Microsurgery Method (FUT)

In this method, a strip of a certain area from the back of head (occiput) is removed with the help of the local anesthesia and without feeling the pain. The cause of selecting this area (which is called the Donor Safe Area) is the point that the hair roots of this area are not consisted of the male hormone receptors (testosterone) and therefore, they are not affected by the hair loss effects of this hormone.

The area of removing hair in the back of head (the dark colored area)

The area of removing hair in the back of head (the area that its hairs are short)

The length of this strip is between 20 and 30 centimeters and its width is between 10 and 18 centimeters. The dimensions of this strip have constraints because the length and the width should be selected in a way that no damages are provided in the skin of the back of head and the skin can tolerate it and more important than all, no pressures are provided in the stitches of the back of head (which are superfine and microscopis) to make the above stitch scar in the form of a hairline and it becomes unclear (the discussed hairline which is the area of skin closure is very thin and it is hidden under the hair directions of the back of head).

Afterwards, this strip is divided into small pieces using the microscope and superfine tools while each piece should have 1 to 3 hair stands (and rarely 4-5 hair stands) (each piece is a so-called graft. The obtained grafts are placed in the cool normal saline (salt) solution. In this cool solution, grafts can be maintained alive and without damaging their vital tissues up to 2-4 hours.

For achieving the best result, the single hair grafts are transplanted into the hairline part because this part of the head is naturally consisted of single hairs.

Grafts with single hairs

Two-hair and three-hair grafts are transplanted behind the hairline and in front of the head to provide an entirely natural result.

Grafts with 2-3 hairs

Grafts with four hairs and more than four hairs are transplanted at the top of the head to provide the maximum density.

Grafts with 4-5 hairs

In the following figure, the different parts of the bald area can be contemplated. In the front thin strip (that the hairline is in front of the head), the single hairs are transplanted and in the back strip which is a little wider, the two and three hairs are transplanted and the grafts with 4-5 hairs are transplanted at the top of the head.

 

Designing different areas of hair transplant in the bald area

The results obtained from the natural hair transplant in the first session will be always better than the next sessions. As an example, if one hundred grafts are transplanted in one session, more hairs will grow and if one hundred grafts are transplanted in two sessions i.e. fifty grafts for each session, the hair growth will not be as good as one hundred grafts in one session. Accordingly, it is better to finish the hair transplant in one session. After completely anesthetizing the hair recipient area, different gaps are created in the bald areas using the small and thin blades. The longitudinal axis of these gaps and the angle and depth of sticking the blade are different for each hair transplant area and carefully doing this step can determine the final result of the hair transplant.

The most important factor about the direction and angle of the hair grown after the hair transplant is the direction and angle of the created gap and it is not related to the direction and angle of the hair while entering the created gap, in another word the hair which is being transplanted follows the direction and angle which is provided when creating the gap. Consider the accurate direction and angle of the gaps and their delicacies in the following figure. Also it can be observed that the front hairline has some irregularities to provide a completely natural result.

The delicate gaps created for transplanting the grafts

Then, each graft is inserted in one gap. This step is time consuming and it takes about 4-6 hours. The transplanted hairs are better to have the height of 3-4 millimeters. Transferring the grafts from the cool salt solution to inside the gaps is done using the superfine and thin forceps to provide no damages to them. The time of the transfer should not be exceeded from 2-3 minutes and the mentioned graft is continuously wetted by the cool salt spray serum during this time to prevent the graft from being dried because one of the most common reasons of the transplanted grafts fails is to become dry while transferring and transplanting them inside the gaps.

After transplanting the hair, one of the three states may happen to the transplanted grafts:

  1. The grafts fall out after 2-4 weeks (but the hair root is alive and healthy) and they grow after 3-4 months (the growth time is 2.5 to 8 months in average). This is the most common situation for the grafts.
  2. The grafts are remained inactive for 10-14 days after the surgery (i.e. they do not grow) and then they start to grow without falling out.
  3. The grafts are remained inactive for 3-4 months after the surgery (i.e. they do not grow) and then they start to grow without falling out. This state is observed only in 5% of the cases.

