Dr. med. Eduarda Jurševiča Estētiskās medicīnas klīnika
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Treating alopecia: FUE hair transplantation with no scars

Treating alopecia: FUE hair transplantation with no scars

With age, the hair on our heads become thinner and thinner. Moreover, it happens not only to men. FUE hair transplantation is a way to solve the problem of hair loss forever.

Why does hair fall out?

Trichologists identify several causes of alopecia (baldness). In men, the most common cause is androgenic (genetically inherited) hair loss due to hormonal imbalance. Other reasons why the hair can become thinner may also be stress, medications, scars and burns on the head (injured skin, follicles), lack of vitamins and minerals, and many other problems.

In women, hair loss is most often associated with hormonal changes in the body and this applies to women of both reproductive age, as well as after menopause.

In any case, no matter the cause of baldness, this disease can and should be combated and it can be done successfully. Today, one of the most effective surgical methods of treatment is hair transplantation using the Follicular Unit Extraction (FUE) method.

Features of the FUE method

FUE is a microsurgical manipulation of obtaining grafts (follicular groups) from the donor zone and their implantation into the recipient zone (baldness zone) without incisions and sutures. Visually it is almost imperceptible that a person has once had a hair transplant.

The operation is performed in three stages.

Using this method, it is possible to restore eyebrows, eyelashes, beard, scalp and places affected by cicatricial alopecia after injuries and burns.

How is the operation performed?

Stage 1:

Using a tubular knife (punch) that resembles a ballpoint pen, surface cuts are made in the donor zone, and then individual follicular groups are removed by carefully pulling them out. Most often the donor zones are occipital, parietal, sometimes the temporal regions.

A follicular group is a natural bundle of hair follicles in the scalp. Each group consists of 1-3 (less often 4-5) hairs.

“The head is a sensitive place, therefore the operation is performed under local anaesthesia: places where the hair is extracted (donor area) and transplanted (recipient area or the bald area) are put under anaesthesia. The location from which it is planned to take the grafts (follicular groups) is discussed with the patient in advance,” says the certified surgeon Vyacheslav Simonov.

Stage 2:

After the hair sampling is completed, a place for the transplantation of follicular groups (baldness zone or recipient zone) is prepared. To perform incisions in the recipient area, scalpels with a blade are used. Cuts (holes) are made with the blade at different angles in places where in the hair will be transplanted in the future.

Stage 3:

Grafts are transplanted into the places where incisions have been made. They are implanted individually, so as to comply with the hairline and the direction of hair growth.

If the bald area is large, the doctor may prescribe a second operation. “Sometimes the initial area of baldness is large, and there is not enough hair for transplantation. Then we gather hair from other places - the chest, the beard or the intimate zone. No need to worry about a potential hair loss in these places after the operation. For each patient in our clinic, we individually assess the density and thickness of hair in the donor zones. Punch allows you us to perform the hair sampling very accurately,” says the surgeon Vyacheslav Simonov.

The first stage of the manipulation is performed in the supine position, while the second and third stages are performed while the patient is sitting, with breaks at the request of the patient. The whole operation can take from about 5 hours to 8-10 hours, depending on the number of follicular groups

The consultation:

The main task of the doctor during the consultations before the operation is to identify the expressed or unexpressed wishes of the patient and to explain the expected and attainable results after the operation.

Despite the patient’s desire and ability to undergo a hair transplant surgery, the doctor has criteria for selecting candidates for a hair transplantation operation. These criteria by which the doctor evaluates the patient during the consultations show whether a particular patient is suitable for hair transplantation or not. The doctor evaluates the patient according to the following criteria: the age of the patient, hair thickness, quality of donor hair, type of baldness (male or female pattern baldness), and of course the patient's expectations. During the consultation, the doctor must be open and honestly explain everything, all the possibilities of the operation and the time it takes to achieve the maximum results. There are cases when the operation is not possible for one reason or another, thereby the doctor could refuse to perform the operation or recommend that the operation be postponed for a couple of years and be performed when the patient has entered another stage of life, for example. Most often the main reasons for the refusal or rescheduling of the operation are the age of the patient (young people around 18-22 years old), thin donor hair, the quality of the hair and the inability to achieve the result expected by the patient.

Preparation for surgery:

Before the operation, the patient undergoes a standard examination - a general blood test, biochemistry, analysis for hepatitis B and C and HIV, get an electrocardiogram. “All the tests can be done at our clinic. Let's say a person comes in on Monday morning, does the tests, and by 12 o’clock I have all the results in my hands. And already on Tuesday we can perform the procedure,” says Simonov.

“The patients can ask an question and bring photographs to show what their hair used to look like,” says Dr. Simonov.

What happens after the hair transplantation?

The donor place where the hair is taken from heals very quickly. Shallow wounds heal after 2 to 5 days. “I warn my patients that, in the beginning, the hair in the transplanted areas will be fluffy and it fall out. Real hair will only appear 5-6 months after the surgery. Typically, 95-97% of the follicles transplanted take root after surgery,” adds Dr. Simonov.

What not to do after the surgery?

- visit a sauna (you can wash your hair the next day);

- comb the hair (the patient can start doing it 3-4 days after the surgery);

- to be in the open sun, in the heat (this increases sweating);

- do sports;

- consume alcohol;

- wear a hat (if you need to cover your head, women are advised to wear a scarf, men - a hood);

- wear glasses (the temples of the glasses can come in contact with the transplant area at the temples).

For the convenience of foreign customers:

If the patients are located in Riga, then they should see a doctor in a couple of days to change the bandages. “If they live far away, I teach them how to care for the hair after the surgery. Any patient can contact me in a form convenient for them. And I always ask my patients to show the results in a week, a month, and so on until after six months after the surgery,” the doctor notes.

How does the restoration of eyebrows and beards happen?

The donor material in this case is also hair follicles from the head or beard. When transplanting hair on the eyebrows, it should be taken into account that this hair will grow the same way as on the head. Therefore, the transplanted hair on both the beard and the eyebrows need to be taken care of.


Interesting fact:

The very first hair transplantation took place in 1522, in Germany. More significant success in this matter was achieved by the Japanese doctor Suji Okuda. In 1939, he transplanted hair to Japanese soldiers after burns. The first significant success in the Kwantung Army was the transplantation of hair to mask the scars from wounds and burns. Nowadays, hair transplantation is carried out for medical reasons, that is, after burns and injuries, but also for more aesthetic reasons, such as alopecia or to hide flaws after plastic surgery.

Vjačeslavs Simonovs
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