Hair Transplant Guaranteed

We use circular micro scalpels for the extraction. Their diameter goes from 0.7 millimeters to 0.9 millimeters and their tip is empty.
These scalpels leave tiny holes that will cicatrize after 7 days. Then, they are completely imperceptibles.

The FUE technique is performed only with local anesthesia so no hospitalization is needed. You should eat normally. Do not do anything out of the ordinary.
If needed, we can give you a smooth sedative before the intervention in order to be relaxed.

In order to identify correctly all the follicular units, we normally must shave your hair. However, we do that in the clinic the very same day of the surgery.
The day of the procedure, and previous to entering to the surgery room, we shave the donor area.

If the patient is going to suffer a big discomfort from shaving the hair, we can avoid it sometimes.
If they have short hair, we can hide the donor area with it. However, it is highly recommended to shave all the hair.
The flaps technique allows us to work on the donor area even when the hair has not been shaved.

A FUE intervention is long and hard-working. The grafts must be transplanted individually and this task lasts for several hours.
According to the number of follicular units, the intervention lasts from one to two days. Espinosa Custodio MD does not usually implant more than 2000 grafts in a session, in order to keep our high-quality santandards.

After entering the surgery room, the extraction phase starts. The capillary surgeon extracts the grafts with the circular micro scalpels. This is a moment of great precision and concentration
After the extraction we prepare the implantation. The capillary technicians classify and count the follicular units. The capillary surgeon starts to implant the grafts into the head.
For the implantation we use some devices called implanters. These are little needles with a ribbed tip which contains the graft.
They have different diameters, depending on the graft’s width.

After the procedure, the patient can go home and lead a normal life. They must avoid direct contact with the recept area, though, as the follicular units can fall.
During the first 3 days, the head looks with tons of tiny wounds. It is recommended to avoid going to work during these days. Furthermore, the face can swell beacuse of the anesthesia.
After 72 hours all the wounds will be closed and after a week the look is completely normal.

The transplanted hair will fall after a few weeks. This is something desirable and completely normal, it means that the transplantation is working. The hair follicle is the structure of the hair and that will still be implanted. That is the real aim of our work.
The implanted grafts will initiate their regular growing cycle from 5 to 6 months after the hair transplantation. That is the moment when the results will start to be visible. From 12 to 15 months after the surgery, the result starts to be completed.
In case of a vestex transplantation the results are slower and you will see the results after 15 months.

We use the FUE technique with almost all of our patients. It is clearly better than the FUSS technique. It is highly recommended for patients with short hair, to avoid scars and to have a lighter procedure.

We suture the skin of the scalp after taking the strip. 10 days later, we remove the itches.
The scar is practically imperceptible when we have long hair. If we have short hair, the scar can be visible.

The intervention is a bit more invasive than FUE’s so the post-surgery period is longer and more uncomfortable. However, it is still a minor surgery with no hospitalization required.

The FUSS technique is less and less recommended. The FUE technique has clear advantages. However, in some cases the FUSS technique makes better use of the donor area so it can be recommended when there is a low capillary density or when many grafts are needed.
Furthermore, with FUSS technique we can not to shave the hair.

There is not a specific moment to do so.
It depends on the patient’s schedule, meaning when they have from 2 to 5 days to rest. If there is a facial edema, 3 or 4 days more can be needed.

None technique is perfect. There are various types and which can be used depends on the alopecia and the patient’s characteristics.

In the extraction phase there are two techniques: FUE and FUSS. In FUE the surgeon extracts each follicular unit individually. In FUSS technique they cut out a strip of skin and the surgery assistants take the follicular units.

There are also two techniques for implantation: the classical one and the so-called stick & place. With the classical one, the surgeon does the incision and the medical staff insert the grafts. With the stick & place technique, the surgeon uses some implanters to do the incision and to insert the grafts at the same time.

The so-called ‘exclusive’ techniques promoted by other clinics are just variants of those two ways to work.

