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iimm HAIR TRANSPLANTATION INSTITUTE
Pantelis Valvis M.D. - Plastic Surgeon, Consultant of Hair Transplant Clinic, Metropolitan Hospital, Athens, Greece
Surgery : Kountouriotou 163 & Sotiros, 18535 - Piraeus, Greece, Τelephone : +30 697 730 8066, Fax : +30 210 422 6070, Email : valvisp@iimm.gr
Hair loss at an early age can be extremely distressing. But baldness is not the inevitable result. It is now possible to put hair back, permanently. There is no need to suffer feelings of low self-esteem, no need to lose self-confidence. Many people in your situation have done something positive about their hair loss. Hair transplanted from the back of the head can be used to replace lost hair and it will stay there, it is permanent, it will not fall out.
Arranging treatment for hair loss is a very personal affair. It is aesthetic surgery. So what do you do next?
The first step is to get a medical opinion from a specialist and the right specialist for aesthetic surgery is a Plastic Surgeon.
Dr Pantelis Valvis is a trained Plastic Surgeon with many years of experience. Simply start by sending him photographs of yourself together with some brief details. He will discuss with you your situation and gather all of the necessary information.
Too often, people like yourself are persuaded to use a particular treatment or method promoted by one of the specialist companies, sometimes this even happens against the opinion of the companies' own doctors.
The truth is that no one knows better than a specialist Plastic Surgeon.
By dealing directly with Doctor Valvis, you will get advice based upon years of personal experience and free of the pressures of company doctrine. He is familiar with the benefits and flaws of all of the methods used by specialist companies.
He is free to advise which method will bring the very best results for you. He has the skills to perform aesthetic enhancements, to create the most natural-looking results, without leaving any traces of intervention.
Biography - Dr Valvis was born in Greece but studied at the Medical-Surgery School of Rome University, becoming a licenced doctor in 1985.
He then returned to Greece and worked in the Clinic of Plastic & Reconstructive Surgery of Metaxa's Memorial Hospital where he took up the Specialty of Plastic & Reconstructive Surgery in 1995.
He started performing hair transplantations eleven years ago and has successfully performed many thousands of procedures since.
Dr Valvis speaks Greek, Italian and English fluently and has frequently attended conferences and seminars abroad presenting many papers including 'Mega session of Micro-mini Hair Transplantation for extensive baldness with a rich donor site'.
He currently has a private practice in Athens and is also Consultant Plastic Surgeon in the Clinic of Hair Transplantation of the Metropolitan Hospital in Athens.
FIT method and Micro-Dense-Pack T-T
The Micro-Dense-Pack method is suitable for small sessions of 800 grafts (about 2400 hairs) up to the largest session of 3500 grafts (about 10,000 hairs) for Total-Transplantation. A sessions may last for between 3-4 hours depending upon the area to be covered and the number of grafts to be placed.
For people with a very extensive area of baldness it is advisable to plan a transplantation over two sessions about 12 months apart.
This method involves the removal of a piece of hair-bearing skin from part of the donor area and the microscopic isolation of individual follicles or follicular groups. The surgeon will only use hair from well within the permanent zone, ensuring a border of permanent hair around the donor area. This is necessary in order to maintain a natural, untouched appearance to the back of the head.
The size of the area of skin removed will depend upon the number of grafts needing to be placed, on the elasticity of the surrounding skin and on the density of the hair in the donor area. The donor area is typically 1.5 - 3 cm wide and the Plastic Surgeon only removes the length needed to prepare the exact number of grafts required for the current session. All follicles removed will be implanted, none are ever discarded. After extraction, the Plastic Surgeon ensures that the rest of the donor area is preserved intact, unmarked and available for use in future procedures.
The removal of the donor area is done with extreme care and precision, making an incision between individual hairs, using surgical binoculars in order to avoid any damage to surrounding hair follicles. The special skills developed by aesthetic surgeons ensure the minimum of disruption to tissues - blood vessels and nerves are left undamaged. Techniques used for delicate facial surgery are applied to this part of the procedure, using special stitches to aid healing with minimum scarring.
The follicles in the piece of hair-bearing skin which has been removed are now prepared for implantation by dividing it into grafts. Using a microscope and tiny surgical instruments, the individual follicles or naturally grouped follicles are isolated and all extraneous tissue is removed. Each graft can contain between 1-5 hairs, depending on the natural grouping. Always, the number of hairs transplanted will be greater than the number of grafts placed.
The advantage of the Micro-Dense-Pack technique developed by Pantelis Valvis is in the selection of grafts and in the visual considerations given to the future effect of the transplanted hair. By removing a piece of hair-bearing skin and isolating grafts from it, the Plastic Surgeon has available a naturally balanced selection of follicular groups to choose from for implantation. The qualities of different types of follicular group are important to consider when they are placed in their new position.
The implantation process requires extreme precision as tiny grafts are placed one by one in exactly the right position, at exactly the right angle, pointing in exactly the right direction and to exactly the right depth.
