• Performed by Dr. Espinosa Custodio, both extraction and DHI implantation.
• Guaranteed results Fast recovery, without scars or baldness.
• Painless surgery, with local anesthesia and the best medical instruments.
Hair Restoration Pack
Postoperative medical treatment for 3 months
Healing and regenerating ointment
Post surgical shampoo
The hair graft, transplant or hair implant basically consists of the redistribution of the follicular units of the head.
That is, the hair is removed from the occipital area, to implant it through a simple painless surgery, in those areas that have been depopulated with hair and that we want to recover. Transplanted hair grows back normally.
Different grafting techniques are the most effective surgical solution to recover hair. The result is not distinguished from the rest of the hair.
Hair transplantation is one of the most demanded hair services currently in Spain. Dr. Espinosa Custodio performs different treatments that will put an end to most problems with alopecia (application of intradermal growth factors, mesotherapy, stem cell treatment, etc.).
The hair transplant consists of 2 stages:
- • EXTRACTION PHASE of follicular units, is the stage where follicular units are removed. Today there are 2 ways to extract them using the FUE technique and FUSS technique. . FUE technique It consists of extracting one by one of the follicular units of the lateral and of the back of the head where the follicles last.. FUSS technique it is the extraction of a strip of skin from the occipital area of approximately 15 cm by 3 cm by means of a scalpel and from there the follicular units are removed. This type of technique is more invasive and sometimes leaves a residual scar.At the end of this stage, the implantation of the follicular units is performed.
- • THE IMPLANTATION It is done using DHI technique is the acronym of “Direct Hair Implantation”.DHI is the most modern and progressive innovation in hair implantation to achieve healthier and more natural results.
- There is another implantation technique, the so-called classic, in which the surgeon makes incisions in the scalp and later the technicians perform the implantation of the follicle. It is a mixed technique performed by the surgeon and specialized technicians.
Hair transplant surgery procedure
STEP BY STEP:
It all starts with a GOOD diagnosis from Dr. Espinosa Custodio, it is the key to a successful hair transplant.
Patients receive simple guidelines to follow before surgery, as well as pharmacological treatment prior to surgery.
Complete analytics and ECGs are also required.
Arrival at the clinic after a light breakfast without coffee.
The day of the intervention begins the day early to be able to carry out the preparations with ease.
Dr. Espinosa will determine, together with the patient, the best design that allows the hair to remain natural. Then the hair is shaved to be able to intervene on it in the best conditions of vision.
The follicles from the donor area are obtained one by one using the FUE technique or on a strip using the FUSS technique. This phase can vary between 1 and 5 hours depending on the technique and the number of follicles to be extracted.
After extraction, it goes to the preparation phase in which the technical team proceeds to classify the follicles, depending on the hairs they have (1,2,3, etc.), and count them.
The extracted follicular units are kept at a low temperature in a special liquid.
It is essential to guarantee the viability of the follicles.
In which the surgeon proceeds to carefully implant the follicles that have been previously extracted in the receiving area.
This phase can last between 2 and 4 hours.
After the end of the intervention, the guidelines to be followed in the following days are remembered and the HAIR RESTORATION PACK is delivered.
Before 72 hours after the intervention, Dr. Espinosa Custodio will pass the first follow-up consultation to ensure that everything is progressing correctly and the first wash will proceed.
AT ALL TIMES THE PATIENT HAS A 24H EMERGENCY PHONE.
FUE - FUSS
FUE TECHNICAL CAPILLARY TRANSPLANT
The FUE technique, called Follicular Unit Extraction, consists of extracting follicular units from areas with good hair density, which we call donor areas. These are extracted using a circular scalpel called Punch that can be 0.7 to 0.9 millimeters, just the extraction space of the follicular units.
In this technique the experience and skill of the surgeon is very important. The benefits of this technique are: it does not leave a scar in the donor area since by randomly extracting the perception of the loss of density is minimal and the rapid recovery. However, it should be your surgeon who diagnoses if you are the ideal candidate to perform this technique.
FUSS TECHNICAL CAPILLARY TRANSPLANT
The FUSS (Follicular Unit Strip Surgery) extraction technique involves the removal of a strip of skin from the neck area. The strip is usually about 1 to 3 cm wide and 15 to 20 cm long. Later the follicular units are separated, by means of a specific instrument and microscopes called Mantis. To be implanted by the classical technique.