It is important to state at this point that in Spain only the medical surgeon can do the incisions.

Espinosa Custodio MD determines in the diagnose which technique is the best for you.

FUE stands for Follicular Unit Extraction, meaning that the follicles are extracted one by one, with each follicle unit containing from 1 to 6 grafts. The surgeon does incisions with a circular scalpel, a punch, that can work manually or with a microengine. That decission does not affect the final result.

A capillary surgeon MUST always perform this surgery. The nurses and the medical staff help the doctor, but they should never do the incisions.

In a hair transplantation, the surgeon extracts the hair from the donor area to implant it into the receipt area.

There are implicit risks in every surgical procedure, like bleeding, infections or a facial edema. When all the protocols are followed, these risks are really minimized. This is a minor surgery, so it does not require hospitalization.

We always recommend this intervention to be performed in authorised clinics applying all the legal protocols.

The main suggestion is being careful with the transplanted hair. Do not touch the grafts and keep them mosturized constantly.
Espinosa Custodio MD tells personally all the steps to be followed before and after the hair transplantation. Furthermore, Instituto Médico del Prado has a 24/7 emergency phone to call us if needed.

Yes, indeed. There is a phase called shock loss where the grafts, after suffering a big stress, fall down. Depending on the patient, from 20% to 80% of the hair fall down three weeks after the intervention.

The results start to be visible from the 8th month, but the final outlook begins at the 12th month. In some patients, however, the final result does not develope until the 18th month.

The patient must know that the post-surgery treatments are as relevant as the surgery itself. The treatments swell the hair and accelerate its growing.

In Instituto Médico del Prado we give you all the necessary treatments to accelerate the process. This is the way to be sure that the final result will be the best possible one.

There are many vitamins helping the hair’s health. Vitamin C is one of the most efficient, fighting against dandruff or grey hair. Vitamin D improves its growth, as B3, B6, B12 and E do. Also, B5 and B1 increase the hair’s brightness. There are more natural elements that help the hair, like pumpkin seed’s oil, biotin, zinc, copper or selenium.

As a preventive measure, we can take care of our hair feeding ourselves with those components that benefit it. The pumpkin seed’s oil is very effective because it blocks the dihydrotestosterone, an enzyme that affects the hair loss. The biotin improves the growing of the fast reproduction tissues, like the hair. The zinc controls the hormonal changes, which increase the alopecia. Furthermore, the copper generates melanin, adding color to our hair, and selenium prevents dandruff.

Espinosa Custodio MD is always the main responsible for the capillary diagnosis. He uses a capillary analysis software called HairMetrix and a special dermatoscope to state the health of our hair and the class of alopecia. He also performs some tests to know the donor area’s health, dermatitis or any other condition. Then he proposes the best solution for the patient and a first design if there is a transplantation. With all this information we make a report that states the perfect capillary treatment for you or how many grafts will be need in a hair transplantation.

There are five main factors of success regarding the hair transplant:

• An accurate diagnose, performed by Espinosa Custodio MD.
• A good medical condition of the patient.
• A high-quality health protocol during the procedure.
• The knowledge, experience, and ability of the surgeon.
• The patient’s post-surgical care.

However, like in any other medical procedure, there is a chance that some part of the transplanted hair does not work as we want to. That is why we offer a warranty.

No. The grafts are totally transplanted, so they can not grow up again. However, this is not visible for others because the rest of the hair covers this area.

Some academic literature states that, after five or six years, some part of this hair can grow up again, but this point has not yet been stated.

Of course, the diet is the base of a good health, capillary included. limit consumption of added sugars and saturated fats, will make the grafts stronger. Also, the intake of proteins, biotin, vitamins A, B, C, E and D3 or another components like iron, folic acid, omega-3 or zinc will strengthen it.

