Hair Loss (Alopecia) and Hair Plantation Techniques:
Androgenic hair loss affects forehead, temple, top and rear top parts of our hair intensely. Starting first as the weakening of hair, this process results in the total loss of hair.
Androgenic Hair Loss, which also causes social problems such as despair and loss of self-confidence in addition to creating a cosmetic defect, is indeed a more serious problem than it seems.
Other factors causing loss of hair apart from Androgenic Hair Loss and Alopecia are out of the scope of treatment of the Hair Transplantation.
Since the hair follicles (roots) on the nape, back and ear, which are the regions that are not affected by androgenic hair loss, are resistant against hair loss, hair transplantation is achieved by taking the hair in these regions and planting them on the hairless region. Thus, lifelong permanent hair can be acquired by planting the healthy hair in the hairless region.
Hair Transplantation Techniques:
The process of taking healthy hair and transplanting it on the hairless region is called Hair Transplantation or Hair Plantation, as more commonly known. There are 2 techniques used all around the world to take out hair follicles. The process of cutting and extracting a piece of skin in the length of 12-13 cm and thickness of 2-3 cm as a block from the region of nape and separating the hair follicles within this skin and transplanting these follicles is called FUT (Follicular Unit Transplantation, Strip Operation).
However, the skin and the traces of the stitches after the skin is extracted pose a high risk of constituting ugly appearances and leaving traces as it can be seen from the photograph as well.
Moreover, in the second and third sessions of the FUT technique, the risk of deepening and enlarging this trace grows bigger and thus a new cosmetic defect is created that the person shall carry all life long.
In FUE and FUE Plus techniques, hair is transplanted from the region of nape and above two ears, which possess the excess of hair, into the hairless region that needs hair. However, this acquisition is based on extracting hair follicles under the skin by means of special needles (punch needles) unlike FUT technique in which the skin is cut and extracted in block. Consequently, FUE (Follicular Unit Extraction - Direct Extraction of Hair Follicles) is a superior method in every respect.
In the picture above you see the extraction of hair follicles on nape region by means of special punch needles entering 2-3 mm under skin and also the hair follicle at the tip of the tool.
You can see that the person can have his hair cut very short since no trace is left on nape region after FUE operation.
Furthermore, FUE and FUE PLUS technique is the only technique that enables taking hair follicle from other regions of the body containing hair follicle and transplanting this hair on the hairless part of the head.
Two most important features of FUE that differentiates it from other hair transplantation techniques are:
1. Since knife is not used, no stitching is done and integrity of skin is saved, it doesn't leave trace.
2. Hair follicles in the body can be used for transplantation.
3. Moreover, plantation quality is the major factor that we will explain in detail later on (1mm round-bottom needle).
FUE definitely has superiority over Strip Operation (FUT). Although FUE and FUE Plus are better methods than FUT, the later is still more commonly used all around the world.
The reason is that FUT is extremely simple and less time consuming (approx. 45 minutes) both in respect of the practice and the practicing doctor.
How FUE is implemented?
Before Operation:
When the patient approves the operation;
* The hair on the acquisition region should be cut 1 mm long at most. Otherwise FUE operation can't be effectuated. The operation in plantation region is at the option of the doctor.
* If the patient uses Finasteride (Propecia) group medicines and lotions containing Minoxidil (Rogain) or medicines augmenting the liquidity of blood such as Aspirin, he should stop taking these medicines.
* Upon the advice of the doctor, the patient should start taking protective antibiotic 1 day before the operation.
* If the patient has any allergic history developed previously against local anesthesia medicines to be used during the operation (Lidocain, Jetocaina, Ultracaina), he should inform the doctor.
Which patients can not undergo FUE operation?
* Diabetics, hypertension and cardiac patients, hemophilia, Hepatitis patients and heavy chronic patients shouldn't undergo FUE hair transplantation operation.
* Those persons that have not allergy against local anesthesia medicines can choose FUE.
