Apart from a commonly known restoration surgery of hair follicles applied in the case of hairloss, other surgeries such as:

• Scar excission
• Scalp reduction surgery
• Implant extender
• Scalp flap surgery for hair restoration
• Hair restoration surgery with an expander are carried out.

These surgeries are often supplemented with hair transplant surgeries. However, it is the surgeon’s experience and knowledge that are decisive factors in terms of selection the most suitable treatment for the existing hairloss.

Scar excission

It is most often applied for those patients with only minor hairloss.

The surgery is carried out under local anaesthesia.

A sufficient laxity of the scalp is of huge importance here.

Planning the direction of an excission, the surgeon has to take into account the direction of hair growth and the area of head where the corrective surgeries will be carried out.

The patient most often returns home after the surgery. No stay in the clinic is requiered afterwards.

On the 7-10 day since the surgery took place, the stitches are removed.

Initially, the scar is pink and narrow. Within the next few months it turns pale. It may also become wider.

Scalp Reduction Surgery

It was Sparkhul in 1978 who as the first in the world introduced the term of scalp reduction surgery. The method alone became popular in the 70s of 20th c. Blanchard, Stough, Webster and Unger are considered to be its great propagators.

In Poland, however, it was Jerzy Kolasinski, M.D., who as the first carried out these surgeries in the 80s of 20th c.

The scalp reduction surgery is most often applied in the treatment of androgenic alopecia and consists in removing a bald scalp from the central region of the head. Depending on the shape and size of the scalp various forms of excission are used.

The surgery is most often carried out under local anaesthesia. It is often possible to reduce even extensive hairloss.

The result of the surgery is visible directly after the surgery is finished.

The only disadavantage of scalp reduction surgery is the fact that a visible scar is left and some pain troubles may last two or three days.

The surgery is repeated every second or third month provided that a patient tolerates the whole procedure well. Thanks to this surgery, it is possible to not only reduce central hairloss significantly, but also to limit the number of hair transplantation considerably. Scalp reduction surgery is an integral part of the hair restoration treatment and it is often associated with hair transplantation.

Applying hair transplantation surgery, after scalp reduction treatment has been finished, allows not only to restore hair in the forehead area, but also to cover the scar which is reduced after the grafts are placed on it, which makes the scar invisible.

Implant extender

The extender is a kind of a temporary implant placed under bald skin with the purpose of reducing hairloss. It was invented and popularized by Patrick Frechet. It consists of an elastic stretching tape and a row of metal hooks on its both sides. The extender is placed in the extended position under the skin. Then, within 4-6 weeks the implant shrinks which results in stretching the scalp on both sides of the bald region, which fills the defect.

The extender is removed during the next surgery, a part of a bald area is cut out and the hairy skin is lifted into the bald position. It is possible to repeat the operation as long as the moment of a total baldness reduction is obtained.

Similar results can be obtained by using a silicon thread called the Nordstrom suture. It was invented by a Finnish surgeon, Rolf Nordstrom, and is applied not only in scalp reduction surgeries, but also in corrective surgeries of scars in various parts of the body.

Scalp flap surgery for hair restoration

Scalp flap surgery for hair restoration is performed in the case of more extensive hairloss located especially on the top of head. The surgery is done in a series of one or two procedures and allows to adjust the scar’s location and hair direction so that the traces of surgical intervention are almost invisible.

This type of the surgery is also applied in case of excissions of neoplastic changes of the scalp.

The treatment often requires covering scars with hair grafts.

Hair restoration surgery with an expander

Because of the restricted application of classic plastic surgeries using scalp flaps for hair restoration, more often the surgeries of stretching the scalp with an expander are performed.

The expander is a kind of an implant placed under the scalp in the area near a scar or a plane hairloss. The expander is filled with physiological salt within the next few weeks by percutaneous injections. Something of a kind of an artificial bump is created. Its capacity makes the stretched skin cover it.

