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The
various techniques |
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The FUX method
The FUX method or the " follicular
unit extraction " (also known as
the FOX or FIT method) is the latest
revolutionary method which was first
introduced by Dr. Rassman at the ISHRS
convention in New York in 2003. Other
contributors to the realization of this
technique were Dr. Woods and Dr. Cole.
The major advantage of the FUX method (FUE surgery)
is that donor material can be obtained
without incision or stitches.
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| Before
the Follicular Unit Extraction procedure |
1
day after the Follicular Unit Extraction procedure |
1
day after Follicular Unit Extraction procedure-
in close-up |
In this technique, the follicular units
are selectively removed from the backside
of the head with the use of a hollow
micro needle (diameter of 0.5 to 1mm),
to ensure that each group of hair follicles
is removed exactly in such a way that
it hair by hair remains in the same
group and the same position, and that
absolutely no extra tissue is transplanted
along with it. In this way, no extra
surrounding skin is damaged. The single
disadvantage of this technique is based
on the fact that it is only possible
to remove a limited number of follicular
units per hair loss treatment, because the procedure
is extremely labor-intense. Nevertheless,
we are able to transplant an average
of 600 to 1300 hair follicles per hair loss treatment.
In some cases, this means that several hair loss
treatments are needed to attain the
desired results (for instance in the
case of already (further) progressed
form of baldness. If the baldness has
progressed too much, the use of this
technique is discouraged.
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| The
stereo-microscopic dissection - FUE surgery |
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The FUT method
The technique of the Follicular Unit
Transplantation (FUT) is the most advanced
and developed method of hair transplantation.
This technique leaves the traditional
"micro-grafting" technique
years behind. In a Follicular Unit Transplantation,
hair roots from the back of the head
are transplanted into the bald spots.
These hair sacs contain the genetic
information for life-long growth, also
after redistribution. In the first phase
of the Follicular Unit Transplantation,
a small strip of skin with extremely
densely growing hair roots is removed
in a completely painless manner. The
growth of these hair roots is not evenly
distributed, but in small groups, the
so-called "follicular units",
which each contain one, two or three
hair roots.
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| The
natural hair growth in close-up |
Follicular
units with 1,2 and 3 hairs |
100 follicular units
To obtain the right number of hair follicles
needed for optimal result in the reception
area, the hair surgeon first estimates
how large the strip of skin needs to
be, before he removes it. The natural
density of the donor area determines
the optimal length and width of the
incision. The strip of skin with hair
follicles is removed by use of the "
single strip technique" (single
strip harvesting). The hair surgeon
removes a strip of skin from the back
of the head with a scalpel. To make
sure that as little as possible is damaged
during the preparation of the transplants,
the strip of skin is removed in one
piece. An important advantage of this
technique is that it is also possible
to transplant small zones with maximal
density.
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| Donor
area immediately after the suture |
Donor
area covered by the remaining
hairs |
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| Donor
area - 1 week after the procedure |
Donor
area - 3 weeks after the procedure |
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| Scar
- 9 months after the procedure |
The
wound is sewed back with a very thin
suture, so that only a small, straight
scar is left, which will be completely
covered with the remaining hairs of
the donor area.
In the second phase, the strip of skin
taken is microsurgically divided into
1,500-5,000 small "grafts",
which each contain a follicular unit.
("follicular unit grafts").
Under favorable conditions this can
deliver more than 8,500 hairs in one
single hair loss treatment. The third phase consists
of the insertion of the grafts or transplants,
which happens under local anesthesia.
During this process, the bald(ing) scalp
is provided with minuscule "reception
channels" or holes, in which subsequently
the grafts are placed with extreme precision.
It is important that naturalness and
hair density are in perfect harmony
with the proportion of face and hairline.
Years of experience and the constant
pursuit of perfection make the FUT-method
of the Practice of Dr. Feriduni
"State of the Art" according
to the highest norms worldwide. The
Practice of Dr. Feriduni is specialized
in reconstructive hair transplant surgery by which
dissatisfactory results of earlier hair
transplantations can be repaired or
improved (punch grafts, flaps, reductions,
scars, inaccurate hairlines or artificial
hairs).
