Permanent Hair Replacement Procedure
On your arrival at the clinic, you are taken through the steps of the procedure. Your medical records are reviewed as you go through the surgical consent form that was sent to you by email. The physician will then take high quality photographs that become part of your permanent medical record. Sedatives, generally oral valium, are given to relax you before the start of the hair restoration procedure, but you can remain fully alert if you like. You will be offered a movie selection, cable T.V., music selection or you can choose to chat with the doctor and staff.
The duration of the procedure will depend on the number of grafts being transplanted. The operation theater is a very relaxed atmosphere for your comfort and pleasant experience at our clinic. You will also enjoy our tasty Turkish cuisine during the lunch and snacks breaks.
Local Anesthesia Administration
After sedatives are given orally, we use a combination of the local anesthetic Lidocaine (Xylocaine), and a longer lasting one called Bupivicaine (Marcaine). High frequency vibration is applied to the skin as the anesthetic is given to decrease the sensation of the injections (this is referred to as vibratory anesthesia). The anesthetic is administered only around the perimeter of the scalp (called a ring block) to make the entire scalp numb. Once the scalp is numb, the remainder of the surgery is painless. If more anesthesia is required, usually around 5-6 hours into the procedure, it will be given before the initial anesthesia wears off.
Dr Civas has developed a new improved anesthesia technique used in hair transplantation. This development guarantees safety as well as a long lasting effect with specific local anesthetic injection and mixed solutions.
In FUT hair transplant, to maximize yield and minimize scarring, the donor tissue is removed from the scalp in a single thin strip (Single-strip harvesting). The location of the donor area is carefully chosen to be a region of the scalp with maximum hair density and the best long-term stability. Only the donor region is shaved short, to a length of approximately 1-mm, so that the uncut hair above the donor region can completely cover the donor area after the procedure. In FUE Hair transplantation, grafts are extracted one by one from the scalp using a combination of sharp and blunt dissection (Three-step technique).
Once the donor tissue is removed from the scalp, it is immediately placed into a holding solution consisting of chilled Ringer’s lactate. This closely mimics the body’s own fluids – it is the medium that is used in organ transplantation. This maximizes the survival of the grafts while they are being held outside the body.
In Follicular Unit Transplantation, the donor area is closed with either absorbable sutures (that don’t need to be removed) or staples, depending upon the person’s needs. In Follicular Unit Extraction the donor area is just covered with antibiotic ointment and a dressing.
In FUT, the individual follicular units (each containing from 1 to 4 hairs) are meticulously dissected from the donor strip in their naturally occurring groups under strict stereo-microscopic control. The grafts are trimmed of extra tissue and the intervening skin between the units is discarded, the grafts are sorted into groups containing either 1-, 2-, 3- or 4- hairs and stored. In FUE, the extracted grafts are placed under a microscope to assess their integrity and to sort them according the number of hairs they contain.
Creating the Recipient Sites
The creation of the recipient sites determines much of the aesthetic look of the transplant – it sets the angle at which the new hair grows and determines the distribution and density of the grafts. Recipient site creation is a critical aspect of hair restoration surgery that requires considerable experience, artistic eye and surgical skill and a keen aesthetic sense.
Once all of the recipient sites are made, the surgical team begins to place the grafts into these pre-made sites. One-hair follicular units are used in the frontal hair line to give a soft, natural appearance and 3- and 4-hair grafts are used in the central forelock area to achieve maximum fullness. Placing is the most time-consuming part of the permanent hair transplant procedure. Graft placement is an exacting process and during this period you will be asked to keep your head relatively still by watching movies, TV or sleeping time passes by unnoticeably fast, of course, you can take breaks as needed to go to the restroom, stretch or eat.
At the End of the Procedure
When graft incision is complete, the position of all of the grafts will be cross-checked. The post-op instructions will be explained and a printed copy will be given to you to take home. This will include the doctor’s contacts, just in case you need any assistance later on.
After the surgery, you should be very careful not to touch or hit your head. When you enter a vehicle or any low roofed areas, you need to bend lower since the anesthesia is still active and you wouldn’t feel anything. You risk damaging the transplanted grafts if you touch, itch or hit your head.