• Carried out by Dr. Espinosa Custodio, both extraction and DHI implantation.
• Guaranteed results. Fast recovery, with no scars or bald patches.
• Painless surgery, with local anesthesia and the best medical tools.
What is a hair transplant or hair graft?
Hair graft or hair transplant is a non-invasive intervention and almost painless that allows us to redistribute hair follicles on the head. Dr. Espinosa Custodio collects hair from the occipital area to implant it in the areas we want to replenish at his hair clinic in Madrid. Your hair will grow back with complete normality with a hair transplant.
Hair transplantation is an increasingly popular procedure in our country because of its excellent results. As you may have seen, there are ever more hair clinics that offer this service to recover hair after androgenetic alopecia. For that reason, it is important to choose your hair specialist correctly for your treatment.
How is a hair transplant carried out?
If you have already thought about other hair medecine, such as intradermal treatments, the mesotherapy or platelet-rich-plasma, and you have chosen hair transplantation, you may be wondering how the technique is performed by Doctor Espinosa Custodio.
A hair transplantation has two phases:
- • EXTRACTION STAGE: In the first place, follicles are collected from the donor area. These can be done with FUE or FUSS technique.
- • IMPLANTATION Follicles are placed with DHI technique or with the classic tweezer technique (stick and place).
Why getting a hair transplant in Madrid?
Low-cost clinics may entail risks for your hair surgery . Our hair clinic is a safe and professional environment where we develop hair treatments in our own surgery room. Furthermore, during the first visit with Doctor Espinosa Custodio you will be able to check out our facilities and the tools used for hair transplantation.
At Instituto Médico del Prado, specialized in hair transplants in Madrid, also performs hair graft mini sessions. If you want to try the technique before going under a full hair transplant or if you believe you don’t need many follicle units, this hair transplant in Madrid may be adequate for you.
FUE and FUSS techniques in a few words
Follicular Unit Extraction (FUE) entails collecting follicle units from areas with a good hair density. For that purpose, we use a precise round 0,7 to 9,9 millimeters surgical knife called punch at our own surgery room in our hair clinic. Doctor Espinosa Custodio always performs this hair surgery intervention, that doesn’t leave any marks nor scars.
Follicular Unit Strip Surgery (FUSS)consists of removing a skin strip from the occipital zone. Then, follicle units are observed through the Mantis microscope and the adequate follicles are separated. FUSS technique can leave a slight scar, but it is then hidden by the own hair.
DHI technique and the «tweezer» technique in a few words
Direct Hair Implantation (DHI) is the most advanced and safe hair medicine technique to implant hair with natural and healthy results. Follicles are implanted one by one, allowing us to manage the angle, depth and direction of each hair. In this last phase no cuts are made: follicles are transplanted with a tool called implanters. This technique must be performed fully by the doctor.
With theclassic tweezer or stick and place technique the surgeon creates a channel in the patient’s skin and the nursing assistants insert the follicle units. It is a mixed implantation technique carried out by the surgeon and the assistants. There is a variation of this technique where the assistants use some kind of forceps or Keep, a similar device to implanters that doesn’t make cuts nor does it have a guide, where the follicle unit is pushed with tweezers
FUE - FUSS
HAIR TRANSPLANT IN MADRID: FUE TECHNIQUE
FUE technique (Follicular Unit Extraction), entails collecting follicle units from areas with good hair density, those we call donor area. These are removed with a round surgical knife called punch that can be from 0.7 to 0.9 millimeters, just enough space to remove follicle units, and can be manual or have a micro engine.
It is important that the surgeon is experienced and skilled. The benefits of this technique are: no scars are left in the donor area since follicles are collected randomly, loss of density is barely noticeable, and recovery is fast. However, the surgeon must be the one diagnosing if you’re the ideal candidate for this technique.
Incisions must always be done by a doctor.
At Instituto Médico del Prado, Doctor Espinosa Custodio applies a protocol so that every collected follicle unit (grafts) from the donor area will survive in the recipient area.