Fox Test:
In most of the clinics, before FUE is applied a test is executed in which 10 - 25 hair follicles are taken as a sample from the patient. If 4 or more hair follicles out of 10 are found to be defective, the patient is informed that FUE hair transplantation is not suitable. Thus, this is a procedure that examines whether the person is suitable for FUE hair transplantation. However it is very useless for experienced doctors to execute this procedure. Since, experienced doctors can take out hair follicles successfully without causing any damage even in curly hair.
Fox Test can be evaluated not as an application testing the suitability of the patient for the operation but the ability of the doctor to execute the operation.
In all of the quality clinics of the world and as advised by experienced FUE doctors, 600 - 1000 hair follicles can be taken out in one session. Since, the number of follicles taken out prolongs the duration of plantation and reduces the chance of expected success in hair plantation.
Doctor takes out 600 - 1000 hair follicles by means of special punch needles. Before the operation, LOCAL ANESTHESIA is applied.
In the picture above you see the nape region right after the hair follicles taken out. Red spots are the small regions from which hair is taken out.
In FUE, hair follicles can be obtained from other parts of the body apart from back and side parts of the head.
Hair follicles taken out are accumulated within sterile (clean - sterilized) serum. During accumulation, cold application should be done for hair follicles. Warm environment causes death of hair follicles rapidly.
Hair follicles (graft) are planted after the acquiring process and sterile glass accumulation plate (Petri cups).
Plantation process:
After the plantation process is over, the region is wrapped with bandage. The patient may feel pain and ache in the forehead and plantation region during the fading phase of local anesthesia. However, this ache and pain responds to Paracetamol group medicines (Vermidon, Parol, etc.) in 10 minutes. Patients don't need to disturb their comfort and daily lives.
After Operation:
Bandages are unwrapped 24 hours later.
The patient can take shower 48 hours later.
Within the first 10 days, the lotions to be advised by the doctor shall be used on certain days.
Miniscule crusts in the forehead heal within 2 days and crusts in plantation region heal within 7 - 10 days.
You see the bruises right after the operation.
These miniscule crusts fall out within 7 days and with the growing of hair planted, cosmetic healing is achieved completely.
Technical Details and Importance for the Success of the Operation:
You see the hair follicles taken by means of FUE technique in the picture. Left to the right: Single (hair follicle including hair), then respectively double, triple and multiple grafts.
The diameter of punch needles for single hair follicle and diameter of punch needles of multiple hair follicles are different. While it is possible to take single hair follicle by 0.5 or 0.6 mm needle, double or triple hair follicles can not be taken by this needle or hair follicle is damaged.
Thus, choice of suitable needle is extremely important. Doctor should be able to take 2.25 strand when he takes out 1 hair follicle because 15 - 20% of hair follicles is the single hair follicle.
If the doctor uses a very thin needle, he can't meet 2.25 strand target and, for example when he needs to transplant 2000-2250 strands in the event of transplantation of 1000 hair follicles, since this number shall be less, the rate of success shall remain low and the patient can not obtain the result that he expects from hair transplantation.
For that reason the diameter of needles should be chosen carefully.
Quality of Hair Plantation:
"The technique of plantation by round needles under 1 mm is the principal determining feature that can be applied in certain clinics in the world."
Whether they choose FUE or FUT (which leaves traces) most of the clinics and doctors leave the operation of plantation to assistant personnel. Although plantation quality is the most important part of the operation, necessary importance is not attached. In this respect, very scarce and unsatisfying results are obtained by very big knives.
Utilization of big plantation knives and lack of attaching importance on the quality of plantation cosmetically causes the formation of "baby doll hair" or "grass man" appearances.
It is the most undesired cosmetic complication in hair transplantation.
Plantation by means of round needle under 1 mm eliminates all of these complaints. Moreover, since it enables frequent plantation, natural and real hair is gained.
As it can be seen in the picture, the hair planted by means of large diameter knives is an example for hair transplantation that do not fit into any aesthetic rule, do not match with real hair in the middle region, and that is qualified as "baby doll hair".
When this hair grows, a worse appearance is formed.
In the picture above, you can see that 6-7 strands come out of each channel due to utilization of large knives and that there are cavities at the bottom of hair and that they earn worse appearances to the patient than the previous state.
In round needle below 1 mm technique, it is possible to overcome this kind of problems completely:
As it can be seen in the picture, it is almost impossible to distinguish planted hair from the original hair. This is an example to the success of creating natural appearances by means of round needles below 1 mm.