One of the worst habits for our hair is smoking. It has a harmful effect in the organism and our hair because of the toxins in tobacco that will come up through the blood and will difficult his nutrition.
A very advisable, on the other side, will be use a neutral pH shampoo, clean it with lukewarm water and rinse it thoroughly, moisturize it, drink lots of wáter, do not smoke, follow a balanced diet and don’t abuse of chemical products (styling gel, hairspray, wax, and so on.).

Yes, you can wear a cap the days coming after the hair transplant if it doesn’t rub the grafted area. As general guidelines:
▫️ Wear a large cap that won’t rest on the grafts.
▪️ Place it from the front towards the back being very careful.
▫️ Use it occasionally to protect yourself from the sun the first days.
▪️ You can start to use it regularly a month after the procedure.
As we always say when it comes to answering this kind of questions, the guidelines listed here are general, and Dr. Espinosa Custodio will indicate how to proceed in your case.

Doctor Espinosa Custodio considers that a successful hair transplant needs all grafted follicle units surviving in the recipient area. For this reason, he doesn’t graft more than 1,500 FU per session. The average time that follicle units spend out of the body never exceeds 2:45h.
Some important aspects for graft survival are:
▫️ The doctor’s skill and experience to extract them without damaging them.
▪️ The care the technicians take when counting and sorting them.
▫️ The correct grafting in the recipient area.
▪️ The amount of time they spend out of the body.
▫️ Keeping them hydrated in a preservation solution.
▪️ Maintaining a constant temperature between 2 and 8ºC.

The resounding answer is NO.
Follicle units to be grafted depend on:
▫️The patient’s donor area: density per square centimeter and extraction area.
▫️The recipient area: the zone that needs restoration.
▫️The intervention’s duration: follicles are a living tissue that get damaged as time goes by outside the body.
Dr. Espinosa doesn’t graft over 1,500 follicle units per session. This condition is part of our excellence protocol, and with it we achieve every graft surviving in the recipient area. Thanks to this process we make sure all grafts are placed correctly, choosing their direction, depth, and position.

It is one of the questions that patients that undergo a hair transplant ask the most.
General guidelines:
▪️ Aerobic: Around a month after you can start with low intensity exercise, that you will be increasing progressively.
▪️ Anaerobic: After a month and a half.
▪️ Crossfit and contact sports: From three months on.
▪️ Swimming: After the fourth month.
IMPORTANT: we have to be very careful with sweat when we exercise. We must clean it properly without rubbing, so it doesn’t stay in our scalp.
As we always say when it comes to answering these kinds of questions, the guidelines we give here are standard, and Dr. Espinosa Custodio will show you how to proceed in your case.

It is possible to suffer from itchiness after undergoing a hair transplant in both the donor and the recipient area. The causes may be diverse, from normal itching from healing to an infection or a contact dermatitis. For this reason, it is key that the weeks after the intervention the patient tells the medical team any abnormal circumstance, so the doctor assesses it and treats it if necessary.

Days after the hair transplant some scabs show up. This fact is completely normal, and it is more visible in some areas than others, since you have small incisions that are healing.
▪️ In the recipient area, we must avoid touching or rubbing during the first days, so these scabs will be there for a few weeks.
▪️ In the donor area, since we are washing it daily, scabs will fall way faster.
▪️ It is very important, especially during the first weeks after the intervention, to follow precisely the indications given by the doctor.
At Instituto Médico del Prado, we schedule our patients the first days to carry out the first washings and show them how they should do it at home. Around 20 days after the intervention, we remove the scabs at the clinic.

The answer to this question is not always going to be affirmative, since not every patient that undergo a hair transplant present androgenetic alopecia or some other kind of alopecia that needs long term pharmacological treatment.
In those patients diagnosed with androgenetic alopecia, pharmacological treatment (both oral or topic) is very important to stabilize alopecia and to improve miniaturized follicles. These treatments are long term, since this kind of alopecia is a genetic characteristic that doesn’t go away with surgery and medication, and it is the only way to stabilize it. However, the doctor must study each case individually.