The preparation and pre-planning of the design of the area to be implanted is crucial to a successful outcome. Once implanted, the hair will be a permanent record of the abilities of the Plastic Surgeon!
The establishment of the new front line (hairline) must appear natural, and the Plastic Surgeons start by selecting single follicles first, staggering the implants slightly, then progressively increasing the density behind in order to achieve a natural-looking result. The curved shape of the line, too, is vitally important to the final effect.
Using surgical binoculars the surgeon creates a tiny hole in the skin by making a small incision in the bald area with the aid of a microtome. The hole is so small (1mm in diameter) that little bleeding occurs. The selected graft is implanted deep into this opening so that it is secure and has access to the nurturing blood supply. The implanted graft quickly heals and becomes one with the surrounding tissue.
By using special instruments, Pantelis Valvis is able to place grafts very close together, as does nature, so that the hair will grow and behave normally as if it had always been there.
FUE method and Micro-Dense-Pack T-T
The FUE method is a more complex and time consuming method and therefore sessions can take longer, up to 8 hours, and the maximum number of grafts is 300 per session (between 600-1000 hairs). The method is also more costly. If a number of sessions is planned, allow six months between sessions.
The FUE method is also referred to as 'no surgery' and 'no scarring' because the area disrupted by the extraction is so small it heals naturally without the need for stitches.
Because of the need to accurately locate individual follicles, the FUE method requires that the head is shaved by the doctor before the procedure starts, making the follicles easier to see and handle. For the FUE method, the Plastic Surgeon uses a tiny circular cutter (punch) with a diameter of between 0.7- 1mm to extract individual follicles or small follicular groups.
The use of this method requires particular care to avoid damage to surrounding follicles. The removal of a large number of individual follicles from a small area can result in patches of bare skin, damaging the donor area. For this reason, the method is not recommended for people in the early stages of hair loss.
Once extracted, the follicle must be prepared and grafted almost immediately. Prolonged time out of the body results in the destruction of the follicle.
The implantation process requires extreme precision as tiny grafts are placed one by one in exactly the right position, at exactly the right angle, pointing in exactly the right direction and to exactly the right depth. The preparation and pre-planning of the design of the area to be implanted is crucial to a successful outcome.
The establishment of the new front line (hairline) must appear natural, and the Plastic Surgeons start by selecting single follicles first, staggering the implants slightly, then progressively increasing the density behind in order to achieve a natural-looking result. The curved shape of the line, too, is vitally important to the final effect.
Using surgical binoculars the surgeon creates a tiny hole in the skin by making a small incision in the bald area with the aid of a microtome. The hole is so small (1mm in diameter) that little bleeding occurs.
The selected graft is implanted deep into this opening so that it is secure and has access to the nurturing blood supply. The implanted graft quickly heals and becomes one with the surrounding tissue.
By using special instruments, the Plastic Surgeons are able to place grafts very close together, as does nature, so that the hair will grow and behave normally as if it had always been there.
Because extraction by the FUE method can be more stressful to the individual follicular groups, it is possible to experience up to 40% loss of transplanted hairs in some cases. The Plastic Surgeon will do everything possible to minimise this loss but will explain to you exactly what your expectations should be if you elect to use this method.
Stages of Hair Loss
Male Pattern hair loss - The early stages of Male Pattern hair loss usually develops in one of two ways, either hair recedes first from the sides of the head (temples) or first from the top of the forehead. The difference can be seen in the pairs of diagrams in the website.
Female Pattern hair loss - The four stages of Female Pattern hair loss, based on the Ludwig Scale charts, are illustrated in the website. Hair loss in women is not as distinct as in men. More often it appears as diffuse thinning throughout the scalp.
FAQ's
I lose some hair every time I wash my hair. How many hairs is it normal to lose daily? - Normal hair loss is 50 to 100 hairs daily but these will re-grow as part of the normal growth cycle.
Does frequent hair washing cause hair loss? - Exactly the opposite! Frequent washing is beneficial because it removes the sebum (a secretion of the sebaceous glands of the scalp) that contains large quantities of DHT. DHT contained in the sebum can be re-absorbed by the skin and affect hair, increasing hair loss.
Is it possible to transplant hair from one person to another? - No. Hair transplantation is, more accurately, hair relocation. Follicles can only be implanted into the same person from whom they were taken. Follicles moved from one body to another will be rejected by the body of the recipient.
Does stress contribute to hair loss? - Of course! Stressful experiences such as surgery or a death of friend of family member can be followed by hair loss. This is a temporary phenomenon (called alopecia areata). Unless other problems co-exist, hair should grow back after a while.
Can a long period of iron deficiency (anaemia) cause permanent hair loss? - No. As soon you treat the deficiency and normalise the iron level in your blood, your hair will grow back again
My hair loss was caused by hormone problems. Will the lost hair grow back again? - If hormone problems are treated quickly, then hair will grow back normally but the longer treatment is delayed, the less likely re-growth will occur.
