1113 - Budapest, Edömér u. 6.

Tel/Fax: (+36-1) 209-29-30

E-mail: info@sikos.hu

Hair transplantation with follicular units. FUT (Follicular Unit Transplantation), FUE  (Follicular Unit Extraction ) Hair restoration surgery with ultrarefined technique

 
 

Hair transplantation, hair restoration, follicular unit transplantation photo gallery   Hair transplantation, hair restoration, follicular unit transplantation video

 

Hair trasnplant before Hair trasnplant after Hair trasnplant before Hair trasnplant after

Basics about baldness, hair loss | Whom hair transplantation (hair transplant, hair implant, hair restoration  hair replacement surgery) is proposed to? | What does hair transplantation with follicular units (FUT) method means ? How the surgery happens ?What is FUE (Follicular exctration) technique?  | How can we achive the best possible yield ? | What result can be expected ? How the success should be provided ? | What complication can occur by hair transplantation? | About our experiences

Sikos Plastic Surgery, Hair Transplant Clinic is a modern private institute, providing the state-of-art hair transplant methods as FUT (Strip) and the FUE (individual follicular extraction) techniques as well. Both procedure is equally effective, the suitable one shall be choosed up to the patient requests and possibilities, due to his/her hair characteristics and other features regarding hair loss.

Leader of the Sikos Plastic Surgery private clinic is Géza Sikos, M.D.  a hair transplant expert in Budapest, Hungary who has more than 18 years in practicing hair transplantation surgery.

Contact to clinic


Hair transplant FUT strip techniquel 2436 grafts ,10 months post.op.

FOR THE VIDEO CLICK ON THE PICTURE!
 

Basics about baldness, hair loss

             The most frequent form of baldness is the so called male pattern baldness, medically referred to as alopecia androgenetica. Alopecia means baldness, the word androgen shows the hormonal origin of the process. This kind of baldness is genetically inherited, not only from father to son but from distance or female relatives.
            Alopecia androgenetica is characterised by its development: most frequently starts at both temples in a triangular fashion, causing receding of the frontal hairline slowly. Meanwhile sheding at the vertex region is increasing permanantly, and the two area contact to each other at the top of the head. Male pattern baldness can occur in females mostly in quadratic manner, diffusely.
By our contamporary knowledge this process can not be influenced definitively, the time and form of its development varies greatly and individually. The only known natural and permanent treatment is the hair restoration plastic surgery, and its mostly developed and modern technique: Hair transplantation with follicular units (FUT and FUE ) (hair restoration surgery)
            Aquired baldness, hair loss can develop as the result of surgery, medical treatment, trauma, burn injuries or different deaseses. Hair transplantation can be performed succesfully in these cases too. Special modificiation should be utilized in some cases. So hair, eye-lash or eyebrow can be reconstructed after burn injuries.
 
Hair transplantation, hair restoration, follicular unit transplantation Hair transplantation, hair restoration, follicular unit transplantation
 
 

Whom hair transplantation is proposed to?

 
Degree and form of sheding and sparsing individually varies greatly. In general everybody has his own judgement about his problem. Smaller sparsing of the hairy scalp can be a great problem for someone, while the same condition does not bother the other.
 
Hair transplantation (hair transplant, hair implant, hair restoration surgery)  is offered to those patients, who are disturbed by their sheding, and this condition is detectable. Operation also advised to perform when smaller areas (e.g. at temple or vertex region ) are effected or diffuse sheding is reported as with females. The indication from one hand is based on the patient’s decision. When sheding is in process, hair transplantation can maintain hairy appearence despite of continous hair loss and baldness never will be seen considerably.
Most people try hundreds of treatments to stop their hair loss. They visit several doctors in years but with male pattern baldness they could not see any definitive progress. Medical treatments can only slow down or stagnate the process but not capable to stop it.
Hair transplantation if performed in right time can shortend this period and increase the patient’s appearence greatly.
 
