Hair Transplant in Madrid and Mexico City | Dr. Espinosa Custodio | FUE Technique

Trasplante Capilar Dr. Espinosa Custodio

Madrid and Mexico City

Excellence in Hair Transplantation

Dr. Espinosa Custodio

More than a procedure, we commit to your result: we include a full year of medication and hair care to ensure the health of your new hair.

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Madrid | Mexico City

• Performed by Dr. Espinosa Custodio, including both the extraction and the DHI implantation.

• Results with fast recovery, no scars, and no visible thinning.

• Painless treatment, with local anesthesia and the best medical instruments.

Standards of Excellence

• Written results commitment
• Diagnosis with doctors and medical design
• FUE technique specialists
• Hair transplant with DHI Implantation
• Pre-operative blood tests and EKG
• Specialized hair treatment room
• Post-operative hair washes
• Follow-up until patient discharge

Commitment to results

The Step-by-Step Process

01.

Medical DiagnosisRigorous analysis performed by our doctors, key to guaranteeing a satisfactory and natural result.

02.

Preoperative PhaseSimple guidelines and previous treatment. We perform a complete blood test and EKG for your safety.

03.

Arrival at the ClinicWe start the day early, allowing each preparation to be carried out with calmness and technical precision.

04.

Artistic DesignDr. Espinosa defines the most aesthetic and natural design together with the patient before starting the intervention.

05.

Follicular ExtractionMeticulous obtaining of follicles using the FUE technique, respecting the density of the donor area.

06.

ClassificationThe technical team processes the follicles under a microscope according to the number of hairs for strategic implantation.

07.

PreservationMaintenance in a biotechnological solution at low temperature to guarantee the total viability of the follicle.

08.

DHI ImplantationThe specialist implants each unit in the recipient area following the natural growth angle.

09.

Hair RestorationDelivery of post-operative guidelines and the Hair Restoration Pack for optimal care at home.

10.

After the procedure, we provide the patient with their Restoration Pack and establish a one-year care plan. This plan includes, at no additional cost, all the medication recommended by the Doctor for the first year, as well as any complementary in-clinic treatment sessions necessary to monitor and enhance follicle survival.

FUE – FUSS

Hair Transplant: FUE Technique

The FUE technique, which stands for Follicular Unit Extraction, consists of extracting follicular units from areas with good hair density, which we call the donor area. These are extracted using a circular scalpel called a punch, which can range from 0.6 to 0.9 millimeters—just enough space to extract the follicular units. This process can be performed manually or with the assistance of a micromotor.

In this technique, the experience and skill of the specialist are crucial. The benefits of this technique include not leaving a scar in the donor area—since the random extraction makes the perception of density loss minimal—as well as a fast recovery. However, your trichologist must diagnose whether you are the ideal candidate for this technique.

Incisions must always be performed by a doctor.

At Instituto Médico del Prado, Dr. Espinosa Custodio and his team apply a protocol to ensure that all follicular units (grafts) extracted from the donor area survive in the recipient area.

Hair Transplant: FUSS Technique

The FUSS (Follicular Unit Strip Surgery) extraction technique consists of removing a strip of skin from the back of the head. The strip is usually approximately 1 to 3 cm wide and 15 to 20 cm long. Subsequently, the follicular units are separated using specific instruments and microscopes called Mantis, to be implanted using the classic technique or stick and place.

This procedure may leave a residual scar that is hidden by the hair itself. Currently, Dr. Espinosa does not perform this technique as he has specialized in the FUE technique.

IMPLANTATION – WITH DHI TECHNIQUE

What the DHI Technique in Hair Transplantation Consists of

DHI stands for Direct Hair Implantation. It is the most advanced hair implantation technique for the recipient area, achieving healthier and more natural results. With DHI, hair follicles are implanted one by one directly into the transplant area with the proper direction, angle, and depth using a special DHI implantation tool called an implanter.

This technique provides 100% natural results and guarantees maximum follicle viability. Dr. Espinosa Custodio has been practicing this technique since 2016 and personally performs the entire implantation of all follicles assisted by his team.

Objective

To ensure that the implanted hair is healthier and stronger by reducing the time the grafts remain outside the scalp. Furthermore, no incisions are required during this procedure. It is performed using devices called implanters. These are like small grooved needles through which the follicle is implanted. They can have different diameters depending on the size of the follicle to be implanted, ranging from 0.64 to 1 mm.

