• Surgery done by Espinosa Custodio MD, FUE extraction and DHI implantation.
• Results guaranteed. Fast recovery, with no scars or bald spots.
• Pain-free procedure, with local anesthesia and the best medical tools.
What is a hair transplantation
The hair transplantation is a pain-free intervention to redistribute the hair on the head. Mr. Espinosa Custodio MD extracts in his capillary clinic in Madrid the hair from the occipital zone to implement it on the recipient area. The hair will grow again completely naturally with a hair transplantation.
Hair transplantation is a buzzing proccedure for its excellent results. The number of capillary clinics is growing and they all want to fight androgenetic alopecia. For that reason, it is more important than ever to choose wisely the capillary surgeon for your case.
How do we do a hair transplantation
If you have ever thought about the capillary medecine, as the intradermic treatments, the mesotherapy or the PRF, and you have chosen the hair transplantation istead, you may be thinking how does Espinosa Custodio do this procedure.
A hair transplantation has two phases:
- • EXTRACTION PHASE: First we extract the grafts from the donor area. THis can be done with the FUE technique or the FUSS technique.
- • IMPLANTATION PHASE: We implant the grafts using the DHI technique or Direct Hair Implantation.
Why choosing a hair transplantation in Madrid
The low cost clinics can be dangerous for your capillary procedure. Our aesthetic clinic is a safe and high-reputed place where we perform many surgeries in our surgery room. In your first visit to Espinosa Custodio MD you can see our whole clinic and all the medical instrument that we use.
At Instituto Médico del Prado, capillary clinic in Madrid, we also perform hair transplantation mini-sessions. These are suitable for patients who want to try the technique or for those patients who do not need many grafts.
FUE and FUSS techniques, in a few words
The Follicular Unit Extraction (FUE) technique consists of extracting the follicular units from high capillary density areas. We do it in our surgery room with a circular scalpel, called punch, from 0.7 to 0.9 millimeters in diameter. Espinosa Custodio MD performs this surgery, that leaves no scars nor bold spots.
The Follicular Unit Strip Surgery (FUSS) consists of taking a strip of skin from the occipital zone. Then, the surgery team observes the follicular units with a Mantis microscope to take all the grafts. In the FUSS technique, the patients can develop a little scar, that will be hidden by the own hair.
The DHI technique, in a few words
The Direct Hair Implantation (DHI) technique is the most updated and safe technique of capillary medicine. Its results are 100 % natural because the doctor implants each graft individually, hair by hair. This way, the capillary surgeon can decide the angle, the depth and the direction of each follicular unit. In the last phase, there are no more incisions: all the follicular units are implanted with a device called implanter. The implanters do the incisions and put the hair at the same time.
Hair transplantation surgery itinerary
STEP BY STEP:
Everything starts with a CORRECT diagnosis by Espinosa Custodio MD. This is the key of a succesful hair transplantation.
The patients get some simple instructions before the surgery, as well as the pills needed.
We also perform a complet blood test and an electrocardiogram.
The patient arrives at the clinic after a light breakfast with no coffee.
The day starts early in order to prepare the surgery room.
Mr. Espinosa Custodio MD designs the hair transplantation with the patient, mixing their desires with the possibilities and the projections of the future growinf of the hair. Then, we shave the hair in order to have the best conditions for the intervention.
We obtain the follicular units from the donor area, using FUE or FUSS techniques. This phase lasts from 1 to 5 hours, depending on the number of grafts and the dimensions of the donor area.
After the extraction, the surgery staff classify the follicular units from one graft to four or more follicular units, and they count all of them.
The extracted follicular units are kept at low temperatures in a special liquid.
This is essential for guaranteeing the follicles viability.
The surgeon implants carefully in the recept area all the follicles extracted.
This phase lasts from 2 to 4 hours.
After the procedure, we remember the patient what he or she has to do on the following days. We also give them a capillary restoration pack.
72 hours after the intervention, Espinosa Custodio MD sees the patient to check that everything is going well and the first wash-up is done.
THE PATIENT CAN ALWAYS CALL TO A 24/7 EMERGENCY PHONE.
FUE - FUSS
HAIR TRANSPLANTATION IN MADRID: FUE TECHNIQUE
The FUE technique, Follicular Unit Extraction technique, consists of extracting follicular units from high-capillary density areas, the so-called donor areas. This is done with a circular scalpel, a punch, from 0.7 to 0.9 milimmeters. This is the diameter of the follicular units.
The knowledge and expertise of the surgeon are key while performing this technique. The benefits of FUE technique are the lack of scars, because the surgeon extracts randomly the grafts so the loss of density is minimal. However, the surgeon must determine if the patient is suitable for FUE technique.
TRASPLANTE CAPILAR TÉCNICA FUSS
The FUSS technique, Follicular Unit Strip Surgery, consists of the extraction of a strip of skin of the neck of the patient. This strip sizes from 1 to 3 centimeters width and 15 to 20 centimeters length. Later, all the follicular units are extracted with a specific medical tools and a Mantis microscope. It leaves a scar, but that will be hidden with the hair.
This procedure leaves a little scar that is hidden with the own hair..
IMPLANTATION - DHI TECHNIQUE
WHAT IT IS
DHI stands for Direct Hair Implantation. It is the most updated and the safest hair implantation procedure. Besides, the results look always natural.