Laboratory Tests before the Hair Transplant

CBC – BS – BUN – Cr – AST – ALT – Alk Ph –  BT –  PT – PTT – CT – HIV  Ab –  HCV  Ab – HBS  Ag  &  Ab – Blood group & R

Recommendations before the Hair Transplant

Avoid consuming the fallowing items for one week before and after the transplant:

  1. Alcoholic beverages, sedatives[1] and pain relievers[2] such as Aspirin, Brufen, Indomethacin (there is no problem to use the Acetaminophen), Vitamin E Tablet and Cigarette.
  2. Completely wash your hairs with shampoo for several times before the transplant.
  3. Try to eat healthy and little foods before the hair transplant.
  4. Please avoid drinking more liquids and teas before the hair transplant.
  5. If you regularly consume a special medicine or you have an important disease, let the doctors know about it before the transplant.
  6. Express all your possible questions and problems related to the current hair transplant to the Jam specialized clinic before the hair transplant to start the hair transplantation with confidence and do not encounter any problems.
  7. Please take off all your jewels (ring, necklace, bracelet, earrings etc.) and watch before the hair transplant.
  8. Because driving exactly after the hair transplant is not good for you, please come to the clinic without the car.

 

[1] داروی مسکن

[2] داروی ضد درد

Attentions after the Hair Transplant

Controlling the pain after the surgery (if there is a pain, the transplanted grafts can be rejected from the head) and carefully and accurately taking care of the scar are the important issues.

It is better to relax at home for the rest of the day after transplanting and when you want to rest at first nights, it is recommended to put two soft pillows under your head and sleep in the form of half sitting.

For one week, strictly refuse to do some actions which may cause bleeding in the hair transplant area such as heavy works that exerting force on them is required, quick movements and severe coughs and bending too much when you are stood like fastening the latchets or picking up things from the ground.

The ice compress is useful at the first night because it reduces the pain and bleeding and it has somehow a pressure compress effect on the scar.

The patient should return to the clinic for removing the wound dressings a day after the transplant. Men should have a comfortable and large cap.

After the first washing in the clinic, it is required to quietly wash the hairs with the prescribed shampoo every day without manipulating your head. The correct way of washing the hairs will be trained.

The redness and inflammation of the head is usually eliminated after 3-7 days. The crusts existed in the hair transplant area will be spontaneously removed in a few days by daily washing the hairs and hence it is required to avoid manipulating or removing them. The stitches of the back of the head will be removed after two weeks.

Using the wig is forbidden in the first week and if the patient insists on using the wig in the second week, it is better not to use it more than 12 hours in a day. The wig is not forbidden from the third week.

The extreme physical activities and sports are forbidden for one week and then, the careful calisthenics (except swimming) are free but it is needed to avoid hitting the head. All kinds of sports are permitted after two weeks. The fresh air and sunlight are useful for the hair transplant area.

After transplanting the natural hair, it is not required to rest or take some time off from work. No problems have been observed until the present day and the patient can return to the work after one to two days.