Advantages of the DHI technique

Innovative procedure with natural results, performed by the doctor.
Better control of the implantation angle and depth. We can orient the transplanted hair at different angles, allowing for a more natural appearance.
There is a higher survival rate of the follicles.
We can achieve a hair transplant with greater density than with other techniques.

No prior incisions are required as hair follicles are transplanted using a special DHI implant tool.
Existing hair is hardly damaged.
The transplant area bleeds less, heals faster, and leaves no mark.
Less damage to the follicular unit during the transplant.
With the DHI method, between 90-95% of the extracted grafts survive.

FUE – FUSS

FUE TECHNIQUE

Does the FUE technique leave marks or scars?

The FUE technique is minimally invasive. Unlike the FUSS technique, which leaves linear scars, with the FUE technique there will be no trace of the intervention. The explanation for this is that micro-scalpels with a hollow cylindrical tip are used for the extraction of follicular units. They have a very fine diameter, from 0.6 to 0.9 mm, leaving small holes that heal one week after the transplant.

A scar is not produced as only small wounds occur, which do not even require sutures for healing.

What is the preparation before the intervention?

The FUE technique is performed as an outpatient procedure under local anesthesia, so it does not require hospital admission. In the days prior, no specific action or care is required.

On the same day of the intervention, you can have breakfast, with the only requirement to avoid consuming coffee or caffeinated beverages.

During the preparation for the intervention, the patient will be provided with an anxiolytic or relaxant to help them feel calmer during the procedure.

Do I have to shave my entire head for the intervention?

This will depend on the type of intervention defined with the doctor. Although there is the possibility of carrying out a hair transplant without shaving or semi-shaved, the most requested option is shaving.

Thanks to this technique, the follicles to be extracted from the donor area can be better identified. In all these interventions, part or all of the occipital area of the head is shaved.

However, we should not shave this area ourselves. It will be the specialized technicians at the clinic who carry out this task prior to entering the treatment room. They are the ones who know how to do it so that Dr. Espinosa Custodio can perform his work properly.

Is it possible to avoid shaving?

In the case of women or men with very long hair, it may be more difficult to accept shaving.

In these cases, an unshaven hair graft can be performed, which allows the extraction area to be worked on without it being perceptible after the intervention.

On the other hand, it is true that shaving is preferable and this is done for men with short hair.

How long does the FUE intervention last?

The FUE technique intervention is long and very laborious. It requires the doctor’s full attention. Dr. Espinosa Custodio performs all interventions over two days. On the first day, 90% of the FUE technique incisions are made, and it takes place from 9:00 AM to approximately 7:00 PM. The second day is dedicated to reviewing the graft and completing the areas where high density has not yet been given to the areas to be implanted. In this second session, the time ranges from 9:00 AM until lunchtime.

The main reason for this two-day technique is to guarantee the survival of the follicles. Transplants are usually planned on two consecutive days. In the case that many follicular units are needed, a third intervention will be required one year after the first ones.

What are the phases of the FUE intervention?

Once the intervention has begun, we will go through several phases, always guided by Dr. Espinosa Custodio. After preparation in the treatment room, the moment for anesthesia will arrive. The doctor will apply local anesthesia and the transplant itself will begin.

The first phase will be the follicle extraction. Using the FUE technique, Dr. Espinosa Custodio, aided by punches and the micromotor, will extract the follicles one by one. The doctor’s team will then proceed to classify and prepare them so they can be grafted.

Once the extraction is finished, the doctor will proceed to their implantation. This will be done with implanters, which can be described as small grooved syringes through which the follicles are implanted.

Both the punches and the implanters have different diameters. Depending on the size of the patient’s follicle, they will range from 0.6 to 1 millimeter.

What is the recovery from the intervention like?

After the FUE intervention, the patient can go home and lead a normal life, always taking the precaution of avoiding direct contact with the area where the implant was made, since the implanted follicles can become dislodged.

The appearance we will have during the first days is of multiple small wounds on the head, so it may be convenient, if we can afford it, to take a few days off or work from home. In the first 48 hours, the face may swell due to the effect of the local anesthesia.

