Frequently Asked Questions - Hair transplantation

Q: Should the hair being clipped for hair transplant surgery?

In terms of haircuts, there are more options more options.1:The hair is completely shaved on the whole head (both the donor and recipient sites). In this case, the hair is shaved 1-2 mm immediately before the surgery in the clinic (it is not necessary for the patient to have a haircut beforehand, it is best if he/she comes to surgery with his/her usual hair length). This way the technique is easy to apply and the patient has the easiest post-operative head care. After about 2 weeks, the hair in the transmitter area will have grown to the point where it completely covers the surgical traces, and there will be no visible traces in the implantation area after about a week with proper head care. One day surgery.2. Partial hair trimming FUE hair transplantation:If the patient cannot do without a longer hairline in the recipient area, partial hair trimming is an option. In this case, only the hair at the back and sides of the head at the donor site is trimmed, the hair on the top of the head can be left and grafts are (also) implanted between the existing hair. One day surgery.3. NO SHAVE FUE hair transplant:In this case, there is no hair trimming at all, hair removal and transplantation is done while preserving the existing hair. These surgeries can take up to two days.

Q: Do I need to take medication after a hair transplant?

The short answer: NOIn more detail:Hair transplantation replaces the hair that is already missing. It has no effect on hair that has already fallen out or on hair that has not yet fallen out. (It may have some effect on the latter, but only temporarily—see the “shock loss” phenomenon. Rarely, in the transplant area, and in some cases in the donor area, the existing hair may experience temporary thinning, known as “shock loss” or “telogen effluvium,” but these hairs will regrow at the same time as the transplanted hair. This phenomenon is caused by surgical stress, and as the scalp’s blood circulation regenerates, the situation spontaneously resolves.)Where hair no longer grows, there are no functioning hair follicles. These are replaced during hair transplantation with fully viable hair strands transplanted from the so-called safe donor area, located at the back and sides of the head. These hairs will not fall out later—they are not sensitive to hormonal effects.There are certain medications (finasteride, dutasteride, minoxidil) known for their hair-retaining effects, which can be used for weakening, falling hair, with certain limitations (see medical treatment for hair loss). The use of these medications after hair transplantation remains possible to preserve existing hair, but they have no effect on the growth of the transplanted, fully viable hair strands.Therefore, it is not necessary (and unnecessary) to take medication to achieve the effects of hair transplantation, but products may be recommended to slow the loss of any remaining hair.

Hair transplant is not painful

Should the hair being clipped for hair transplant surgery?

In terms of haircuts, there are more options more options.

1:
The hair is completely shaved on the whole head (both the donor and recipient sites). In this case, the hair is shaved 1-2 mm immediately before the surgery in the clinic (it is not necessary for the patient to have a haircut beforehand, it is best if he/she comes to surgery with his/her usual hair length). This way the technique is easy to apply and the patient has the easiest post-operative head care. After about 2 weeks, the hair in the transmitter area will have grown to the point where it completely covers the surgical traces, and there will be no visible traces in the implantation area after about a week with proper head care. One day surgery.
2. Partial hair trimming FUE hair transplantation:
If the patient cannot do without a longer hairline in the recipient area, partial hair trimming is an option. In this case, only the hair at the back and sides of the head at the donor site is trimmed, the hair on the top of the head can be left and grafts are (also) implanted between the existing hair. One day surgery.
3. NO SHAVE FUE hair transplant:
In this case, there is no hair trimming at all, hair removal and transplantation is done while preserving the existing hair. These surgeries can take up to two days.

Hair transplantation cannot permanently eliminate baldness or hair loss process

Patients who haven’t read anything on this topic yet but encounter such claims often ask.
So, to answer briefly: NO, hair transplantation cannot permanently eliminate baldness!

Hair transplantation is not a solution for balding (hair loss) but a solution for baldness, to replace missing hair.

I want to draw attention to the terminology: “balding” refers to the process of hair loss, while “baldness” refers to the already permanently established absence of hair. Of course, in everyday practice, these two concepts are not so sharply distinguished, but when such a statement comes from an expert, it can be very misleading!

Hair transplantation does not solve balding because it does not affect the remaining hair that is still falling out or is about to fall out, but it does replace the lost hair that will not grow back.

