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Hair Transplantation

What are the reasons of hair loss?

There are different reasons of hair loss in men and women. The hormone responsible for male-type hair loss is DHT (dihydrotestosterone). In women, hormonal changes cause hair loss. For example, in women with increased subcutaneous fat tissue thickness, testosterone level changes in the blood and in this case, menstrual irregularity and hair loss are seen.

Other reasons of hair loss include improper working of the thyroid gland (hypothyroidism), anaemia due to iron deficiency, unconsciously made diets, vitamin deficiencies, and birth.

Apart from these, disorders about the scalp can also cause hair loss such as alopecia areata, liken planus, SLA.

Is there a treatment for hair loss? Does the medical treatment provide hair growth again?

If there is an underlying disease for hair loss; low levels of thyroid hormones, iron deficiency anaemia, vitamin deficiencies, etc. should be diagnosed and treated. The replacement of the deficiency will largely stop your hair loss. Providing a hormonal balance will also be effective in stopping the hair loss. Treatments are intended to prevent new hair losses. It is not possible to recover a hair follicle which sheds together with its root.

The use of Finasteride (Propecia), which acts by reducing the level of dihydrotestosterone in men, can slow and stop the hair loss rate. In addition, minoxidil-containing spray-form drugs help to stop hair loss. But these drugs are effective as long as they are used. If the treatment is not continued regularly, hair loss may start again.

Other methods that can be used to stop hair loss and increase the health of the existent hair are PRP and mesotherapy methods. Both are the methods applied with micro-needles. They do not help to grow the hair which fell but thickens the thinned hair follicles.

The effects of the treatments are personal.

How is PRP applied?

PRP (Platelet Rich Plasma) is a plasma that contains high concentrations of clotting cells (platelets). Coagulation cells contain growth factors and have a curative effect in the region where they are injected, as well as activating stem cells.

Your doctor will take 20 cc of blood from you. S/he places this blood in a special device that separates the coagulation cells and obtains a coagulation-rich plasma with a special device that rotates rapidly (3000 rpm for 4 minutes). 3 ml of PRP is obtained from 20 ml of blood. This plasma is quickly injected into hair follicles before it loses its effect. It is applied with micro-needles, so you feel less pain. Then you should not wash the area for 2 hours and avoid direct sunlight.

The efficacy of PRP is directly related to the method of obtaining and its application technique.

Who are suitable for hair transplantation?

If your hairless areas are highly effective on your behaviour in the community, if you are extremely uncomfortable with this situation when you look at the mirror every time, if you are distressed enough to cause a limitation in your social relations, it is best to consult a Plastic Surgery specialist. The first and most important stage of hair transplantation begins with the examination of your hair structure, hair area, hair loss region and the extraction area. The secret of the success is the match of the patient’s expectation and the result of the procedure. Therefore, the first interview is important. The result that is gained from a person whose hairline is in the original position but who has rare areas between hair strands, whose nape area is hairy and healthy is different than in a person whose hairline is completely disappeared and who has complete bald areas until the upper part of the nape. People should have realistic expectations. The goal is to improve the physical appearance. The biggest concern of patients whether their expectations to be fully met or not. Our aim as a plastic surgeon is to evaluate the current situation in the best way, to reveal the natural result and to give a clear picture to our patient what kind of an image will appear after the hair transplantation.

What is checked in the examination before the hair transplantation?

Successful hair transplantation begins with a detailed evaluation. Your doctor listens to you at first. Family history, diseases, and medications are important. In most of the applications, the diagnosis is the hair loss which is caused by the genetic predisposition. This is especially important for women. It is important to know whether anaemia and the hormonal imbalance are present or not, polycystic ovary syndrome history, menstrual irregularities. Then your doctor determines your hair loss type. Then, we examine the donor site where the hair follicles will be taken. We look at the hair density, hair thickness, hair colour, and scalp health. Sometimes dandruff, redness, small pimples can be seen on the scalp. These findings are important in terms of seborrhoeic dermatitis, eczema, and psoriasis. If a person has healthy hair, it is appropriate to have hair transplantation.

After all these examinations, you will be informed about the area of hair transplantation, the transplantation density, and the result.

Do I reach a satisfactory density after hair transplantation?

The result of the hair transplantation depends on the experience of the team, size of the extraction area, the viability of your hair follicles and the thickness of your hair follicles. In case of a suitable donor site and appropriate hair thickness, 100 hair strands cover the skin in cm2. 100 hair strands are equal to 50 hair follicles when transplanting with a follicle consisting of two hair strands. Our basic approach is not to use multiple hair follicles as possible in the anterior hairline area.

The result which will be achieved in a person with a hair loss area reaching to the upper part of the nape and fine hair follicles in the donor site is definitely different from the result which will be achieved in a person with a very suitable donor site width and thick hair follicles.

What is the FUE technique?

The FUE technique is the process of hair extraction with micromotor and microwaves from the donor site between the two ears. The most important advantage of the FUE technique is that it allows the roots to be removed without damaging hair follicles. There are no permanent scars where hair follicles are extracted.

What happens on the hair transplantation day?

You will come early to the hospital on the day of hair transplantation. After completing the necessary paperwork, your doctor will take your photo before the procedure. After taking photos, your hair is cut short. This is necessary for hair follicles on the donor site and rare areas between the hair to be visible.

Then, we plan the front hair line and draw with a skin pen in patients with a disappeared front hair line. At this stage, patient expectations and suggestions are taken into consideration. One of the most important points supporting the natural result in hair transplantation is the front hair line. Drawing is made by considering the forehead structure and facial structure of the person. None of our hair lines is in the form of a straight line and the hair follicles are arranged side by side. For this reason, we pay attention to the fact that hair follicles are transplanted wavy and scattered on the scalp. Besides, it is very suitable to make the front hair line with single and fine hair follicles.

Patients coming for hair transplantation have two major concerns. The first is how the result will be, the other one “will I get too much pain?”. The pain during hair transplantation happens only during the injection of the local anaesthetic agent that we initially perform. The degree of the pain felt during local anaesthetic injection varies from person to person. The pain threshold can be easily tolerated even in patients with a low pain threshold.

First, you lie in the prone position and hair follicles are extracted. The aim is to use the donor area in the maximum efficiency. It is very important not to damage the hair follicles during extraction. Even if damaged hair follicles are transferred, they cannot produce hair.

You will be in the supine position during the opening of the channels where the hair follicles will be placed. The channels should be opened at an appropriate density in a scattered pattern (because our natural hair is randomly distributed) with appropriate depths and triangular recesses along the front hairline. At the same time, the hair directions are also determined during the channel opening phase.

At the last stage, the obtained roots are placed in the opened canals.

When can I see the result of the hair transplantation?

It will be explained to you how to take care of your hair after the hair transplantation. We will do the first washing and show you how to make it. Redness and crusts may occur in the transplanted and extracted areas. These will disappear within 10 days. Then the hair strands that we planted begin to fall but the roots remain inside. Then, the transplanted hair follicles begin to fall but follicles stay inside. Then, new hair strands come out. This falling and growth period may last about 8 months. It should be waited for 8 months in order to see the result of the hair transplantation.