Hair Loss & Treatments

The source of the restored hair units is the hair roots between the ears which are programmed not to be lost

FUT method means “Follicular Unit Transplantation”. The hair roots to be transplanted are taken from the region between the ears as a narrow band; after this procedure a thin scar is left in the hairy region. Each follicular unit is carefully separated under microscope and prepared for restoration in Transmed. Each unit prepared is a graft to be transplanted to its new localization.

FUE technique means “Follicular Unit Transplantation”. Roots to be restored are obtained by extracting follicular units one by one with a special device. This method also provides extraction and use of the body hair as a technical principle. The advantage of the method is that no scar is left on the localization where roots are extracted one by one. Its disadvantage is that the procedure is performed after the hair is shaved with a number zero. In both FUT and FUE methods, the hair roots are placed into their new localizations with the same technique.

Androgenetic hair loss is a lifelong process. After a successful hair restoration surgery operation, the surrounding hair will continue to be lost, even if the life time of the restored hair is arranged to last lifelong. Therefore, preventive programs have been developed. With an interview with your physician a maintenance program is arranged for you with combination of systemic drugs, topical lotions and local treatment.

Hair restoration can not be performed in individuals with inadequate number of roots in the donor area. Hair restoration is not recommended during treatment of soft tissue diseases, when hair loss is very unremarkable yet and in individuals with bleeding-coagulation problems.

If a FUT operation is performed, the aim is that the scar formed in the donor area to be noticed with difficulty even by the hairdresser and to be covered by other hair. For this objective, there are studies providing elimination of FUT scars completely using new Extra-Cellular Matrix.

In October 2003, Dr. Rassman defined the first version of FUE method which he named F.O.X. procedure in the meeting of World Hair Surgery Association in New York. Rassman have been performing Transmed FUE operations since January 2004.

Transmed plastic surgeons have performed 10 million follicular unit restorations in more than 5000 FUE sessions since 2004.

4000 follicular unit transplantations can be performed daily through FUE technique. This number is adequate to make a large bold area hairy. In cases where this number can not be reached with only FUE, FUT and FUE techniques are used in combination and thus two separate operations with an interval of one year are prevented and time is gained for the patient.

Whatever technique is performed, the transplantation area appears red because of thin red crusts for one week. This redness is decreased on the fifth day. After shedding of the crusts, this region recovers its previous appearance completely after the eight or tenth day.

For an operation which will be performed with FUE technique, the hair should be shaved with a number zero. This means that the patient will not participate in social life because of the scars in the donor area. However, in patients with long hair, if the number of roots which will be extracted is small, the donor area is shaved as bands and the regions where the roots are taken are covered by the hair after the intervention. Thus a faster return to social life can be provided.

You can swim in the sea or pool 15 days after the operation.

You can walk and exercise 7 days after the operation and participate your routine sportive activities two weeks after the operation.

This is a decision left to the patient. From the medical perspective you can continue your work or social life immediately after the operation. Crusting in the donor area and the region where hair transplantation is performed is eliminated in about 8-10 days with the application of Fast Forward method.

No, no visible scar is left in the donor area even if the hair is shaved after FUE procedure.

Yes. However, if the number of hair roots which will be extracted is small in patients with appropriate hair structure, the donor area is shaved as bands and the regions where the roots are taken are covered by hair.

These operations are performed only by plastic surgeons, because this procedure is included in the category of microsurgery and requires medical information. Cosmeticians, technicians or nurses are not authorized to perform this operation. In Transmed Hair and Cosmetic Surgery Clinic, these interventions are performed by

İlker Apaydın, MD.
Özge Ergün, MD.
Ali Emre Karadeniz MD. and
Ali Dursun Kan, MD
under medical directorship of Melike Külahçı, MD.

For patients who ask for general anesthesia Esin Özaçmak, MD. (anesthesiologist) is working as a consultant physician.

1. Local anesthesia is used in operations performed with FUE technique. This local anesthesia which should be effective for a long time should be used by surgeons with medical education and experience.

2. During extraction of follicular units microscopes are used not to harm the roots and to extract each one from the skin with right interventions. Only if extracted by plastic surgeons with microsurgery education with care and caution, the hair roots are transplanted in a productive way.