Balding is a process, the result of so-called miniaturization (considering male pattern baldness – androgenic alopecia). Miniaturization occurs over several growth cycles, leading to the gradual thinning, depigmentation, and eventually the permanent loss of hair. (The hair transforms from terminal to vellus.) The affected hair loses its strength, its diameter gradually decreases, and miniaturization ultimately ends with the complete cessation and death of the hair follicle function.
This process typically takes 10-15 years over multiple growth cycles, but for some, it may be much shorter or longer, and it varies greatly in extent. For example, some people may lose almost all of their hair by age 22, while others may only experience partial thinning in their 50s or 60s, perhaps only on the crown.

Because we are dealing with a PROCESS, we often encounter patients in a state where hair loss may still be ongoing, but there are already clearly bald areas where hair will not regrow. In such cases, it is advisable to perform hair transplantation to replace the missing hair. However, this does not affect the other hairs in any way, neither positively nor negatively. (We are not discussing the phenomenon of shock loss, which may temporarily occur after surgery.)

Do I need to take medication after a hair transplant?

The short answer: NO

In more detail:
Hair transplantation replaces the hair that is already missing. It has no effect on hair that has already fallen out or on hair that has not yet fallen out. (It may have some effect on the latter, but only temporarily—see the “shock loss” phenomenon. Rarely, in the transplant area, and in some cases in the donor area, the existing hair may experience temporary thinning, known as “shock loss” or “telogen effluvium,” but these hairs will regrow at the same time as the transplanted hair. This phenomenon is caused by surgical stress, and as the scalp’s blood circulation regenerates, the situation spontaneously resolves.)

Where hair no longer grows, there are no functioning hair follicles. These are replaced during hair transplantation with fully viable hair strands transplanted from the so-called safe donor area, located at the back and sides of the head. These hairs will not fall out later—they are not sensitive to hormonal effects.
There are certain medications (finasteride, dutasteride, minoxidil) known for their hair-retaining effects, which can be used for weakening, falling hair, with certain limitations (see medical treatment for hair loss). The use of these medications after hair transplantation remains possible to preserve existing hair, but they have no effect on the growth of the transplanted, fully viable hair strands.

Therefore, it is not necessary (and unnecessary) to take medication to achieve the effects of hair transplantation, but products may be recommended to slow the loss of any remaining hair.

Which Hair Transplant Method is Recommended for Whom?

This question can be answered by understanding the patient’s characteristics and expectations. At the Sikos Hair Transplant Clinic, both modern FUT strip harvesting and FUE individual extraction methods are available. We provide the same excellent results for our patients with both of these methods! In our opinion, a well-prepared hair transplant clinic should be able to offer all advanced methods available to those interested. In our daily practice, the FUE hair transplant method, involving individual extraction, is the most prominent. The main reason for this is that most of our patients have very short hairstyles (since they are balding…), so the gentle use of the donor area is definitely beneficial for them. The FUT strip harvesting method may be suitable for middle-aged or older male patients with longer hairstyles and for women. If someone does not want to cut their hair short (which is necessary for the FUE procedure), strip harvesting (FUT) hair transplantation is also a good solution. In this case, the signs of the procedure on the donor area are not visible even immediately after the surgery, as the hair covers it. If multiple FUT hair transplant surgeries are performed, will multiple scar lines remain on the back of the scalp? Of course not! Only one scar line remains because the new strip excision always includes the previous surgical scar line. How painful is the procedure? Hair transplantation surgery typically lasts 4-6 hours and involves minimal discomfort and little pain. At the beginning of the surgery, we administer anesthesia to the donor area with injections, and we also need to give injections at the frontal hairline. This is unpleasant and involves minor tension pain, which takes about 2 minutes out of the entire surgery. After the injections, we can ensure complete numbness of the scalp and the operated area during the surgery. There is no pain after the surgery, although slight tension may be felt in the donor area for a few days. Do I need to cut my hair for the surgery? With the FUE technique, the hair in the donor area is shaved to 1-2 mm, as this is necessary to properly apply the technique. Within about 2 weeks, the hair will grow enough to completely cover the surgical marks. In some cases, when the patient cannot go without a longer hairstyle in the recipient area, partial hair trimming is possible. In this case, we only trim the hair at the back and sides of the head, and the hair on the top can remain, with grafts being implanted among the existing hair. With FUT strip harvesting, it is not necessary to cut the hair for the surgery; it can be any length from 1 cm to 20 cm. Before the surgery, the assistants shave the hair at the donor area, but only the width of the strip. Thus, after the strip is removed and the wound edges are sutured, the existing hair length will effectively cover the suture line. How long does it take to heal, and when can I go out in public after the surgery? Small scabs form around each implanted hair on the scalp, which fall off on their own within about 7-10 days. However, swelling may develop on the forehead, which also resolves completely within about 10 days. The scalp may also exhibit slight redness during this initial period. Based on this, it can be said that it takes about 10-14 days for all traces of the surgery to disappear, allowing you to return to social activities.

