Hair Transplant Surgery - Summary Technique

First considerations

First, pre-operative photos are taken, the donor area is marked and prepared, and the recipient area (bald region) is marked. After, the surgical strategy is discussed with the patient, using mirrors.

In the Surgical Room

Removing and closing the donor area

A light sedative is given to the patient in order to provide a sleepy, calm state throughout the surgery (click here end learn more about anesthesia).
The first step is to remove and close the donor area. During this part of the surgery we use a pillow specially designed to provide comfort to the patient.

Preparing the Follicular Units - FUs

While the surgeon and assistant remove and close the donor area, the team, composed of six surgical assistants, begins to separate the follicular units.
First, slivers are obtained by slicing the donor strip at one follicular unit in width using high resolution microscopes.

Once produced, the slivers are put into a saline solution.

After, each sliver is divided to obtain the follicular units. Each FU is handled with care to preserve the integrity of the entire hair structure (including glands, bulbs, roots and associated structures).

The follicular units are preserved in a cool saline solution until the moment of their placement.

Placing the Follicular Units

After closing the donor area, about 20% of the grafts are already prepared and immediately placed while the others are being prepared. In other words, the first to be prepared are the first to be transplanted so that they spend as little time as possible outside the body.

As you can see, the process is dynamic and should not take too long (more than six hours) so that the FUs do not dry out and lose their vitality, which could reduce the percentage of graft integration (the survival of the grafts once transplanted).

With this dynamic as well as a large, skilled surgical team, it is possible to perform the surgery uninterrupted. We optimize the surgery time and are able to obtain 100% graft integration.

During this moment in the surgery a different pillow, also specially designed, is used, allowing for patient comfort.

Microsurgical instruments are used to create a small perforation and the FU is inserted immediately after.

Placing the FUs in the bald region previously marked

These instruments come in different diameters and for each type of FU the appropriate blade is used, that is, the needle whose diameter is proportional to the size of the graft.

The single-hair FUs are used in the frontal hairline, placed in a milimetrically irregular pattern to provide a more refined, natural appearance.

After the first lines, the 2-hair FUs are placed, while the 3-hair FUs are reserved for the areas where greater density and volume is desirable, that is, the areas where there will be a greater aesthetic impact (which varies case by case).

In this phase, several principles must be observed:

Caution must be exercised when handling the grafts – they should never be handled by the bulbs as they are not resistant to pressure and can die.

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Distance between the grafts – a minimum distance of approximately 0.5 to 1.0mm must be adhered to when placing the grafts, as well as the angle at which they grow, so that the transplanted hairs conform to the manner in which the pre-existing hairs naturally lie in each region of the scalp.

Revision

At the end of surgery, the transplanted grafts are repositioned so that they are all at exactly the same skin level, avoiding irregularity in the scalp in the future.

Finally the recipient area is washed and cleaned.

*Transplanted area before and one day post op

No Bandage Necessary
After concluding the hair transplant and the revision of the transplanted area, we apply a special “fixing” spray, which creates an invisible layer. No compression or bandages are necessary and the patient will leave surgical room in this more discreet manner, both practical as well as more comfortable.

As thee grafts are transplanted with hairs 3mm in length, the result can already be seen. We show the patient the result and the number of grafts (FUs) obtained which are counted and categorized on a white board in the surgical room.

The patient is then taken to a recovery room where some medication is given as well as instructions for the first post-operative day. A light meal is served 30 minutes after the surgery has ended and the patient is free to leave.

The post-operative period is smooth. You will probably have a light pain in the donor area in the first 24 hours which is easily managed with pain killers we provide.

The following day the patient’s hair is washed at the clinic and then may return home.

*day after

We will provide you with all the necessary information, special shampoo, hat, medication, etc.

The sutures in the donor region do not need to be removed as the stitches are biodegradable and will fall out on their own (not requiring removal).

The micro-scabs that form beginning on the third or fourth day after surgery will subsequently fall out one to two weeks after surgery.

*7th day post op

About 20% of the transplanted hairs will continue to grow, however the remaining 80% of the transplanted hairs will fall out at the time the scabs do. They will begin to grow again around the third month post-surgery at a rate of approximately 1cm per month.

*15th day post op

So, the final result will be seen from 9 months to 1 year after the procedure.

Before	After 6 months

As these hairs do not have the genetic code for baldness they will not ever fall out again.

Learn more about the post-operative period.