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The "dense-packing" technique
Thanks to the most advanced " dense
packing " technique it is now possible
to implant 50 to 80 follicular unit
grafts per cm² in just one single
treatment, without influencing the blood
circulation in a negative way. This
is also the reason why the micro-openings
in which the grafts are placed cannot
have a larger diameter than 0.3 - 0.7mm.
Even in the case of small indentations,
this technique makes it possible to
transplant more than 2,000 grafts (>4,000
hairs) in one single hair loss treatment. For
larger surfaces of baldness and a good
donor situation, our medical team is
more and more often able to transplant
3,000 - 5,000 grafts (>8,500 hairs)
in one single treatment. As a result,
most cases only need one treatment ("one-session-philosophy").
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Mega-dense-packing
with 90 FU/cm²
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5300 follicular units
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Reconstructive
hair transplant surgery
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A large portion of the hair transplantations
executed by Dr. Feriduni are reconstructive
hair transplantations, in which dissatisfactory
results of earlier treatments from other
clinics can be repaired or improved.
Thanks to the FUX- and FUT-methods and
the use of various laser systems we
are able to correct, amongst others,
punch grafts, inaccurate hairlines,
mini grafts and scars from reductions,
flaps or artificial hairs.
Normally, the existing transplants or
scars can be camouflaged by the transplants
of a reconstructive hair transplantation.
If necessary, the existing transplants
are even removed, redivided into follicular
units and subsequently transplanted
in a natural pattern.
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Punchgrafts
The punch graft method is one of the
most frequently executed dated techniques.
Punch grafts are big transplants that
have been redistributed in groups of
on average 8 to 10 hairs. As a result
of this, the density of the transplants
is too high, and the density around
it much too low. Often, they are placed
in an even pattern of rows, which leads
to an unnatural-looking and unaesthetic
end result. This technique often results
in severe damaging of the patient's
donor material and it shows a lot of
scar tissue.
ND:Yag laser
The more punch grafts, the larger the
damage to the donor area. Because of
this, fewer healthy hairs are available
for the realization of a beautiful and
full reconstruction. Nevertheless, even
in these cases it is possible to obtain
good results.
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Unnatural hairlines
The
creation of a beautiful, natural-looking
hairline is one of the most important
elements for a successful result, and
also a true challenge for the hair surgeon.
Nevertheless, it often happens in other
clinics that the hairline is set too
low, too round or too straight, which
leads to an unnatural appearance.
When a hairline is too low, transplants
can be removed surgically or by use
of laser systems. However, it cannot
be excluded that no scars whatsoever
remain visible.
Too straight a hairline can be corrected
by a reconstructive hair transplant
in which the follicular units are placed
in an uneven zigzag pattern. This results
in a softened hairline, leading to a
natural appearance.
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Minigrafts
Throughout
the years, the techniques of hair transplantations
have evolved dramatically. In the 1960s
and 1970s, small skin transplantations
with a diameter of 2.5mm up to 4mm were
executed, the so-called punch grafts.
The 1980s were the revolutionary years
of the mini/micro grafting technique.
The transplants were diminished to half
or a third of the size of punch grafts,
and usually consisted of 3 to 5 hairs.
Aesthetically speaking, this was already
a vast improvement, but through the
entrance of microsurgical hair transplantation,
this technique is also already dated.
Because of the realization of a FUX
or FIT, the mini grafts can be smoothed
away completely.
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Nido-
or artificial hairs
In the past, there were frequent hair
treatments in which artificial hairs
were implanted. These artificial hairs
cannot be accepted by the body and will
be rejected, which results in very bad
scarring. These scars can be perfectly
camouflaged with the use of the FUX
or FUT method.
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| Result
after reconstruction |
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Scarring
as a result of reductions and flaps
In
the flap technique, a flap of skin with
hair is prepared unattached and is placed
on a bald area on the head. Because
of this method, a defect comes into
existence in the areas in which the
hairy donor skin is removed. It is very
difficult to aesthetically remove this
defect. Also, there is a risk that the
flap is rejected, which means a loss
of transplanted donor skin. Moreover,
the rotation changes the direction of
the hair follicles, which often leads
to it that the hairs start to grow in
an undesired direction. The unaesthetic
scars of flaps can usually be corrected
by a scar correction, if necessary in
combination with a microsurgical hair
transplantation.
