Hair transplantation: This is how a hair transplant works

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“The most important thing is: You live!”, says a colleague at the sight of the partly bloody pictures. I say: “Nonsense, the important thing is to sprout hair!” What a life that would be, with the prospect of another 50 years with 6-millimeter bristles, which I just can not talk myself into as practical? Yes, I dramatize. But the transplant stopped what started in my late 20s – the advance of balding scalps. To anticipate: The strains, long not as dramatic as the photos would have you believe, are worth it. But in turn. 

I am talking about a few thousand hairs. What is it for one who has transplanted millions of them? In the Haranni Clinic Herne I meet him. When the master introduces himself, I stumble: “Anakin? Like the one from Star Wars?” He shakes his head. “Hanneken, Constantin Hanneken.”Galactic about the 57-year-old is his record: Thousands of transplants go to his account, for 29 years he is on the road on behalf of men’s hair. My head is in good hands.

Why do men lose hair at all?

In most cases, hair loss in men is caused by the male sex hormone testosterone. One of its degradation products, dihydrotestosterone (DHT), shortens the hair growth phase in the scalp and causes the hair roots (follicles) to die. Follicles at the back of the head are usually less sensitive to DHT, so that most men continue to grow a lot of hair at the hairline into old age.

Where do the hairs for hair transplantation come from?

“About half of the hair from the hairline can be removed without the loss being obvious,” says Dr. Frank Neidel, President of the Association of German Hair Surgeons. 
During hair transplantation, the active follicles of this region, which is densely populated with hair, are removed and transplanted to the bald areas on the top and front of the head. Holes are punched in the scalp under local anesthesia where the hairs are to be implanted.

What are the methods of hair transplantation?

There are 2 Transplantation methods:

  • The Strip method: Hair roots are taken under the microscope from a narrow strip of skin that has been punched out.
  • The FUE method removes individual hair roots with the help of a hollow needle. Recently, robots have been used for this method.

Is robot technology worth it?

The head of the clinic Dr. Darius Alamouti (www.dariusalamouti.en) explains, “This technology prevents scars and guarantees growth rates of 98 percent.” Hanneken adds: “What Artas can do, no human being can do. The robot scans the removal area, evaluates each graft, i.e. the hair follicle units with 1 to 6 hairs, picks out the cream pieces and punches them without damaging them. 

The technique of taking out single follicles is called the FUE method (Follicular Unit Extraction). It replaces the alternative strip technique FUT (Follicular Unit Transplantation), in which a whole strip of hair is cut out from the back of the head. There, above the nape of the neck, is always the removal zone. Because that’s where body hair grows that, unlike head hair, never falls out: ideal transplant candidates, that is!

How does a hair transplantation with a robot work?

The hair has to come down for the operation: My head is shaved, and Hanneken draws the planting zones on it. So that the robot can dig up my scalp, it first injects 10 syringes into the back of my head. They are really something: I just resist my urge to jump up after the 5. injection and retaliate for the unexpected pain. Lucky for both of us, because it lasts only seconds and the anesthesia sets in quickly. And so I take a seat – almost relaxed – on Artas, the Hair2-D2 of the transplant scene. 

Hanneken: “Thanks to the fine robot mechanics, the punched holes are only 0.5 to 0.9 millimeters in size.” 20 years ago, patients still had craters 2.5 to 4 millimeters in size rammed into their heads.

After a short break and more anesthetic injections (this time in my forehead) Hanneken starts to carve 1400 more holes in my head. “Now experience pays off,” says the surgeon. He has to count his holes in his mind and keep track of how many follicles are present and with what quality. “Because it’s important to place them according to size and natural growth,” says Hanneken.

An hour later I’m sitting there with 2800 holes in my head, The grand finale of the operation begins: The harvesters from before start to plant the pre-sorted grafts. Will they find all the holes?

Can the pain of a hair transplant be endured?