To establish the operative indication and the expected result , we must take several facts and conditions into consideration. The most usual are:
•          Origin of baldness
•          Form and degree of baldness
•          Patient’s anamnesis ( formal interventions on the scalp, family heritage )
•          Hair and scalp characteristics
•          Patient’s requests, expectations
 
 

Norwood scale  Norwood scale

Norwood classification chart

These factors must be judged individually, and knowing them, in form of a personal consultation the operation plan is established together with the patient. This plan concerns not only the actual surgical treatment but involves the possibility of any next operation due to further hair loss.
Our candidates are examined and informed in detail. We establish the origin, form and degree of the patient baldness, and evaluate the attributes of the donor site given. We ask for previous medical treatments, surgeries, illnesses, allergie to medicaments etc. Clearing up the patient’s expectation and informing them about the details of the procedure, we concludes to the possible operative solution. Our candidates have the choice to see our previous patients’ results in photos or get in touch with some of them to have personal informations.
 

What does hair transplantation with follicular units (FUT) method means ? How is the surgery happens ? What is FUE (Follicular exctration) donor harvesting technique?
 

            The basic of this intervention is the fact that hair follicules at the occipital and fringe regions are not sensitive against hormons so those who are going to be bald even in great extension have their remaining hair at that areas. According to the principle of the so called  „ donor dominance” follicules transplantated from this areas bring and maintain this feature at the recipient site so from the transplantated follicules hair grows normally what does not shed later.
            Formally utilized types of surgeries with bigger skin-islands containing 6-10 or more hairs, or 300-400 grafts transplantation in one seat are not justified any more in our modern era.
The contemporary microsurgical method of  transplantation with follicular units (FUT- follicular unit transplantation) gives much more: entirely natural appearence, no more „brush like” disturbing hair knots or heavy scars. Our method gives acceptable density and even from short distance no one can see that the new hair is transplanted.
 
 FUT (Strip harvesting) method
                   Donor area is the occipital region of the scalp. By the regular "strip" donor harvsting method we remove in horizontal direction a long, narrow strip from ear to ear of the hair-bearing skin. The edges of this wound are closed, so there is no lack of hair, only a narrow, soft scar line what is invisible in the hair. This scar is closed with the special " trichophytic suture", which by means hair are growing through the scar, so it would not be seen in a short 0.5 cm hair even.
This strip are sliced into slivers, and from this very small skin islands are cut, containing only 1-2, or 3-4 hair follicules ( follicular units). These are called follicular unit grafts, formally called the 1- 2 hairs micro, 3- 4 hairs  minigrafts. Preparation and cutting of the grafts is an extremely precise and meticulous work, survive of the grafts are greatly upon the technique utilized. We make small incisions with special instruments at the recipient area, and the grafts are positioned in them one by one.
Transplantation (implantation of grafts)  is done by 1-2 hairs FU grafts at the frontal hairline with ultrafined technique, while the rest of the scalp are covered with mixtured type ( 1-4 hairs) follicular grafts. No scar formation is detectable nearby the transplanted grafts, direction and mood of hair growing is natural by the utilization of the correct technique. 
 
 

FUE method                    FUE grafts                                                 

FUE (follicular unit extraction) techique means the removal of the follicular units each by each, by the use of micro punch knife (usually diamater 0.6-1 mm), and leaving several dots of minimal scars on the donor area instead of the thin linear scar of the strip.  These very small scars are not visible. By this technique we can provide usually 800 -1500 FU grafts/surgery. We can repeat the surgery on the next consecutive day, so in one seat we can provide 1600-3000 Fu grafts in average.
Incisions and implantation is the same as with strip technique.
Due to high demand of technical skill, experience and time consuming feature of the Fue technique, price calculation/graft is higher than with FUT(strip) method. Knowing the pros and cons of this technique, we carefully select candidates for this method.
 
 FUE technique can be recommended to :
 
  • Patients who like to wear their hair very short in the donor zone or might consider shaving off all their hair. 
  • Patients who only require a small hair transplant, for example to hide the scars of a face lift or an eyebrow transplant.
  • Patients with a donor zone with limited hair (female hair loss)
  • Patients who wish to hide the scar of a previous hair transplant intervention.
 

