Hair loss & treatments

Myths & FAQs

Dr. Christopher Tzermias

Dermatologist | Contact
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FAQS before Hair Transplantation

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Is hair transplantation a new method for the management of hair loss?

No. Since the beginning of 1930s Japanese doctors had already started to transfer successfully healthy hair follicles from the affected areas of the scalp and body.

In 1959, the American pioneer doctor in hair transplantation, Dr. Norman Orentreich proved scientifically the dominant trait of the donor area (donor dominance), whereby the transferred hair is not susceptible to the deleterious effects of androgens on the recipient area and, therefore, they never fall.

Since then 85 years have passed during which hundreds of thousands of people worldwide have had hair transplantation.

How many hairs are transplanted in hair transplantation?

Our hairs do not grow on a hair by hair basis, but in the form of hair follicles, i.e. in “families” of 1 to 5 hairs maximum. This is the basic anatomical unit of hair. In modern hair transplantation procedures follicular units are transplanted, not groups of hair follicles.

From which areas and how do we collect the hairs?

We “exploit” all hair follicles of the stable hair zone at the back of our heads, which are not sensitive to the damaging effects of hormones.

Fifteen years ago special tools (incisors) were used to extract the grafts. In this technique extraction of hair follicles was performed blindly and significant amount of time was necessary (i.e. more than 10 hours for 1000 grafts), as well as shaving of the hair. This technique was appropriate for less than 5% of hair transplantation cases.

As time passed, techniques for the appropriate use of the donor area have been improved amazingly, through the use of microscopes and special instruments, allowing the extraction of individual follicular units and their tranfer in areas of hair thinning. This is actually the most advanced hair transplantation method F.U.E. (Follicular Unit Extraction), which can be conducted painlessly, without stitches and with no scars or marks.

Will it be possible to see hair thinning in the areas from which hairs are removed?

Νο. Hair density in the donor area is such that it allows the use of 50% of its hair follicles, without making hair thinning visible in this region. It is worth noting that 50% corresponds to an average of about 10,000 hair follicles, approximately 30,000 hairs.

Does hair transplantation leave marks?

No. The modern method of individual follicular units extraction (FUE) excels precisely in the fact that it is a minimally invasive technique. Unlike previously used hair transplantation methods, no scalpel is required for the FUE, as hair follicles are extracted with specific microscopic tools one by one and transported one by one in hair thinning areas. With this method, no marks or scars remain in the donor area.

How long do hair transplantation hairs last?

The result of hair transplantation lasts forever. The permanence of these hairs is due to their stability of the area from which the grafts are collected. Other features which are also transferred during hair transplantation include the texture of the hair and their colour. So when hairs at the donor area become white, also the hair of the recipient area will become white.

The permanence of the result is one of the greatest benefits of hair transplantation and is a fact. But it can turn into a problem when the method is applied by inexperienced physician. An inaccurate design may be satisfactory for someone at the age of 25 but it will be the same throughout his/her life.

Is it necessary to provide special care to the transplanted hair?

No. You can brush, cut, dye and provide no special hair to these hair so that to maintain them in good condition.

Are there cases that hair transplantation cannot be performed?

Yes, for instance when there is no zone of stable hair growth or in cases of non-androgenetic alopecia.

Another case is when the donor area has very little hair or when this area is too small to provide an aesthetically satisfactory result.

Now, with the right design and distribution of the grafts, in combination with better use of the donor area and the use of microscopes, we can manage even advanced cases of hair loss, always taking into account certain limitations.

Today only rarely do we observe medical reasons to avoid hair transplantation, and these are only seen in people with blood clotting disturbances.

The complete and objectively assessment and diagnosis will give you the right and accurate answer.

For the right diagnosis, trichoscopy is the most objective “tool”, with which scalp condition is studied per square centimeter and it is possible to identify the needs of areas with hair thinning as well as the potential of the donor area.

Does it hurt?

Hair transplantation is performed following topical anaesthesia in a medical environment. Some people say that this procedure is similar to visiting the dentist. The truth is that the mouth cavity is much more sensitive than the scalp.

Often people who start a hair transplantation procedure feeling really anxious end up sleeping because they feel relaxed and they trust the physician and his/her team, not because of the drugs.

Do I have to stay in the hospital for hair transplantation?

No. At the end of the procedure you can return to your home. Hospitalisation is not required. For legal reasons driving is not recommended when you leave the medical practice

Given that FUE method no stitches are used and no incisions are made, no painkillers or other type of medicines are given after the session. Furthermore, there are no limitations of everyday activities, and therefore this method is appropriate even for athletes, people who do heavy manual work, as well as those who cannot stay for a long period of time out of work.

When is healing completed?

A few days are enough both for the donor and for the recipient areas, since the sites from which individual hair follicles are extracted and implantation are tiny. As we stressed, through FUE method no incisions are made and no stitches are placed, which minimises the recovery time.

For how long do I have to be absent from work?

In many cases, it is not necessary to be absent from work not even for one day. Since the FUE method is minimally invasive, you can return to work the following day after the procedure. Absence from work is not dependent on the recovery time, but on whether you are interested in the opinion of your colleagues. If you have enough hair to cover the sites of extraction and implantation of the hair follicles, then the procedure will go unnoticed. Otherwise, a person with grade VI hair loss, a few days of absence from the workplace are enough.