After 72 hours, the extraction scars will be closed, and after the first week or ten days, the appearance will be practically normal.

When will I notice the effect of the transplant?

The transplanted hair will fall out a few weeks after the intervention. This is expected and normal, and it does not affect the hair follicle, which is the structure that is truly the objective of the transplant.

The grafted follicles will start their normal growth cycle and, between 5 and 6 months, we will start to see the first results. However, it will not be until 12 to 15 months have passed that we will see the complete result.

In the case of the vertex, commonly called the crown, the process is slower and it is from 15 months onwards when it will complete its course.

When is the FUE technique appropriate?

The FUE technique is the one currently applied to more than 90% of hair transplant patients, as it has clear advantages over FUSS. It is especially suitable for people who want to wear their hair short, avoid scars, or who do not want to undergo a more aggressive intervention.

FUSS TECHNIQUE

Does the FUSS technique intervention leave a scar?

Yes, it leaves a small scar. This is because with this technique a strip is extracted from the donor area, which is subsequently sutured. The stitches are removed 10 days after the intervention.

It is a scar that, however, can be concealed with the patient’s long hair (from 1 or 2 cm) but will be visible if we opt for a shaved or very short haircut.

Is recovery the same as with the FUE technique?

The intervention is somewhat more invasive than FUE, so the post-operative period also implies a longer recovery process and some more discomfort. In any case, it is also an outpatient intervention performed under local anesthesia that does not require hospitalization.

When is the FUSS technique most indicated?

Although it is clearly in decline with the appearance and refinement of the FUE technique, there are indications and advantages. With FUSS, the donor area is better utilized, so it may be indicated for patients with a small donor area or where a significant volume of follicles is required.

It also reduces treatment time and avoids shaving the hair, making the intervention not so noticeable.

MORE FREQUENTLY ASKED QUESTIONS

What is the best time of year to get a hair graft?

Dr. Espinosa Custodio considers that there is no best time of the year to do a hair transplant. Throughout the year, the process is similar. It is normal for it to be done at the patient’s convenience, as it is recommended that they have several days of rest, between three and five, to be calm and carry out the necessary care for the head.

It must also be taken into account that facial edema can occur after the operation, which will resolve after 3 or 4 days. If social interaction is to be avoided, those rest days are also recommended.

Which is the best technique?

There is no perfect technique. There are several types of techniques which can be adapted to each patient according to their pathology and characteristics.

In the extraction stage, there are 2 techniques: FUE, where the specialist extracts the follicular units one by one (hair by hair), and FUSS, in which a strip of skin is cut and from there the technicians remove the Follicular Units (FUs).

For implantation, there are also 2 techniques: Classic or forceps, which is a mixed technique where the specialist makes the incisions and the technicians place the follicular units. And the implanter technique (DHI), in which the doctor makes the incision and introduces the follicular unit simultaneously.

It should be remembered that, by law, incisions can only be made by a registered doctor. Dr. Espinosa Custodio will examine you and determine which is the most appropriate technique for you.

What is FUE?

FUE is the acronym for Follicular Unit Extraction, the extraction of follicular units one by one; each follicular unit can contain from 1 to 6 hairs. The specialist makes incisions using a circular scalpel (called a punch); this can be manual or have the help of a micromotor.

How is a hair transplant performed?

It is a procedure that MUST ALWAYS be performed by a medical hair specialist. Nurses and technicians assist the doctor, but they must never make incisions on the patient.

It consists of the extraction of the follicular units (the hair) and the subsequent implantation of these same units in the area to be restored.

Does the hair transplant technique have any risk?

As in any medical procedure, there are implicit risks: bleeding, infections, facial edema, etc., but if performed with all sanitary protocols, the risks are minimized. It is a minor outpatient treatment, meaning without hospital admission.

What care should I have after the graft?

Basically, it consists of taking care not to touch or manipulate the implanted area and hydrating it constantly.

Dr. Espinosa Custodio personally explains the care to follow and, subsequently, it is provided in writing. In addition, we have a 24-hour telephone for emergencies.

Does the implanted hair fall out?

Yes, but momentarily. There is a phase called the shock loss phase in which the follicular units can fall out due to the stress of the process. Depending on the body, from 20% to 80% can fall out. This phenomenon appears 3-4 weeks after the intervention.

Can anything be done to speed up growth?

