Hair transplantation

All patients want their hair transplant to be perfect - as does the hair surgeon carrying out the transplant. The main aspects of any transplantation: to make the result look as natural as possible, without it being obvious that the person has had a transplant - and to make the treatment as pleasant as possible for the patient. Achieving a natural looking hairline is one of the most important criteria when selecting a hair surgeon - all patients want the end result to be positive, without it being noticeable that a transplant has been performed. To achieve such naturalness, several aspects come into play. Knowledge of different techniques, experience, a meticulous style of working, artistic talent and three-dimensional imagination are needed to design a hairline looking as natural as possible. Also needing to be considered are the proportions of the face and the patient's wishes.

The beauty / aesthetic appearance of any face is to a great extent dependent on the harmony of its proportions. Not only one's own psychological satisfaction, but also the effect one has on other people, the choice of a partner and one's career prospects very often depend on our sense of aesthetics and beauty. A special focus here is on the face and the interaction between the eyes, nose, mouth and hair. This harmony, which we see as being beautiful and aesthetical, was already being underlined by Leonardo da Vinci centuries ago, as found in his studies of proportions and his Golden Ratio. The same is true for the Fibonacci numbers and their relationship to the Golden Ratio: we see a certain relationship between two numbers or sizes as an ideal proportion, as the epitome of aesthetics, harmony and beauty.



This applies to art, architecture - and to nature. With the face being part of nature, this also applies to the face, with the hairline in particular playing a decisive role in determining facial harmony. Where hair is missing around the hairline, we see the face as lacking in harmony. This explains the eminent importance of the hairline.
Recognising the principles of facial proportions requires a hair surgeon not just knowing these principles, but fully understanding them and being in a position to put them into practice, creating a result that looks completely natural without being noticeable as a transplant. 

The hairline at the side of the face frames the face, significantly contributing to the way the face looks, and playing a decisive role whether a person looks young, and whether we see the face as being beautiful. This means that a receding hairline and age-related hair loss around the temples can significantly change the facial harmony as we see it. With the appearance of the person affected often felt as disadvantageous, this is why the design of the hairline at the side of the head - the temple angles and temporal peaks - is of great significance in any hair transplant. 

To gain the right hairline here (as is the case with the upper and middle hairline), individual FUs are implanted. The design of these temple hairlines demands a great amount of skill on the part of the hair surgeon. He must not just master hair transplantation techniques, but also have the requisite experience and artistic talent to achieve a result in which transplantation is not noticeable.

The term "hair density" refers to the number of follicular units per square cm on the scalp. Average hair density of a healthy scalp varies from 60 to 110 follicular units per square cm. Hair density varies from one person to the next, meaning that it is not easy to establish natural hair density in hair transplantation.
The goal of any transplantation is to achieve an aesthetic result, looking as natural as possible. To achieve this, the hair surgeon must not just know the patient's hair density at the moment of transplantation, but also needs to take into account future age-related hair loss. Dependent on the area of the scalp being treated, the hair surgeon will juggle with different densities to achieve the right density - the one best suiting the patient. This all requires a lot of time, patience, experience and talent. When hair becomes too sparse or alternatively when hair is too dense, the result can look unaesthetic.

What is the logical consequence? The success and quality of a hair transplant is to a great extent dependent on the quantity of transplanted hairs and how natural they look. The more grafts there are available, the more natural the result one can expect.
The high number of available grafts, the tiny size of the FUs and the use of a special incision technique (the Lateral Slit Method) allow grafts to be inserted much more densely (Dense-Packing). This in turn often means that only one transplantation session is needed (One-Session Philosophy). 

The use of the Lateral Slit method enables incisions to be made taking account of natural hair alignment. Moreover, higher hair density can also be achieved, meaning that the result is harmonious, looking completely natural.
The Lateral Slit method enables the angle and arrangement of the hairs to look even more natural. In particular in the area around the front and side hairlines, where skin is thin and sensitive, the use of the Lateral Slit method is very advantageous.
The use of the Lateral Slit method places greater demands on the operating surgeon and his team, in particular with regard to preparing the incisions and implanting the grafts.

There are different causes behind the loss of eyelashes - illness, radiotherapy, accidents or burns, pressure and stress caused to the eyelashes through the use of artificial eyelashes, permanent make-up, etc. Some women naturally have short, sparse or thin eyelashes and would like to have long, thick ones looking natural. An eyelash transplant or eyelash dense packing can give these patients what they are looking for, restoring their original appearance.

Results

The female hairline is variable in position.  However, a “normal” female hairline is typically positioned 5 to 6.5cm above the brows and usually begins at some point where the scalp slopes from a more horizontal position to a vertical one.  This optimal position allows for ease of hairstyling and provides facial harmony and balance.  



There are a number of women who have a hereditary high hairline or high forehead. The appearance of a high hairline can make women look masculine and/or older than they actually are. The associated high forehead is often seen as unattractive and their hair styling is often limited to combing downward (bangs) to camouflage it. These women, even though there are no signs of hair loss, are dissatisfied with their naturally high forehead and wish they could lower their hairline to a more cosmetically pleasing location. 

The female hair line lowering procedure starts by making a non-repeating, irregular Trichophytic incision within the fine hairs of the anterior hairline. This incision cuts across the hair shafts but leaves the bulb of the hair follicle intact. The trichophytic technique allows hair growth through the scar to help camouflage it. By this method, we try to create a similar transition zone as seen in follicular unit grafting. The hairline subsequently appears natural and undetectable. 
After the incision, the scalp lifted off of the skull all the way to the back of it. Tumescence is used to minimize bleeding. Extensive undermining (a process used to separate the scalp from the underlying muscles and supporting tissue to increase elasticity) is performed in this plane and is rapid and bloodless. In the forehead, dissection in this plane is done to just below where we want the hairline. The scalp is then advanced forward and the excess non-hair bearing forehead skin is excised with an incision that is parallel to the bevelled trichophytic incision. The wound is closed in two layers. The deep layer of the scalp is closed for strength and to approximate the wound edges. The skin closure is done with delicate fine stitches. To ensure a good cosmetic result, there is no tension on the wound. A light dressing is placed and removed on the first postoperative day. A cosmetic result is appreciated immediately. The hair may be combed downward and there is minimal bruising and oedema. Sutures are generally removed 7 - 10 days later. Many patients have resumed working and social actives in 4-5 days.

The most important concern to this technique for hairline advancement is the possibility of an obvious or unattractive scar. The technical points of the trichophytic incision are critical in avoiding this complication. As the hair grows and the wound matures, the scar will become virtually non-existent. Hair grafts could later be performed if the scar were visible. Overall, patients tolerate this procedure very well. Patients often report some decreased sensation of the frontal scalp, but this usually resolves by 6 months. Other complications have been extremely rare.

There are many reasons why a previous hair transplant may have gone wrong: they range from transplants performed by people without the requisite skills, experience or care, via a lack of knowledge of state-of-the-art techniques, to such factors as badly trained staff, a lack of artistic talent or no sense for aesthetics and harmony on the part of the hair surgeon.
(read more on the risks of a cheap hair transplant)

The ones who suffer are the patients, as they are the ones having to live with the consequences of the unsuccessful hair transplant - hair or hairlines looking unnatural, wrong hair alignment (wrong exit angle of the grafts), or scarring. Corrective treatment can lead to significant improvements. The corrective possibilities open to reconstructive hair surgery involve a range of different and often complementary techniques. Used together, they can achieve the desired results.