Hair transplantation in our clinic
During the first visit, the patient's scalp and hairs are examined as the general health. This examination assesses hair state and density, by using the specific equipment of a trichology clinic.
The hair follicle special microscope analyzes the hair using o source of light passing through the follicle (transillumination) and supplies information on the structure, growth cycle and the oil (sebum) deposits. This information is mandatory for the clinician to establish the correct diagnosis, decide on the treatment and monitor the results.
* Transillumination of the hair extracted by pulling
* Facilitates the diagnosis:
*Gives information on:
- High lightens the hair structure
- Elaborates an overall hair diagram
- Enhances the presence of regressive hair
- Possible infectious/parasitic diseases
- Sebum production
- Degree of scaling
The video dermatoscope and the digital trichoscope help not only with information on hair and skin features but process and store images, with 10x maximization, which are them used during the operation, to compare the results or to decide the best treatment. The software used (Trichoscan) help determine the hair density and types and provides information on their metabolism. The Hair Diagram mode evaluates the current hair state and the Anagen mode allows us to assess the hair metabolism.
The video-dermatoscopy method provides:
- viewing of the hair and scalp and 10X maximization
- easy image recording
- ea Hair Diagram
- the hair follicles stage in Anagen mode
- Dedicated software
- Dedicated database
- Increased accuracy of:
- The hair transplantation
- The treatment's efficiency assessment
- Usefulness in Clinical Trials
The accurate measurement of the hair density indicates precisely the number of grafts necessary for obtaining quality esthetic results.
The appointment for the Surgical Procedure is arranged after establishing the patient's health state and the extraction/implant areas.
Skin ultrasound imaging
- Exclusion of possible sub-cutaneous inflamation
- Diagnosis of concurrent skin diseases or processes that could lead to transplant failure
- In conjunction with the clinical examination and blood tests leads to 100% certainty on the patient's general health state in order to avoid possible transplantation counter-indications.
Hair loss causes
Alopecia is a term that defines the hair density decrease, caused either by excessive hair loss or by hair growth delay. Currently, alopecia areata and androgenetic alopecia occur most frequently. At the same time, temporary hair loss may also occur, caused by stress, infections, food and endocrine issues, inflammatory conditions or malignancy.
In medical terms, there are two types of alopecia: scarring alopecia and non-scarring alopecia. Scarring alopecia affects the skin and the hair and usually in this case, for correction, hair transplantation is necessary. Non-scarring alopecia’s cause must be establish, treated and if the hair loss is irreversible the option of hair transplantation can be considered.
Alopecia areata is a non-scarring hair loss caused by inflammation around the hair follicle with an autoimmune background. The stem hair cells are affected and blocked, temporary or permanent, leading to large areas of hair loss.
As any auto-immune disease, it takes complex investigations and appropriate approach is the basis of high quality therapeutically results.
Androgenetic alopecia is the most frequent alopecia and it affects half of the male population and 10-20% of the female population. The cause is known in men’s case: the exaggerated activity of the 5α reductase enzyme also present in the bulb area, which turns testosterone into dihydrotestosterone. The treatment is clear and the doctor diagnoses the associated conditions that may endanger the evolution and affect the treatment response. We consider that for the time being there is no universal treatment available and on the contrary, the treatment must be customized for each patient.
In women’s case, androgenetic alopecia is a manifestation of the peripheral metabolism disturbance of sexual hormones. Most frequently, diffuse hair thinning occurs (the so-called female pattern) but a hair loss similar with the men’s one may also be occur (male pattern). The lab investigations and the exploration with specific equipment can establish the most efficient therapy method.
The factors affecting the absence, the thinning or the damage of the hair may be:
- Congenital diseases, some people are born without hair on scalp areas;
- Medical conditions, scars caused by burns, trauma, infections, surgical interventions, inflammation;
- Intoxication with various substances – medicines causing side effects;
- Chemical and atmosphere pollution;
- Nourishment deficiencies, quite frequent in our country;
- Mental, professional and social pressure
- Hormonal disorders
- Negative environment influences (radioactivity).
Hair loss medical treatment
The hair follicle is a living organism: it come to life, feeds, breathes, grows permanently up to maturity and then falls. This is the life or regeneration cycle and then a new hair replaces it. The duration of a healthy regeneration cycle takes between 4 and 10 years, which means a root can generate 10-25 new hairs during a life cycle. Should a hair fall from a specific cause, a new hair will grow instead, but no more than 10-25 times. Obviously, if a regeneration cycle shortens to a couple of years, months or even weeks, in a short time interval, if no measure is taken, baldness may occur.
Cause number 1 : DHT a testosterone product excessively metabolized
Regardless of causes, the condition’s triggering is related to a product of the testosterone metabolism, a male sexual hormone, also produced by women, in smaller quantities. The excessive DHT metabolism diathesis is most frequently transmitted genetically.
This product is metabolized from the blood testosterone by the 5α enzyme reductase which is found in the hair follicle root matrix. Whenever the DHT quantity is produced excessively, it has destructively on the root cell growth process. And it has two major consequences:
- It stimulates the sebum secretion in the hair root area;
- It obstructs the hair growth and it shortens the regeneration cycle.