Complications of the Hair Transplant

  1. The skin edema: The mild edema appears in the forehead. The following proceedings are useful for reducing or removing it: sleeping in the way of half sitting at first nights, preventing the medicine use (except the prescribed medicines) for two weeks, using the hot compress for 15-20 minutes, 3-4 times in a day and using the headband (for increasing the absorption of the liquids).
  2. Bleeding: There is usually a mild bleeding and it happens in less than 0.5 percent of the patients. The cold compress, pressure dressing and sleeping in the way of half sitting are useful.
  3. The mild anesthesia and paresthesia in the hair transplant area which is transitory and it will be better. Because of this anesthesia, the patient’s head is hit and he does not understand it and because of this, he should be very careful, especially while getting on and out of the car.
  4. Allergy to the using medicines which is rare.
  5. The differences between the transplanted hairs and the previous hairs from the point of the mount of being curly, color and the diameter of the hair that all of them are temporary and they will be overcome during the time.
  6. The pain of the hair donor area and the hair recipient area which is mostly mild and transitory and it will be quickly better by using the Acetaminophen Codeine tablets. By using the new methods of transplanting the hair into the head, the severe headaches (that can be seen before) will never happen.
  7. Itching: It is common. The topical corticosteroid, cold compress and oral antihistamines can be useful.
  8. Crust in the hair transplant area: It happens in the first three days and it appears because of the secretion of the coagulated serum and blood from the around of the grafts. Crusts do not provide any problems for the transplanted hairs and they will be slowly better. Cleaning and washing (but with caution) the hair transplant area prevents the occurrence of the crust and it is very important. The crusts should not be peeled because the transplanted follicle can be peeled. Daily washing the hair with shampoo, using the oxygenated water ¼ and the wet compress can be useful.
  9. Grafts can be moved or come out: It is mildly common and it is not important. This state happens because of itching the area, hitting (hitting the head while getting on and out of the car is one of the most common issues), pulling the grafts by the patient, severely combing the dry hairs, extremely bending when you are stood, pushing, exerting force, severely rubbing during the washing and the extreme pressure of the shower water. Combing the hair should be done when the hairs are wet i.e. after using the shampoo.
  10. Pustule: A number of pustules are usually created and they are not very important. These lesions are created from several weeks to 2-4 months after the surgery. To prevent the appearance of pustules, the hair transplant area should be cleanly washed by the shampoo. Using the hot and wet compress, local antibiotic and if it was not useful, using the oral antibiotic and sometimes opening and emptying the pustules are the therapeutic proceedings of the pustules.

 

Some Important Points

      1. The transplanted hair shafts will grow in first days after the hair transplant and they will be longer but these hairs will enter the rest state after about one month and they will gradually fall out. The transplanted hairs will gradually regrow after 3 months and the complete hair growth will be possible in about 6-8 months.

      New hairs may grow at different speeds and they are sometimes different from each other from the point of color, thickness and consistency but all of these problems can be mostly solved.

      For patients with thin hairs (most of the patients who are enthusiastic in the hair transplant are these people), the previous hairs will also enter the rest state for about one month after the transplant and they may also fall out (because of the stress, the prescribed medicines and sometimes the unknown reasons). This hair loss is natural and it happens more in women than in men for unknown reasons. This situation may continue for 4-6 months and the transplanted area may evidently seem to be thinner. Having thin hairs can be painful but it is temporary and when the hairs come out of the rest state and the transplanted hairs grow, the view of the hair transplant area will be normal.

      After growing the transplanted hairs, they can be washed, they can be cut, they can be dried by the hairdryer and they can be formed. Generally, 9-12 months after the transplant, the bald area will completely return to its normal growth.

      1. Because the transplanted hairs are removed from the areas which are usually out of the male hormone receptors and the male hair loss never happens, so these hairs will not usually fall out for years.
      2. In each session of the natural hair transplant, 5000 to 10000 hair stands (or in another word, 1800 to 4000 grafts) are transplanted based on the method.
      3. The hair transplant in the Jam specialized clinic can be provided with a written guarantee and if there are any problems or the patient is dissatisfied (that its possibility is very low), the hair transplant can be repeated for free if the patient is satisfied or his money will be returned (part of the money can be returned based on the number of hairs or all the money will be completely returned).
      4. The number of the transplanted hairs in the area with thin hairs is directly related to:
      5. The density and area of the hair in the hair removal zone
      6. The area of the zone with thin hairs which is the hair transplant area

      If the hair density and the area of the hair removal zone is greater and the area of the hair transplant zone and its thin hairs is less, the better result will be provided.

      The hairs which are available in the area of thin hairs (before the hair transplant), they may fall out or become thinner in the future (because of the same reason that the hairs already fell out or became thinner). This is not related to the hair transplant in the present day and if it happens, the hairs should be transplanted again to become thicker once more.