In the first picture you see the deformity of the direction of hair, lowness of plantation quality and insufficiency to form hair line in plantation of hair follicles by knife.
In the second picture, you see the naturalness of directions and angles of hair, success of forming new hair line and harmony with natural hair thanks to round needle technique.
Taking the hair follicles by means of FUE technique enables plantation by round needles with a diameter below 1 mm. Since the diameter of hair follicles obtained from the skin and under skin tissue by FUT doesn't permit plantation by means of plantation needles in this thickness.
Thus, hair acquiring method is related to plantation method in a way.
Why is the Plantation of Hair Line Important?
Hair line is the hardest part of hair plantation and the most important region that determines the result. Since, hair line is the region that the person sees the first in the mirror and unnatural appearances prove the failure of the operation.
In this respect, the doctor should definitely obey aesthetic principles while forming the hair line. Plantation should conform to the natural structure of hair.
FUE PLUS technique renders hair line perfect and natural because plantation is done by means of round needles below 1 mm in FUE Plus technique and moreover single hair follicles are planted by 0.6 mm needles and thus it becomes possible to plant 100 hair follicles per cm2. FUE Plus technique renders the most natural result in formation of hair line.
You can see an example of reforming the hair line by FUE Plus technique. This is an example of obtaining a successful result by using 0.6 mm needle as a result of planting 100 hair follicles per cm2.
When the picture is zoomed, you can see the appearance of naturalness and success in FUE Plus technique.
You see the plantation of 100 hair follicles per cm2 by FUE Plus technique and the result in the second picture 8 months later.
The angles of planted hair and indents in the shape of zigzag and also plantation of only single hair follicles in the hair line are the basic factors in reaching this natural result.
Implementation Areas of FUE:
1) Androgenic Hair Loss and alopecia
2) Brow plantation
3) Elimination of FUT trace in patients having applied FUT (success rate up to 60%)
4) Covering the scars formed on haired head skin.
All Aspects of Becoming Successful in Hair Transplantation:
1. Experience in FUE and FUE plus techniques
2. Correct choice of the diameter of punch needles
3. Use of round needles with diameters below 1 mm and choice of 0.6-0.7 mm needles in FUE Plus
4. Respect of the doctor to his job and to the patient, his commitment to patient's rights
5. Continuity of the team and long term cooperation
6. Respect of the doctor to his job and awareness of the fact that the decision of hair transplantation is a very important decision in his life. Regarding FUE and FUE Plus techniques an artistic process.
7. Ensuring quietness and cleanliness of the operation room and use of magnifier goggles that zoom up to at least x6 ( Heine, Zeisa ).
Thus, formation of technical and psychological infrastructure and experience of the doctor is very important.
Indications of Commercial Motivation:
Unfortunately, in many clinics all around the world and in Turkey, commercial motivation is found to be dominant in hair transplantation operations. Due to this unfavorable motivation that is brought about by very expensive implementations of aesthetic sector, many patients have suffered. The most fundamental indication of this perspective is the presence of companies whose owners are not doctors. These business owners employ doctors and have these execute hair transplantation. Moreover, although FUE and FUE Plus are very superior techniques, the presence of companies and clinics that apply FUT and FUT+FUE together is another example.
CONCLUSION:
FUE and FUE plus are methods that do not disturb the integrity of skin, increase validity and desirability all around the world and bring forward the artistic side of hair transplantation in which knives are not used.
Indeed, hair transplantation is an illusion. It is a method that compensates for your longing for your previous natural hair and solves the problem of alopecia as best as possible.
It should be noted that it is not possible to transplant hair in the density and form of your previous natural hair. However, FUE and FUE Plus techniques accomplish their task of "illusion" by solving what is impossible in the most natural way possible without creating a new cosmetic deformation.
CONTACT US:
Dr. Gökhan Gür
email: info@gurhair.com
Phone:
+90 (312) 466 00 62
Mobile: +90 (532) 364 71 23
Address:
Tunus Caddesi
No: 90/4
Kavaklıdere / ANKARA / TURKEY