The unbalance occurring in the testosterone metabolism affects preponderantly the hair on the front and top sides of the scalp. The side and rear areas are not affected because they are endowed with independent metabolism in the DHT presence.
Hair loss takes place in three successive stages:
The regressive stage - the shortening of the follicle regeneration cycle, which means its life is shortened dramatically. Hair starts falling massively. It is the disease stage that can be stopped with a treatment based on regenerative tinctures that must suppress the cause directly: the testosterone produced DHT. It is followed by the activation and the regeneration of the affected root’s cells and by a normalization of the cycle.
The distrophic stage, which means the appearance of short, thin and wooly hair (down). In this phase, the disease generally stops, in women’s case. Yet, the disease carries on in men’s case. Massive, treatment-based regeneration becomes impossible in most cases, but the hair transplantation technique is much more efficient. LONG TERM RESULT.
The atrophic and lethal stage – the hair root becomes inactive or irrecoverably dies. Androgenetic alopecia or baldness installs. In this phase, no so-called regenerating treatment works. There is no wonder lotion or pill, anywhere in the world, but just attempts, more or less successful, of pharma companies to sell illusions. Hair transplantation thus becomes the ONLY LONG-TERM ALTERNATIVE.
The Egoclinic medical team are the specialists desired . We use general and specific medical treatments traditionally used in our clinic as a result of long-term experience.
The stimulation of the hairs by using:
- Laser-based hair growth stimulation methods;
- Scalp masks providing scalp treatment and hair growth stimulation;
- Local treatment – mesotherapy;
- The choice of standard treatments available on the market, adapted for each patient.
Platelet rich plasma (PRP platelet-rich plasma) a highly effective method in the treatment of alopecia
Hair follicles, along with the uterine lining in women, is the only body with the cyclic evolution in the course of human life, with a growth phase (anagen), a phase of stagnation of growth (catagen) and phase of hair (telogen), followed by reinitiation growth cycle.
In this way there is a continuous renewal of hair throughout the body, with no visible thinning areas. Research into the biology of the hair showed a great deal of factors that control hair growth and cause cell activation burgeoning stem region of the hair bulb. These activated cells differentiate, initiating anagen phase and the growth of new hair. A variety of growth factors play a key role in the induction of cyclic transformations that induce regeneration or stop the growth cycle through the programmed death (apoptosis) of cells constituting the hair (follicle keratinocytes).
The main growth factors are epidermal growth factor (EGF), vascular-endothelial growth factor (VEGF), insulin growth factor 1 - like, fibroblast growth factor (FGF). Platelets release a large amount of growth factors and certain growth factors platelet (PDGF), transforming growth factor beta (TGF beta 1 and 2), epidermal growth factor (EGF) and growth factors vascular-endothelial (VEGF).
The involvement of these factors in the regeneration cycle of the hair has made in the last 8 years to use the appliance platelet rich plasma (PRP) in hair growth, primarily in the context Hair own, and after the evidence obtained, stimulating dermal papilla, with the release of vascular and fibroblast growth factors, is used in the treatment of alopecia, of course after proper diagnosis thereof.
Along with the extremely important role of platelets, plasma obtained and injected contains nutrients, electrolytes, growth factors, completing the beneficial effect on hair growth. As you can see in the video attached platelet rich plasma (PRP) is obtained by harvesting the patients own blood and processing by means of centrifugation through special filters being an effective product safe and non allergic, so long as it is obtained according to protocol and professionals, in terms of diagnosis and manipulation certainly correct therapy.
In Egoclinic after determining the exact diagnosis of alopecia, the assessment of any other associated diseases, use a series of 4 sessions, with injections in the affected area. In severe cases repeat at 6 months. Depending on the type of alopecia may be the only therapy, or may be associated other specific treatments.
Using this treatment in implant hair grows so implanted hair density (about 15%) by stimulating cells implanted stem bulb, and accelerates hair growth implanted by vascular and fibroblast growth factors.
Hair transplantation technique
In our clinic we use follicular units - hair follicles growing in the same unit with the oil glands - giving the transplanted hair the natural appearance even if the patient prefers short haircuts. With this method, one can not make the difference between the transplanted hair and the natural one.
Extracting the hair follicles can be done by using two safe and efficient methods, acknowledged in hair transplantation, depending on the patient's option.
Individual Follicular Unit Extraction (FUE - Follicular Unit Extraction) the follicular units are extracted one by one from the entire surface of the donor area. This can be performed from the scalp - the crown of scalp area - and also from other body areas.
Extraction of the Follicular Units in strips (STRIP) the grafts are extracted at the same time from the scalp crown area and then separated using a microscope. The donor area is then resurfaced using a reconstruction method that will allow the hair growth even through the scar remaining after the extraction, with the best esthetic effects.
These methods can also be combined, thus providing the extraction of enough grafts in the cases of advanced hair loss.
The hair transplantation is started after agreeing with the patient on the method, considering his physiology and the outcome desired.
The grafts orientation follows the natural transplantation lines. In our clinic we can transplant hair in the scalp, eyebrow, moustache and beard areas by using grafts from the scalp's posterior area and from other body areas as well.