since the operation does not extend beyond the level of the hairy scalp, the tissues located deeper in the head are not harmed.
Does FUE hair transplantation leave any scars?
No permanent scars are left after the FUE hair transplantation operation.