There are several different techniques available to treat balding, though the most common ones are based on micro transplantation, hair follicle or hair follicle unit transplants. There are two main ways in which donor grafts are extracted today:
- Strip harvesting: often called the DS technique (for Donor Strip).
- Extraction of individual hair follicles units: called the FUE technique (for Follicular Unit Extraction).
Sometimes, both techniques are combined to obtain more grafts, increase hair density and optimize results.
Extracting hair follicles is only the first step out of five of this hair transplantation technique.
Technical and manual expertise of surgeons is fundamental to get the best possible and more natural results.
> BEFORE SURGERY IS PERFORMED:
A complete and individualized assessment is provided to determine the causes of the existing baldness and advice is provided on the best treatment in every case, depending on every patient’s particular situation and expectations.
A full pre-operative check up is then performed and, when needed, the surgeon may ask for further lab tests.
> THE HAIR TRANSPLANTATION PROCEDURE:
1- First consultation with advice on further surgical planning. Decision on scalp hairline design or on any other body area transplantation design.
2- The harvesting zone is analyzed by the surgeon and a plan is set up to extract the grafts.
As stated before, the DS or the FUE technique can either be used to get the same results.
The strip harvesting technique:
The surgeon usually harvests strips from the posterior and lateral areas of the scalp since these are not hair-loss prone parts of the body.
Width and length of the hair strip will depend on factors such as the number of required grafts, the density of the donor site and the final results expected.
Donor site is then sutured and covered by patients’ adjacent hair.
The FUE technique:
Individual extraction of follicular units one by one can be performed either manually or automatically (motorized extraction).
Hair is usually harvested from the posterior and the lateral parts of the scalp.
Number of follicle extractions will depend on the characteristics of the receiving area.
3- Preparing the grafts
Hair grafts are harvested using one of the previously mentioned techniques, are controlled and dissected with the help of a microscope and then preserved in a prepared solution following the surgeons’ instructions.
4- Micro incisions to prepare the receiving area
Type of incisions performed and type of instruments used will depend on both the results planned by the surgeon, following the established surgical program, and on patients’ individual expectations.
This part of the process has much to do with the “design” of the future transplanted area. Natural results and required final density of the implanted areas are often linked to the expertise of the surgeon.
The number of inserted grafts may vary from 1.000 and 3.000 or more and are chosen accordingly for every patient.
5- Graft insertion
All removed follicles are cautiously processed and implanted using specific micro instruments.
Graft insertion has to be done in a determined angle, density and pattern following Dr. David Pérez-Meza’s technique.
This stage, like the former one, has much to do with the expertise of the surgeon.
A protecting bandage will then be applied on the area during 24 hours.
The number of surgeries to be performed may vary from one patient to another and will mainly depend on individualized factors.
Patients will generally need at least 2 surgeries to optimize the final results though some patients may achieve the expected results after a sole surgery.
> POST OP PROCEDURES:
During the monitoring visit, conducted 24 hours after surgery, the bandage will be removed and the hair washed.
After a strip graft harvesting surgery has been conducted, stitches will be removed during a monitoring visit performed 10 to 12 days after surgery.
When patients live in another part of the country or in a foreign country, indications as to the removal of stitches can be given for professional staff to carry it out there.
Final results will probably show 10 to 12 months after surgery has been completed.
Specific medical treatment for baldness will also be given to help stabilize hair loss and optimize results.
> TYPE OF SURGERY AND ANESTHESIA:
This surgery is ambulatory. It is usually performed under local anesthesia or local anesthesia plus sedation.