There is not a best shampoo among others. If you want a secure choice, a pH neutral shampoo should be the best option, also after a hair transplant, when our hair is vulnerable. Some time after, we recommend to analyze our hair in order to adapt the shampoo to our characteristics, like form or thickness.

Both drugs have a high security profile despite the doubts generated to the patients. The most worrying side effects are the sexual ones, but it appears only in 3% of the cases and could be reverted by the regulation of the dose.

There is no problem in getting a hair transplant while suffering from seborrheic dermatitis. Dr. Espinosa Custodio will study your case and will prescribe a specific shampoo that will help with this problem.

There are different test that Dr Espinosa Custodio performs in the diagnostic consultation. It will help on determinate the alopecia that the patient suffer. In most cases, it will be androgenetic. However, sometimes he will need a capilar biopsy that will help in the problem identification.

If you are pregnant or looking for pregnancy, you should ask it to the doctor, it does not matter if you are a man or a woman. This drugs can affect semen quality and will produce side effects on the embryo, so you should stop the medication a week before starting searching for a baby.

The process of Minoxidil is slow. Its qualities and benefits will be noticed weeks after starting the dosage. Thanks to it, our hair will be thicker and if we keep regularity on dosages, the effects will continue. Although, if the dosage stops, the situation of the hair will revert to what it was.

A keloid can be a little inconvenience in a hair transplant. If you suffer this pathology, the doctor should know it. He usually performs a test before the full transplant. He will know, in this way, how the skin will react and how it can affect the transplant.

The Body Hair Transplant (BHT) is an occasionally used technique, Dr. Espinosa Custodio does not usually performs it. It consists in the follicle extraction from different parts of the body that will be placed in the head. This parts could be beard, chest, belly, arms or legs. As they are from other parts of the body, morphologically, they are not similar to the ones in the head. Because of that they should be implanted in the middle zone, in order to give density and not in the first line.

In a hair transplant, the live follicle needs optimal conditions in order to ensure survivability. At the Instituto Médico del Prado we use preserving solution of the highest quality. Which are similar to the ones that save and protect organs like hearts, livers, pancreas or kidneys that will be transplanted. Thanks to this solution we will obtain a survivability of almost 100%.

It is possible to perform hair transplants in all our body, such as eyelashes. Currently, Dr. Espinosa Custodio does not perform this technique, although there are other doctors who are specialized in it. This intervention is made in a similar way, extracting the follicles from one side to implant them in another.

The pubic hair transplant is something that could be done. For the most part, women may need to recover or see their pubic hair grow because, in addition to aesthetics, this hair has a physiological function. It helps prevent sexually transmitted diseases, which leads to a possible improvement in health. This hair graft is not painful during the intervention, as it is performed with local sedation.

In the field of aesthetics, eyebrows are in vogue. Eyebrow transplantation is added to treatments such as microblading, shading, dyes, micropigmentation or extensions. Thanks to this transplant, the eyebrow can be increased in density, outlined and drawn naturally. Follicular units of a single follicle should be selected, usually extracted from the nape of the neck. Recovery from this intervention will be similar to hair grafting.

To achieve a natural first line in a hair transplant is one of the most important targets that all the doctors look for. It is the biggest detail that can ruin or enhance the results and be finished in a satisfactory way, for both the patient and the doctor.
Because of that, follicular units with only one follicle are selected for the first line. It will increase progressive with two and three. It will be a natural line and will do a perfect entrance. Furthermore, the design will be done with the morphology of the patient’s face and will be convenient to listen the surgeon recommendations.

One of the proposals of having a hair transplant could be a scar in our head. It could be caused by an accident or a hair transplant with the FUSS technique. It is certain that a hair transplant can be done on a scar, helping in that way to cover it. However, you should choose a surgeon with enough experience so the implant will be fully satisfactory.

