Hair Transplantation

Hair Transplantation

For many men, baldness is an inevitable part of aging. For men with genetic hair loss problems, hair loss can start at a much earlier age. After this process, no surgical intervention or medication will help with hair regrowth. Hair transplantation is the healthiest application. On hair transplantation methods, scientists develop new technologies and methods every day and support developments in this field. Turkey is one of the most important centers in the world in terms of using these technologies and having successful doctors.

Although hair transplantation seems like an aesthetic operation, it is an application where surgical procedures are performed and experienced doctors and a high level of sterile environment are required. Since advanced technology equipment is also used for this procedure, the treatment center should be well equipped. Otherwise, it is not possible to obtain the desired results, and results that may threaten health may be encountered.

As Fuller Hair Transplant, we choose the institutions and doctors we recruit with this awareness and sensitivity, and offer our patients a risk-free treatment environment. Our most important criterion is that the center is sterile, technologically equipped, have experienced doctors, and that the institution has the features clearly determined by the Ministry of Health and that they have obtained the necessary licenses.

When should hair be transplanted?

There is no definite period for hair transplantation, because we do not have a method to determine if or when the hair loss will stop. Therefore, hair can be transplanted when the patient is ready. Hair transplantation does not have a preventive or stopping effect.

There is no specific season for hair transplantation, but it is necessary to adjust the date knowing that there will be a recovery period of about 3 weeks after it.

Procedures Before Hair Transplantation

Learning Patient's Medical History: Before hair transplantation, it should be determined whether the patient has any other disease, whether he/she uses any medication, or whether he/she has allergies. Those with ischemic heart disease, those with infectious diseases, and those who use blood thinners are not suitable candidates for transplantation. Diabetics should have their blood sugar adjusted, and blood pressure patients should have their blood pressure under control.

Hair Examination: It is necessary to look for fungus, scarring or dermatitis on the scalp. Hair can be transplanted into the scars, but they are disadvantageous in terms of density and efficiency. If there is an active fungal disease, it should be treated first. Then, with a special tool, the number of hairs per cm2 and the thickness of the hair are measured separately from the front, top and nape regions.

Photo Shoot: Before Transplantation, hair photos should be taken from the front, both sides, back and top. Shooting with a studio system gives more detailed information.

Blood Test: A blood test is taken to understand whether there is a contagious blood disease and to look at the bleeding values. HIV and hepatitis patients should not hide their condition.

PRP: It is done within 10 days before planting in order to make the recipient area more convenient for future hair follicles with growth factors. For this procedure, 9 cc of blood is taken. The solution obtained after a 10-minute centrifugation is injected into the skin of the entire recipient area with a fine needle in small doses. Although it is not a very painful procedure, it is recommended to wait 30 minutes after applying Emla cream to the head beforehand.

How is hair transplantation done?

Hair transplantation is a surgery and must be done in a hospital by law. It is performed under local anesthesia. It is not a painful procedure. Only in the beginning, a short-term burning occurs due to the drug, while the first-line anesthetic is injected. Apart from that, it is a comfortable surgery. You can bring a book to read or watch a movie.

Initially, a vascular access is established and a prophylactic antibiotic injection is given. Then, you lie face down and grafts are taken from the nape. Following this, a break is given, while the grafts taken are checked. Afterwards, the channels are opened in the lie back position and the follicles are placed inside. A transplant of 3,500 grafts takes an average of 5 hours.

At the end of implant, a single dose of steroid injection is made to reduce edema, the donor area is covered with a dressing, a band is attached to the forehead to prevent facial swelling, the planted areas are left open.

One Stage or Two Stages?

In hair transplantation, 3,500-4,000 grafts can be transplanted in one session. In patients between Norwood Types 2 and 5, this figure is already sufficient. For types 6 and 7, more plantation is required. However, in this case, it is preferred to plant 4,000 first. After seeing the result of the transplanted hair 1 year later, second session is held. Because in this way, the first planting can be retouched, or in case of a possible complication, all the eggs will not be put in one basket. Because there are a total of 6,000 follicles that can be taken from the nape.

When it is done in two stages, the front parts are filled in the first session and the top of head is closed in the second session.

Is the hair cut?

In order to get hair from the nape in the FUE technique, the hair must be short. Because the cylindrical blade at the end of the micromotor used should center the follicle and enter it from its full circumference. Otherwise, the follicle may be missed. For a good result, donor hair must be short.

However, if the area to be transplanted is only at the temples as in Norwood Type 2 and 3, and it is not necessary to plant by entering between the hairs on the top, then the hair can be transplanted without cutting the front hair.