My father suffered from hair loss. Will I lose my hair too? - From the genetic code that we all inherit from our parents, there is, unfortunately, a 60% possibility of this happening.
Will pills and food supplements solve the problem of women's hair loss? - Specialised food supplements can stop hair loss if it is symptomatic alopecia. If hair loss is caused by androgenetic alopecia these treatments are just a temporary help.
Can I stop hair loss by cutting my hair short or shaving it? - Cutting and shaving does not affect the hair root so the rate of hair loss is unchanged. Hair loss only occurs when something affects the formation of new hair in the root.
Is there a pharmaceutical answer to hair loss? - In some cases, yes. Drugs can be used to slow the rate of, or even prevent, further hair loss. There is no pharmaceutical treatment which can permanently re-grow lost hair. If you are in the first stage of baldness, a combination of finasteride-minoxidil can help you keep your existing hair. The only way for hair to grow permanently in areas of hair loss is by transplantation. Any pharmaceutical therapy should only be used after consultation with, and only on the recommendation of, a doctor. For reference, Propecia (finasteride 1mg) is a pill originally developed for prostate treatment. Research has shown that some patients taking the drug noticed a delay in hair loss from the top and back of the head (though not from other areas). It should be noted that this only occurred where there were live hair follicles and that it only happened whilst the patients were taking the drug. Only 2% of men taking the pill for 1 year and 5 % of those taking it for 2 years had positive results and these positive results stopped 6 months after ceasing to take Propecia. Rogaine (minoxidil 5% solution) was originally used in the 1970s for patients with high blood pressure. As a lotion, it can delay hair loss and can sometimes result in hair re-growth whilst the drug is being used. The lotion is sometimes used after hair transplants.
What is dihydrotestosterone (DHT) and why is it responsible for hair loss? - Dihydrotestosterone is one of the main androgens of the human body and is produced by testosterone with the help of an enzyme called 5 alpha-reductase. Dihydrotestosterone stimulates hair growth in the face and body, but at the same time also causes shrinkage of hair follicles that are sensitive to it (genetic predisposition).
Which is the best method of hair restoration for me? - Everyone is different. A method suitable for one person might not give the best results for someone else. In many cases, a combination of methods are used to achieve the desired effect. When you have an Initial Consultation, your doctor will be able to assess your situation and advise you of the most suitable techniques for your particular case.
Where is hair transplanted from? - Hair is taken from the back and sides of the head and implanted into areas of hair loss or hair thinning. This donor hair is genetically programmed to last a lifetime. Wherever it is implanted, it will resist the androgens in the blood which caused the original hair to fall out. The donor hair follicles will continue to grow and thrive as they would have done in the area from which they were taken.
Why is there no hair loss in the donor area? - Hair growing on the back and sides of the head is programmed genetically not to fall out. Even people with extreme hair loss keep their hair in these places. This hair is resistant to the effects of testosterone - the cause of hair loss in other parts of the head. What is more, the hair from these areas continues to be resistant to the effects of testosterone even when it is moved to a different part of the head.
How permanent will transplanted hair be? - Hair transplantation lasts a lifetime. The follicles used for transplantation come from areas which are resistant to the effects of DHT - the cause of hair loss. For this reason, care should be taken with the placing of the implanted hair - it will be with you a long time. Plastic surgeons are able to give advice based on years of experience and are skilled at creating a new hairline which looks natural and attractive.
How long does it take? - This depends on the method(s) used and the area to be covered. Using the Micro-Dense-Pack T-T technique with multiple follicular extraction it could take up to 4, using the follicular unit extraction (FUE) method it could take up to 8.
Is it painful? - No. Transplantations are carried out with topic anaesthesia so you won't feel any discomfort. Also, the procedure is carried out in a nice friendly medical environment making you feel comfortable.
How long does it take to heal? - After 7 to 10 days there will be no outward signs that you have had a hair transplantation. The transplanted follicles will be almost invisible until the new hair starts to grow.
How much hair can be transplanted in one session? - With modern techniques it is possible to treat extensive baldness in one session. A lot depends on the size of the donor area and the method used. If there is sufficient hair available, using the Micro-Dense-Pack method it is possible for a skilled Plastic Surgeon to implant 3,500 grafts in one session (each graft may contain between 1-5 hairs so it is equivalent to about 10,000 hairs). The follicular unit extraction method involves taking and placing grafts one by one so the maximum number of grafts which can be placed in one session is 500 (about 1000-1500 hairs).
How long does it take for the new hair to start to grow? - With hair transplantation, it is only the hair root which is implanted. Although the skin in the implantation area heals in a few days, it takes about 3-4 months for the root to establish itself and to start to produce a new hair. The hair will then grow at a normal rate and will reach an appreciable length by about 10-12 months after transplantation.
