Most importent information about hair transplantHair transplantation is a certain and safe method offering a natural and esthetic way to oppose hair loss. It can effectively reduce typical a man's baldness. About 50% of healthy hair follicles can be taken from the back and side areas of the head, that are not affected by hair loss. The hair follicles along with part of the tissue, are transplanted to the balding areas on the top of the head where they will continue to grow throughout the patient's life, as they are under a different form of genetic control than the follicles on the front and top of the head..
The hair which remains on the donor area should still look natural. However, there are some cases when it is not possible to cover all of the bald area because the amount of hair in the donor area is not enough. The planning for each surgery is based on an individual approach but when young patients' hair style is taken into consideration, the priority is to provide them with a natural lifelong appearance rather than a fashionable hairstyle. Moreover, hair transplantation is a treatment which takes into account the aging process as well as the individual process of hair loss, so the surgery should be planned in a way guaranteeing a natural and long-lasting hair style.
The typical male hair loss is called Androgenic Alopecia, and is genetically based. The reproductive hair cells, which are in the base of the hair follicle, have their own genetic code determinating their sensitivity to the male hormone testosterone. Testosterone causes the hair follicles in some head areas to produce weaker and thinner hair until they finally vanish. Conversely, the hair follicle in the beard and under the arms, stimulated by the testosterone, produce more developed hair. Unfortunately an effective remedy which can stop this process or reverse it is unknown. A varied hair loss process means that men in their twenties as well as in their fifties can have a definitely formed baldness. The thing they have in common is the crown of hair in the back and side areas of the head. The genetic code of the crown hair follicles means that they are not sensitive to dihydrotestosterone (a metabolite of testosterone) and they are not subject to the inherited effects of "balding genes".
Before surgery, the patient's expectations and the possibility of their fulfillment are thoroughly discussed, and the surgery plan is put into writing. Moreover, just before surgery its scope and procedures are confirmed once more and photographic records are taken. The patient is asked to orally take some medicine to prepare him for the surgery. Thereafter, a local anesthesia is performed. It prevents pain during the surgery, and for a few hours after it. The hair in the donor area is cut in such a way that the suture is not visible at the end of surgery. After the mentioned preparation the patient is taken to the OR, where the tissue from the donor site is collected. The wound is sutured from edge to edge. Then the patient rests comfortably and the surgeon begins the most important stage of the operation i. e. preparing of the harvested tissue to obtain micro-grafts. The surgeon acts carefully in order not to waste any of the hair follicles. The size of the micro-grafts has to be matched well as to fit to the prepared micro holes in the recipient area. At "Medical Hair", we are used to applying micro-grafts with a diameter of 0,6-0,9 mm.The micro holes are located as close to each other as possible. In turn the hair obtains the optimal density and grow in a natural direction. During this procedure it has to be taken into consideration that some patients will need hair thickening in the future. The transplantation of about 800 micro-grafts usually takes about two hours. In exceptional situations we are able to transplant up to 2000 micro-grafts, but in the majority of cases the scope of surgery is limited by the quantity of hair follicles that can by obtained.
Hair transplant involves removing hair follicles from one part of the scalp and transplanting to other areas of the scalp. This procedure appears relatively simple, but is in fact quite complicated and requires taking into consideration a variety of factors, which can affect the expected treatment outcome. The grafting process (extracting hair follicles) is one of several stages of the hair transplant procedure and is discussed in detail with patients to explain the often conflicting opinions in this regard.
Present-day hair restoration surgery uses two grafting methods.Strip Harvesting (STRIP)
takes a strip of scalp from the occipital area, which is then cut into individual follicular units (using optical instruments). After the strip graft is collected, the scalp is stitched up and a linear scarring is formed. Hair left at the place of extraction must be sufficient for natural appearance of the rear part of the head (occiput).
In FUE (follicular unit extraction)
, individual follicles of hair are removed from the occipital area (0.8 to 1.0 mm in diameter). After the grafting procedure is completed, the follicular units are transplanted onto the recipient site (where the grafts are transplanted) using one of common hair transplant procedures, irrespective of the type of grafting procedure which was used to extract the follicular units. The only difference between the two methods consists in the grafting procedure on the donor site, and the grafting procedure itself is considered to have no impact on the final hair transplant effect on the recipient site.
STRIP is often referred to as the ‘old’ method, and FUE – as the ‘new’ procedure. Is this classification correct?10 years ago, FUE was believed to replace STRIP harvesting. However, STRIP remained in use and each of the two grafting methods appears to offer a variety of advantages, as well as some disadvantages and addresses different problems, which makes them complementary to each other.