 

 Comparison between FUT and FUE methods
 
 
STRIP (FUT)
FUE
Donor tissue removed
Scalp tissue in extent of about 1-1.5 cm wide and approx. 22- 28 cm long (ear to ear) is removed
Only the follicular units are excised
Donor scar
Linear scar from ear to ear, Normally 1-2 mm wide, white, soft scar, no palpable, no visible in 0,5-1 cm hair.. Tricho suture makes it more undetectable as hairs are growing through the scar. 0.5 -1 cm long hair gives full cover. Short hair style at the donor area makes the scar visible.
Several, but very small dotted scars, which are invisible in about two weeks postoperatively. Convenient for short hair style
 
Hair style at donor area
Only the size of the strip is clipped, no signs of surgery immediatly after
All the donor area is shaved. Hair regrowth for sufficent cover takes place in 2-3 weeks.
Partial shaving also possible to retain hairy cover in donor area but less graft can be harvested so.
Possible number of grafts /seat
Depends on the donor density. In average 2000-3000 follicular unit grafts (from the strip area )
1 seat consists usually 1 or 2-3 surgeries on 2-3 consecutive days, with approx.800-2400 grafts alltogether
Graft cutting
Follicular grafts are created from the scalp strip by experienced nurses under magnification
No need for graft cutting
Implantation
Ultra refined technique, lateral slit
Ultra refined technique, lateral slit
Best candidate for surgery
Dense donor area, with longer hair
Who has no problem with the linear scar
High graft demand in one seat
Patient with short hair style
Low grafts demand
Correction or touch up surgery
Who does not want linear scar
Comfort, position during surgery
Strip excision, wound closure needs about half hour lying on abdomen, rest of the surgery (incisions, implantations) in comfortable half-sitting position. Small pain is only initially during injection of local anaesthetics.
Graft harvesting in different lying positions, on face and sides for about 4 hours rest of the surgery (incisions, implantations) in comfortable half-sitting position. Small pain is only initially during injection of local anaesthetics.
Regeneration, socialization
Crusts and oedema (swelling), small alteration in skin colour will takes place for 7-10 days. Back to normal in 10-14 days at least possible
Crusts and oedema (swelling), small alteration in skin colour will takes place for 7-10 days. Back to normal in 10-14 days at least possible
Time of the surgery
5-6 hours usually
6-8 hours usually (less graft- shorter time)
Possible repetition of surgery
2 surgeries (cc.8 months apart earliest) surely can be done. More intervention rarely possible or recommended due to scar formation, but FUE technique still possible after strip removal(s).
Next seat can be done in cc.6 months apart earliest with the same graft number. Following surgeries also possible increasing transplant effect. FUE harvesting still can be done after any strip surgery.
     
 

How can we achive the best possible yield ?

 
            Close investigation of the hairy scalp shows hairs growing in special groups. This anatomical – physiological bundles are called follicular units. Each of this unit contains 1-2-3-4 hair follicules. During the later mentioned graft preparation and transplantation procedures we put emphases to maintain these units for the best quality an quantity of grafts in order of the most natural appearance, reminding of the original state.
 

              

   2,3 hair / mm2                                           1,7 hair / mm2 

Different density of the hairy scalp 

 

From the strip the preparation and cutting of the grafts is an extremely precise and meticulous work, survive of the grafts are greatly upon the technique utilized. We make small incisions with special instruments at the recipent area, and the grafts are positioned in them one by one.

Transplantation is done by 1-2 hairs FU grafts at the frontal hairline, while the rest of the scalp are covered with mixtured type (2-3-4 hair) FU grafts. No scar formation is detectable nearby the transplanted grafts, direction and mood of hair growing is natural by the utilization of the correct technique.

Surgery is performed under local anasthesia, with some pain and discomfort for 3-4 minutes, but total anaesthesia can be achived for the entire procedure. The operation lasts for 5-6 hours, patients are resting, sleeping or chating during this time in great comfort. The procedure is outpatient, patients can leave the office on their own feet. Following surgery there is no pain, small tension at the donor site is possible, but it disappears step by step. For one day headbandage is applied, removing it careful haedwash is necessary for every day in the first 10-14 days to eliminate the crusts around the incisions.One can count on some swelling (reactive oedema) on the forhead which disappears in about 10 days itself.

This FUT and FUEmethods and its smaller modifications are considered as the most contemporary one and its popularity is well known all over the world. The procedure is not troublesome for the patient, goes with only some discomfort. The method offers a reliable and permanent solutions to those who are suffering or disturbed by their baldness or hair loss.

