Before choosing your surgeon, be sure to ask everything you need and to receive accurate and clear answers. Do not forget to check pictures of patients that the surgeon has operated on and find out how many sessions you performed in these patients. Confirm that the doctor is a specialist and meets all legal standards and biosecurity . Do not make hasty decisions.
The field of hair restoration surgery (HRS, for its acronym in English) is comprised of professionals from different backgrounds, including dermatology, plastic and general surgery, and otolaryngology, among others. Unfortunately, training in hair restoration surgery is not part of the residency program of regular medical career and rarely makes the same level as the current practice.
For this reason it is very important to get a degree in HRS and is precisely why the International Society of Hair Restoration Surgery (ISHRS, for its acronym in English) has much relevance in the training of doctors who decide to pursue this specialty today. The ISHRS, to the same extent, offers practical specialization in various medical centers around the world .
To date, no evidence of significant differences in the action of Finasteride among different ethnic groups. Its effectiveness compared with pattern hair loss on the forehead is higher in the crown. There is no evidence of its effectiveness in treating the temples (sides of the head, above the ears).
Currently no known harmful effects on either drug when used according to manufacturer’s instructions; for this reason it is advisable to follow all instructions before using. Using Finasteride can be potentially harmful to the development of the male fetus in a woman if the drug is ingested during pregnancy; in this case, it is recommended that pregnant women do not handle crushed or broken tablets. Studies have shown that concentrations of this drug in the semen of men is negligible; if man can stop using when conception is not necessary.
The number of sessions depends on
1) The area of the scalp was treated
2) the number and size of grafts used and
3) the density of transplantation and
4) the individual characteristics of the patient.
Ex.: coarse hair provides greater density than fine. The estimated session number is discussed during consultation with your specialist.
While hair transplants are more expensive than some alternative treatments , the results are permanent. Thus, most patients are considered a good investment for your future.
The most common hair loss cause is heredity; therefore, men and women can inherit the gene for hair loss parent. The men, meanwhile, are more likely to inherit this genetic condition as testosterone and its metabolite dihydrotestosterone, DHT, activates the genetic program that generates hair loss in follicles. Currently, there is no known method to combat this type of hair loss (androgenic alopecia, AGA).
The age of onset, extent and speed with which hair is lost varies from person to person. Some serious illnesses, poor eating habits and even some vitamin deficiencies in the body can accelerate this process; dyes and chemicals for hair can also cause it when applied improperly. Use of hats or caps, poor blood circulation, excessive use of shampoo or clogged pores, however, are not causes of hair loss .
Hair loss is sudden, it will take several months to a year after stopping the medication. That’s why we lose one or two days of treatment, although not recommended, generally not harmful.
It is advisable to take at least two days of rest after surgery. You must wear a baseball hat or balaclava type after surgery for sun protection. Patients should avoid strenuous physical activity for at least five days after surgery
Postoperative depend on compliance with the instructions given after surgery. Small scabs on the scalp graft sites will form. Generally speaking, these scabs disappear in 4-10 days.
The shampoo may be resumed 24 hours after surgery (baby shampoo should be).
The suture used in the donor area can not be detected immediately after surgery, as it is completely covered by your existing hair. We use absorbable sutures (ie, they are dissolved by the body) Normally the grafted hair will be lost within 2-4 weeks. New growth will begin in 3-4 months and length will increase approximately 1/2 inch per month.
Yes. The transplanted hair is removed from one area of the body (donor site) and transferred to another site (receptor). The transferred tissue is not ‘rejected’ because it is not a foreign tissue. The transplanted hair maintains its own characteristics, color, texture, growth rate, and curl, after transplantation. The vitality of the grafted follicle is maintained by the rich blood supply to the scalp. In recent years we have developed techniques and instruments that allow surgeons to achieve truly natural results by transplanting a large number of small grafts. We have found that hair grows from the scalp in groups of one, two, or three hair follicles, called ‘follicular units’, which may transfer after removing excess surrounding tissue; this allows the grafts have a denser and more natural.
