Hair transplant techniques

Classic Strip Harvesting

At the first stage of actual surgical intervention, a surgeon removes a donor strip (graft) usually taken from back and temporal zones of the patient’s head. Hair follicles (hair units) in these areas do not have receptors to perceive the effect of male hormones androgens, which harmfully influence on the hair growth, and are consequently genetically immune to hair loss.

Further, using an electron microscope, the surgeon cuts follicular units, which are hair groupings with a common sebaceous gland and blood supply, as well as individual hairs from the strip with a special scalpel. This piece of work is performed by several qualified assistants, while the surgeon is making incisions in the area into which grafts are transplanted (transplanted hair; a graft generally is comprised of 1 to 4 hairs) and, if needed, carefully shape the patient’s lost front hairline. Afterwards, one or two assistants insert the prepared material. The whole procedure takes 4 to 10 hours, depending on the number of grafts harvested. During one session, if there are enough resources in the donor zone, it is possible to transplant up to several thousand grafts and more.

The advantages of this technique are a large amount of transplanted hair, effect of natural hair growth, absence of noticeable scars and density of 50 to 90 hairs per square centimeter.

All procedures are completely painless with the exception of administering an anesthetic, but it is a simple injection using a syringe. There are no visible scars and bleeding at a spot of the surgery although a short-term swelling is possible and small crustings appear which smoothly and painlessly peel off in a few days.

Our surgeons are most technically proficient with a technique of buried suturing that enables to make a scar almost invisible. The transplanted hair begins to grow in 3-4 months, and the ultimate cosmetic effect becomes apparent in about a year after the surgery.

Seamless FUE

FUE (Follicular Unit Extraction) or seamless hair transplant is an advanced technique of the follicular extraction. The method and special tools required for the procedure ensure a high survival rate of the grafts. FUE is a sparing hair transplantation technique that avoids the need for harvesting a donor skin strip from a back zone of the head. Follicular unit extraction involves isolation of small follicular groupings typically consisting of 1 to 4 hairs from the back donor zone, with the punches and further transfer into the recipient zone. Microscopic grafts allow even distribution of the transplanted hair in the balding sites, and genuine look that is perfectly identical to the natural one.

The same technique that is more often called BHT (Body Hair Transplant) enables our surgeons to successfully transplant hair from the patient’s chest and abdomen which is an ideal material for densification of receding hair and in case of insufficient amount of grafts in the back zone, to the balding sites. Post-procedural healing is faster and less painful while swelling is fairly moderate, the grafts fully survive within eight days after the surgery, and a wound in the donor zone is repaired within 1-2 weeks. The advantage of the FUE is that a minimal patient’s donor material is no longer an obstacle to full-scale surgery, especially with regard to that the procedure may be used for hair transplant from a back zone of the head as well as from a chest and abdomen. Patients who underwent a FUE surgery do not have any noticeable scars in the donor zone. Some transplanted hair may start growing soon after the procedure. Generally, time limits for germination of the most transplanted hair are the same as compared to the classic strip harvesting.

Eyelashes and Eyebrows Restoration

Eyelashes and eyebrows may be lost due to various reasons such as: mechanical traumas, thermal, chemical or electrical burns, physical or local diseases, regular plucking, radio- and chemotherapy, surgical removal of tumors. Absence of eyebrows and eyelashes may be congenital as well. To repair eyebrows, individual hairs, or micrografts, are used which allows to thoroughly replicate a contour designed by a patient and a doctor and to achieve a perfectly natural look. To restore eyelashes, a transplant surgeon selects only the finest donor hair, grafts which are often some individual hairs to be transplanted into the eyelid. The transplant material is typically harvested from a back zone of the head by either strip harvesting or FUE. To make the transplanted hair grow in a desired direction after the surgery, patients are recommended to use eyebrow gels and trim them periodically with nail scissors.

We have gained a unique experience in performing such surgeries. As early as 2004, we started transplanting micrografts into coronal incisions on the eyelid margin. The results have been supervised within the next 3 years. For our very first patient who lost her eyelashes due to traumas, we performed a hair densification in the injured area in 2005 and a correction followed in December, 2006. The visual aesthetic result was equally pleasing to the patient and us.

For grafts, we take advantage of a concept throughout suturing in the eyelid tissue, which we slightly changed by using an own version of the needle as opposed to French-eye needles (Alan J. Bauman MD), and, when reshaping natural forms, do not harvest a single hair for transplantation since the eyelashes usually grow in groups of 2 or 3 hairs. By accurately processing every graft, we remove tissue around a hair shaft and follicle as much as possible thereby avoiding overload of the eyelid by additional subcutaneous tissue and destruction of the subcutaneous eyelid layer structure. These are photos of a surgical site on the eyelids of our patient. You can see a newly created line of eyelashes over and between short and thin natural hair. In this case, we aimed to achieve densification of the patient’s own eyelashes unsatisfactory in their density and length.

If applicable, eyelash transplant may involve repeat surgery to increase their density. Alopecia areata (circumscribed), of unknown origin and mostly with no predictable results, is a contraindication to the procedure.