HAIR TRANSPLANT WITH FUSS TECHNIQUE
FUSS (Follicular Unit Strip Surgery) extraction technique consists in extracting a strip of skin from the back of the neck. This strip usually is approximately from 1 to 3 centimeters wide and 15 to 20 centimeters long. Afterwards, follicle units are separated with specific tools and a kind of microscopes called Mantis, and then implanted with the classic technique.
With this procedure a residual scar may remain, but it is covered with the own hair.
Doctor Espinosa Custodio no longer performs this technique since he is now specialized in FUE technique.
IMPLANTATION - DHI TECHNIQUE
WHAT IS IT ABOUT?
DHI stands for Direct Hair Implantation. It is the most advanced implantation technique in the recipient area, with it healthier more natural results are achieved.
With DHI hair follicles are directly implanted one by one at an adequate direction, angle and depth using a special DHI implanting tool called implanter. This technique delivers 100% natural results, and it guarantees maximum follicle visibility.
Doctor Espinosa Custodio has been carrying out this technique for over 6 years and it is himself fully implanting every follicle, assisted by his team.
Ensuring implanted hair gets healthier and stronger since the time grafts are kept out of the scalp is reduced. In addition, no incisions are required during this procedure.
It is carried out with tools called implanters. These are like small, fluted needles we use to implant the follicle. They can have different diameters depending on the size of the follicle to implant, they can be from 0.64 to 1 millimeter.
DHI technique advantages
- □ Innovative procedure with 100% natural results and carried out by the doctor.
- □ Best control of implanting angle and depth. We can position transplanted hair in different angles, wich allows a more natural look.
- □ Higher follicle surviving rate.
- □ We can achieve a hair transplant with a higher density: with DHI, high density goes from 70 to 90 grafts per square centimeter. With the classic tweezer technique this amount goes from 50 to 60 grafts per square centimeter.
- □ No previous incisions are required since hair follicles are transplanted using a special DHI implanting tool.
- □ Existing hair is barely damaged.
- □ Transplant area bleeds less, heals faster and no marks are left.
- □ Lower damage to follicle units during transplanting.
- □ With DHI technique, between 90 to 95% of collected grafts survive.
FREQUENT - QUESTIONS
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.
▪️ 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.
SURGERY RATES - HAIR TRANSPLANTATION
Classes II and IIa
From 1.000 to 1.500 grafts
From 1.500 to 2.000 grafts
From 2.000 to 2.500 grafts
Class III vertex
From 2.500 to 3.000 grafts
From 3.000 to 3.500 grafts
From 3.500 to 4.000 grafts
From 4.000 to 4.500 grafts
From 4.500 to 5.000 grafts
From 5.000 to 5.500 grafts
How do we work at Instituto Médico del Prado?
- ▪ Capillary diagnosis with Dr. Espinosa Custodio
- ▪ Hair transplant with FUE and DHI techniques
- ▪ Results guarantee (see conditions)
- ▪ Presurgical session (full blood work and ECG)
- ▪ Every hair medicine treatment needed included
- ▪ Follow up visits until discharge
- ▪ Postsurgical pack for at-home care
- ▪ Postsurgical washings
- ▪ 24/7 phone assistance
At Instituto Médico del Prado we carry out your hair transplant with all health guarantees. We are a specialized center in hair transplantation with FUE (Follicular Unit Extraction) and DHI (implanter).
Dr. Espinosa Custodio has been practicing hair transplants for over 6 years and he has a strong background of this surgical discipline.
Hair transplantation is a long but rewarding process. Unlike other surgeries where results are immediate, with hair transplants results can be assessed around a year or a year and a half after the intervention. Doctor Espinosa Custodio guarantees his results in writing, so that hair transplant meets the patient’s expectations.
Doctor Espinosa usually implants around 2,000/2,200 follicle units per session. This condition sits on our excellence protocol and with it we achieve all follicles (grafts) surviving in the grafted zone. Thanks to this process we make sure every graft is placed correctly, choosing the direction, depth, and position of each one of them.