Be very realistic needs and the type of work performed and the patient have a vision about what it will look in the future. Offering or expect to get the original density having the patient usually is not feasible. Working with real expectations, the total number of grafts required for each patient depends on the contrast between the color of hair and skin, the density of the donor area, scalp laxity, the number of hairs per follicular unit and hair character itself (color, texture, thickness). The surgeon considers these factors and combines them with patient expectations to estimate the amount of work required. Still, a predictable outcome does not always ensure patient satisfaction. A man accustomed to his baldness will be easier to meet and accept a limited result, a young man who is beginning to lose his hair and remembers the days when he looked in the mirror and saw the strong and dense hair of his adolescence. The young patient will always want the front line he had in his youth and not be content with less. Because the surgery is permanent, the surgeon must take into consideration an appropriate capillary design for life and also take into account the reservations in the donor area. Mature patient with significant hair loss will be much happier with a high frontal hairline restored and a modest amount of natural hair covering his head for the first time in years. The vast majority of patients seen are between these two extremes, and this is where we have to carefully guide the patient to achieve clear and reasonable goals. Taking human psychology, capillary dynamics and based on practice is not always wise to recommend a specific number of grafts. The suggested amount is guidance, not a final figure. The impact of a transplant depends on the area to be transplanted and the number of grafts used. (See Scale Norwood -Hamilton).
Follicular unit consists of one to four hair roots, sebaceous glands, hair erector muscles, follicular peri vascular plexus, a neural network and peri follicle (a circumferential fine collagen casing defining unit).
To transplant the most natural form of grafts to be transplanted in a follicular unit. Considering the aesthetics of the capillary anatomy know that the closer we get to the front line, Follicular Units containing less hair (unicapilares) and as we progress to back these units are two to four hairs.
The scalp has an approximate area of 500 cm2 (23 by 23 CMS . Which is equal to 50000 mm2) and an average of 200 hairs per cm2 (80-100 Follicular Units). Thus, no bald scalp has a follicular unit mm2 and as each unit has an average of two hairs, then the total number of hairs will be about 100,000 . These numbers vary by patient and race.
At most, 50 % of hair from the donor area (occipital and temporal regions) can be removed so they do not look slightly thickened. Theoretically, in cases of male pattern moderate patterns (types V or VI ), 12.5% of the scalp is safely available for transplantation, ie approximately 12,500 hair or Follicular Units 3000 to 4000 .
Fullness appearance involves the hair mass , which is related to the number of hairs, the thickness of the individual strands of hair, texture, color and curly. Moreover, the color contrast between the scalp and hair also has a significant influence on the optical illusion of fullness.
Most experts agree that average capillary density in no bald patients is 200 hairs / cm2 (+/- 70) and that only 50% of this number is required to achieve a semblance of normal density, ie 100 hairs / cm2 (+/- 3 ), or what is the same half of Follicular Unit 45 cm2 .
The only limitation is the size of the donor area (available number of resistant follicles to DHT). Which must be carefully judged sites with higher aesthetic impact restored. Once agreed an achievable plan that frames a natural appearance, only then will proceed to surgery. The FUE from other parts of the body is so far only an experimental technique with many constraints to be resolved.
Until recently all that existed in Colombia was the technique of transplantation with ‘punch’ (the famous doll hair), very unnatural to use circular knives of 1-2 cm. they extracted and inserted many follicular units together and let the rather battered donor area.
Currently some plastic surgeons are using the technique of micro grafts with moderately acceptable results. The reason for this is that they do not perform these surgeries often (have exclusive operating room, do not have adequately trained personnel and prefer other faster procedures), so there are a motivation to improve or update this revolutionary practice.
The two major advances is that now can be transplanted follicular units, respecting the growth of each hair group and not an arbitrary measure, as it did before default. The second advance and hand with the first, is the possibility of using dissection instruments and finer and accurate implementation that allow lower transection and trauma, most follicular survival and better cosmetic results.
No, absolutely not. Current techniques allow putting hair between existing hair, improving and restoring ladensidad. Although in the future may need another session is just one step ahead of baldness.
Yes. I am able, in most cases, to reverse the misfortunes of a bad transplant. The poor patients with locks, doll hair or hair in ‘corn rows’ have the option to achieve a more natural look. I am able to repair those patients with irregular lines or lower limits of previous hair transplants. I take off bunches of hair, dissected under magnification and reimplanted .
If the patient has enough donor tissue grafts can be transplanted around these strands and so ‘dissolve this unnatural image’ excellent results.
There are different degrees of ‘Bad Transplants’, but all devastating for the patient and/or their loved ones.
My patients find it less annoying that the intervention of a dentist, who feels under pressure or discomfort. They are usually busy enjoying a movie; others choose to sleep some time. What should be noted about this surgery is that it is long, and this is tiring when not treated with a sedative. The surgery is performed under local anesthesia injected with fine needles where the patient feels only mild stings at first.
The surgery is ambulatory. My patients resume normal activities after the first week or even the next day if the work does not require a lot of physical activity.
It is my responsibility to inform patients about all treatment options. If you are not a good candidate for a transplant, I’ll tell you why. Very young patients often have unrealistic expectations. Medications such as Minoxidil and Finasteride may decrease the process and should be tried first, or together with the original proceedings.
