Our hair is an essential part of how we look. For this reason, hair loss can cause anxiety in certain circumstances, which affects our capacity to forge relationships and our level of self-confidence. Nonetheless, common baldness is not considered an illness, as it is a problem that regularly appears and affects lots of people. Alopecia affects both men and women, although men suffer from it more severely: it affects 40% of the male population compared to 10-15% of the female population.
The hair loss process can start from the age of 18 or 20. Its initial manifestations tend to affect the hairlines first, from which the term “receding hairline” derives, and/or the area around the crown of the head. The most common problem is hair follicle miniaturisation, which increasingly thins the hair and makes it grow more slowly, lighten and lose its quality. There comes a point when hair stops replenishing itself and, in other words, stops growing, which leads to the progressive reduction in the amount of hair the patient has.
There are many causes of baldness. Hereditary, genetic predisposition together with hormonal factors are the cause in 90% of cases (androgenetic alopecia or common baldness). However, it can also result from other types of factors, such as stress, burns, some infectious diseases, hormones, postpartum changes, taking certain medicines, etc. Alopecia is never caused by washing frequency, type of shampoo, use of hats, poor circulation or seborrhoea. These are unrealistic misconceptions used to explain the cause of the process.
A solution for alopecia has been sought after for many years. In fact, many treatments exist, which provide temporary solutions to varying degrees of efficacy. However, the permanent solution, which provides the highest levels of satisfaction due to its excellent results is the natural hair restoration technique, which involves a transplant of the patient´s own hair. This refined technique has been substantiated by over thirty years of development and progression, as well as outcomes that have seen unprecedented success.
We also have a clinic in Madrid. More information can be found under "Hair Restoration Surgery"
Surgery duration
5-7 hours
Bed
It is not required
Recovery
3 days
Anesthesia
Local with sedation
Effect
10 months
Results
Long-lasting
Procedure
Surgical Procedure - FUE and FUSS (Strip)
Hair restoration surgery allows hair coverage to be regained by extracting the patient´s own hair follicles and relocating them in the areas affected by the hair loss.
In hair restoration surgery, 2 techniques exist: one called FUSS (Follicular Unit Strip Surgery) and another called FUE (Follicular Unit Extraction). The former technique consists of extracting a small strip of scalp and subsequently cutting this down using optical magnification instruments in order to separate the follicular units one by one; and the FUE technique consists of extracting follicular units (where the hair follicles are grouped) one by one using a round scalpel.
In essence, both techniques can be summed up in 3 steps:
1. Extraction of the follicles from the donor site (the sides of the head or nape of the neck, which are areas that never lose hair, because they are genetically coded that way) in order to cover the area where hair has been lost. In the case of the FUSS (strip) technique, the look of these donor sites is unaffected, as the wound is stitched following the extraction, which minimises the scar, and remains camouflaged by the surrounding hair. In the case of the FUE technique (extraction hair by hair) there are multiple tiny holes, which subsequently heal, meaning that the small wounds are indiscernible and intermingled with the surrounding hair.
2. The follicles extracted are divided into follicular units of 1, 2 or 3 hairs, as they were in the original site. In this process, the whole follicular unit is isolated (dermal papilla, follicle, gland and subcutaneous fat), which will be the initiator for the new hair. It is a meticulous process, on which the final result depends.
3. The third step is the reimplantation or the insertion of the grafted hair follicles into the alopecic area. For this, a local anaesthetic is administered to the treatment area. The distribution of hair follows aesthetic patterns determined according to age and the future development of the alopecia. These are usually implanted initially in lines of one or a maximum of two hairs, which provides a natural look, while grafts of 2, 3, 4 and up to 5 hairs are inserted in the rest of the area, which are responsible for providing the desired density.
The duration of the surgery largely depends on the area to be reconstructed, but in order to provide an estimate, the average duration is between 4 and 6 hours. It is a surgery that can be completed as an outpatient procedure, under local anaesthetic and, if necessary, with sedation.
Once the period of adapting to the new area has passed, which tends to take between three and five months, the transplanted follicles generate new hair and start their external growth at a rate of approximately 1 centimetre per month. This graft retains the characteristics of its original site and follows the same development indefinitely, because they are cells that are insensitive to the effect of testosterone and its metabolites. The hair will continue to grow in longitude and diameter during a period of six to twelve months following the procedure. However, the final result will not be seen until around ten or twelve months have passed.
The hair will remain on the patient for the same time it would have in the donor site, that is to say, for life, and will not require any type of special care in the future.
In general, 4,000 to 5,000 hairs are inserted in each session, meaning that one or two sessions are sufficient for remedying the alopecia. The results are permanent, without any possibility of rejection, as the grafted hair belongs to the patient and no follow-up treatment is required.
The intervention is performed under local anesthesia and sedation. The presence and collaboration of the anesthesiologist affect the well-being and comfort of the patient.