In some cases where very little transplantation will be made, the patient is told to grow their hair on nape long and only the 3x 6 cm area to be taken is cut short, the long hair on it can camouflage the cut area.

When Do You Get the Results?

Hair transplantation is a long-term treatment. One month after transplantation, the transplanted hair enters the telogen phase and begins to shed. Then it starts to come out again from the 3rd month. It takes its final form 9-11 months later.

What Should Be Considered After Hair Transplantation?

After transplantation, the patient can return home on foot. He/She begins to take painkillers and antibiotic tablets. The next day, the dressing on the neck is changed, and the hair washing program is explained to the patient. After this stage, if the patient lives in another city, he/she can return. There is no harm in traveling by plane.

On the 2nd day after transplantation, the patient removes the dressing on the neck himself/herself and leaves it open. A softening solution is applied to the transplanted area and then daily washings for 15 days are started with a special shampoo. The purpose of the washing program is to gradually clean the blood clots around the follicles and prevent infection.

For the first 15 days, it is necessary to lie on your back, not to wear a hat if possible, and to avoid sweaty activities.

Factors Affecting the Result

A 10% loss in each hair transplant is considered normal. However, there are factors that reduce the retention of the transplanted hair. These are as follows:

Smoking: Smoking causes constriction of skin vessels and impairs nutrition. Wound healing is also delayed in smokers. Although smoking is not a definite obstacle, not smoking as of 15 days before planting and until 15 days after planting, increases success.

Infection: The most important reason for hair transplant failure is infection. The main source of infection is ignoring sterility during planting. During the 10-day period after transplantation, it is necessary to keep the head clean and not to do activities that will make you sweat too much. Due to the structure of the scalp, the infection may not show itself fully. It mostly occurs in the form of abscess (folliculitis) in the hair follicle.

Mechanical Trauma: There is nothing but a blood clot that keeps the hair follicle placed in the canal during transplantation. It takes about 15 days for the follicle to adhere to its new location. Therefore, in this process, hitting, rubbing the planting area or touching objects such as a hat/clothing may cause the follicle to dislodge. Especially baseball caps are extremely harmful. If a hat is to be worn, it is necessary to choose a high and hard-topped, low-waisted fedora style hat.

Hair Thickness: If the donor hair thickness is thin, it will cover less.

What are the complications?

Early Complications: Bleeding, bruising, facial swelling, redness at the planting sites, pain in the nape and infection.

Late Complications: Not getting the desired result due to hair loss, open areas on the nape due to excessive intake.

Is a Second Transplantation Necessary?

The transplanted hair does not shed after it settles, but the destruction of the existing hair during planting as a result of the acceleration of genetic shedding may cause the desired result to not be achieved. However, this does not indicate the failure of transplantation. In such patients, a second transplant is recommended as the image will be the same as the previous one and it will show that the hair has been transplanted.

If the transplanted hair has not grown due to infection or any other complication, a second transplant can be planned. However, the reason for the failure must be well understood.

All the 2nd plantings are planned 1 year after the first and can be done if there is enough donor hair on the nape.

Who Cannot Have Hair Transplantation?

  • Patients with insufficient donor area. This could have several reasons:
  • Structurally very sparse and thin nape hair
  • Having had a hair transplantation before
  • Type 7 patients with a very thin strip of donor hair left behind
  • Those with Ischemic Heart Disease: The adrenaline solutions given may strain the heart.
  • Those who use blood thinners: Aspirin should be discontinued at least 10 days before, warfarin type drugs should be replaced with short-acting drugs.
  • Patients with active infection of the scalp.
  • People with infectious blood diseases such as HIV and hepatitis.

What should be the expectation?

  • The expectation in hair transplantation should not be to return to the bushy hair at the age of 17. There are two reasons for this:
  • In a normal scalp, there are 80-100 follicles per 1 cm2. There is an average of 2.4 hairs in a follicle. The maximum density that can be achieved when hair is transplanted with the FUE technique is around 35 follicles per cm2. Because technically, even the thinnest channels are opened, it is not possible to place more hair.
  • Even if the technology develops and it is possible to plant more dense hair, this time there is not that much donor hair on the back of the neck. A maximum of 6000 follicles can be taken from a nape. Since the follicles are taken, they are not replaced by new ones. If we try to carry all the density in the nape to the front, this time there will be openings in the nape.
  • As a result, we can expect 2 things: a new hairline and a density enough to cover the shine of the scalp when viewed from  afar.
  • Hair transplantation does not have a preventive or stopping effect on shedding. Moreover, when transplanting hair to thinned areas, it may even be possible to damage the existing hair on the right and left with surgical trauma.