At Dr. Espinosa Custodio’s Hair Unit, our commitment does not end in the operating room. To optimize results and accelerate the process, we include oral medication during the first year in all our transplants, as well as the necessary hair treatments (PRP, mesotherapy, etc.) based on each patient’s progress. All of this is provided at no additional cost, with the goal of ensuring an excellent final result at 12 months. Yes. During the following months, in addition to pharmacological treatment, sessions of PRP or mesotherapy can be scheduled.

Does the hair removed from the back grow back?

No, we transplant the entire follicular unit, so that hair does not grow back. However, a high density will remain in the area that will make the loss imperceptible.

What are the scabs like after the transplant?

Days after the transplant, scabs start appearing. This is completely normal. In the recipient area, we must not touch or rub during the first days. In the donor area, by cleaning it daily, the scabs will fall off much faster.

How is the first line of the hair implant drawn?

Achieving a natural first line is fundamental. Single follicle units are selected for the transition, and the design is always made according to the morphology of the patient’s face, following the doctor’s recommendations to guarantee facial harmony.

Therefore, for the first line, follicular units with a single follicle are selected, progressively increasing to two and three, so that the line is natural and a good hairline remains. In addition, the design must always be made according to the morphology of the patient’s face, and it is therefore convenient to listen to the doctor’s recommendations.

Can a scar be covered with a hair transplant?

One of the reasons for undergoing a hair graft can be a scar on the scalp, whether from an accident or a previous transplant with the FUSS technique. The truth is that a hair graft can be performed over a scar, thus helping to conceal it. However, a medical specialist with sufficient experience must be chosen so that the implant is fully satisfactory.

Can I use hair fibers after the hair transplant?

Hair fibers are used to conceal alopecia. Regarding the transplant, it will be necessary to attend the first consultation appointment with the doctor without having applied these fibers in the previous days. If the intention is to use them afterwards, applying them during the first month will be prohibited and, if it is continuously, you should wait 3 months.

Can I have a hair graft if I suffer from psoriasis?

Psoriasis is a skin condition that causes rashes and red spots. In principle, there should be no problem between the hair transplant and psoriasis, although an experienced medical specialist must assess the disadvantages and benefits.

When can I dye my hair after the hair transplant?

It is recommended to wait at least one month to dye your hair again. After that time, healing will be complete and we will not damage the follicles.

Can hair fall out during menopause?

Menopause brings a series of hormonal changes that can affect hair: it may become thinner, break easily, or lose nutrients. If we see hair falling out, we should see a specialist.

Is it possible to perform a transplant with long hair?

It is possible to do it without shaving. However, it must be a specialized clinic that performs this technique, as not all centers are qualified for it.

Can I have a hair graft if I am a smoker?

Yes, but you must inform the doctor. It would be optimal to be able to stop smoking days before the transplant, since tobacco makes healing difficult and influences the progression of alopecia.

How are follicles treated during the hair graft?

The preservation and treatment of follicles during the extracorporeal phase is vital. The follicle must be preserved in solutions such as Ringer’s lactate or HypoThermosol to avoid lesions due to drying or microtrauma.

When can I cut my hair after the hair transplant?

To cut hair: In the donor area, 1 month for scissors and 2 for clippers. In the recipient area, 2-3 months for scissors and 6 months for clippers.

Am I a candidate for a hair graft?

It is necessary to meet requirements such as having a sufficient donor area and stabilized alopecia. Meeting the requirements will allow us to be considered as a candidate for a hair transplant.

What is hair graft transection?

Transection is irreparable damage to the follicle that prevents its growth. A high transection rate means the graft fails.

Why does the implant in the crown take longer to grow?

The growth of hair in the crown is slower due to factors such as lower vascularization or compression while sleeping.

Does hair fall out after childbirth?

It is common to suffer from telogen effluvium after childbirth. Around 30% of hair can fall out, but it is a completely temporary process.

What is ringworm?

Ringworm (Tinea capitis) is a fungal infection that appears in patches and is transmitted by contact or infected combs.

What is folliculitis?

Folliculitis is the inflammation of the follicles. After a graft, it can appear when the hair starts to sprout again.

How is diffuse alopecia treated?

Diffuse alopecia manifests with progressive miniaturization all over the head and is treated with drugs and grafts.