In a reduction method, or "Alopecia
reduction" , a balloon is placed
under the part of the scalp where hairs
need redistribution, which is usually
removed after three months. Gradually,
the balloon is blown up, which leads
to an expansion of the scalp. The hairy
donor skin is then surgically replaced
to the bald spots on the head. If the
skin is sufficiently flexible, a reduction
can also be executed without preceding
tissue expansion. The reduction method
unfortunately often leaves unaesthetic
scars that can be removed or improved
by means of a reconstruction.
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Since
the operating procedure of these dated
methods are often very complex, we can
only judge them in a theoretical manner.
A personal consultation can show the
possibilities for reconstructive hair
transplantation.
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The
consultation
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During the consultation, the hair surgeon
will go through the entire hair loss treatment,
and listen to your personal desires.
He will advice you in an honest manner
and depending on your hair type and
donor situation, the following will
be discussed with you:
- The number of grafts
- The new hairline
- The growth direction of the hairs
and the zones that need to be treated
- The costs of the hair loss treatment
The central issue of the consultation
with the hair surgeon is to inform you
about all possibilities to improve your
hair situation. We will only treat you
if all of your personal desires can
be granted.
Conditions
are:
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your
hair loss is not caused by medical,
physical or mental issues |
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your
hair ring contains a sufficient
amount of healthy hair roots to
guarantee a beautiful and aesthetic
result |
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the
technique and treatment have been
discussed extensively |
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you
are aware of the temporary inconveniences
after treatment |
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the
expectation pattern after result
has been discussed |
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Before
the hair loss treatment
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Prior
to undergoing a hair transplantation,
there are a few restrictions that need
to be adhered to by the patient. Below,
you find an overview of these indications:
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It
is best not to smoke or to drink
any alcohol from three days prior
to the treatment. A good night's
rest is also very much recommended. |
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Acetylsalicyl
acid-containing medications such
as aspirin and pain killers should
not be taken 7 to 10 days prior
to the treatment. This also goes
for stimulating and narcotic drugs.
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Medication
that has already been prescribed
must be taken along to the clinic
and must to be shown to the operating
doctor. |
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If
you use medication against coagulation
of the blood, for example Cumarin
derivatives such as Marcumar,
you are requested to contact our
doctor. |
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On
the day of the treatment, it is
best to only use a light breakfast.
After all, our clinic provides
a breakfast. |
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We
advise you to wear comfortable
clothes on the day of the treatment,
which certainly do not need to
be pulled over your head, and
also to wear comfortable shoes.
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The
treatment
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The treatment happens under local anesthesia
and is practically fully painless. The hair loss
treatment starts with a medical cleaning.
After anaesthetizing the back of the
head, the hair surgeon has the choice
of two different techniques: the Follicular
Unit Extraction and the Follicular Unit
Transplantation. After removal of the
follicular units or the strip of skin,
there will be a short break. The patient
gets an extensive breakfast after which
he can relax for a while. The medical
team will at that time cut the strip
of skin and divide it into single, double
or triple grafts.
After the break, the patient may return
to the operation room. After anesthesia
of the head, the physician will use
micro needles to make minuscule holes
of 0.3, 0.5 and 0.7mm in the scalp.
Afterwards, the grafts will be transplanted
into these holes.
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| Dr.
Feriduni makes the micro-incisions
in the recipient area |
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The extreme precision with which the
holes are created and the precision
of inserting the grafts guarantee a
perfectly natural result, which cannot
be distinguished with the bare eye from
the untreated areas without hair loss.
The complete treatment usually lasts
3 to 6 hours and is concluded by a medical
cleaning. Finally, the instructions
for the first night are discussed with
one of the nurses. The next morning,
a final check-up takes place. After
care of the scar and a final cleaning,
the patient can go home.
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Possible
side-effects
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Occurring
of a tense feeling at the location
where the hairs were removed. |
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Formation
of wound scabs up to around 10
to 12 days after hair loss or alopecia treatment; in
some cases until 2 to 3 weeks.