 

  

 

Hair transplantation, hair restoration, follicular unit transplantation
Hair transplantation, hair restoration, follicular unit transplantation
 
Hair transplantation, hair restoration, follicular unit transplantation Hair transplantation, hair restoration, follicular unit transplantation
 

What result can be expected ? How the success should be provided ?

The number of the transplanted grafts are determined by the the extend (the need) of the recipient area and the capacity (number and quality of  hairs) of the donor site.  In averege  at Sikos Plastic Surgery clinic 2000-3000 follicular unit grafts are transplanted in a single session, rarely less but in some case more. The grafts are positioned in a network manner on the bald area for the contribtion to the natural effect. The number of the grafts and their positioning is decided in every patient individually due to all of the above mentiond facts and circumstances. Increasing the density some of the cases second or more sessions are indicated no earlier as 6-8 months, to make the result close to the original state.

Healing of the small and sharp incision wounds are almost invisible, so about two weeks after the surgery and the elimination of the small crusts (scubs) literally there is no trace of the intervention. No scars around the graft can be detected, hairs are emerging from the skin regularly in natural manner.

The frontal hair zone needs special interest. This part is the most conspicuous, where the frontal skin meets the hairy scalp. The natural look of the frontal hairline can be provided by the special placing of very fine 1-2 hairs micrografts. Survival of the 95-98% of the transplanted hairs could be guaranteed by the use of the proper technique. Regeneration of the hair follicules after transplantation takes usually 2-3 months, the hair shafs starts to grow after this resting period. From this moment the hair can grow even 1 cm/month, so in 6-8 months hair will be 3-5 cm long. The newly growing hair held its characteristics,  corresponds in every respects of the original one at the donor site. Hair wash, cutting, colouring, combing is possible in genuin manner.

One of the secret of the success of the microfollicular transplantation is the well prepared and trained surgeon-assistents teamwork. Utilizating the most precise and meticolous atraumatic technique the survival of the transplanted hair could be provided the best. A well trained team is capable to prepare and implant in average about 2000- 3000 or more follicular unit grafts in one session within 5-6 hours. The doctor -medical assistents team of the Sikos Plastic Surgery is prepared to meet this requirements due to some years of practice of this special technique.

Though restoration of the original density can not be our goal, the available result (just as well with one session ) enough to eliminate the bald appearance of the patient and hair gives younger look also.   

 

What complication can occur by hair transplantation? 

Hair transplantation is a surgical procedure so complications can occur. Their incidence are very rare. Considering the remarkable vascularity of the scalp, inflammations almost never occur or only mildly which can be treated easily. Ejection or death of the transplanted grafts can be avoided applying the above mentioned atraumatic technique. Scar formation at the donor area rearly can ended with somehow wider scar, which is still invisible, whilst the hair is 0.5-1 cm long at least. The experience of the surgeon is most of importance, especially creating the natural appereance at the frontal hairline. The effect of an unnatural hairline is very disturbing.       

 

About our experiences:

Sikos Plastic Surgery  is specialized in hair transplantation , FUT, the state-of-art follicular
unit transplantation technique, FUE (Follicular Unit Extraction harvesting technique) and have experiences with many patients for more than 17 years in this field.
We have a specially trained assistancy team and dr.Sikos has accomplished trainings, courses and congresses in the USA ( FUT course in Los Angeles 1998, FUE course in Denver 2006 and several other appearences) and in other countries and occasions. He is the member of the International Society of Hair Restoration Surgery ( ISHRS) and the Formal General- Secretary of the European Society of Hair Restoration Surgery (ESHRS).

 

Basics about baldnes, hair loss | Whom hair transplantation (hair transplant, hair implant, hair restoration hair replacement surgery) is proposed to? | What does hair transplantation with follicular units (FUT) method means ? How the surgery happens? What is FUE (Follicular exctration) technique ? | How can we achive the best possible yield ? | What result can be expected ? How the success should be provided ? | What complication can occur by hair transplantation? | About our experiences


Hair transplantation, hair restoration, follicular unit transplantation photo gallery  Hair transplantation, hair restoration, follicular unit transplantation video
       

Copyright © 1998-2007 Sikos Aesthetic, Plastic Surgery
All rights reserved

Copyright © 1998-2007 Sikos Aesthetic, Plastic Surgery
All rights reserved