Then everything is over, and Hanneken dismisses me with a parting pain: He seals the dug-up scalp with spray plaster – it burns like hell! Astonishing: shortly afterwards I feel as if nothing had happened. It stays like that – except for a slight pulling in the evening, there is no subsequent pain. But there are a few little things you should be prepared for after such an operation.

What to look for after hair transplantation?

  • With blood crust and bandage on your head you will be looked at, let’s say, a little skeptically by fellow men for 1 to 2 days.
  • From the 2. day the big tingling begins. The head itches, and preferably at night. However, scratching is not allowed, because for 4 to 5 weeks the rule is: no mechanical stress on the head – otherwise grafts can come loose. The super-GAU! By the way, this also means: do not wash your hair under a hard water jet and do not bump your head.
  • From the 3. day the swelling on the head goes down, the tissue water moves slowly downwards over the eye and cheek area – this gives you from hour to hour a new cute to frightening sight. But do not worry, after a few days the spook is over again.

How long does it take for the first hair to grow after the surgery?

About 9 months later: Yes, the hair sprouts. From the front, from above, clearly visible from the side. From behind, in the tonsure area, unfortunately not. But: Instead of expecting miracles, I would probably have to perform a 2. transplantation. And: “12 months after the operation you can expect 95 percent of the visible result, the rest will come gradually,” explains Hanneken. But I am satisfied with the result even now.

What does a hair transplant cost?

Modern technology has its price: Artas costs half a million euros, plus licensing costs and consumables. Depending on the number of follicles, a patient pays between 3500 and 7000 euros for the operation. Plus value added tax. Health insurance companies do not cover the costs.

How long does a hair transplant take?

Scanning and piercing takes about 1.5 hours, after which 3 assistants use tweezers and harvest the pierced follicles for another hour.

What are the risks of hair transplantation?

There are no guarantees of success. The visible success of the hair transplantation can be estimated about 12 months after the transplantation. To the risks is that follicles are rejected, so that the after-growth is missing. Wounds can also become infected, causing scars on the scalp.

Are there alternatives to hair transplantation?

Hard facts: About 80% of all German men must expect hair loss. If you are lucky, hair loss stops at the receding hairline. Most men, however, develop a tonsure or a semi- bald patch in the course of their lives. A few then decide to go bald and shave a cool full bald head. Most men, however, try to fight against hair loss. Before deciding to have a hair transplant, people usually try other types of treatment. There are now many remedies and methods against receding hairline & Co:

  • TincturesSolutions with 5% minoxidil result in visible growth,” explains dermatologist Dr. Gerhard Lutz from Bonn. Important: apply directly to bald patches! Also advisable after transplants, so that your remaining hair remains. Cost: from 20 euros for 1 month.
  • TabletsIn case of hereditary hair loss, act early – according to studies, the active ingredient finasteride requires up to 2 years of patience. Cost: Around 110 euros for 3 months (prescription).
  • ToupetsCustom-made hairpieces supplement the hair, such as removable models (Skinlight, around 1500 euros, lasts up to 2 years) or permanent hairpieces (Contact Skin, from 330 euros, up to 6 weeks). Lutz warns against contracts for regular renewal: “In case of skin irritations caused by the glue, the money is gone anyway.”

Conclusion: A transplant provides visibly fuller hair

Today, my hair is visibly thicker from the front and side and ready again for impractical looks without the use of trimmers. Of course, there are also the ethical questions like “Are cosmetic surgeries reprehensible?” or “Do I have to justify myself for a hair transplantation?”. Everyone should answer this for themselves. But one thing is clear: thanks to Jürgen Klopp, Benedikt Höwedes, Robert Harting and other celebrities, lifting the curls has become socially acceptable. But I am also richer in an astonishing realization: I have the least hair in my head, not on it! Because I seem to be the only one who permanently thinks “My hair is not as full as it should be”. Many people do not even notice this. Frequent reaction in conversations about the surgery: “Light hair? I have not noticed!” With the knowledge it lives even more relaxed.

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Alicia Vargo Author
Consultant seller in an off-line sex toy store
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