The next stage of treatment consists in excising the loss (scar), and the defect is covered with the stretched scalp. The first surgery is often performed under local anaesthesia, but another one under general anaesthesia.

The treatment involves the risk of infection and skin necrosis. Moreover, the head deformation may be difficult to hide during the treatment.

The final result of the treatment compensates all the inconveniences the doctor and the patient suffered from during several months.

Due to its character and the possibility of complications, hair restoration surgery with an expander is reserved only to corrective surgeries of extended scars of the scalp caused by mechanical trauma, burn or an unsuccessful surgery.

ALL THE MENTIONED TYPES OF SURGERIES ARE PERFORMED IN THE KOLASINSKI CLINIC.

Our surgeon will explain to you in details what each surgery consists in and what risk they involve during a consultation visit.

The post Hair restoration surgeries first appeared on Kolasiński Clinic.

Hair transplant procedure is a surgical intervention that involves restoring hair in bald and thinning regions. It is performed due to the following reasons:

• Male androgenic alopecia
• Female androgenic alopecia
• Posttraumatic baldness
• Post-burn alopecia
• Hairloss from radiation
• Postinflammatory alopecia – after the inflammatory state is healed
• Post-operative scarring
• A supplement of hair restoration surgeries of the scalp
• Hairloss in the regions of eyebrows, lashes, moustache and the chin
• Hairloss in pubic regions
• Hair restoration on the chest in the case of transvestites

Hair transplant procedure was first described in 1959 by the American doctor Norman Orentreich who is generally recognized worldwide as a pioneer in this field of surgical procedures.

Hair grafts used by Orentreich had the diameter of 4-5 mm and, in comparison to today’s surgeries, they did not produce a very aesthetic effect.

In 1981 Rolf Nordsrtom as the first in the world described the application of micrografts. They improved considerably the aesthetic effects of the treatment.

In 1984 Headington as the first explained the notion of follicular units. In the 90s of 20c. the surgeris using follicular units gained bigger and bigger popularity and today they have become one of the leading methods of hair transplantation surgeries.

In 1984 it was Jerzy Kolasinski, M.D., who performed the surgery of hair transplantation as the first in Poland.

In hair transplantation surgeries a scalp fragment is extracted from the back regions of the head, next it is cut up into small grafts containing single follicular units (FU), and afterwards FUs are implanted into bald regions.

A microscopic picture of natural hair growth as a group of follicular units.

The FUE (follicular units extraction) method has been quite popular for the last few years.

In contrast to the classical methods, in the first stage, single folliular units are collected from the back region of head. The consecutive phases of the surgery are similar.

Before & after pictures
Hair transplant

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Is hair transplantation right for you?

Hair transplantation surgery can improve both your appearance and your mood which does not mean that you will look perfectly and that the attitude of other people towards you will change.

Before you take the final decision, think over carefully your expectations and discuss them with our surgeon.

Best candidates for hair transplantation surgery are people of reasonable expectations, in the case of whom the process of baldness is noticable in a particular part of the head. In other words, it is possible to determine exactly the regions of hairloss, or those which are thinned out (the recipient region) as well as regions of stable, good hair growth (the donor region).

The surgery should not be performed in the case of more advanced patterns of hairloss.

Also people with vague and too high expectations should not undergo the surgery of hair transplantation because the obtained effect may be for them not only very unsatisfactory but may also become a source of psychological discomfort.

Advanced diabetes, serious cardiovascular diseases , irregular hypertension, inflammable diseases of the scalp, ‘patchy’ hairloss, all pose contraindications to perform hair transplantation surgery.

However, if you are a healthy person and your expectations are reasonable, you can be a right person to undergo the surgery.

Male hairloss

Androgenic balding is the most frequent type of balding in case of men. Its reason remains unknown, although some genetic prerequisites may play a huge role in here. The second extremely import ant factor triggering this process is an active form of a male testosterone hormone called dihydrotestosterone (DHT).