What is poliosis?

Poliosis is a localized cluster of white or gray hair (white streak), as opposed to scattered gray hair.

Does a hair transplant hurt?

There should be no pain during the hair transplant. Local anesthesia similar to that of dentists is used.

How can I prepare for a hair transplant?

Preparing properly includes following the prescribed medication, prior blood tests, and avoiding stimulants such as caffeine or tobacco.

Can I have a transplant for scarring alopecia?

Scarring alopecia requires an expert evaluation. It is likely that a small preliminary graft test will be performed.

Why is a hormonal analysis required?

The doctor requires a hormonal analysis to know values such as dihydrotestosterone and adjust the best medication.

I suffer from rosacea, can I have a hair graft?

Rosacea is not dangerous for the graft, although it may require a prior test on the tissue.

How we work – Instituto Médico del Prado

•
Hair diagnosis with our doctors
•
Using FUE and DHI techniques
•
Commitment to results (see conditions)
•
Pre-operative (complete blood work and EKG)

•
Smart dermatoscope (HairMetrix By Canfield)
•
Follow-up included until discharge
•
Post-operative pack for home care
•
Hair washes after the graft
•
24-hour telephone assistance

At Instituto Médico del Prado we perform your hair graft (Madrid and Mexico City) with all sanitary guarantees. We are a center specialized in hair transplantation using FUE (Follicular Unit Extraction) and DHI (implanter) techniques.

Dr. Espinosa Custodio has been dedicated to hair transplantation since 2016 and possesses a solid background in this discipline.

Hair transplantation is a long but very rewarding process. Results are not immediate; in hair transplantation, final results can be assessed around a year or a year and a half after the intervention. Dr. Espinosa Custodio commits to his results in writing (see conditions), so that the hair graft meets the patient’s expectations.

Dr. Espinosa usually implants around 2,000 follicular units per session. This condition is part of our excellence protocol, and with it, we ensure that all follicles (grafts) survive in the grafted area. Thanks to this process, we also ensure that all grafts are placed correctly, choosing the direction, depth, and position of each one.

Nevertheless, each patient has characteristics that are studied individually. Always at the doctor’s discretion, sessions can reach 2,500 to 2,600 follicular units.

All transplants performed by Dr. Espinosa Custodio and his team are carried out in his hair clinics in Madrid and Mexico City, Instituto Médico del Prado. He is the one who performs all incisions during the operation (mandatory by law), both in extraction and implantation. We apply the FUE technique for extraction and the DHI technique for implantation, the most advanced methods which require the greatest mastery from the doctor.

The diagnostic consultation for hair transplantation

The beginning of a hair transplant is the trichological diagnosis. Our doctors are responsible for compiling your medical history and diagnosing your hair situation. This determines whether you are a suitable candidate for the transplant.

Our doctors are aided in the diagnosis by a smart trichoscope, Hairmetrix By Canfield. This is an innovative system that analyzes hair density, grafts per square centimeter, and the thickness of follicular units.

If you are a candidate for a hair graft, we will study your donor area to determine how many follicular units can be transplanted, as well as those needed in the recipient area. The doctor will create the most suitable design for you in order to obtain the most natural result.

Diagnostic and assessment consultations with our doctors have an associated cost.

You can also request an initial assessment from the doctor through our online consultation form.

Hair treatments before and after the graft

If you need preliminary treatments to ensure healthy and strong hair before the transplant, we will carry them out in our hair clinics. This is normal and forms part of the hair implant process.

After the transplant, we include all the necessary washes to care for your hair, as well as the removal of scabs a few days later. Additionally, we will provide you with a post-operative hair pack with everything needed to care for your hair: thermal water, regenerating cream, cervical pillow, oral medication, and items for proper hair cleaning.

The months following the transplant are as important as the graft itself. Therefore, the doctor will meet with you periodically and perform the treatments you may need.

Hair Transplant in Madrid

The price is a sliding scale calculated based on the implanted follicular units, from €3 / Follicular Unit (graft) VAT included.

▪ There are no extra costs to add.

▪ Includes follow-up care until discharge, with supportive hair treatments.

▪ Medication included for 1 year.

Minimum amount: €4,000

View rates in Madrid

Hair Transplant in Mexico

The price is a sliding scale calculated based on the implanted follicular units, from $65 MXN / Follicular Unit (graft) VAT included.