What will my new hair be like? - After transplantation, your new hair will be just like your normal hair and you should treat it normally too. The hair will grow normally and you can wash, cut and dye it just like normal healthy hair.
How much hair loss can be covered by transplantation? - The area which can be covered and the density of transplanted hair will depend on the hair in the donor area. A Plastic Surgeon will be able to advise you of the best way to make the most of the available hair in your particular case.
I have already had a hair transplantation but am unhappy with the result. Can I correct it? - Of course. Plastic surgeons using modern techniques are able to correct many of the problems caused by the poor quality of previous procedures. A Personal Consultation with a Plastic Surgeon will establish what is required to rectify the problems.
How long after the first transplant can I have a second procedure? - After 10-12 months you can safely carry out the second procedure.
Are there any age restrictions with transplantation? - There are no age restrictions. As soon as you become concerned about hair loss it is best to seek advice from a specialist.
Why would a transplantation be impossible? - One reason would be the lack of donor hair. This can happen when the baldness is caused by something other than androgenetic alopecia - for instance, burns or medical conditions. Another reason is that the donor area could be too small to provide sufficient hairs for the area which needs to be transplanted as a result of previous procedures. Blood disorders too can prevent or restrict transplantation.
Can a woman have a hair transplantation? - Certainly. When hair loss has been caused by androgenetic effect, transplantation can be used to cover the areas of hair loss. It can also be used to correct the shape and density of the hair front line and to increase the density of thinning hair by implanting between existing hairs. By carefully selecting the follicles, Plastic Surgeons are able to resolve the problems of the most demanding clients. If hair loss has been caused by hormonal problems, transplantation is not suitable.
How long before I see results from a hair transplantation? - It takes about a year for the results of hair restoration to be fully appreciated. By that time, the implanted hair will have grown and you will be able to brush and trim your hair as normal.
How permanent will transplanted hair be? - Hair transplantation lasts a lifetime. The follicles used for transplantation come from areas which are resistant to the effects of DHT - the cause of hair loss. For this reason, care should be taken with the placing of the implanted hair - it will be with you a long time. Plastic surgeons are able to give advice based on years of experience and are skilled at creating a new hairline which looks natural and attractive.
Glossary and Useful Information
alopecia: the medical term which covers hair loss or baldness in general. Different causes of hair loss or baldness have more specific names, eg alopecia areata and androgenetic alopecia. Whatever stage of baldness you may have reached, micro-dense-pack hair transplantation can result in natural-looking hair restoration.
androgenetic alopecia: also called androgenic alopecia, the most common form of hairloss or baldness in men which also affects women too. Loss of hair or thinning hair and baldness is due to the damage caused by androgens circulating in the bloodstream. Some people are genetically predisposed to have follicles (hair roots) which are more sensitive to the effects of DHT, dihydrotestosterone, a chemical caused by the action of an enzyme upon testosterone. The effect of DHT is to cause progressive miniaturisation of the hair follicle (hair root) and eventual permanent cessation of hair growth from it - in other words, losing hair, thinning hair and baldness. The follicles (hair roots) most susceptible to DHT are those found on the front and crown of the head. Hair on the back and sides of the head are resistant to the effects of DHT. Micro-dense-pack hair transplantation results in permanent hair loss treatment.
angulation of graft: natural hair does not grow straight out of the skin but is at an angle. Replicating this natural angle during the process of hair transplantation gives a much more natural effect when the hair grows. Hair loss or baldness, when treated correctly, can be replaced by a natural-looking head of hair.
back of the head: the back of the head contains hair which is programmed genetically to resist the destructive effect of DHT. This resistant quality of the follicle (hair) continues even if the follicle is relocated into an area of hair loss (hair transplantation). The back of the head is therefore a rich source of donor hair. The size of the donor area will govern the number of follicles (hairs) available for hair transplantation. It is therefore helpful for the plastic surgeon to know the size of this area - in other words, the measurement from the start of hair growth at the base of the neck to the point at the top of the head where hair growth stops. Micro-dense-pack hair transplantation results in permanent hair loss treatment.
balding areas: areas of hair thinning or total hair loss. Hair loss or thinning hair occurs for different reasons and the areas affected by hair loss can be an indication of the cause and the stage of baldness. The rate of hair loss or thinning hair changes over time and can stablise. It is necessary for a plastic surgeon to know the areas of your head which are affected by baldness or thinning hair and the current rate of hair loss. A simple chart has been developed by doctors to categorise stages of baldness.
baldness: everyone suffers hair loss. It is part of the ageing process. As the density of our hair is reduced through hair loss or hair thinning, the effect gradually becomes more noticeable. As hair becomes more sparse, the term 'thinning' turns to'balding' which turns to 'baldness', although exactly where one stage ends and the other begins is more of a subjective judgement. Whatever stage of baldness you may have reached, micro-dense-pack hair transplantation can result in natural-looking hair restoration.
