WHAT IS THE NORWOOD SCALE?
The Norwood Scale is a classification of MPB from remedial thinning to progressive hair loss. The scale makes it easier to understand the present grouping and determine potential future loss. It goes from 1 to 7 with 7 being the most aggressive form of hair loss.
CAN ANYONE HAVE HAIR TRANSPLANT?
Hair transplant is generally used to treat MPB & FPB, but not Alopecia Areata or Trichotillomania cases.
Just because people retain hair around the sides and back of their head does not mean they are suitable for a transplant. Extensive research must be done to ensure that the person is aware of what can be achieved and the doctor is clear on realistic goals. After a thorough consultation process, transplants are often a compromise between doctor and patient.
CAN I ACHIEVE A FULL HEAD OF HAIR?
The art of hair transplantation is the illusion of a full head of hair. Logic tells us you cannot replace all lost hair, but you can mask the loss to give the illusion of more hair. The fact is that most men lose 40% of their hair before realizing they are thinning.
WHAT IS DONOR MANAGEMENT?
Donor management is vital to the long-term happiness of the patient. Obviously we have a finite amount of hair to transplant, so it is important to use it wisely. The patient must be aware of the limitations as well as of factors such as future hair loss, age, hair loss classification and desired goals. Some men have home-run hair and can treat any degree of hair loss whereas others are limited in terms of coverage.
WHAT ARE HAIR CHARACTERISTICS?
People with better hair characteristics are more likely to get a better result with fewer grafts. Characteristics include hair coarseness, curl, density, and skin colour in relation to hair colour. If these are positive it will lead to a better result.
WILL IT LOOK NATURAL?
Hair transplants are not just about technical ability but also a talent for design, especially when creating the front hairline. A doctor with a gift for design will create the most natural looking head of hair, virtually indecipherable from original hair. This will be the difference between a good transplant and a great one.
WILL IT WORK?
The idea here is simple. Male-pattern baldness does not affect the hair on the sides and back of your head. This allows the movement of grafts to an area of thinning while maintaining its natural characteristics.
HOW LONG IS A PROCEDURE?
This depends on the procedure and the amount of grafts placed. Strip procedures of 5,000 grafts plus are completed in one day while FUE procedures over 1,500 grafts are budgeted for consecutive days, i.e., 3,000 FUEs over two consecutive days.
IS IT PAINFUL?
Hair transplants are considered minor surgical procedures performed with just a mild sedative under a local anesthetic. Many say the administrative element is the worst part of the procedure. Strip procedures can be slightly more uncomfortable, particularly post-op, with tightness around the suture, and this may last for a few days. Post-op is less dramatic with the FUE procedure than a FUT/Strip although in general a mild painkiller will relieve any discomfort.
WHICH TECHNIQUE IS BETTER?
There is no simple answer to this question. Each technique has its pros and cons. That is why a consultation is vital in deciding which procedure is best suited for the individual’s goals, stage of hair loss and long-term happiness.
CAN I USE SOMEONE ELSE'S HAIR?
The easy answer is no. The genetic properties of the follicle must match those of the recipient and while research on donor transfer has begun, it is still in its very early stages.
CAN HAIR BE TAKEN FROM OTHER PARTS OF THE BODY?
The use of body hair FUE is a newer form of transplant and should only be a last resort for patients whose scalp donor area has suffered so much trauma that there is little hair to take. Body hair can be taken from the back, chest, arms and legs but it is different from scalp hair and the patient must be aware of this before considering it. It is BHR policy not to rush into large body-hair procedures. In our experience, smaller operations spread the yield for the best long-term results.
WHAT IS A MEGA SESSION?
This term is common in the industry and refers to either a strip or FUE procedure of over 3,000 grafts with a large amount placed in one session to give maximum density and coverage without the need for multiple procedures.
WHAT IS DENSE PACKING?
This is the art of placing follicular units close enough together to ensure a natural result/density in one pass. For example, hairline design should not have large gaps between hairs that would require a second operation at a later stage. The amount of follicular units placed will change depending on hair characteristics, hair shaft quality, ethnic origin, hair colour, curl, and existing hair density. The skill here is being able to place follicular units close together without compromising the growth of each hair, the angle of the site and the size of the gauge used, which will all affect the result.
WHAT IS TRANSECTION & GROWTH RATE?
Transection is the loss of follicles when they are removed from the donor area. This occurs when the follicular unit is damaged upon removal. An acceptable rate of transection is approximately 5 – 7%.
Growth rate is the percent of follicular units that grow after placement in the recipient area. This rate is compromised if the FUs are not placed correctly, stored effectively or damaged during placement. An acceptable growth rate is approximately 94 – 98%.
WHAT IS SHOCK LOSS?
This is a term used to describe the temporary loss of existing hair around the newly placed hair in the donor area. This is countered by growth stimulants and the doctor’s skill in placing the units. The phenomenon is temporary (if it occurs at all) and often not even noticeable – sometimes it is the continued thinning of the surrounding hair as opposed to actual loss.
WHAT IS SCALP LAXITY?