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Occurring
of redness of the scalp up to
2 to 3 weeks after hair loss or alopecia treatment,
in some cases until 1 month after
treatment. |
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If
the advised resting period (1
to 2 weeks) and the instructions
are not adhered to, it is likely
that one will keep a deafened
feeling at the location of transplantation
for 2 to 3 weeks after treatment;
in some cases even up to a maximum
of 1 year after treatment, as
well as a redness for several
months. |
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It
is possible that the nose, forehead
and/or side of the face swells
up around 2 to 3 days after treatment;
this will diminish at most after
6 to 7 days. |
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Despite
the fact that the danger of infection
is practically zero, it is at
times possible that the sebaceous
glands become irritated. On rare
occasions, depending on the skin
type, it is possible that cellulite
(usually temporarily) develops
during the curing process, and/or
a (usually temporary) change of
color of the scalp (redness).
Extremely rarely is the occurring
of keloid formation (scar formation).
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Other
possible complications are: swelling,
contusion and numbness, which
may at times occur - usually temporarily
- after the treatment, around
the treated area. |
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After
the treatment
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To spare the transplants as much as
possible, you should sleep on your back
the first night after the treatment,
and try to remain in a straight position.
It is advisable to sleep in this position
for the first five nights.
To
avoid complications, you should strictly
adhere to the following directions:
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No
physical burden and sporty activities
(for a duration of 4 weeks) |
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Avoid
dusty spaces (for a duration of
3 weeks) |
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It
is inadvisable to wear a helmet,
hat or things in your hair (for
at least 2 to 3 weeks) |
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sauna
and solarium are not permitted
for 4 to 6 weeks |
In
principle, there is a check-up examination
the next day and two weeks after the
treatment. It is likely that a more
or less visible swelling develops the
day after the treatment, which will
disappear at most after one week. After
the treatment, thin wound scabs will
develop in the transplanted area, which
will largely disappear by themselves
after 7 to 10 days. The medical team
will remove the stitches in the donor
area after 14 days, as well as the remaining
scabs (if still present) in the transplanted
area.
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The
growth process |
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The first month
During the first days after the hair loss or alopecia treatment,
small blood scabs will develop at the
level of the small incisions. As the
healing process progresses, the scabs
will start to itch and eventually, they
will partially become loose in the form
of flakes. Most of the transplanted
hairs will become loose during the second
and third week after treatment, together
with the flakes, and they will eventually
fall off. This is a natural process.
After the hair transplant surgery, the hair roots will
be weakened by a diminished supply of
oxygen and after a few weeks, they will
reject the hairs that are still present
in the transplanted roots. The hair
roots are only weakened but not damaged,
and will therefore produce new and strong
hairs, which becomes visible after 4
to 5 months. We wish to point out that
sometimes at density treatments, closely
positioned hairs may also fall out,
which will also reappear after this
period of time.
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| 2
days after the hair transplant surgery |
2 weeks after the hair transplant surgery |
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From the third to the fifth month
From the third month after the treatment,
the patient will notice that new, young
hairs start to arise. Sometimes small
zits appear under the skin which the
patient will often experience as disturbing.
However, this is part of the growth
process, in which new hairs try to find
a way out. From the fourth or fifth
month after treatment, several new hairs
will be visible, first of thin and downy
structure , but as the growth process
progresses, they will become thicker
and sturdier.
6
months after the hair transplant surgery
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After one year
Medically speaking, the complete end
result of the treatment can only be
determined after 12 months. The transplanted
hair will grow just the same as the
natural hair, and requires no special
care. Since we find the result of the
treatment and the satisfaction of the
patient very important, we try to monitor
the growth process as well as possible.
The patient will usually visit the operating
surgeon for consultation after 2 weeks,
3 months, 9 months and 1 year after
the treatment. Pictures are taken which
are entered in the patient's file. At
the final check-up (after 1 year), the
patient receives a copy of these pictures,
together with a picture from before
the treatment. In this way, the patient
can become aware of the extent to which
his hair has changed.
1 year after the hair transplant surgery |
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