With this procedure a residual scar can be left hidden with the hair itself.
IMPLANTATION - WITH DHI TECHNIQUE
WHAT DOES IT CONSIST OF
DHI is the English acronym for Direct Hair Implantation. DHI is the most modern and progressive innovation in hair implantation to achieve healthier and more natural results.
With DHI, the hair follicles are implanted one by one directly in the transplant area in a specific direction, angle and depth using a special DHI implant tool, providing 100% natural results and maximum viability.
Ensure that implanted hair is healthier and stronger by reducing the time the grafts are kept out of the scalp. Further,no incisions are required during this procedure.
It is done through devices called Implants or Implants. These are like small syringes with a ribbed needle through which the follicle is implanted. They can have different needle diameters depending on the size of the follicle to be implanted.
Advantages of the DHI technique
- > Innovative procedure with 100% natural results and 100% done by the DOCTOR.
- > Better control of the angle and depth of implantation. We can orient the transplanted hair in different angles, which allows a more natural appearance.
- > There is a higher tissue survival rate.
- > We can achieve a higher density hair transplant: En la técnica DHI, alta densidad es 70-90 injertos / cm2. Con la técnica clásica de las pinzas esta cifra es 50-60 injertos / cm2.
- > No incision holes are required since the hair follicles are transplanted using a special DHI implant tool.
- > Existing hair is not damaged..
- > The transplant area bleeds less, heals faster and does not leave a scar.
- > Less damage to the follicular unit during transplantation.
With the DHI method, between 90-95% of the grafts removed survive.
FREQUENTLY - QUESTIONS
• FUE TECHNIQUE
For the extraction of the follicular units, micro-scalpels with a hollow cylindrical tip of a very fine diameter are used, which is usually 0.7 0 to 0.9 mm.
These scalpels leave tiny holes that heal in about a week. It is actually a multitude of small wounds, but they are imperceptible after healing.
The FUE technique is performed in an outpatient intervention and with local anesthesia, so it does not require hospital admission, nor being in fasting conditions or other precautions typical of interventions with regional or general anesthesia.
The patient is also given an anxiolytic or relaxing so that he can be more relaxed during the intervention.
In order to identify the follicles to be extracted from the donor area, the hair must be shaved.
On the same day of the intervention and before the entrance to the operating room the donor area is shaved.
In the case of women or men with very long hair it may be more difficult to assume shaving.
In these cases you can practice a technique called curtains or flaps that allows you to work the extraction area without being noticeable after the intervention.
In men with short hair it is preferable to shave.
These are long and very laborious interventions. Having to transplant the follicles one by one the surgical task usually lasts for several hours.
Depending on the number of follicular units, the intervention can last one morning, an entire day or even take place in two consecutive days. However, it is usually done in one day. Dr. Espinosa Custodio can perform up to 3000 implants in a single day.
Once in the operating room the first phase is called extraction, in which with the cylindrical microbisturis the capillary surgeon removes the follicular units one by one in a thorough and high-precision process.
After extraction, the preparation takes place, in which the team of hair technicians classifies and prepares the follicles for implantation. This preparation is carried out simultaneously with the extraction so that when the surgeon has just removed the follicles, implantation can begin.
Implantation can be done through implanters. The implanters are like small syringes with a ribbed needle through which the follicle is implanted.
They can have different needle diameters depending on the size of the follicle to be implanted.
After the FUE intervention, the patient can go home and live a normal life, always taking care to avoid direct contact with the area where the implant was made, since the implanted follicles can detach.
The appearance during the first days is of multiple small head wounds 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 become inflamed due to the effect of local anesthesia.
After 72 hours the scars of the extractions will be closed and after the first week or ten days the appearance will be almost normal.
The hair that is transplanted falls a few weeks after the intervention. It is something expected and normal but that does not affect the hair follicle, which is the structure that really is the goal of the transplant.
The grafted follicles will begin their normal growth cycle and between 3 and 6 months we will see the results of the new hair by changing the appearance of our scalp. At 9 months the result is already complete.
The FUE technique is the one currently applied in more than 90% of hair transplant patients, since it has clear advantages over FUSS. It is especially suitable in people who wish to wear short hair, avoid scars or who do not want to undergo a more aggressive intervention.
• FUSS TECHNIQUE
The skin of the scalp is sutured when the strip is removed and the stitches are removed after 10 days.