combined techniques: there are essentially only two methods of obtaining follicles (hairs) for implantation - multiple follicular extraction, FIT, and follicular unit extraction, FUE, - but there are numerous techniques used for hair implantation. Each method of hair extraction has its own advantages but is dependent on the hair in the donor area. The requirements of the area of hair implantation - the area to be covered, the density to be created, the position of existing hair - often mean that a combination of methods and techniques of hair transplantation is required to create the best effect. Each person is different so there is no one method or one technique of hair transplantation which will always be suitable for everyone.
complete transplantation: see mega-session. A full hair transplantation in which all of the bald areas are covered. Hair transplants have been carried out for more than 50 years, during which time techniques have dramatically improved. There was a time when only a small number of grafts could be made in one session which meant that patients with large areas of hair loss or baldness had to undertake several sessions over a considerable period of time to make a complete transplantation of the area of hair loss. The obvious disadvantage was that the patient had to continue his life for months or years with only a partially completed hair transplantation. Techniques today enable large areas to be treated in one session avoiding the problem of partially completed hair transplantations.
cosmetic surgery: also known as aesthetic surgery or plastic surgery, is the term used for surgical intervention for reasons other than required by medical necessity. Though commonly used for enhancement of a person's natural appearance, the skills of the plastic surgeon can also be used to improve the appearance of people who have suffered trauma through accidental damage or through extensive medical surgery.
direct hair implantation: using the FUE (follicular unit extraction) method, follicles (hair roots) are removed one by one and implanted immediately into the area of implantation. This process is slower than multiple follicular extraction, FIT, and not so many hair grafts can be placed in one session by this method.
direction of hair: hair does not grow straight out of the skin, nor does it hang straight down from the top of the head. Each of us has a natural direction of hair growth around the scalp - usually a spiral from a point near the crown. Plastic surgeons take care to follow the natural direction of hair growth when implanting hair (follicles) in order to achieve the most natural-looking results. Micro-dense-pack hair transplantation results in permanent hair loss treatment.
donor area: the area of the scalp which contains hair resistant to the chemical process which causes hair loss or balding - usually this is hair on the back and sides of the head (sometimes referred to as the permanent zone). Hair from this area can be transplanted to any area of the head where it will continue to last a lifetime. In most people, up to 50% of the hair can be removed from the donor area without any noticeable effect. That same hair can be used to cover a much larger area by implanting it at a less dense rate. When hair loss has been caused by a medical condition, accidental damage or by reasons other than androgenetic alopecia, the size of the donor area may be restricted and a different part of the scalp may have to be used as a source of donor hair.
donor site hair: donor site hair differs from the hair in balding areas in that it is genetically programmed to last a lifetime - to resist the destructive effect of testosterone which is responsible for hair loss, hair thinning, baldness or receding hair. In normal circumstances, nobody ever loses all of their hair. Celebrities who have used a hairless head as part of their image have usually achieved the effect by shaving at least part of their head!
donor strip: a small piece of hair-bearing skin which is taken from the donor area - that part of the head which contains permanent hair follicles (hair roots) - so that the follicles it contains can be separated and implanted individually in the areas of hair loss or receding hair. The size of the strip will be determined by the number of hair grafts to be placed - every single follicle (hair) will be implanted, none are discarded. Whatever stage of baldness you may have reached, micro-dense-pack hair transplantation can result in natural-looking hair restoration.
extraction procedure: there are two ways that follicles (hairs) are extracted, either singly by follicular unit extraction (FUE) or in a group by multiple follicular extraction (FIT). Both methods require the use of topic anaesthesia. Neither method, if it is carried out correctly, will leave a scar in the area from which hair was extracted (donor area). The FUE method requires that the single follicle is implanted almost immediately and the process of extraction and implantation is therefore slower and fewer hairs can be implanted safely in a single session (800 maximum). Multiple follicular extraction (FIT) does not have these restrictions and up to 10,000 follicles can be implanted in one hair transplantation session. Micro-dense-pack hair transplantation results in permanent hair loss treatment.
female alopecia: hair loss and baldness in women. More common than people imagine, many women suffer from hair loss but are adept at concealing the fact. Hair loss in women may occur due to the same factors as male hair loss (including androgenetic alopecia) but may also be caused by other factors like lack of iron in the blood and hormonal problems. Female hair loss is often temporary and can be treated medically. When female hair loss is permanent, the remedy can be hair transplantation, the same as for male hair loss.
finasteride: Propecia (active ingredient finasteride 1 mg) is a pill originally developed for prostate treatment. Research has shown that some patients taking the drug noticed a delay in hair loss from the top and back of the head (though not from other areas). It should be noted that this only occurred where there were live hair follicles and that it only happened whilst the patients were taking the drug. Only 2% of men taking the pill for 1 year and 5% of those taking it for 2 years had positive results and these positive results stopped 6 months after ceasing to take Propecia.