This type of baldness most often is so typical that it is called ‘male pattern baldness’. Each stage of the process was described precisely by Norwood. It allows to define easily a current state of the scalp. It also facilitates the specification of the range of the corrective treatment.

The process of baldness most often begins at the age of 18-20. However, it also happens that the first signs of hairloss take place at the age of 40 or even 50. Generally speaking, the later the process of balding starts, the better prospects of its treatment are.

The colour, thickness and the structure of hair is taken into account in the case of a patient suffering from alopecia. A significant prognostic factor here is a family interview. A man whose father, grandfather and brothers all suffer from baldness has smaller chances of hair preservation.

The treatment of androgenic alopecia in the case of young man starts with the application of Propecia (finasteroid). It is a medication which by stopping the production of DHT may benefit the condition of the scalp. Unfortunately, this medicine does not work in the case of all patients. Hence, in order to estimate its effectiveness, it is necessary to carry out a trial treatment which may take up to three months. If the improvement is noticed after this period, then the treatment may be continued. A lack of any visible improvements indicates putting the medicine away.

It should be also remembered that Propecia may result in a potency drop. It, however, refers to a small group of men. This risk is determined to be around 1%. Such a side effect more often occurs at older men. It should be emphasized that it is not a constant side effect and putting the medicine away helps to get over quickly.

Following the statistics, Propecia is effective as far as the improvement in the central scalp of head is concerned. Hence, it constitutes a supplement of the surgical treatment which concentrates on the forehead region of head.

Female hairloss

Women suffer from balding definitely more rarely. It is rather an effect of protective activity of feminine hormones, namely oestrogens. Hence, alopecia most often refers to women after the period of menopause. However, it rarely leads to such hair loss as in the case of men. Women usually suffer from thinning out of hair of various intensity in the central region of head with no hairloss in the forehead region. It was precisely classified in the so called Ludwig Hair Loss Scale.

This process is quite often caused by miniaturization (i.e. the decrease of hair diameter) in these regions of the head.

Also younger women call for this type of surgical treatment. The most frequent reason of their visit in the clinic is too high forehead hairline. The reasons of this state can be found in genetics. A surgical treatment becomes then the only effective method of correcting this defect.

Female hairloss can be also the very first symptom of hormonal irregularities or even serious diseases of exocrine glands. Therefore, this problem should not be underestimated and all female patients should be directed to an endocrinologist. The most frequent diseases resulting in falling of hair are the following: thyroid gland disorders (hyperactivity or hypoactivity), adrenal glands, pituitary gland and ovaries diseases. Only those female patients in case of whom the above-mentioned diseases were excluded can be treated surgically.

Surgical risk

Hair transplantation is a safe surgery. It rarely results in limited infection of the head skin. After extended surgeries, head skin feeling may be lowered. However, it most often is of a temporal character.

In the past the surgery of the frontal region resulted in the swelling of the forehead and eyelids. Nowadays thanks to a proper anesthesia forehead swelling occurs extremely seldom.

Planning the operation

Our surgeon will estimate a general condition of your health during the preliminary consultation. He will also suggest the type of a surgical treatment on the basis of the examination of your head.

Remember to tell the surgeon what your expectations are. The surgeon will judge on the basis of the examination whether they are realistic. He will also give you full information on the applied methods of a corrective surgery.

You will also receive information on the anaesthesia and the costs of treatment.

Remember to inform the surgeon about what medications or vitamins you take, or whether you smoke or not.

How to prepare oneself for the operation

Our surgeon will give you full information on all necessary preparations for the operation. Remember to avoid taking aspirin for 10 days before the surgery. For esthetic reasons, it is recommended not to have hair cut. Longer hair will help you to cover the traces of surgical intervention more easily.

Head should be washed on the day of the surgery in the morning or in the evening the day before.

You may drive your car on the operation day. There are no contraindications as to driving a car next day.