3. The number of roots in the donor area is limited. Therefore, each hair root is important for patients and for the plastic surgeon who wants to perform a successful operation. Careful extraction of the follicular units from the donor area requires expertise.

4. Hair transplantation is not limited to extraction of the roots. Necessary experience and knowledge for keeping the extracted roots, planning the canals where the roots will be placed for each patient individually, presence of a plastic surgeon experienced in hair restoration, an educated medical team and high-technology equipment are very important for the success of hair restoration.

This time depends on the number of roots to be restored and the hair structure of the patient. Approximately 1500-2000 grafts are transplanted in one session and each session lasts about 3-4 hours.

Up to 4000 grafts can be restored daily in operations performed with FUE technique in direct proportion with the capacity of the donor area. Exceeding this number would lead to non-optimal results based on our experiences and discussions with foreign colleagues.

Thin crusting occurs for 8-10 days after the operation. These crusts are shed from the head like dandruff and are completely eliminated in 8-10 days when washed daily. In this period, the patient may go on with his daily life and work by wearing a hat. The hair starts to grow in the first three months. One year after hair restoration, the aimed appearance is reached.

Most healthy adult men with adequate hair in the donor area (the region between the ears) are appropriate for hair restoration.

Yes.

%20 of our operations performed in Transmed are correction operations which we perform in patients in whom hair restoration was performed in different clinics.

To correct these cases which are known as “Baby Head” or “Grass Man” and which is named “Pluggy Look" in the literature an experienced operator should work specifically for that patient spending two fold longer time. Generally, correcting an erroneous intervention is more difficult than to perform the first intervention..

Correction operations require a good planning. A patient who has undergone an unsuccessful operation has limited donor area. In this case, the hair surgeon should make a good plan considering hair transplantation, the age of the patient, his expectations and the hair transplantation type previously performed.

In cases where the donor area is used completely, the transplanted hair may need to be extracted from their places, processed under microscope and restored in an optimal way. Every single hair strand is of great importance for the correction operations to be successful.

Wound and band scar
Hair loss occurs as a result of injury to the head because of various causes.

In these regions, FUE “Follicular Unit Extraction” method is preferred. However, a consultation and a test restoration performed with a small number of follicles are recommended before such a correction operation.

In addition, another therapy used frequently is the operation performed on wound scars which occur as a result of hair restorations performed with FUT. It can be followed up in the medical literature Trichophytic closure which is one of the current closure techniques prevents externally appearing injury. However, FUE technique is used to camouflage the non-cosmetic scars formed when this method is not used.

In these type correction operations, hair roots are extracted form the donor region and placed in the line of injury. Thus, the wound scar is prevented from being remarkable and causing social discomfort.

Camouflage
Negative results of hair restoration which is known as “doll head” or “pluggy look” generally arise from using thick and multiple-strand hair follicles for the front hair line

A simple principle is used for solution. Single and thin hair roots are placed in a row in front of these large and unnatural hair roots as covering a fence. With a right planning, thick hair strands are kept behind this thin strand wall. As a result of a good correction operation, these large hair roots are localized in a way that the hair appears to be a head full of hair.

Correction operations require a good planning as well as patience. The surgeon generally does not prefer a single intervention because of working on a consumed donor area. Instead, he/she uses a part of the remaining donor area and performs the first stage of the correction. One year later a small and supplementary intervention is performed depending on the result obtained.

Hair restorations with wrong direction
Growing of the restored hair with an angle inappropriate for the hair roots in the localization and thus unnatural appearance lead to the most difficult correction operations.

In such correction operations, adapting the localizations of the new hair roots with the directions of the roots which were placed with a wrong angle may worsen the problem. However, placing with the right angle again causes an unnatural appearance because the hair growing as a result of the previous operation with a reverse angle.

In such cases, it is preferred to place the new hair roots without a very dramatic change in angle, to perform the new transplantation without drawing attention and to correct the previous situation.

