Hair Transplant Blog

About your hair clinic. I have heard that some doctors use to work in clinics which are not in very good conditions for a hair transplant. Could you give me some information about your hair clinic?

In order to realise a good hair transplant you must have a good team, a good technique and also a good clinic. Both the consultations and the surgeries take place in this clinic: clinique capillaire Grand Roi in Brussels, Belgium. I welcome the patients for the consultations and I realise the surgeries in a operating room which respacts the European rules, iso 2000. The air is purified by a system of spray, oxygen is available, the sterilisation room is separated… It is very important to provide comfort to a patient during the whole surgery so the armchair can be adjusted to change the position very often. For the patients living in another country, we arrange the accommodation in a very comfortable hôtel only 10 min far from our clinic.
For more information, have a look on our web site.

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People often say that hair transplant is sometimes painful. I have read on your web site that it is almost painless. Can you tell me more about the pain, during and after the surgery?

Local anaesthesia is administered for the surgery, and when it is done properly the surgery is practically painless. Here is how it works: it is important to go on very progressively and to deliver stings only on already anaesthetised zones. So the placement of the grafts in that zones is totally painless. It is remarkable to notice how the donour area, which receives between 2000 and 3000 incisions, is completely painless on the day after the surgery. On the day after, only the donour area, where the strip was removed, could be a little bit painful.

My Doctor told me that other techniques could be used: the scalp reduction and the rags. I thought that these techniques were obsolete and disused.

Indeed, both techniques are less and less used. The scalp reduction consists of surgically removing the tonsure or the bald area. The scalp is then stretched to cover the bald spot. The surgery lasts about one hour and gives immediate results. It calls up hair from lateral areas. Moreover, it is quite painful and this surgery leaves a central scar which is visible and the scar can widen in the long term. The orientation of the displaced hair often looks artificial.  For more details, you can have a look on this web page.

Rags. This is another obsolete technique. It consists of displacing large areas of the scalp. The orientation of the hair transplanted does not give a natural effect. This technique could be useful during reconstructive surgery, for example after an accident.

These technique cannot be qualified as surgeries against balding, even more when they are used to redefine the front line as the final result is not natural.

…I have had a bad hair transplant, three times! My front line is too straight, the grafts are too big and I have the impression that people only look at my forehead when they meet me…

Unfortunately, although nowadays hair transplant techniques prooved to be ready, some doctors still do not take enough care nor enough time in making the surgeries. There are two techniques to correct a bad hair transplant on the front part. You can either take off most of, or all, the bad grafts thanks to the use of micro punches, like the one used for the FUE technique,  or you have to implants new grafts between the huge ones in order to hide the non natural aspect.

I have read that the doctors use different kind of tools to make the recepient sites for the grafts. How does it work? How can it have an influence on the results of the hair transplant?

These tools can be classified in two categories: sharp medical instruments, or needles. As far as I am concerned, I decided to adopt Dr Hasson and Dr Wong’s system of little pieces of custom-made rasor blades cutted using a mini-shear. The advantage are that you can adjust them and they are very sharp. Moreover, they can be cutted on beveled edge and this helps to limit at lot the agression of the deep parts of the skin. I usually use three different sizes in order to make a very precise work throught the existant hair. I do not use needles because they cannot give me the opportunity to limit the depth of the recepient sites. Furthermore, they lacerate the skin tissues particularly when they are used to make hundreds of recepient sites (they can be used once). I believe that the quality of the tools can influence the result of the transplant: for the quality of the regrow and to make the surgery undetectable.

I would like to understand how the trichophytic suture works? I read that it is a new technique?

This is an old technique, which has been redescovered in 2005 by Dr Mario Marzola (Australie). In 1999, during the ISHRS Congress, Dr Simon Rosenbaum gave information about it; and this technique had its rebirth during the expansion of the FUE technique. In fact, most of the patients are worried about the scar left by the strip of the FUT technique. Many tests were done until the ISHRS congress in Las Vegas, in 2007, and only one technique of trichophytic suture has been chosen. A little strip of skin is taken, about 1 mm wide, from the inferior part of the skin which is going to be sutured in order to let the hair grow through the scar during the healing. Thanks to the trichophytic suture the scar is almost always unnoticeable, sometimes undetectable. Unfortunately, we do not have many indications yet that is why it must be used very carefully.

I would like to know your opinion about the density of incisions. I have read that some doctors can reach 90 grafts per cm². Is it possible? Is it reasonable?

This is a very interesting question. There are two important limits for the density of the recepient sites. First, if you go over the number of 35 or 40 recepient sites per cm² there is a risk of bad regrow. There is also very often the risk that the grafts collapse because the density is not reasonnable. Second, the patients who asked for a high density forget that the number of grafts, even if it is an important number, must be spread on a surface big enough to make a satisfying result. If we increase too much the density, the surface to cover will decrease. It is better to think about it in this way. What is the best way to spread in density and on the surface the number of grafts reached? The key to obtain a good hair transplant is more the distribution’s strategy then the quest for maximal density.

…I have read once on an American web site that it is possible to make an eyelashes transplant. Could you give me more details about it?

Eyelashes Transplant is a fascinating topic. This technique has been redescovered recently. You will find all the details on my web site. We could use hair, or body hair which is even better, as donour area…

Good morning Doctor, is it true that the use of the microscope can improve the hair transplant, and the quality of the grafts? I am reading many dissimilar opinions on the internet and I do not see which are the advantages…

In my opinion, the use of the microscope is essential for the cutting of the grafts. Thanks to it, it is possible to avoid the transections (bad cutting of the hair which stops the regrow of the hair). It allows to cut and to sculpt the grafts making the thin ring of skin on the top as little as possible. It permits also to protect the telogen hair (the resting phase of the fu) which are shorter and transparents. For white hair, the microscope is incontrovertible. With the use of the microscope the transection rate is around 1%, while 10 to 40% of the hair are destryed during the naked eye cutting.