Capillary fibers are used in order to disguise the alopecia. They are small filaments that adhere to the hair via electrostatic charge. You must not use it days before the first consultation or surgery. If you want to use it before the hair transplant you should wait for a month in a sporadical way or 3 months if you will use it daily.

Psoriasis is a sickness that causes rashes in our skins, that could cause itchiness. It is a frequent disease that ‘attacks the scalp among other parts of our body. In principle, there should be no drawbacks between hair transplantation and psoriasis, although an experienced surgeon should carry out the intervention and assess, positively or negatively, the drawbacks and benefits that can be provided.

The ultimate goal of hair transplantation is to improve our physical appearance. We will recover our hair months after the surgery, but we can have doubts about when will be the time to dye our hair. It is recommended to wait at least one month to do it. If this time has passed the healing would be finished and we will not hurt the follicles.

Dr. Espinosa Custodio has incorporated into the diagnosis a genetic test (Trichotest) that will help determine the patient’s baldness. This makes a specific guide to help stop alopecia and adjust the medication.

The menopause carries out a lot of hormonal changes that can affect, in more or less quantity, at women. One of this changes could appear in our hair. It can be thinner, break up easily or lose nutrients. in addition, if a loss of density is observed and we see the hair fall out, we should visit a specialist.

One of the inconveniences of having a hair transplant should be the length of our hair. Normally, the head should be shaved before the surgery, but it is possible doing it without shaving. However, it should be in a specialized clinic where this technique is done. It is certain that not all the surgeons can do it.

Yes, it is possible to have a hair transplant while being a smoker, but you should tell this situation to the doctor, as well as the regular intake of alcohol or other illegal substances. It will be optimal if you can avoid smoking days before the surgery and maintaining it. Several studies reflect the difficulty of tissue healing and influence to the progression of alopecia.

There are lots of important characteristics during the surgery. One of that is the conservation and treatment of the follicles when they are in the extracorporeal phase. The Doctor will be responsible of the care and manipulation of the follicular units, because of that it is necessary to have an exhaustive protocol. Take care and not mistreating this hair, will make it grow stronger and healthier later. The follicle has to be preserved in a solution that could be saline, lactated ringer, saline+PRP, autologous plasma, Hypotermosol+ATP, PRP or Custodiol HTK, etc.
Care should also be taken with injuries that can occur on the graft. They are ischemia/reperfusion, due to cold, desiccation or dehydration and microtrauma. A trained and experienced team will be important to have the best treatment for the follicle.

There are different keys that must be taken into account to obtain the best result in a hair transplant. Among them are: the health of the patient, the surgeon who is going to operate on him, the technical team that assists him, the instruments used in the surgery and the time that the follicle remains in the extracorporeal phase. Choosing the best clinic will be the basis for achieving the most natural result.

One of the most important questions after the hair transplant is when can I cut my hair. It will depend on the technique and the zone in our head. We will differentiate between donor and recipient area. In the donor area we should wait a month for cutting with scissors and two months for razor. In the recipient area we should wait between 2 or 3 months withs scissors and 6 months wiht razor.

We will show you recommendations for before and after the surgical intervention. These are sorted chronologically, and they will help you in all processes of the hair transplant intervention.

The following guidelines before the surgery are very important for you, so we can guarantee an optimum quality during the intervention:

1.- Don’t practice any sport or physical effort 5 days before the surgery.

2.- If you’re using Minoxidil you will need to stop the treatment 4 weeks before the surgery and restart it a week after. If you’re using Finasteride, keep on taking the usual dose.

3.- Aspirin or anti-inflammatory medication can’t be taken for 10 days before the surgery. Let the doctor know if you’re using any anticoagulant medication before the transplant.

4.- Do not take any vitamin complex, including vitamins E and B, 10 days before the intervention because it increases bleeding.

5.- Don’t consume any alcohol at least 3 days before the transplant and avoid caffeinated drinks (e.g.: coffee, coke…), since they increase bleeding and sensitivity to medication used during the transplantation.