Eyebrow restoration
Eyes constitute the most characteristic parts of the face. Eyebrows play an important role in forming different expressions of the face by framing the eyes. There is no cosmetic or medicinal treatment to grow hair in areas of lost or deficient eyebrows, yet. Independent of the cause, hair roots can be transplanted in the field of lost eyebrows and new hair appearing like eyebrows can be provided to grow.

Eyebrow restoration can be defined as restoration of healthy hair roots which are programmed genetically not to be lost for a lifetime obtained from the area which is localized between the ears in the posterior part of the head and which is called donor area, in the areas of eyebrows.

This procedure starts with the patient’s decision for the eyebrow form he/she wishes after consultation with the plastic surgeon. Afterwards, a mild sedative agent is given to the patient and local anesthesia is administered in the region where the procedure will be performed. The procedure lasts about one hour and the patient can have a bath 24 hours after the procedure without any problems.

Mild crusting and erythema is observed in the transplantation area after the procedure for four days. The area where the restoration is performed completely heals at the end of 6-7 days. Full growth of the transplanted eyebrows takes 3-6 months. Although a second intervention is generally not required, the growth is evaluated at the end of the sixth month and a second intervention is performed to obtain the desired outcome, if needed.

Eyebrow restoration is a procedure which requires specialization. This is because the angles and directions of the hair in the eyebrow area are different from the scalp hair. The hair in the scalp area grows with an angle of 45 degrees, but the hair in the eyebrow area is almost parallel to the skin. The roots in this region grow vertically in the intersection region with the nose, downwards in the superior part of the eyebrows and upwards in the inferior part of the eyebrows. They become a single line when they combine at the end. The roots obtained from the scalp should be placed into very small canals in the skin as follicular units which are extremely thinned, so that no scar is left in the region and a natural appearance is achieved. As you can see, because of all these reasons formation of new eyebrows by a specialist plastic surgeon is very important.

No complication occurs in eyebrow restoration. However, it should be kept in mind that new eyebrows grow faster than the hair. Therefore, new eyebrows grow faster compared to your own eyebrows especially in the first year after eyebrow transplantation. After one year, new eyebrows start to adapt the growth rate of the region they are localized.

As important is healthy hair for a good appearance for women, so can be hair and mustache important for self confidence and external appearance in men. However, sometimes men do not have beard and mustache with a density as they desire.

According to the statistical figures of International Hair Surgery Association (ISHRS) published in 2008, an increase of 110% has been observed in beard and mustache transplantation operations in Turkey and the regions around Turkey especially with an increase of knowledge of individuals about hair restoration.

The density, tissue and hair quality of beard is completely under control of genes. After the beginning of puberty beard hair gets thicker and gain their terminal forms in three years. Unless an important change happens in the levels of the virility hormone, beard hair maintain this characteristic properties.

Loss of beard and mustache may be due to autoimmune diseases as well as cutaneous diseases. Other than this, the heaviest picture arises from hormonal imbalances. The virility hormone testosterone should be controlled when it decreases below the threshold value in men. Loss of beard may also be observed in the disease called alopecia areata.

There is no cosmetic or medicinal treatment to grow hair in areas without hair, yet. This is also valid for beard and mustache.

The solution is beard and mustache transplantation.

Beard and mustache restoration can be performed from the age of 20-22 when the hormones reach the basal level. This procedure is preferred for men who wish to grow their side whiskers, like the appearance of a beard of two days, but have irregular or deficient beard hair.

Beard-mustache restoration can be performed in all healthy men who have no beard or who have bold regions in patches in their beard. One of the most common interventions is restoration in a region with a scar.

Beard-mustache restoration can be performed in anyone who has hair on the scalp. The operation is performed by extracting hair roots from the area between the ears (just above the neck with thinned hair) or the areas above the ears.

As with hair restoration, FUE is used in patients who accept number zero hair cut and FUT method is used in patients who do not want to have number zero hair cut in beard and mustache restoration.

On the day of transplantation, the skin heals as red crusts and gains its previous appearance one week later without any scar. No severe pain occurs after facial hair restoration as with scalp hair transplantation.

Approximately 8-10 weeks after the intervention the outcome starts to display itself. The beard hair which is present and scalp hair which is transplanted can not be visually differentiated. The outcome is natural and persistent.