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Cirugía y medicina plástica, estética y reparadora

Hair implants


F.U.E (Folicular Unit Extraction) 

 


  

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Micrografting is a very satisfactory for androgenic baldness and the best results are obtained in cases where hair loss has stopped. It consists of filling in bald areas using single-hair with the patient’s own hair.

The technique involves removing a strip of hair from the occipital area and taking small microimplants, one to three hair follicles for each implant. After their treatment, they are placed in the area to be reimplanted. All this is done in the same operation.

The procedure is done on an outpatient basis under local anesthesia and sedation, and lasts three to five hours, depending on the number of follicles to be reimplanted (about 500-800 in a single session.)

The new hair will start growing in three months.




This procedure is peformed in two stages:

 

 

STAGE 1: Follicular Extraction Units

 

Random micro incisions are made with very low caliber punches (0.75 mm) at a very controlled depth along the axis of the follicular unit. The circular cut helps to isolate the follicular units in their position. The success of this stage depends on the particular skill of the surgeon in aligning the punch perfectly parallel to the follicle axis, to avoid cutting the follicle when making the cut. They are then removed carefully, using fine tweezers.



The micro incisions create small circular wounds which heal rapidly, leaving nearly invisible scars and thus speeding up the recovery process. This procedure doesn’t involve much risk of neurovascular injury, and there is very little bleeding due to the numbing technique used (the application of the anesthetia in order to discreetly relax the tissue, the skin in this case), which greatly reduces bleeding and helps control the penetration of the punch (approx. 3-4 mm), a point just beyond the hair erector muscle.



As the hair follicles are extracted, they are classified in units of 1, 2, 3 or 4 hairs, placing them in Petri dishes with physiological saline solution or Ringer’s lactate at +4ºC for proper storage until they are transplanted.


STAGE 2: Transplant of Follicular Units:

 

For the placement of the Follicular Units, we use an instrument called Implanter. It is a thin needle that creates micro-incisions of a predetermined density and pattern, and at a consistent angle and direction in order to achieve a natural and realistic model. This tool automates the processes of incision and transplant in a single operation.



Dressings of the donor or recipient areas are not necessary after the transplant.


Instruments:



- Titanium micro-punches of 07-09mm.

- Extra-fine dissection tweezers.

- Choi implanters.

- Petri dishes.

- Binocular lenses.


 

Do patients usually come with magazine clippings or photos of someone who they want to look like?

Without a doubt, I’ve had cases like this, but the hair that looks good on you isn’t always like the hair of the person you want to look like. It’s important to know how to guide a patient well, and especially how to work together on this issue as a team. The design of the anterior hairline plays an important role in defining and marking the face, so it is difficult to look straight in the eyes of a person with a receeding hairline, say, when we are speaking in front of them from close range. It is an "artistic challenge" for a hair surgeon to find the appropriate design, which is something that varies greatly from one person to the next as it is closely related to facial geometry and architecture, and undergoes changes due to aging.


Some patients who are still young ask for the hairlines they had as teenagers (in other words, very low), probably because they still remember clearly the youthful line that they lost so soon. Indulging this request would result in an unnatural effect in a few years since the transplanted hair will remain unchanged. Artistic and ethical sense is essential in the assessment and proposal of a hair transplant design to our patients.

Are there alternatives?

The FUE technique offers the advantage of rapid recovery, as well as transplantation mini-sessions at different times as an alternative that the patient can even plan over a certain period of time for their seasonal or financial convenience.

What is the ideal time of year for hair implants?

Hair loss tends to accelerate in autumn and winter, and we usually see an increase in hair transplant surgery in these months, also because people want a more active lifestyle in the warmer months.


It is you who will determine the best moment to receive your transplant, and this depends on your lifestyle. Some people prefer to hide their treatment and therefore must choose at what point they can disconnect from their social life. Others enjoy showing everyone how they’ve finally made their dreams come true.


Then there is the question of when you want to see the hair growth. Suppose you want a significant increase by a certain date, because you have an important event coming up. In this case, you would need to plan your procedure eight months in advance.


In other words, there is no ideal season.

What is the level of patient satisfaction? And for the surgeon?

Usually excellent for both.

Why are some patients good candidates for this technique and others aren’t?

Generally almost all patients are elegible, except for those whose hair has certain characterisitcs that make follical removal much more difficult.