6.- Avoid the consumption of stimulant substances for at least 1 week before the transplant.

7.- You can continue your usual treatments for arterial hypertension, diabetes, stomach lining, etc.

8.- Drink plenty of water the previous week to the surgery.

9.- Don’t smoke for at least one week before the surgery, since it slows healing down and increases the probability of infection, so graft survival risks being compromised. Up to 5% of grafts can be lost, regardless of the surgery, technique, or surgeon’s skills.

10.- The morning of the intervention day, you should wash your hair with regular shampoo making sure you remove any remaining of product you may be using (hair spray, styling gel, etc.)

11.- Don’t shave your hair, it will be done at the clinic.

12.- Wearing a button down or zipper top.

13.- In case of using local anesthesia: light breakfast the morning of the transplantation, avoid caffeinated drinks (e.g., coffee, coke…).

14.- We advise not driving back home since you may take some medication that causes drowsiness (sleepiness).

15.- It is mandatory making blood works that show data such as blood count, blood sugar, ionogram, blood clotting, HIV, Hepatitis B and C, as well as an electrocardiogram.

Medical recovery from a hair transplant is usually quick. The night of the intervention, pain may appear in the donor area, which usually responds well to the analgesic treatment prescribed by the doctor. The day after the intervention, it is common for an edema to occur on the forehead caused by the “drop” of the local anesthesia from the scalp and that will disappear in 1-2 days. Scabs will appear that will be removed at the clinic following the doctor’s instructions.

From the fourth or fifth day the patient will be able to return to their social and work life.

1.- Avoid driving after the intervention due to the medication administered that can cause drowsiness.

2.- Make light meals avoiding saturated fats.

3.- Avoid alcohol for 48 hours and it is also recommended not to smoke during the following days.

4.- Take the medication prescribed by the doctor.

5.- Wear loose clothing to avoid friction that could injure the grafts.

6.- Apply cold to the forehead as a preventive measure to avoid inflammation.

7.- Sleep with your head slightly elevated the first few days, supporting the back of your head, avoiding friction with the grafted area. You can use a cervical pillow to help.

8.- Sexual activity can be resumed a week after the intervention.

9.- Protect yourself from the sun. Direct exposure to sunlight should be reduced as far as possible during the first 15 days. You can use hats or caps that do not support the grafted area.

10.- You will be able to bathe in swimming pools three months after the intervention. At sea, this time will be reduced to two months.

11.- From 10 or 15 days after the graft we can resume aerobic exercises, avoiding them being competitive, group or extreme. Strength exercises can be done from 2 months.

A document will be given explaining the immediate postoperative recommendations. In this section they are summarized in a general way.
After the intervention, you should not wash your head since the first washes will be carried out in the clinic. You should sleep seated upright avoiding supporting the receiving area on the pillow.
Days after the intervention you will have an appointment with Dr. Espinosa Custodio who will review your progress. In this consultation, the first wash will be carried out and you will be told how to do it at home.
Donor area
This is the area from which the follicular units were extracted.
You will have to wait to remove the pressure bandage the next day.
After removing the bandage, Aquaphor ointment should be applied. This will be applied once a day for 7 days.
Days after the intervention you will have an appointment with Dr. Espinosa Custodio who will review your progress. In this consultation, the first wash will be carried out and you will be told how to do it at home.
Receiving area
In the area where the follicular units were implanted.
After surgery it is important to keep the recipient area hydrated. You will be provided with sulfur water for this (sulfur can cause a strange smell). After finishing it, you can use thermal, physiological or sea water.
You will need to apply it every hour for the first seven days after your hair transplant. Thereafter it will be held every two hours.
You can apply it whenever you need it, either due to an itching or stinging sensation, or if you feel it is very dry.
Scalp washing should be done with the shampoos provided, and you should use them for the first few weeks. You can then use your regular shampoo.