Type of anaesthesia

Hair transplantation is performed under local anaesthesia. While anaesthesia is applied, you may feel a little pain in the injection place and faster heartbeat. It is a result of a small quantity of adrenaline which definitely prolongs the time anesthetic works and reduces bleeding during the surgery. You will receive a sedative orally before the surgery, which will decrease the feeling of anxiety before and during the operation.

Surgery

The method of grafts distribution, their kind and the number all depend on the size of bald regions, colour and hair features.

The surgery starts with extracting a scalp fragment from side and back regions of the head. It usually has the shape of a strip which is about 1 cm wide and a few centimetres long (depending on the number of grafts planned).

The place of the extraction is stitched with a continuous stitch. A horizontal scar is a natural result of the surgery, nevertheless it can be easily hidden in hair. Depending on the type of the head skin, the scar may be from 1 mm to 3 mm wide. Currently applied TC technique allows to minimize the scar width and makes hair grow through the scar. Therefore, the scar becomes less visible.

When the FUE method is applied, particular follicular units are taken individually by means of micropunches. This is why the entire back region of head is shaved, and next anaesthetized. This method allows to extract about 2000 grafts during one surgery.

After the surgery, invisible scattered scras remain.

The FUE method is applied in corrective surgeries of small bald areas, and linear scars especially in back regions of the head.

FUE method is suitable for people who are going to wear hair very short as well as the correction of linear scars of the hairy skin of the head.

The method alone is more time-consuming, hence it is twice as expensive as the classical method.

If the traditional method is applied, then an experienced technician cuts the extracted strip of the skin into grafts of a microscopic size containing single follicular units.

Thanks to our personnel’s huge experience, we perform very complex surgeries at one time – up to 3000 gratfs during one session. Such a size of the surgery allows to cover with grafts even very extensive bald regions. Surgeries with 1500-2000 gratfs are performed most often.

The exact number of grafts is determined on the basis of the patient’s medical examination.

A significantly huge advantage of larger sessions is a better use of the donor region, a considerable saving of time a patient has to spend on the treatment (what other clinics carry out during two or three surgeries, we perform at one time! )

The most time-consuming part of the surgery is placing the grafts in the recipient region.

The team form our clinic has worked out its own implanting technique called four-hand-stick-and-place.

At present, it is the quickest method of performing hair transplantation surgery in the world, which is confirmed by numerous comparisons to other methods.

Thanks to this technique, an average tiem needed to carry out the surgery takes in the case of 1000 grafts 1,5-2 hours, 1500 grafts – 2.5-3 hours, 2000 grafts – 3-4 hours and 3000 grafts 4-5 hours.

Not only does such a short time of the surgery improve the patient’s comfort considerably, but it also influences the longevity of hair grafts significantly.

An incision made by the surgeon leaves a space for a graft. It will be located either under the gland or under the chest muscle. The space will be next filled with a graft.

The surgeries involving FUE technique last significantly longer, usually one day including a lunch break.

After the operation

A dressing is usually applied directly after extensive surgery. In the case of minor surgical procedures the head is left without any dressings.

The Patient usually stays 24 hours in the clinic after extensive surgeries. In the case of minor surgeries, the patient may return home after 2 hours since the surgery was finished.

In the evening a moderate headache can be noticeable, however, an orally taken painkiller is enough to alleviate the pain.

Next morning, the dressing is removed, and the patient receives detailed post-operative recommendations and leaves the clinic without the dressing.

There are no contraindications to drive a car on the same day or to make a journey by plane.

A few days after the surgery, the swelling of the forehead and eyelids may occur, nonetheless, a cold compress, and in justified cases small doses of steroid medications allow to alleviate these side effects.

Most often after 14 days a control visit in the clinic takes place. Then, the stitch is removed from the back region of the head.

Recovering

It may take from a few to a dozen or so days to recover.

Depending on the type of the job performed, you can return to work after one or two weeks.

Our surgeon will inform you when you will be able to start physical exercises.