 

For baldness in stages VI and VII on the Norwood-Hamilton Scale, it is advisable to associate FUT / FUE / BHT for better short-term results

Can it be combined with any other treatment or appliances?

A transpant doesn't stop the hair loss process.

Depending on the progression of baldness, it can be combined with Minoxidil, Finasteride, or both after surgery to stop the loss of non-transplanted hair and care for the effects of the procedure over time. The application of LLLT, a low-intensity laser, can be helpful in the healing process of the grafts.

Price

For the price of the procedure, the first step is to have a consultation, the costs can vary greatly from one individual to another, depending on several factors including the availability of donors, degree of hair loss, possibility of future loss expectations and preferences individual.

 

FUE is usually more espensive than other techniques to involve an intense and detailed professional work, where the surgeon with special skill, one who removed and placed all grafts with excessive consumption of time. Prices range between 4 and 6 euro for UF.

What are the expectations of patients?

Expectations are highly variable from one patient to another, but the most demanding want the most natural look possible in the hairline, high density and guaranteed graft survival. All this in a procedure with less chance of complications and no linear scar. This can be accomplished with FUE!

What kind of scar does it leave? What care is required? How long does it last and how noticeable is it?

Post-operative care begins as soon as the patient leaves the clinic. The patient will irrigate receiving area regularly to reduce scab formation and aftert 24 hours after will gently wash with a medicated shampoo. After shampooing, you can gently rinse by pouring cups of water on the head. You can dry your hair by softly touching it with a towel. The donor site can be cleaned more aggressively. It should continue this process every day for a week.

 

Usually, the patient may experience swelling on day 2 or 3 of post-operation. We recommend our patients take anti-inflamatory medication and that they also sleep at a 45-degree angle or with their head elevated, if possible. You can also apply an ice pack for 15 minutes to help relieve swelling. Around day seven scabs should start to fall off. The micro-scarred wounds heal very quickly just by washing and leave tiny dots that are usually perfectly hidden, even while wearing the hair very short.

What is new about this technique, as opposed to previous techniques?

The FUE method emerged and developed in recent years, as an alternative to generate Follicular Unit Hair Transplant Donors, in a less invasive way than the classic strip, without using a scalpel, linear scar or sutures. This allows the patient to wear their hair very short even after the procedure. The recovery is excellent, quick and painless, guaranteeing almost immediate incorporation of the patient back into their normal activities, including sports.



With FUE it is possible to extract individual follicular units from any area, and this allows the surgeon to choose the best hair transplant according to development. This occurs, for example, in the restoration of the anterior hairline, achieving the most natural results. Is also possible to remove hair from other parts of the body (chest, back, beard, etc.). This option is useful for people who have exhausted their donor capital. With this technique, known as BHT (Body Hair Transplant), the hair grows longer and faster in the scalp, probably due to greater blood supply.



Given the thinner nature of the grafts provided by FUE provides, they can be brought much closer to the recipient area, making for far superior densities. Follicular Units isolated by this method are ideal for covering very wide scars created by the strip method, for the reconstruction of limited cosmetic areas such as eyebrows, eyelashes, beards, mustaches, etc, and the camouflage of scars left by facial liftings.

 

What is the general profile of a hair implant candidate?

The choice of a patient follows the general rules of traditional hair surgery FUSS (the strip method), dealing mainly with patients who have realistic expectations, a specific level of irreversible loss and a stable donor site that provides sufficient follicular units to permanently repopulate the affected areas without risk.

A specific candidate FUE is:

1.   The young patient.
2.   The active patient.
3.   The patient who wants a short hair style.
4.   The patient who wants any hair style.
5.   The patient who wants the least invasive surgery.
6.   The patient who wants a procedure that doesn't produce a linear scar.
7.   Correction of previous transplants.
8.   Camouflage of scars from previous strip transplants.
9.   Treatment of eyebrow loss, loss of eyelashes, mustache, beard.
10. Post-lifting alopecic scars.
11. Donor sites with little elasticity.
12. Insufficient donor sites.
13. Those who want the most advanced hair transplant.
14. Those who want the only true independent hair transplant.



Women tend to have a more diffuse loss, which requires that doctors be much more selective when accepting women patients as candidates for transplant.



However, if the candidate is the right person, the transplant can have the same benefits offered to a man.

 

 

 



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