Is a Two-Day Hair Transplant Better Than a One-Day Procedure?

Answer: it is completely clear that a one-day surgery is more advantageous in every respect than a multi-day hair transplant procedure. Explanation: What does a one-day or multi-day hair transplant mean? This concept usually arises in the context of procedures performed with the FUE hair extraction technique. In one-day surgeries, hair follicles (grafts) are typically extracted from the donor area within 5-7 hours and then implanted into the hairless area. In a 2 (or 3) day surgery, the same process (extraction, implantation) takes place each day, spread out over several days with varying durations each day (about 3-6 hours).

With a two-day surgery, you cannot extract more hair from the donor area than with a one-day surgery. Many people think that if a certain amount can be transplanted in one day, then multiple times that amount can be achieved over several days. This is not the case. The utilization of the donor area is limited both per surgery and overall. Typically, around 3000 grafts (about 6-7000 hairs) can be extracted from the donor area in one surgery. (Of course, many factors influence this, but that’s not the topic here.) This can be done in one day or over two or more days, but the number of hairs that can be extracted and transplanted does not increase with the number of surgical days. With proper technical preparation, a large amount of hair can be safely transplanted in one day. If the necessary experience is lacking or if multiple days are planned from the outset, it is not disadvantageous for the success of the surgery on its own.

Multi-day surgery involves more discomfort. In the case of multi-day surgeries, the patient must visit the clinic each day, receive injections (anesthesia) each day, and undergo all phases of the surgery each day. For the patient, it is as if they are having a separate surgery each day for 2-3 days—which is exactly the case…

How Does the Donor Area Heal after Hair Transplantation (Hair Implantation, Hair Transplant)?

After graft extraction using the FUE individual extraction technique, the pinpoint scars are not visible, even with a short hairstyle. In this case, we must be careful not to be too aggressive, because if too much hair is removed from the donor area, it could become thin, and the “moth-eaten appearance” would not be aesthetically pleasing. This applies to both single and multiple consecutive surgeries. Determining how much hair can be extracted without noticeable thinning is a case-by-case assessment based on the density and quality of the donor area. During hair transplantation (hair implantation), we transplant the patient’s own hair, using the back and sides of the head as the donor area, where the hair always remains. In the case of strip harvesting (FUT method), a long, narrow strip of scalp is removed in an arc at the height of the upper part of the ears. The length of this strip is about 25 cm, and the width is about 1-1.5 cm. (This is the size of the incision that can generally be safely closed without tension.) The edges of the scalp wound are sutured together, leaving no bald area, only a thin scar line, which is not noticeable or bothersome later on in the hair. However, if someone shaves their head completely, the scar line may become visible. After strip harvesting, the scar line usually heals as a thread-thin white scar, often barely visible, and the hair covering the donor area conceals it well, even at a length of just 0.5 cm. After a temporary feeling of tension lasting 2-3 weeks, the area fully heals, and rarely, some sensation changes may occur in the nape area, but this regenerates within 2-3 months. To ensure even better scar healing, when possible, we use the so-called “trichophytic” (briefly, tricho) suture. The essence of this technique is that we cut the edge of the skin diagonally along one wound edge, so after healing, hair grows through the scar, providing even better concealment. With sufficient experience, this can be avoided well, but rarely, it may still occur (especially if multiple surgeries are performed) that the scar becomes wider, in which case scar revision may be considered. Generally, we can say that the scar line in the donor area is not bothersome for patients, not noticeable, not tight, and it is the best method for extracting the most hair strands.

Hair transplantation (hair transplantation) surgery usually takes 6-8 hours, is a low-stress, low-pain procedure. Hair transplantation is performed under local anaesthesia with injections. Once the injections have been given, we can provide complete anaesthesia to the scalp and the operated area during the operation, so that the procedure is essentially completely painless.
Local anaesthesia is administered at the donor site at the beginning of the operation by injections into the scalp. This is done partially, i.e. only a small area is anaesthetised at a time and then we proceed step by step. The recipient area (the front hairline, the top of the head) will still need to be injected later. The anaesthesia is uncomfortable and may cause some minor stabbing pain, but several techniques are used to reduce the discomfort. These include local cooling, vibration, minimally invasive needles and small-bore syringes. Anaesthesia is not a problem for the vast majority of patients. Of course, individual variations are possible and can be managed well with patience and skill.