Scarring in the occipital area can be considered a serious disadvantage, and FUE has been recommended for many years as a no-scarring method. The majority of patients have some small linear scars in place after STRIP, which can be easily covered with the hair growing on it. In FUE, the linear scar is replaced by multiple minor oval incisions in the occipital area. These tiny punches are visible as lighter or darker ‘spots’ when the hair is pulled apart (or in individuals wearing very short hair).
The greater the extent of the FUE procedure (the higher the number of grafts collected), the higher the risk of a ‘moth-eaten fur’ effect. In addition, when the follicular units are collected at a too short distance from each other, the punch-like scars may form larger scarring. Two different areas (donor site and non-donor site) can also be formed in the occipital area. On the contrary to FUE, two skin areas of identical follicle density are sutured back together in the STRIP method. In addition, both methods need to be compared in terms of a number of different factors. First, graft survivability must be considered. FUE grafts are thinner, with smaller volume of tissue surrounding the hair follicle. This makes them more likely to dry out and more susceptible to damage in the course of treatment. Moreover, follicle units collected in the FUE procedure are exposed to mechanical damage when handled with surgical tools. They can be pressed together, pulled, or clamped. It also takes longer to complete the grafting procedure using the FUE method, and the grafted hair follicles are more exposed to damage.
It is also important to consider the extent of damage of hair follicles during the grafting procedure. In the STRIP method, the grafting procedure is visually controlled and more follicle units are left intact. On the contrary to STRIP, FUE grafts are collected at random, and the hair or the hair follicle is more likely to be damaged. Surgeons should customize the type and depth of incisions to the hair growth angle, and should continuously control the hair growth conditions, which are typically different on the side or rear parts of the scalp. As a rule, the percentage of damaged hair increases proportionally to the number of follicular units collected.
FUE is considerably more labour- and time-consuming. In general, strip grafting delivers a lot more grafts during a single grafting procedure. As many as 4,000 – 7,000 hair follicles can be harvested in a single STRIP procedure. A single FUE session to extract 2,000 hair follicles is considered a time-consuming and difficult procedure. However, FUE extends the area where the follicle units can be collected, whereas strip grafts can be taken from a limited scalp area only. Post-operative recovery time is also important. The operating field for STRIP consists of a 1 cm wide scalp strip. After the graft is collected and the scalp is stitched up, the stitch is immediately covered by the hair growing above it. On the other hand, a large occipital area needs to be prepared for FUE (the hair must be in fact shaved), and the operating field can be covered only when the hair grows back. All of the aforementioned aspects need to be taken into consideration in planning and selecting the best hair transplant method. Please note that these factors refer to a specific stage of the treatment only, and the final treatment outcome depends on a variety of other factors.
To sum up, it is currently believed that:
both methods - STRIP and FUE – are acceptable grafting procedures for hair transplant, the cost-risk ratio is more favourable to STRIP, which is cheaper and more cost-effective,
patients are required to have at least several centimetre or millimetre long hair in the occipital area to cover the post-treatment scarring, FUE is recommended for patients who want to avoid a linear scarring in the occipital area, FUE is recommended to patients who require a small number of follicular units to be transplanted (small hair loss), FUE requires good quality, dense hair growing in the occipital area. Each hair transplant needs to be preceded with consultations with a surgeon experienced in hair transplant treatments, who is skilled in both methods and is familiar with the advantages and disadvantages of each of them to help the patient choose the best-suited procedure. Our clinic offers both methods. As the first clinic in Poland, in 1995 we introduced the implant of micrografts using STRIP method, and since 2006, we have carried out transplanting using FUE method.
Recommendations before and after hair surgery1. Before surgery, perform vaccination against hepatitis (jaundice).
2. Term treatment should be planned so that the postoperative period (8-12 days) did not interfere with the "important" matters professional and personal.
3. Hair before the treatment should have a minimum of 2 inches in length, to the best possible way to "hide" a state of post-operative (the longer the better).
4. Two days before the planned surgery should not consume alcoholic beverages and drugs containing aspirin.
5. If surgery is planned 7.30-8.00 and you live at large distances from the place of surgery, we suggest arriving the day before surgery and overnight stay in the clinic or a nearby hotel.
6. After surgery, you can go home or stay in the clinic (need prior reservation).
7. After surgery you can not drive for 12 hours due to the medications given.
8. After treatment for 14 days do not perform heavy physical work (including the gym or swimming pool).
9. Place of the transplant should be protected from the harsh sun for 6 weeks (the solarium).
Warsaw: FUE & FUT methodes at competitive prices
Check our hair transplant clinics:
Katowice: BHT, FUE, FUT methods. Clinic offer free transport from Krakow Balice Airport or Katowice Airport
Clinic in Krakow performing transplantation with most modern S.A.F.E.R Hair Transplant device.
Clinic situated in Warsaw performing transplantation with most modern S.A.F.E.R Hair Transplant device.