Of course it is also possible depending on your individual needs to perform hair transplantation without shaving neither the donor nor the recipient area. Unshaven-FUE (U-FUE) is a technique in which the collection of follicular units is completed after cutting the hair (a step that may not be necessary in many cases) and these are then transferred to the recipient areas and placed in between the rest of the hair that haven’t been cut. Since the follicular units are collected from various areas of the donor area, trimming is not visible, as these areas are particularly small and they can be covered by the neighbouring hairs that haven’t been cut.

How long should I wait before shampooing my hair?

The day after the transplantation is completed you can was the donor area and from the 3rd day you can wash all your hair. Everyday shampooing is necessary to keep your hair and scalp clean and helps in the completion of the healing process and in the growing of the new hairs as soon as possible.

Will this be obvious to my close friends and family?

As already mentioned, this depends on the hair you have. For your close relatives (husband/wife, parents, etc.) this is not true. Do not forget that hair transplantation is performed for you above all and you want them next to you to support you in your choice. There is no reason why you should keep this a secret.

When will I see my new hair?

When grafts are implanted on the scalp they have small hair for technical reasons only. Some of these hairs (between 30% and 90%) will fall during the following three weeks.

The hairs that will remain on your head will already be longer by one centimetre. The rest will start re-growing from the second month onwards up to the 12th month.

To see the final outcome a single hair that grows is not sufficient but it should also get longer, be brushed with the rest, etc.

Is hair transplantation a surgical procedure?

Actually it is a pure medical procedure and it is performed by trained doctors and nurses in a suitable septic area.

Can women take advantage of hair transplantation?

Yes, of course. Hair transplantation is performed in cases of male-pattern hair loss with a good donor area either to cover up the areas of hair thinning from the frontal hairline or to make hair thicker, following the appropriate preparation. By choosing the right grafts and the right amount of thinning we can improve the appearance of even the most demanding woman.

Is hair transplantation performed on the scalp only?

It is a procedure that can be performed in any part of the body if there is need for permanent hair growth. Hair transplantation can be performed to cover up scars or burns at any part of our body. We can restore hair loss in sideburns, beards, moustaches, eyebrows, eyelids.

The new techniques that we use allow us to do so.

How natural is the result?

The result is absolutely natural. The result of modern hair transplantation methods goes unnoticed, with absolutely naturally looking hair and a healthy scalp.

We usually say that if we put a hair follicle in the middle of a large area of hair loss nobody will be able to understand that it has been performed by a human.

When is the result of hair transplantation complete?

The final assessment for a complete hair transplantation is performed one year later. Practically in most cases we have a clear picture after ten months.

I use a wig (additional hair). Can I have hair transplantation?

Yes. No special care is needed for transplanted hair, which is the main problem of using additional hair. However, we cannot provide hair density similar to a wig.

Apart from this, the natural appearance of transplanted hair cannot be compared to the stability and lack of natural appearance of even the best wig.

Furthermore, hair transplantation in people using a wig requires special monitoring so that not to destroy the transplanted hair by the wig.

Nevertheless, a wig or something similar can be used 4 days after a hair transplantation session.

Does hair transplantation stop hair loss?

Hair loss is a progressive process and it won’t stop through hair transplantation. This is why special attention and experience is required when designing the hair transplantation, so that to meet the aesthetic needs of a person throughout his/her life and to be able to predict the future progress.

A great advantage is to take care of the existing hair thinning problem through hair transplantation, before a gap is created on the scalp. This way it is possible to do hair transplantation without being noticed and without the effects of baldness.

This way we can perform more quicker sessions for hair transplantation, depending on the progress of hair loss, so that to never look bald.

Up to what age can I have hair transplantation?

There is no limit in terms of your age.

Our team has successfully performed hair transplantation in an 8-year-old child for the treatment of burns, as well as in men and women at the age of 70 to treat their hair loss.

When do we consider a hair transplantation successful?

A hair transplantation procedure is considered successful when a large number of follicular units are transplanted, when the donor area is fully used, when the follicular units have a similar to natural hair thickness. When these conditions are met we can have an excellent and naturally looking result that nobody can notice.

What is the role of technology in hair transplantation?

The use of microscopes to distinguish the grafts and various automatic devices, such as various implanters which are used to place them have improved the quality and the speed that hair transplantation is performed.

At the same time digital trichoscopy and digital dermatoscope allow us to make objective diagnosis and monitoring of the results.

These tools are mandatory for any colleague who is performing hair transplantation.

What has changed over the last years in hair transplantation?

Only in the early 1980’s was it been recognised that hair grows not singly, but in specific anatomic units that are called follicular units (FU’s), which consist of 1, 2, 3, 4, or rarely 5 hairs, with discrete nerve and blood vessel supply, a connective tissue sheath, and sebaceous gland.

These FU’s are the natural groupings of the hair, the way it normally grows and should be used in hair transplantation if we want to achieve a natural result while taking full advantage of the donor area. This is possible only through the use of microscopes.

With respect to natural hair anatomy – apart from greater using this method would allow us to create the most undetectable result, and also allow us ease in following the natural angles of emergence from the scalp, from an angle of 10 degrees in the region of the temples and at the back of the scalp to 60 degrees at the center of the scalp. The angle of growth is another critical factor for the naturalness of the result. These angles at which hairs grow from the scalp are quite important, as they vary widely depending upon the area of the scalp we are observing.

Imitation of nature is inviolable rule in terms of the hair volume. For example, there can be no effect when transplanting one-hair hair follicles only – as some people attempt to do, as this is something that is not happening naturally. The volume of hair is the result of hair follicles more than one hair, which we must maintain and strengthen at specific areas, such as the central area of the scalp.