Hair micrografting is performed on an outpatient basis. In any case, the patient remains in the clinic for a few hours until the effects of the drugs applied for sedation wear off.
Benefits
Hair restoration surgery is a permanent technique, which provides a huge aesthetic improvement and completely natural-looking results.
By acting as your own hair donor, you avoid any possibility of rejection.
A general anaesthetic is not necessary. Only a local anaesthetic is used.
Gallery
Pre-operative
The preoperative rules are very straightforward and apply to any type of surgery. A preoperative consultation with a hair specialist, who will complete the appropriate tests for verifying your state of health, the extent of the baldness, the quality and quantity of your donor site and the development of the alopecia, is required. Your case will be assessed based on the results of these tests and your medical history to avoid complications. In the event that it is not possible to have a consultation with your specialist in person, you can send some photographs of the donor site and the affected area to obtain an initial approximation.
Hair restoration surgery for treatment of alopecia is never urgent, so it is advisable that the patient is aware of all time frames, aspects and indications for the procedure before making a rash decision.
Putting yourself in the hands of a surgeon who is exclusively dedicated to this type of procedure is very important for achieving optimal results.
Aftercare
Postoperative care is very easy to carry out, especially in terms of caring for the grafted area. How to clean and care for the area at home is explained to the patient in detail.
The patient can essentially return to their usual activities within 48 to 72 hours, taking into account the aforementioned care, as there will be a small wound on the patient´s scalp in the case of the strip procedure, and multiple small extraction points in the case of the FUE treatment, in addition to the micro-graft in the receptor site.
Once the period of adapting to the new area has passed, which tends to take between three and five months, the transplanted follicles generate new hair and start their external growth at a rate of approximately 1 centimetre per month.
F.A.Q.
How should common alopecia be treated?
In the initial stages of hair loss, we use the drugs available for this: Minoxidil for topical treatment and Finasteride tablets for oral treatment. These delay the hair loss process, although they rarely stop it. In more advanced cases, hair restoration surgery is the only permanent medical solution.
How has the hair transplant process developed over time?
Its development in terms of the instruments used, as well as the aesthetic outcomes and patient comfort, has been continuous since 1990. In its early stages, 1,000 to 1,500 hairs were transplanted per session. Currently, 3,000 to 3,500 hairs are transplanted and, in the case of major donors with pronounced baldness, even up to 4,000 hairs can be transplanted in a single session. Exceeding this figure could reduce the survival rate of the grafted hair follicles, which currently exceeds the benchmark of 98% of the grafted hair follicles grown in each patient.
Who can benefit from this surgery?
The candidates for undergoing this type of surgery are those experiencing permanent hair loss, chiefly men with medium level or advanced alopecia. Some women with androgenetic hair loss, patients with scarring (burns) and patients who wish to regrow their eyebrows, beard or pubis also turn to hair restoration surgery. It is ultimately a procedure that is recommended for all patients aiming to regain part of their lost hair naturally and for life.
When is the best time for the surgery?
In an initial consultation, the surgeon will advise you and take note of the future development of your alopecia. In doing so, the surgeon will outline a plan according to your individual characteristics and the suitability of your donor site, the current extent of the alopecia, its future development and the desired expectations. Drawing on experience and detailed information, you and your specialist will decide on the ideal time for your first surgery.
What is the objective of the surgery?
The objective is to regain hair naturally and for life, using a minor surgery that is carried out as an outpatient procedure. The aesthetic outcomes are pleasing and completely natural-looking.
Does the surgery leave scars?
The surgery leaves a very fine scar in the area from which the hair is extracted, which is concealed by the surrounding hair.
How many sessions are required?
As this is a personalised service, the number of sessions varies according to the type and extent of the alopecia. For guidance, one session is sufficient for low level hair loss and between two and three sessions are required for advanced hair loss. In these cases, the amount of time left between each session is set by the patient, although it is advisable to leave a gap of four to six months between them.
Is any special care required?
Once grown, this hair will behave in the same way as the hair from its origin site, that is to say, its development is the same as the hair at the nape of the neck. The main advantage is that it will not restrict the future life of the patient, who can forget their past preoccupation with how their hair looked.
How long do the results last?
The transplanted hairs are permanent and last for life. This assertion is justified by the results obtained since the first transplants carried out in 1959, as well as by our professional experience of over fifteen years. It is an autograft, which retains all the characteristics of its origin site.
What is the process for getting a good result?
As this is a personalised service, the number of sessions varies according to the type and extent of the alopecia. For guidance, one session is sufficient for low level hair loss and between two and three sessions are required for advanced hair loss. In these cases, the amount of time left between each session is set by the patient, although it is advisable to leave a gap of four to six months between them.
Expert opinion
Dr. Dorian González
The hair transplant technique where small follicular units of just one, two or three hairs are implanted, provides a greatly improved aesthetic and completely natural-looking results. It is the permanent solution for alopecia and the results last for life.
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