follicle placement: once the follicles have been detached, either after extraction by FUE or multiple follicular extraction (FIT), the follicle or follicular group is implanted as a single graft into an area of hair loss or receding hair. There are various names given to hair transplantation procedures causing some confusion amongst readers but the final result of a hair transplantation or hair implantation is far more to do with the skill of the plastic surgeon carrying it out than it is to do with a 'technique'. Placement involves aesthetic judgments concerning the position and angle of a follicle, and consideration of the density and shape of hairs as a group and the overall effect on the head of hair as a whole. The transplanted hair will last for a lifetime so it is very important for it to be placed correctly.
follicle: the tiny tubular sheath beneath the surface of the skin containing the organ which produces hair. Follicles producing hair on the head are often grouped together naturally and emerge from the same pore in the skin. All follicles and follicular groups (follicular unit) are surrounded by an area of hairless skin.
follicular damage: follicular damage can result in irreversible hair loss. Follicles can be damaged by a number of different causes. Androgens circulating in the blood stream progressively weaken the follicles (miniaturisation). Follicles can be damaged by trauma caused by an accident, for example burns. Follicles can be damaged by neglect - hair care is an important factor in reducing hair loss. If care is not taken, follicles can also be damaged in the surgical process of transplantation. Microscopically isolating follicles and follicular groups carefully can prevent follicular damage. Studies have suggested that the FUE method, if not carried out extremely carefully, can result in follicular damage both to the follicle being removed as well as to its neighbouring follicles.
follicular grouping technique: nature groups small numbers of follicles together around a common blood supply. This follicular group then emerges from the skin through the same pore producing between 1-5 individual hairs. Modern equipment and techniques allow for each follicular group to be isolated and transplanted intact in the natural grouping. By simulating the way hair grows normally, a skilled plastic surgeon can create a natural-looking effect with natural hair density. Whatever stage of baldness you may have reached, micro-dense-pack hair transplantation can result in natural-looking hair restoration.
follicular unit: a group of 1-5 follicles which grow together in the scalp sharing the same blood supply. The group can be transplanted as a single unit by grafting it into an area of hair loss or receding hair. Micro-dense-pack hair transplantation results in permanent hair loss treatment.
front line: or hairline, the shape on the forehead and top of the head defined by the extent of hair on the head. Nature determines this line at first but as hair loss progresses the line recedes and starts to break up. When hair is implanted it redefines the front line. The placing of hairs when they are implanted should be done carefully and in such a way as to create a natural effect - for example, defining a line which is curved, asymmetrical and slightly staggered. Often the plastic surgeon will physically draw this line on the head with a marker before the transplantation. Once the hair has been transplanted the hair will be permanent, the front line will not change again.
growth angle: the angle at which hair grows naturally. This angle differs from one person to the next. When hair is transplanted (hair implantation) it is important for it to fit into the natural pattern of the recipient.
hair density: the number of hairs contained in a given area of the scalp. The plastic surgeon will use a magnifying densitometer to measure hair density precisely. Hair density varies from person to person and varies with age for any one person. We all lose hair as we grow older and the density of our hair decreases. Some parts of the scalp are less susceptible to hair loss than others and retain a higher hair density. Hair density is important to the hair transplantation process. Firstly, hair density in the donor area establishes how many hairs are available for transplantation. Secondly, the density of implanted hair will establish what area can be covered by the available hair. Up to 50% of the hair in the donor area can be removed before it starts to show. Implanted hair can be effective even if it is placed at about half the normal density, enabling a much greater area of hair loss to be covered than the area occupied previously by the donor hair.
hair loss medications: a centuries-old industry built around the dreams of bald men to re-grow lost hair. Many concoctions fail to deliver on promised profundity. But there are some genuine medical remedies too. For men, research has shown that an unexpected side effect of some drug therapies is that hair loss can be stopped and, in some cases, hair re-growth can occur (see finasteride). Unfortunately, the effect only lasts whilst the drug is being used. For women, hair loss can sometimes be the side effect of a medical condition. Such hair loss in women can be reversed if medical conditions such as lack of iron in the blood are treated. It is best to consult a plastic surgeon about the causes of hair loss first, to establish if there is a clinical treatment appropriate before making decisions about hair transplantation.
hair loss: there are many reasons for loss of hair (baldness or receding hair) to occur. Some hair loss (hair thinning) forms part of the natural growth cycle - old hair is shed as the new hair grows, some hair loss is temporary, for example, brought about by medication, stress or a shock, some hair loss is permanent, caused by the ageing process as follicles gradually lose the ability to grow new hair through the miniaturising effects of hormones in the bloodstream. Micro-dense-pack hair transplantation results in permanent hair loss treatment.
hair plugs: also called traditional standard grafts. The early method of hair transplantation was to take a small plug of hair-bearing skin (3-4mm in diameter containing up to 30 hairs per graft) and implant it into a slightly smaller hole in the skin of the area of hair loss. A number of these plugs would be distributed throughout the area of hair loss. When the hair in the plugs grew it covered the uneven density to a certain extent but the plug effect became obvious in the swimming pool or when the hair became wet. The result is called doll's hair for obvious reasons. Nowadays, this undesirable effect can be corrected by skilled treatment by a plastic surgeon.
