Capillary Microsurgery or Capillary Grafting

Hair transplantation is a minimally invasive surgical technique (does not require hospitalization) that improves hair density in patients with different types of alopecia. The technique of choice is hair transplantation with micro grafts, in which follicular units (FUs) from the occipital region (genetically more resistant to alopecia) are transplanted and implanted in the areas of alopecia.

Hair transplantation is a therapeutic tool that will not replace medical treatment, but will be used as a complement to it.

Micrografting (or hair transplantation) is a surgical procedure that is the most advanced solution for hair recovery and is applied to both men and women.

Hair transplantation is a very simple procedure. In order to perform a hair transplant it is necessary to perform a hair examination and obtain a clinical history with which the specialists can analyze its viability.

If it is the recommended solution for your case, the specialists will make a design of the scalp area where the hair is to be recovered, always ensuring an aesthetic image according to the age, race and facial structure of the patient.

In the operation, the medical team extracts the hair follicles from the back of the head for subsequent implantation in the recipient area, respecting the same angle or direction of the original hair, achieving a very natural and aesthetic appearance.

Nowadays, hair implants can be performed in other areas such as the beard and eyebrows.

The extraction procedure of the follicular units to be implanted can be performed in two different ways: FUE technique : Unit by unit by manual extraction or FUSS or FUT or FUG technique (Also known as strip technique) by extracting a strip of skin with follicles from the scalp.

STRIP TECHNIQUE (FUSS OR FUT OR FUG) : It is the graft of follicular units. The process consists of extracting, through local anesthesia and a small surgery, a strip of tissue from the back of the head, from which the donor hair follicles will be extracted. The hair follicles will be separated one by one by an expert clinical team before being transplanted individually to the recipient areas.

FUE TECHNIQUE (FOLLICULAR UNIT EXTRACTION): With this process, each follicular unit is removed one at a time from the back and sometimes the side of the scalp using “punches” of 1 mm or less. Using a mechanized system, the entire follicular unit is removed with its hairs, leaving a small hole of that size that will heal very quickly.

Once the follicular units have been obtained (independent of the extraction technique), the next step is the implantation of the follicles.

Currently, there are two methods of implantation: The classic forceps technique and the DHI or Implanter.

In the classic technique, in order to perform the implantation, incisions (holes where the follicular units will be inserted) are previously made. These incisions can be made with steel or special (Sapphire) needles or scalpels and then each follicular unit is implanted with forceps.

In the DHI or Implanter, the mechanism does not require previous incisions since the same instrument makes the hole at the same time as it implants the follicle.

Not everyone is a candidate for a hair graft. It is necessary that a specialist makes a diagnosis to the patient, to evaluate the type of alopecia he/she suffers and the donor area.

Occasionally there may be cases in which hair grafting is not the most appropriate option, due to a scarce donor area or low density. There may even be cases in which the patient suffers from a disease that is not compatible with some of the techniques used.

There is no age limit when it comes to undergoing a hair graft, as long as the patient is in good health, does not suffer from any previous organic or dermatological pathology and has a suitable donor area. However, doctors prefer not to operate on people who are too young, in order to study the future evolution of their alopecia and because of the low results in relation to the final density.

The number of follicular units needed for a graft depends on several factors and is individual for each patient, that is why it is important to have an assessment by a qualified professional in the field.

The transplanted follicle has the same characteristics as the hair in the donor area, therefore, it is considered a hair protected from hormonal damage, however, it is still a follicle and can fall out due to mechanical, chemical, psychological or pharmacological actions.

It is unlikely, since it is the patient’s own hair, there are no antibodies that detect the implanted hair as foreign; but there is a possibility that between 8-10% of the grafted hair does not grow.

The medical recovery is usually quick, but not the aesthetic aspect, which will require 7-14 days of recovery so that the patient does not notice the signs of the intervention.

The procedure as such is not painful, however, doctors apply local anesthesia for the patient’s comfort during the intervention and thus facilitate the surgical process and the patient’s recovery.

The duration of the procedure depends on the technique used and the number of follicles to be implanted.

If the FUE Technique is applied, the surgery can last between six and eight hours. In any case, it is not an operation that requires hospitalization, so the patient can go home after undergoing the hair graft.

The postoperative period for hair transplant is usually very well tolerated, since it is an outpatient surgical procedure and the techniques are increasingly less invasive.

After the operation, which usually lasts about 6 hours, the patient will be able to resume normal life.

After surgery, patients may present:

• Reddening of the skin in the recipient area.
• Inflammation or swelling of the scalp, forehead and sometimes even the eyes. This only lasts for a few days.
• Itching or pruritus (mild to moderate degree), mainly due to crusting.
• Post-surgical telogen effluvium: Some patients may experience worsening of their hair density in the first 3-4 months after surgery due to the stress of the procedure.
  
• Low survival of transplanted follicles: this is the most important and feared complication for transplanted follicles. patients, as it will produce an inferior result than expected. Many times there is no specific cause although most cases are due to lichen planus pilaris after surgery.

By following postoperative care instructions, these potential complications can be significantly reduced.

It is not necessary, but it is 100% recommended since this way it is easier to visualize the areas
depopulated to perform the surgery. At the same time, aesthetically it is more beautiful after surgery.

Once the hair transplant postoperative period has passed, the appearance of the recipient area will be very similar to the one it had before the surgery, and it will remain in this “stationary” phase for a few days. approximately 4-5 months. The transplanted follicular units will begin to grow from 4-5 months to 12 months in the frontal zone and 18 months in the crown, exponentially.

In some patients, it is possible that the first 3 months after surgery there may be a slight worsening of hair density due to telogen effluvium suffered by non-transplanted follicles due to the stress of surgery.