The hair restoration surgery consists of different stages which are as follows:
anesthesia ,donor harvesting , recipient site preparation and graft insertion,bandage and post operative stage.
Donor area harvesting
There are two main methods to prepare the follicular unit grafts or to harvest healthy hair from the safe donor area.
1-Strip harvesting or FUT, in which a strip of skin is excised from the best area of the back of the scalp and the donor site defect is sutured and repaired painlessly under local anesthesia .?Then the skin strip is dissected to follicular unit grafts containing one to three follicles. The main advantages of this technique are
It is the fastest method to harvest large amount of grafts in just a single surgery (2500 to 4000 FU grafts or about 5000 to 8000 follicles )
The preparation of the grafts are done by using microscopic magnification so there is the least amount of hair wastage or transection
There is no need to shave the patient’s head
The grafts are harvested from the best quality area of donor scalp
If the surgery is performed with reasonable skill the scar is barely noticeable . FUT can be done for two three times in most patients each 9-12 months. FUT can be done in combination with FUE to increase the number of grafts harvested
2. Follicular Unit Extraction (FUE) or Follicular Isolation Technique (FIT ) is the other method of graft harvesting . In this method follicular units are harvested one by one from the patient’s scalp by means of small manual or motorized punches.. A punch is a cylindrical blade (0.8 10 1 mm in diameter which upon introduction to the scalp extracts only a single follicular unit . There is No linear scar left on the scalp after surgery . The graft are harvested from all the surface of safe donor area .
FUE can be performed in most of the candidates but it is particularly suitable for those patients who wear their hair very short or plan to shave their head sometimes after surgery and those who have stiff scalps from the beginning or after FUT sessions. It is also the preferred technique for small procedures and when one plans to camouflage the visible scalp scars .
The pace of harvesting is slower and usually patients must come for 2 sessions to have 3000 to 4000 follicular unit grafts. The patient should shave their head for the FUE procedure .
- Body hair harvesting is a variant of FUE from donor areas other than scalp . The best body donor area is the beard area . Body hair is only used as a reserve donor bank after scalp.It should not be used as the sole donor area in patients but only in patients whose safe donor area is depleted.
The harvested grafts are transferred to a holding solution and are kept cold and hydrated until they are inserted to the recipient area .
Recipient site preparation and graft insertion
Regardless of the harvesting method the FU grafts are one by one to very small slits in the bald recipient area. All measures are taken to insert the gafte in natural density and direction . The most critical issue is to design a appropriate and very natural hairline and cosmetic.result. Today with this modern methods we claim that our cosmetic results are absolutely undetectable and completely natural with best cosmetic results in Iran.
By the end of the surgery. The surgical area is washed to minimize the scabs and and the bpdonor area is anesthetized again with long acting local anesthetics so that he or she will feel no pain in the first night .
The day after surgery the bandage is removed and the patient is instructed to wash the pir head daily.
The stitches if present are removed about 8-10 days after surgery .
The transplanted hair falls off after 4-8 weeks and restarts to grow after 2-4 months. The patient can appreciate their final result in one year but even after 6 months a significant amount of grafts have grown and the result is satisfactory enough .
The side effects of hair transplantation
There is no important side effect to threaten the patient’s health and regrowth of grafts .
Facial swelling occurs in a minority of patients and is totally resolved in two days and has no detrimental effect on the final result.
As soon as the grafts begin to grow there be few bumps and folliculitis which is self limited .
Scalp skin numbness is a temporary side effect of FUT. usually resolves in a few months.
Hiccups after surgery is a very rare side effect.
After complete growth most of the transplanted follicles are permanent but in some patients continuing medical therapy for hair loss seems to optimize and maintain the final result .
Should a second procedure required it is preferred to be done 9-12 months after the first session.