This is more important for strip procedures but is also important in FUEs. Skin is amazingly pliable and a strip can be removed without dramatically compromising tissue or even the cosmetic appearance of facial features, for example. Scalp laxity plays an important role in the transfer of hair from the donor to the recipient area. A person with better laxity can expect better healing and potentially more transplants. However, the more procedures, the less laxity the scalp will have.
CAN I HAVE MORE THAN ONE HAIR TRANSPLANT?
The potential number of grafts on an average scalp can exceed 8,000, but this is not possible or ethically wise to transplant in one procedure. Additional procedures can be carried out at a later date if the person loses more existing hair or wants more coverage, and good donor management allows for the sensible distribution of hair and the best possible overall result.
WILL I NEED MORE THAN ONE HAIR TRANSPLANT?
Factors such as age, Norwood Class and progression of hair loss will help answer this question, but in most cases a person will undergo more than one procedure, even if there are many years between each one performed.
WILL I BE LEFT WITH A SCAR?
Regardless of the technique or how well it is performed, if skin tissue has been cut or punched there will be a scar. With the strip technique, closure methods have made linear scars nearly undetectable even with very short hair. The FUE technique is much less invasive and scarring even less dramatic. Sometimes scarring is invisible to the naked eye even if the head is shaved.
WHEN WILL MY NEW HAIR GROW?
The transplanted hair in the recipient area takes about one week to bed into to the skin tissue and cardiovascular system. The hair can start to grow within the first month and then fall out, leaving no visible signs of the transplant. It is common for 80% of the placed hair to initially fall out. The follicle then rests for three to four months before growth starts. At this stage it is normal to have 30% growth; 60% at six months and the rest at 9 – 11 months. It can take a year to see full maturity and true results.
WHAT ARE THE HEALTH RISKS?
There are very few health risks associated with hair transplant, but we still take all necessary medical precautions with surgical procedures. Risks are typically related to the healing process and even post-op infection is very unlikely if you follow the instructions and take the medications provided.
WILL MY HEALTH AFFECT THE HAIR TRANSPLANT?
Generally there are no medical conditions that would deter you from undergoing hair transplant. Having said that, a blood test is taken before any procedure and it is your responsibility to declare any conditions you may have or medications you are taking.
Certain precautions can be taken before and after your operation to aid healing and encourage the best possible result. These mostly have to do with your cardiovascular system. We advise you to not smoke or drink alcohol before and after the procedure (see the pre- and post-op instructions).
HOW LONG DOES THE HEALING TAKE?
This can depend on the procedure. Recipient sites heal at the same speed for either procedure but donor healing may vary. In the recipient area there will be short shafts of hair surrounded by a small scab. You begin to wash your hair the day after the procedure. The scabs are washed away gradually and the shafts of hair fall out. This normally takes 10-12 days until there is very little to see.
With the strip in the donor area, the suture can be hidden if your hair is kept long. The suture can be removed 10 days post-op but the area will remain a little red for a month while the skin tissue relaxes. With FUE in the donor area, the punches are hidden by your hair growth. Even after seven days it is hard to see any signs of the transplant while they heal.
Swelling can occur on the forehead, especially in large procedures that involve hairline creation. This is normal, starts the day after the procedure and typically last three days. There is no danger to your health or the success of the procedure. Gentle massage and an ice pack will keep this to a minimum.
WHAT AFTER CARE IS NEEDED?
Post-op care helps stop infection and speeds the healing process. Products include anti-bacterial cleansers and shampoos, which are generally used for the first two weeks before returning to your regular products.
CAN I RETURN TO WORK / PLAY SPORTS RIGHT AWAY?
Although the procedure is classed as minor, it is still surgery so a couple of days rest is advised. The cosmetic signs of the Hair Transplant will last for a couple of weeks, so depending on your lifestyle and/or job you may wish to wait until there are no visible signs. Medically speaking, however, it is perfectly feasible to return to work within couple of days.
Physical activity is not advised for a number of weeks after the procedure. There are a number of reasons for this. The cardiovascular system should not be tested while the grafts are still embedding themselves into the recipient area and any scar line could stretch if there is pressure or pulling on the scalp skin tissue.
The BHR Clinic believes in transparency and top patient care. We try to ensure that you feel like you are in safe and professional hands from the moment you contact us until long after your procedure.
Unless otherwise stated, the fees represent the cost per graft / follicular unit placed for both FUE & FUT / Strip Techniques for either virgin scalp or non-repair cases.
Smaller graft numbers of either FUEs or FUTs that are not listed can include such procedures as eyebrow, beard or sideburn reconstruction. Small patterns of hair loss will be assessed on an individual basis to cater to the needs of each person. There is a minimum surgical charge of 2,000.00 Euros but please be advised of the specific costs when you have your assessment at the clinic.
Repair cases can hold many different challenges and requirements not considered in a normal case. Dr Bisanga has a reputation for repairing some of the most difficult cases ever seen in the industry, including such techniques as graft removal and redistribution, scar revision/FU placement into a scar line and placements in previously impaired skin. Due to the personal nature of repair cases, they are treated on an individual basis and priced only after consultation.
Please contact the clinic for a personal assessment in regards of pricing for your specific cases, such as – but not limited to repair surgery – graft removal, eyebrow reconstruction and the cost per graft / follicular unit placed through FUE and FUT / Strip techniques for virgin scalps.