The suture that is made after removing the strip leaves a scar that is virtually imperceptible if we have a little long hair (1-2 cm at least). If we opt for very short hair it can be visible.
The intervention is somewhat more invasive than in the FUE, so the postoperative period also implies a greater recovery process and some more discomfort. Anyway, it is also an outpatient intervention performed with local anesthesia that does not require hospitalization.
Although it is clearly in reverse with the appearance and improvement of the FUE technique, there are indications and advantages. With the FUSS, the donor area is better used, so it can be indicated in patients with a small donor area or in which a large volume of follicles is required.
It also reduces surgery time and prevents shaving of hair, so the intervention is not so noticeable.
• MORE FREQUENTLY ASKED QUESTIONS
We believe that there is no special time to perform it, it depends on the availability of the patient, that is, when you have a few days (2-5) to take care of it.
In some cases, facial edema may occur and will resolve in 3-4 days.
There is no perfect technique. There are several types of techniques which can be adapted to each patient depending on their pathology and characteristics.
In the extraction stage there are 2 techniques: FUE the surgeon removes the follicular unit one by one (hair by hair) and FUSS in which a strip of skin is cut and from there the technicians take out the Follicular Units (UF).
For the implantation there are also 2 techniques: Classic or tweezers, it is a mixed technique, the surgeon makes the incisions and the technicians place the follicular units. And the implant technique (DHI) in which the surgeon makes the incision and introduces the follicular unit simultaneously.
The rest of “exclusive” techniques that indicate some clinics specialized in hair transplantation, are variants of those mentioned above.
Remember that incisions can only be made by a registered doctor in Spain.
Dr. Espinosa Custodio will examine you and determine which technique is best for you.
FUE is the acronym of Follicular Unit Extration, extraction of follicular units one by one, each follicular unit can contain 1 to 6 hairs. The surgeon makes incisions by means of a circular scalpel (called punch), this can be manual, or by means of a micromotor, the final result is not affected if it is manual or motorized.
It is a surgery that should ALWAYS be performed by a hair surgeon. Nurses and technicians assist the doctor, but should never make incisions to the patient.
It consists of the extraction of the follicular units (the hair) and later the implantation of these in the area where you would like to restore. [/ inwave_accordion_item]
We always recommend that it be carried out in clinics authorized by Health and apply all sanitary protocols established by European legislation.
It basically consists of being careful not to touch or manipulate the implanted area and constantly hydrate it.
Dr. Espinosa Custodio personally explains the care to follow and gives it to you in writing. However, we have a 24-hour telephone in which the patient can communicate all doubts that may arise.
Yes, there is a phase called shock loss phase in which the FU that have suffered stress, the same surgery is a stressful process for the hair, they can fall. Depending on the patient’s organism, they can fall from 20% to 80%. This phenomenon appears at 3-4 weeks after the intervention.
The results begin to be visible from the eighth month, but it is not until the year when we can assess the final result. There are patients in whom the process can be extended until 18th month.
The patient should keep in mind that post-surgery treatments are as important as the surgery itself so that the hair transplant is successful. In addition, these treatments accelerate the hair growth process.
From the Hair Unit of Dr. Espinosa Custodio we give all the necessary treatments to accelerate the process and that the result of the hair transplant is optimal.
The factors that will influence success will be:
• The diagnosis by Dr. Espinosa Custodio.
• Patient’s health status.
• The procedure is done with all health guarantees.
• The training, experience and skill of the doctor.
• Aftercare by the patient.
However, as in any branch of medicine there is nothing absolute or decisive and there is a possibility that some follicular unit would not adhere. [/ Inwave_accordion_item]
There are studies that suggest that, if there are any pluripotential cells of the follicle in the donor area, they can leave at 5/6 years. It is something that is under study.
HAIR TRANSPLANTATION - SURGERY PRICES
Grade II y IIa
Grade IIIa y IIIvertex
Grade IV y IVa
6.800 € 2 surgeries
Grade V y Va
7.200 € 2 surgeries
500 € / 100 fu
1.000 € / 200 fu
The mini-sessions are specially designed for patients who:
> Don’t want to shave their heads (neither donor zone nor recipient zone).
> Want their hair transplant to go unnoticed.
> Want a change in their aspect more gradual.
> Do not have much time and need to join their working life almost immediately.
> Want to do a small test session before committing to complete surgery.
