What is a hair transplant or hair graft?

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 2,000 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 2,000 to 2,200 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.