Hair transplantation is the process of transplanting hair follicles (grafts) taken from the back of the scalp, where hair is genetically resistant, to bald areas of the scalp such as the front and top where hair loss and thinning are apparent. Historically, hair transplantation was performed using the FUT (Follicular Unit Transplantation) procedure, but more recently, it has been performed using the FUE (Follicular Unit Extraction) procedure. Hair transplantation takes 4-8 hours depending on the size of the bald area. It is performed under local anesthesia. Only the back of the scalp, the donor site, and the bald, recipient site are numbed. If necessary, short term sedation may be used to prevent the patient from feeling pain during the local anesthesia. The patient can make a well-informed decision about this.
FUT Technique
It is based on the principle of surgically removing a strip of hairy skin from the donor area, the back of the head where hair is denser, and separating the hair follicles one by one under a magnifying glass so that single or double hair grafts are implanted into the incisions made on the recipient area. It is a method that has recently been abandoned due to the fact that it involves an incision in the back of the head, between the ears, and the associated scar, as well as the fact that not enough hair follicles are available for removal.
FUE Technique
It is an constantly evolving technique in terms of modern devices manufactured in the light of ever developing technology. Since the back of the scalp where hair is genetically resistant the hair and its roots are taken from this donor site using a "micro motor" device. These hair structures are called grafts. Each graft contains an average of two roots, but may contain one or three roots as well. This method provides better results, but it is more demanding for the patient compared to the FUT method, as the removal process takes longer. In addition, if the back of the scalp is not dense enough, the hair is too thin, or too much hair is removed, there may be a noticeable thinning of the back of the scalp.
Planning the Procedure
When planning the procedure, the age of the patient, whether or not the hair loss continues, the size of the recipient site, and the hair frequency of the donor area are important. Hair transplantation should not be performed before the age of 24-25. Baldness at this age is an indication that the size of the balding area will increase in the next few years. It is wise to wait and see if the patient's hair loss is progressing rapidly. It is important to understand where the baldness will be greater, and where more hair will need to be implanted It is very important to address the hair transplant candidate's concerns about the result, and inform him what the most realistic expectation should be. Nowadays, there is a lot of misinformation about this topic everywhere and on the Internet. This makes patients anxious and causes them to keep their expectations at the highest level. Furthermore, the number of roots to be implanted is sometimes exaggerated. Some of the grafts contain one root, and some contain 2 or 3 roots. On average, each graft is considered to contain 2 roots. Usually, 3000-5000 grafts can be transplanted, depending on the need, and the condition of the back of the scalp. Sometimes it may be necessary to split the procedure into 2 sessions to achieve sufficient frequency. It is essential to well-inform the patient about this.
DHI (Direct Hair Implant)
This type of hair transplant is performed without shaving the patient's hair. Only the donor area is shaved. Since the upper and lower areas are not shaved, it is possible to partially cover the area with long hair. This technique uses an implanter pen. However, since the process takes longer and is relatively inefficient, it should only be preferred in special cases.
What are the Points to Consider in Hair Transplantation?
Protecting the grafts from drying out and damage.
Transplantation procedure must be planned, taking into account the growth angle, the hair’s natural direction, and the direction of the incisions.
A careful planning should be made not to have a straight hairline, especially when drawing the frontal hairline. It is important to focus on the natural look. It is also necessary to adjust this line according to the age of the person.
After the transplant procedure, it is important to make sure that there is no bleeding. The dressing is applied in the most appropriate way, the patient is taken to rest in an appropriate environment, and the patient is discharged with a prescription and some recommendationsThe patient should avoid driving. The patient is instructed on the position he/she should lie. A follow-up appointment is mad efor the patient to visit the clinic again in 2 or 3 days. The first scalp wash is performed. Again, the patient is given some instructions, and advised to apply a moisturizer to the recipient site.
After the hair transplantation, some sensitive people may experience swelling (edema) on the face and eyelids, especially after frontal transplantation. These disappear in a short time. 7 - 10 days after the transplantation, crusts may form on the recipient site, and they disappear naturally. The transplanted hair may fall out in 3-4 weeks, but it begins to grow back in 3 months. The hair takes its final shape and form in 6 months to 1 year.
Evaluation of the Patient for Hair Transplantation
A systemic condition or skin disease that causes hair loss is contraindicated for this procedure.
The presence of any medical conditions and the medications the patient is taking are important. The most important of these are heart medications and blood thinners. In such a case, the patient should consult his / her doctor, and ask if he / she can stop taking them for a while.
It is also recommended that the patient stop or limit smoking, and the consumption of alcohol, and caffeinated beverages.
Although rare, bleeding, dermoid cysts related to hair follicles, and infections may occur, and some grafts may not survive as desired after hair transplantation. It is important to remember that these are rare complications.