Some patients present themselves for surgery with very early hair loss and a significant amount of miniaturization. In a situation such as this, the better solution is to treat the condition with medication and to wait until a transplant is necessary. However, with recent improvements, there is no need to wait until hair loss has progressed to such an advanced degree that it causes emotional distress and anxiety.
The procedure is performed under local anesthesia. Once the skin is anesthetized, no other pain or discomfort is experienced during the procedure. Our on-staff anesthesiologist, according to the patient's age and physical condition, medical history and the duration of the procedure, makes the selection of pre-surgical medication and of local anesthesia.
This method allows for a more accurate control of hair graft angulation and direction. Lateral orientation causes less tissue damage, permits closer graft placement, and makes hair strands shingle, creating the illusion of more volume.
With modern techniques, many women with pattern hair loss are now candidates for the procedure. The most important factors are the long-term donor/recipient area ratio and the patient's expectations of the surgical result.
We continue to closely monitor the development and advancement of new technology that can help to improve our results. We are convinced that the FUE process is the most effective technique that has been developed until now. With manual FUE, we are able to control the procedure during its execution. We are also able to maintain control of the adjacent area, so that we can preserve and use the donor area as effectively as possible. The examination of each graft for its quality prior to extracting another is possible with FUE and every moment of the procedure can be adjusted and changed as it is deemed necessary. In implementing this technique, every piece of equipment used is sterilized.
Megasessions can provide excellent density, coverage and naturally undetectable results without compromising the growth. However, it is not an option for every patient. It is important to have an experienced team perform such a surgery.
The transplanted area will have scabbing and may look pink for 7-10 to days after the surgical procedure. There is usually a bit of redness in the transplanted regions that dissipates in the range of 2-4 weeks.
We recommend that you take at least two full days off work after the surgery. After that point, it is a matter of personal choice. Bear in mind that there will be some swelling and scabbing. Swelling can be avoided by using ice packs. Scabbing, however, will most likely be visible. A loose fitting hat may be worn, but if a hat is not an option for you, it might be better to take a week to ten days off work while the scabbing heals.
Smoking causes decreased blood flow to the scalp thus contributing to poor wound healing. Smoking is also considered to be a factor in poor hair growth. A common recommendation is to abstain from smoking for at least 1 week prior to the surgery, and for at least 2 weeks after the procedure has been completed.
PRP is an autologous preparation of blood plasma with platelets. It contains growth factors and other bioactive proteins that aid in wound healing. In order to obtain it, a patient's blood is spun in a centrifuge that separates the solid from liquid components. Some hair transplant surgeons use PRP in either by, storing the grafts until they are placed on the scalp, or by injecting PRP into the scalp prior to the placement of grafts. The results of studies on the use of PRP as an adjunctive modality in hair transplantation remains controversial.
Graft storage is important for graft survival. We use a storage solution composed of HypoThermosol and Liposomal ATP. The combination of both elements brings together two benefits: one of graft stress reduction during storage with another that addresses cellular deficiency during and after graft storage. Additionally, we use a storage device that chills grafts from 0°C to 4°C and maintains this temperature. The ability of hypothermia to suppress metabolism is the key to maintaining tissues.
Grafts must undergo revascularization in order to survive. The transplanted graft requires about 5 days to revascularize and to become replenished by the new blood supply. Once the graft is removed, tissues are immediately cut off from their supply of oxygen and other necessary nutrients. Oxygen and glucose are required for the production of the cell's primary fuel, ATP. If oxygen is inadequate, loss of the entire follicle or a percentage of the follicle may occur, resulting in new hair growth that is fine and weak. One method to replace graft oxygen deficits is to use liposomal adenosine triphosphate (ATP). When used as an additive to the holding solution and as a post-operative spray, liposomal ATP was shown to enhance graft survival and graft quality.
It takes 6-8 months to begin to see a cosmetic difference. The period between surgery and new hair growth is typically 2-3 months. Each hair has its own timetable. Therefore, the change will happen gradually. About 20% of the hair grows between the second and fourth months, while about 60-70% grows between the fifth and eighth months. Hair continues to mature for up to 18 months after the surgery.