RECOMMENDATIONS FOR HAIR TRANSPLANTATION SURGERY
We indicate the recommendations for before and after surgery. These are ordered chronologically and will help you in all the processes of hair transplant intervention.
The following indications prior to surgery are very important for you, in order to ensure optimum quality in the intervention:
1.- Do not perform any sport or physical effort, 5 days before surgery.
2.- If you use Minoxidil you should stop treatment 4 weeks before surgery, and use it again one week after surgery. If you use Finasteride continue taking the usual dose.
3.- Aspirins or anti-inflammatories cannot be taken during the 10 days prior to surgery. Inform the doctor if you are using any anti-coagulant for treatment before transplantation.
4.- Do not take any vitamin complex, including vitamins E and B, 10 days before the intervention because the bleeding increases. Also, avoid any herbal products during the same week.
5.- Do not drink alcohol at least 3 days before the transplant and avoid drinks with caffeine (eg coffee, Coca-Cola …), because they increase bleeding and sensitivity to the drugs used in the transplant.
6.- You can continue with your usual medication (AHT, hypoglycemic agents, gastric protector, etc.).
7.- The week before surgery drink plenty of water.
8.- Do not smoke at least one week before surgery, because it delays healing and increases the likelihood of infection, so graft survival can be compromised. Up to 5% of the grafts can be lost, regardless of the surgery, technique or skill of the surgeon, the patient’s own care.
9.- The same morning of the intervention, when showering you should wash your head with normal shampoo making sure to remove any remaining product that you are using for your hair (hair, lacquer, etc.).
10.- Do not shave the hair, the clinic will perform the haircut.
11.- Come with a button-down shirt and / or zip.
12.- In case of local anesthesia: light breakfast the morning of the transplant, avoid drinks with caffeine (eg coffee, Coca-Cola …).
13.- We advise you not to drive back home as you may receive medication that causes drowsiness (sleep).
14.- Analytics that reflect data such as “blood count, blood glucose, ionogram, coagulation, HIV, Hepatitis B and C” are necessary. An electrocardiogram will also be required, with no more than 2 weeks before the intervention in case of being older than 60 years and / or with previous cardiac pathology.
Approximate time 7-12 hrs. You must be patient, as it may take time, remember that this procedure is thorough and delicate at the time of extraction and implantation. Avoid moving, and if you have to communicate to the surgeon. Like if there is something painful keep calm at all times and communicate it to the surgeon.
How are the postoperative days of a hair transplant?
Usually, medical recovery from a hair transplant is rapid. The night of the intervention, pain may appear in the donor area, which usually responds well to the usual analgesic treatment.
The day after the intervention, it is common for edema to occur on the forehead caused by the “lowering” of local anesthesia from the scalp, the effect of gravity. This frontal edema does not require treatment and gives in 1-2 days.
In the receiving area, the micrografts are perceived in the first days as “small scabs” on a redness basis. Within a few days, the scabs break off.
At the cosmetic level, the signs of a hair transplant are usually perceived during the first days after surgery. We can say that from the 5th or 6th day the patient (or the patient) can rejoin their socio-labor activity.
What care should I follow after a hair transplant?
Among the most important advice for after transplantation we would highlight (in chronological order after the intervention):
1.- Avoid using the car right after surgery because due to the medication provided you may not be able to drive.
2.- Make light food and easily digestible foods after surgery, avoiding saturated fats.
3.- Avoid alcohol for 48 hours and it is also advisable not to smoke during the following days.
4.- The prescribed medication begins (antibiotics, anti-inflammatories and stomach protector). The use of pain relievers and medication to promote rest is not usual, although you can take them if your doctor prescribes it.
5.- Wear wide clothing to avoid rubbing when you wear it that can damage the grafts.
6.- Apply cold on the forehead as a preventive measure to prevent swelling.
7.- Sleep with your head slightly elevated the first few days supporting the back of the head avoiding friction with the grafted area. You can use the cervical pillow of the hair restoration pack that we have provided.
8.- Sexual activity can be resumed a week after the intervention.
9.- Protect yourself from the sun. Direct exposure to the sun’s rays during the first 15 days of the postoperative period should be reduced, as far as possible, by wearing hats or caps.
10.- Swimming in swimming pools avoid it during the 2 months following surgery. At sea it is allowed per month.
11.- From 10 or 15 days after grafting we can resume aerobic exercises, preventing them from being competitive, group or extreme. Weight exercises can be done after 2 months.