One week after the surgery, little eschars covering grafts will start falling out. Then, it is recommended to massage the regions applying children’s olive cosmetic which will considerably fasten this process, and reduce the feeling of itchness of the head skin at the same time. Our surgeon will discuss with you the rules of caring about the operated regions.

Transplanted hair fall out most often within two weeks after the surgery. It is caused by the post-operating shock which makes the follicles go into the phase called telogen.

New hair begins to grow after three months. The speed of growth amounts to 1 cm a month. You may see the first effects after 5-6 months.

When hair transplantation surgery is performed in the region where the hair is thinned out, so far growing hair may also fall out moderately. In order to limit this reaction, it is recommended to apply before the surgery Regainy 2-5% (Loxon) and Propecia alternatively. It is also reasonable to carry out such a treatment after the operation. Our surgeon will discuss with you all the details of proceeding.
The post-operative scar will be tougher and pink initially. Within the next few months the scar will soften and become pale. Even though a scar always remains after the surgery, its direction and location make it almost invisible.

It is necessary to remember that the treatment composes of two- or even three surgeries. If the entire bald region is covered at the first surgery, during the second one a much better density of hair is obtained.

During the preliminary consultation our surgeon will inform you about the assumptions of the treatment, including the number of surgeries planned.

Your new appearance

The effect of hair transplantation surgery gives a substantial satisfaction for the majority of patients.

Many of them emphasize a considerable improvement in mood and relations with other people.

TC – Trichophytic Closure

It is the latest method of closing the wound in the donor area after a skin strap has been taken for transplantation.
The advanatages of the technique:

• Narrow scar
• Hair grows through the scar
• Virtually undetectable, esthetic scar
• Hair can be cut shortly in the donor area

The TC technique is successfully performed in the Kolasinski Clinic.

almost invisible, esthetic scar after the donor area wound has been closed by means of the latest TC technique.

Your decision on hair transplantation surgery is personal and should be a result of your own needs. Your mood is the most important.

If the operation comes up with your expectations, then it is possible to speak about full success.

The post Hair Transplantation first appeared on Kolasiński Clinic.

Body Hair Transplant – Indications

The BHT procedure is most often performed in the following cases:

• to complete the effects of previously performed hair transplantation if the donor area located on the scalp is insufficient
• to perform a slight hair transplant procedure in the area of eyebrows, moustache and beard
• to correct the scarring in the scalp area including those scars remaining after previously performed hair transplant by strip procedure

The best candidates qualified to the BHT procedure are the patients with abundant hair in such regions as chin, chest, back or legs.

Body Hair Transplant – Procedure

The procedure is performed under local anesthesia.

The hair in the donor area are clipped to a 1-2 mm length.

The operator uses magnifying glasses to achieve a significant picture enlargement.

By using a special instrument, single hair follicles (FU) are taken from the hairy skin and put into special containers filled with preserving fluid at low temperature.

The donor area is covered with a dressing that contains antiseptic ointment.

The donor area heals within 5-7 days leaving invisible traces.

The grafts are inserted in the bald region (recipient area) by a well-known four-hand-stick-and-place technique.

The benefits of BHT procedure

• expanding the procedures of hair transplant by using donor areas which have never been taken into account before

• the possibility to correct the scars on the scalp without the necessity to create new scars in this part of the body
• the possibility to correct the scars of the upper lip in men using hair of the same structure taken from the chin area

• leaving minimal usually almost invisible traces in the donor area
• using hair which so far patients have considered useless or even “unwanted”

Disadvantages of BHT procedure

• slightly different nature of the hair than the ones growing on the scalp
• the necessity to anesthetize the extensive donor area
• moderate discomfort of the donor area after the grafts have been taken

The number of grafts used in hair transplantation is limited due to limited possibilities of the donor area on the scalp. Using the grafts taken from other parts of the body expands the possibilities of this procedure without leaving visible traces of surgical intervention.

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