All hair transplants carried out by Doctor Espinosa Custodio are performed at his clinic in Madrid, Instituto Médico del Prado. Assisted by the clinic’s team, it is him making all incisions throughout the surgery (mandatory as per law in Spain), in both extraction and implantation. We apply FUE technique for extracting and DHI technique for implanting, the most advanced and the ones that require the most doctor’s skills. We never reuse any kind of tool.
The beginning of hair transplant is trichological diagnosis. Doctor Espinosa is always responsible of elaborating your medical history and to diagnose your hair situation. This way we can determine if you’re a suitable candidate to perform the transplant. In this session, apart from detailly analyzing your alopecia kind and degree, we establish the most adequate strategy to help you. If you are not fit to undergo a hair transplant, you may be recommended to do the adequate hair medicine treatments (PRP, mesotherapy, carboxytherapy, and so on) for you, always from a medical point of view. We can also compliment these treatments with hair micropigmentation sessions.
It is important being able to determine if the patient has a good donor area that allows performing the transplant.
Doctor Espinosa uses a smart dermatoscope for the diagnosis, Hairmetrix by Canfield. It is a new system that analyzes hair density, grafts per square centimeter, and follicle units’ thickness. This way we can precisely determine the treatment the patient needs, as well as analyzing the evolution after the treatment objectively.
If you are candidate for hair transplant, we will study your donor area to determine how many follicle units we can transplant, as well as the needed grafts in the recipient area. The doctor will plan the most adequate design so that we achieve the most natural result.
Diagnosis and assessing visit with Doctor Espinosa Custodio has a cost of 70€ (50€ in case of telemedicine), that will be discounted from the final price of the transplant or hair treatment.
Capillary treatments before and after hair transplantation
If you need previous treatments to get healthy and strong hair before transplantation, we’ll carry them out at our private clinic in Madrid. This is something standard, it is part of the process of a hair transplant, and it is included in the price.
After the transplant, we include all required washings to take care of your hair, as well as scab removal a couple of days after. In addition, we’ll hand you out a postsurgical capillary pack with everything needed to look after your hair: thermal water for the recipient area, a regenerative cream for the donor area and a neck pillow for you to sleep comfortably preventing follicle damage, as well as the needed oral medication and the items for an adequate hair hygiene.
Our patients count with 24/7 telephone assistance for any queries or doubts.
The months coming after the transplant are as important as the procedure itself. Without a good medical follow up, with no treatments nor oral medication, results may not be the most successful. For this reason, the doctor will meet you periodically, and will perform the treatments you need. We may also carry out a follow up blood work. Everything is included in the price (except oral medication).
Throughout the whole procedure we’ll take pictures and videos so we can analyze in detail your evolution.
The price is 2.25€ per Follicle Unit (graft) VAT included.
▪ There is no extra cost to be added to this amount.
▪ It includes every needed treatment, both pre and postsurgical.
> 2,000 grafts x 2.25 € = 4,500 €
> 2,500 grafts x 2.25 € = 5,625 €
> 3,000 grafts x 2.25 € = 6,750 €
> 3,500 grafts x 2.25 € = 7,875 €
> 4,000 grafts x 2.25 € = 9,000 €
> 4,500 grafts x 2.25 € = 10,125 €
> 5,000 grafts x 2.25 € = 10,250 €
In case of restoration of previous surgeries, scars, eyebrows, beard, no – shave and minisessions, prices start at 3€/graft.
Dr. Espinosa also carries out minisessions specially designed for those patients who:
▪ Don’t want to shave their head (neither donor nor recipient area).
▪ Want their hair transplant to go unnoticed.
▪ Want a gradual change of their look.
▪ Don’t have much time and need to go back to their working life almost immediately.
▪ Want to do a small trial session before committing to a full surgery.
Online diagnostic consultation
GUIDELINES FOR HAIR TRANSPLANT SURGERY IN MADRID
Important information for foriegn patients
- □ Specialized clinic in foreign patient care.
- □ Help in finding accommodation.
- □ Natural results.
- □ Accommodation search help.
- □ Bilingual atention (english and spanish)
- □ Guaranteed farmacological treatment all over the world.
- □ Adaptability to patient needs.