Patients with unrealistic expectations are poor candidates. Those who seek to satisfy the interest of another person, are not good candidates.
There are many problems and psychological consequences suffered by all those who lose their hair. There are men who narrate that have lost business, jobs and opportunities because of their diminished appearance; some feel older, others say they are battered and worn with a picture, including others have who have divorced because of his baldness and wanting to rebuild their lives, have had serious difficulties to woo a woman, as the esteem has dropped them substantially.
As these effects are many more psychologically damaging to men. Without realizing them less capable in their jobs, their confidence has reduced the unsuspecting degrees. Because this security have lost it slowly with her hair through the years when the transplant is doing and see results is when they realize what they had lost. Then the recovery of their qualities, mood, improved appearance, self-confidence, etc. begins, and their lives come into a real and pleasant rebirth.
We really are very rare cases of infection after surgery. In the rare cases that it has detected some small infection, is a patient neglect to follow post-operative instructions. Even if an infection occurs, it is easy to cure with common antibiotics that may be prescribed by us or by any physician. Other postoperative complications are Hiccup, by manipulation of scalp treated with low doses of haloperidol. Really exotic, complications are: arteriovenous communications in the donor area, usually temporary dysesthesia, bad hair since it follows different directions at the growth pattern of the rest of the hair (due to poor technique) and less exotic, in patients with multiple surgeries or when donor has taken too much tissue, visible scars.
No, it is NOT the same. In Follicular Unit Transplantation implant size is determined by the nature. In the mini or micro implant graft size is determined arbitrarily auxiliary cutting the donor tissue at the request of the capillary surgeon.
In the mini and micro implants no prima conservation and indemnity of follicular units. Preferred factors are operative time and economy. The auxiliary used the knife to quickly generate strips of tissue that subsequently separated into thin grafts using direct visualization (more often than with loupes or microscope). Therefore, the resulting implants are generally larger containing several follicular units, and therefore a greater number of hairs in each graft. Consequently largest donor area is also needed.
The biggest advantage of FUT (besides preserving units to increase efficiency and capillary growth) is the ability to transplant a small receiving areas (inputs, scars, crown), then the resulting grafts are smaller.
For a capillary surgeon is essential to have knowledge of anatomy and aesthetics of hair to achieve the best results. The shape and hair texture vary depending on their evolutionary status and location. We can distinguish several types of hair: called lanugo is a fine, light hair and unpigmented that surrounds the fetus and usually falls around the eighth month of pregnancy.
The hair is thin, light and almost invisible hair seen on the forehead and scalp in prepubertal age. The normally thick, long and variably pigmented terminal hair characterized adulthood. Subtypes of terminal hair in the scalp, eyebrows, upper lip, chin, underarms, chest and pubis.
Hair may become the terminal hair; eg, facial hair in adolescents can become beard. Also the terminal hair on the scalp may become hair, and male pattern baldness and female androgenic alopecia
The two most currently used techniques are the “Technical Strip” and FUE (Follicular Unit Extraction) present a comparative table of the advantages and limitations of each technique.
- Less time for extraction.
- Possibility of mega sessions.
- Linear scar is covered with hair.
- The length of the linear scar vs.
- The sum of the multiple scars have a less than or equal to the worst case size.
- The extraction procedure is a classic that has stood the test of time.
- The sum of extraction and preparation time together are much lower.
- There are points with absorbable suture to avoid having to remove
- You can only remove hair from the head.
- Lowest price.
Technique of Follicular Unit Extraction
- More time for extraction.
- Requires multiple sessions.
- Multiple tiny scars that are covered with hair.
- Line is not scar.
- New technique that began in 2002
- Although to get the follicular unit is ready to be transplanted theory , it must be reviewed microscopically to assess its integrity.
- No suture.
- We can use hair body parts (experimental surgery).
- Extremely expensive.
The hair replacement can afford more than ever. After a formal medical examination and discuss your expectations, we can give a real estimate of time and cost required to achieve your goal.
The fees they charge many hair transplant surgeons can cause confusion. Some charge per graft, others hair, and even hour session . The important consideration for any patient is receiving the natural and necessary for a fair price density. Our patients say the results are unmatched and say: ‘Is money better spent in my life.’
A hair transplant is valid only if it satisfies the patient. Although the value is an important consideration, should not be the only thing to consider. Unlike other treatments for hair loss, the cost of each surgical procedure is an expense that is performed once. HairDoctors charge fees according to the size of the session. We offer financing plans if money is limited. We accept most major credit cards.