hair restoration: strictly speaking, hair restoration can only occur if hair loss was caused by a temporary factor and the follicle is still able to produce new hair. Some medication can restore hair in some cases but this effect is usually only apparent whilst the medication is being used and disappears when medication is ceased. Baldness usually occurs when the follicle dies permanently. Hair CAN grow again and thrive in an area of baldness but only if it is transplanted from a different part of the head. Micro-dense-pack hair transplantation results in permanent hair loss treatment.
hair root: hair grows from a small organ located beneath the surface of the skin commonly referred to as the hair root. The medical term for the hair-growing structure is a follicle. A follicle measures about 1mm in diameter and extends to about 3-4mm below the surface of the skin. The follicle contains the entire mechanism for growing hair. If this follicle is implanted into an area of bare skin it will establish itself and continue producing hairs. Micro-dense-pack hair transplantation results in permanent hair loss treatment.
hair transplant: the process of taking hair from the permanent zone and transplanting it into an area of hair loss or baldness. A receding hairline or thinning hair can be permanently transformed by hair implantation into a natural-looking head of hair.
hair transplantation: hair relocation, the permanent remedy for areas of hair loss. By removing hair roots from areas of the scalp which are resistant to hair loss and placing those roots into bald areas, hair will again thrive, changing your appearance forever whatever stage of baldness you have reached.
hairline: or front line, the line at the top of the forehead where hair growth starts. The hairline forms the frame around the face and helps define our appearance. Hair transplantation (sometimes called hair restoration) changes this line forever so it is important for any alteration to the hairline to be made by the hands of an aesthetic surgeon (plastic surgeon). Micro-dense-pack hair transplantation results in permanent hair loss treatment.
implantation: or grafting of hair, the insertion of single follicles or follicular groups into the scalp in areas where a person is losing hair. Once the hair follicle has been removed from the donor area it is stripped of excess tissue and inserted into a tiny incision in the skin of the bald area of the head. The incision heals in a few days without leaving a mark and the implanted hair follicle grows in its new location as if it were natural. Losing hair no longer means inevitable baldness.
implanted hair: exactly the same as normal hair. When it has grown fully it is indistinguishable from the rest of the hair on the head.
implanter: a tool used to place follicles into bald areas of the scalp. Modern techniques use microscopes, microsurgery and small, specialised tools to work with precision, creating superior results. The micro-dense-pack hair transplantation technique results in natural-looking hair restoration.
local anaesthesia: hair transplantation takes place using local anaesthesia. Topic anaesthetic is injected into the skin of the donor and implantation area to cause numbness in the same way that a dentist numbs gums prior to dental work. You will be conscious and comfortable throughout the whole transplantation procedure.
mega session: a hair transplantation in which a large area of baldness is covered using a large number of hair grafts. Up to 10,000 follicles can be transplanted in one session using multiple follicular extraction (FIT) depending on the availability of sufficient donor hair.
methods of hair transplantation: there is a confusing variety of names used for hair transplantation. Each clinic, each centre, each website, seems to have its own individual named method. Put simply, there are two parts to the process of hair transplantation - the extraction and the implantation. There are just two methods of extraction - FUE (follicular unit extraction) and multiple follicular extraction (FIT). Each results in small grafts of follicles or follicular groups (follicular units) which can be stripped of extraneous tissue and implanted into bald areas or areas of thinning hair. The Micro-Dense-Pack technique for the placement used by the plastic surgeons here has been developed to recreate natural-looking hairlines and natural density of transplanted follicles thus creating a totally natural effect.
micro session: one disadvantage of extensive hair transplantation is that it can have a significant affect on appearance - for example, someone thought of as bald later has a full head of hair. An alternative to the mega session is the micro session whereby a patient has a number of small hair transplant sessions as hair loss progresses thereby maintaining their appearance. The FUE method has many advantages for patients interested in this approach to hair loss.
micrograft: a graft smaller than 1.5mm in diameter which may contain between 1-3 hairs per graft
minigraft: a graft of between 1.5 - 2.5mm diameter which contains 4-12 hairs per graft.
minoxidil: Rogaine (active ingredient minoxidil 5% solution) was originally used in the 1970s for patients with high blood pressure. As a lotion, it can delay hair loss and can sometimes result in hair re-growth whilst the drug is being used. The lotion is sometimes used after hair transplants.
natural appearance: nature is never perfect and it is these imperfections which endow a natural effect. Placing follicles so that they are too evenly spaced or form a straight line or are too symmetrical on the head, all of these qualities give an unnatural appearance. The art of aesthetic surgery is to enhance appearance by replicating nature and natural qualities as far as possible.
non-invasive hair transplant: a term used incorrectly to describe FUE (follicular unit extraction). Implantation, transplantation, is an invasive process by its very nature. Extraction by FUE removes only a small area of skin which heals without requiring stitches.