▪ There are no extra costs to add.

▪ Includes follow-up care until discharge, with supportive hair treatments.

▪ Medication included for 1 year.

Minimum amount: $85,000 MXN

View rates in Mexico City

Grade II and IIa

2,000 to 2,500 grafts

Grade III

2,500 to 3,000 grafts

Grade IIIa

3,000 to 3,500 grafts

Grade III vertex

3,500 to 4,000 grafts

Grade IV

4,000 to 4,500 grafts

Grade IVa

4,500 to 5,000 grafts

Grade V

5,000 to 5,500 grafts

Grade Va

5,500 to 6,000 grafts

Grade VI

6,000 to 6,500 grafts

Minisessions

Dr. Espinosa also performs minisessions, which are specifically designed for patients who:

Do not want to shave their head (neither the donor nor recipient area).

Want their transplant to go unnoticed.

Want a more gradual change in their appearance.

Do not have much time and need to return to work almost immediately.

Want to do a small test session before a full transplant.

Book an appointment

Calculation of Follicular Units

How to calculate follicular units?

To estimate follicular units at IMP, we calculate the area (in cm2) of alopecia presented by the patient. We multiply the result by the number of grafts that must be placed in each area based on the patient’s characteristics.

In this fairly precise way, we know the follicular units that the patient needs. It should be noted that in addition to this calculation, an analysis of the donor area must be performed to evaluate if the transplant is viable.

The average density so that alopecia is not noticeable is around 50 grafts/cm2, although it varies depending on the area (the front line requires more), hair type, color, and thickness.

Estimation according to Degree of Alopecia

Based on the Hamilton-Norwood classification, these are the estimated ranges:

> Grade II: 2,000 grafts
> Grade II a: 2,000 to 2,500 grafts
> Grade III: 2,500 to 3,000 grafts
> Grade III a: 3,000 to 3,500 grafts
> Grade III vertex: 3,500 to 4,000 grafts
> Grade IV: 4,000 to 4,500 grafts
> Grade IV a: 4,500 to 5,000 grafts
> Grade V: 5,000 to 5,500 grafts
> Grade Va: 5,500 to 6,000 grafts
> Grade VI: 6,000 to 6,500 grafts

In the diagnostic consultation, the doctor will indicate the exact figure and the strategy to follow.

Recommendations for Hair Transplantation

Introduction to the Process

We provide the recommendations for before and after the intervention. These are listed chronologically and will help you through all the processes of the hair transplant intervention.

Pre-operative Recommendations (Before surgery)

Critical instructions for optimal results:

1-5: No intense sports (5 days before). Suspend Minoxidil (10 days before). Avoid aspirin, anti-inflammatories, and vitamin E and B complexes (10 days before). No alcohol or caffeine (3 days before).
6-9: Avoid stimulants (1 week before). Drink plenty of water. Smoking is prohibited (1 week before): it compromises the survival of the graft.
10-15: Wash your head the morning of the appointment. Do not shave your hair. Wear a button-down or zippered shirt. Eat a normal breakfast (no caffeine). Do not drive after surgery. Blood work and EKG are mandatory.

Post-operative and Recovery

What are the days following the hair transplant like?

Fast recovery. The first night there may be discomfort manageable with pain relievers. Edema (swelling) in the forehead is common and disappears in 1-2 days. Scabs will be removed according to medical indication.

Social and work reintegration from the 4th or 5th day.

Immediate Care after the Transplant

Diet and Habits: Light meals, avoid alcohol (48h) and tobacco. Sexual activity after 1 week.
Posture and Clothing: Wear loose clothing. Sleep with your head elevated for the first few days (cervical pillow).
Protection: Apply cold to the forehead. No direct sun (15 days). Pool after 3 months, Sea after 2 months.
Sports: Gentle aerobic exercise after 10-15 days. Strength/Gym after 2 months.

Maintenance: Donor Area and Recipient Area

Donor Area

Apply regenerative ointment once a day for one week.

Recipient Area

Constant hydration: Use thermal water every hour during the first week. It is vital for the survival of the follicles.

Washing: Do not wash your head on your own for the first few days; it will be done at the clinic and you will be given instructions for home care with a special shampoo.