no-scarring technique: if performed correctly, no transplantation method leaves a noticeable scar. With the FUE technique of hair transplantation a small circle of skin containing a single follicular unit is removed for immediate implantation. This leaves a small wound which heals without the need for stitching. Multiple follicular extraction requires the removal of a small piece of hair-bearing skin which is then dissected microscopically into individual grafts of single follicles or natural follicular groups. The incision made to remove the piece of skin will require stitches to aid healing. The technique used for this part of the operation is crucial to prevent scars or marks remaining after healing. The special techniques used by plastic surgeons have been perfected to allow incisions to heal without visible scarring. Plastic surgeons performing hair transplantation use these techniques when they perform multiple follicular extraction (FIT).
number of grafts: the number of implants made in a session. Grafts could be single hair follicles or follicular groups containing a small number of hairs in a natural grouping. The plastic surgeon will use a microscope to individually prepare each follicle or follicular group for implantation and every single graft is recorded. The number of grafts will have been agreed before the procedure, the plastic surgeon removes this amount, prepares them and implants every one of them, none are wasted. You will receive a confirmation certificate of exactly how many grafts were implanted.
pain-free procedure: see local anaesthetic. All methods of hair transplantation are pain-free and are carried out with the assistance of an anaesthetist and using local anaesthetic.
permanent zone: the area of the head containing hair which is resistant to the effect of androgens circulating in the blood stream. This zone is usually the back and lower sides of the scalp. The hair here is considered permanent and it keeps this permanent quality even when transplanted to an area of bare skin or baldness. Whatever stage of baldness you may have reached, micro-dense-pack hair transplantation can result in natural-looking hair restoration.
plastic surgery: a term used for surgical intervention for reasons other than medical necessity. Plastic surgery is used to reconstruct tissues after trauma, an accident, burns or major surgery. It can also be used to enhance the appearance of a patient. Plastic surgeons who have specialised in hair transplantation or hair implantation can use their particular skills to great effect, ensuring the best results without signs of intervention. Whatever stage of baldness you may have reached, micro-dense-pack hair transplantation can result in natural-looking hair restoration.
procedure: the surgical operation of extracting and implanting follicles or follicular groups. Whatever stage of baldness you may have reached, micro-dense-pack hair transplantation can result in natural-looking hair restoration.
Propecia: see finasteride, the active ingredient in this medication.
recipient area: area into which the extracted follicles and follicular groups (follicular units) are implanted. The size of the recipient area is governed by the number of hairs available in the donor area.
scalp: the skin and hair covering the top of the head. When hair loss or hair thinning starts to occur, a head of hair slowly turns to visible bare skin. Whatever stage of baldness you may have reached, micro-dense-pack hair transplantation can result in natural-looking hair restoration.
sides of the head: the temples, high on the sides of the head, are usually the first areas to suffer hair loss as the hairline recedes. Lower down the sides of the head, just above the ears, the hair is resistant to the causes of hair loss and this hair is permanent and can be used as donor hair. Whatever stage of baldness you may have reached, micro-dense-pack hair transplantation can result in natural-looking hair restoration.
single hair grafting: a technique of hair transplantation in which the follicles are removed and implanted one by one.
strip extraction procedure: the multiple follicular extraction (FIT) technique of hair transplantation in which a long narrow piece of hair-bearing skin is removed, usually from the back of the head. Then, under a microscope, the individual follicles and follicular groups are isolated from surrounding tissue and prepared for individual implantation. The advantage of this method is that a natural balance of sizes of follicular groups is available for transplantation unlike FUE which, because of the contraints of the punch size, restricts the plastic surgeon to the extraction of only smaller follicular groups (4 hairs maximum).
thinning hair: the first signs of hair loss become visible as the density of hair reduces to a noticeable extent. The effect of DHT in the bloodstream upon follicles (tiny hair-producing organs in the skin) is to begin to miniaturise them. These follicles become smaller and produce hair that is progressively thinner and less pigmented. DHT also affects the growth cycle of the follicle causing it to produce a shorter and shorter hair until the follicle finally dies and hair production ceases irreversibly. Whatever stage of baldness you may have reached, micro-dense-pack hair transplantation can result in natural-looking hair restoration.
transplant session: a single procedure, extraction and implantation of an agreed number of grafts in one 'sitting'. Depending on the methods used, up to 10,000 grafts can be made per session which can allow a complete transformation in one go (mega session). If further sessions are required, a second session can be performed about 10 months after the first.
transplanted hair: relocated hair, hair taken from a donor area and implanted into an area of hair loss. Whatever stage of baldness you may have reached, micro-dense-pack hair transplantation can result in natural-looking hair restoration.
treatment: the medical or surgical care given to a patient to achieve a desired result. Whatever stage of baldness you may have reached, micro-dense-pack hair transplantation can result in natural-looking hair restoration. |