Using the DHI technique, the follicular units are implanted one by one, directly on the receipt area. The surgeon can choose direction, angle and depth of each graft, using the toolf of the DHI: the implanter. A little device that makes the incision and the implantation at the same time with 100% natural results and no risks.
Increasing the strength of the hair implanted by reducing the time that the follicular units are out of the head. Also, there is no need for incisions using DHI.
The implanters are the equipment that we use in DHI. These are little injections with tiny needles that hold the grafts. They are of different sizes, depending on the width of the follicular units.
Ventajas de la técnica DHI
- > Innovative procedure, with 100% natural results and completely made by the doctor.
- > Total control of the angle and depth of the implantation. The doctor chooses the angle of the grafts, creating a completely natural look.
- > Higher survival rate of the tissue.
- > We can have a denser hair transplantation. With DHI, we can get up to 90 follicular units per square-centimeter. Without it, the maximum is 60 follicular units per square-centimeter.
- > There are no holes or scars on the receptor area.
- > The previous hair do not suffer.
- > There is less bleeding, a faster cicatrization and no scars.
- > The follicular units damage is reduced. From 90 to 95% of the follicular units survive.
FREQUENT - QUESTIONS
• FUE TECHNIQUE
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 3 to 6 months after the hair transplantation. That is the moment when the results will start to be visible. 9 months later, the result starts to be completed.
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.
• FUSS TECHNIQUE
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.
• MORE FAQS
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.
OUR RATES - HAIR TRANSPLANTATION
Classes II and IIa
Classes IIIa and IIIvertex
Classes IV and IVa
Classes V y Va
500 € / 100 grafts
1.000 € / 200 grafts
What is included in our fees?
In Instituto Médico del Prado we do your hair transplantation… and much more than that. The hair transplantation is a great experience to obtain the best version of yourself. For that reason, Espinosa Custodio MD guarantees its results. This is the way for us to exceed your expectations.
Espinosa Custodio MD usually implants from 2,200 to 2,400 grafts per session and no more. This condition is part of our excellency protocol and a must for not breaking any follicular unit. This way, all the grafts are implanted correctly and we have more time to choose the direction, depth and position of each one of them.
The beginning of the hair transplantation is the trichological diagnosis. Espinosa Custodio MD starts your clinical history and states your diagnosis. This way, he determines if you are a suitable candidate for transplantation.
If you are, we will perform a trichological analysis of your donor area to determine how many grafts can we transplant. We will also do your design to obtain natural results. This trichological report costs 70 euros (50 if it is performed via online). This sum is always discounted of all of our treatments. Furthermore, we will make a blood test and a an electrocardiogram to evaluate your health.
If your hair needs to be treated before the surgery, in order to be healthier and stronger, we will do them in our private clinic in Madrid. This is something normal, it is a part of the capillary implant process and, of course, they are included in the price.
Espinosa Custodio MD performs all the transplantations at Instituto Médico del Prado. With the help of the clinical staff, he is the only responsible for all the incisions during the procedure (which is mandatory in Spain). Not only in extraction, but also during implantation. Our transplantations are done with FUE and DHI techniques, the most developed and complicated ones, and we never reuse the surgery tools.
After the transplantation, we do all the necessary wash-ups to take care of your hair. We also take out the scabs some days later. In addition, we give you a capillary restoration pack, which includes everything you need for taking care of your hair: thermal water for the receipt area, a regenerating cream for the donor area, and a cervical pillow to sleep well. We also provide the first doses of the oral medication and the tools for a good capillary clean. And remember that you have available a 24/7 emergency phone.
The next months are as important as the surgery itself. With no adequate clinical follow-up, treatments or oral medication, the results will be disappointing. For this reason, the doctor will see you, at least, once per month, and we will perform all the necessary treatments. It is also possible that we will perform another blood test. All this is included in your price, except for the follow-up oral medication..
Through all this process, we will take photographs for analyzing deeply your evolution. At the end, we will offer you a photo montage to see correctly the final result of your visit to Instituto Médico del Prado.
The minissesions are specially designed for those patient that:
> Do not want to shave their head (nor in the donor area nor the receipt area).
> Want their transplantation to go unnoticed.
> Want a gradual change on their look.
> Do not have much time and want to go back to normal almost inmediately.
> Want to try a short session before accepting a complete surgery.
HAIR TRANSPLANTATION RECOMMENDATIONS
We tell you in this section the main recommendations for before and after this procedure. The recommendations are in chronological order, and they will help you in all the processes of the hair transplantation.
These indications are very important for obtaining a high-quality result from this procedure:
1.- Don’t do any sport or physical effort in the 5 days prior to the surgery.
2.- If you take Minoxidil, you must suspend this treatment 4 weeks prior to the surgery, and restart it a week after the procedure. If you take Finasteride, keep taking your regular dose.
3.- Aspirins and anti-inflammatory pills cannot be taken in the 10 days prior to the surgery. You must tell the surgeon if you are taking a blood thiner.
4.- Don’t take any vitamins complex for the 10 days before the intervention, specially those including vitamins E and B, because they may increase the bleeding. Herbs products are also prohibited.
5.- Don’t drink alcohol in the three days before the hair transplantation and avoid caffeinated drinks. They increase the bleeding and can interact with the medication.
6.- You can keep taking your regular medication, if any.
7.- Drink more water than the usual for the week prior to the procedure.
8.- Don’t smoke on the week prior to the procedure. Smoking can delay cicatrization and increases the chanfe of infection. The survival of the grafts can be compromised. Depending on the experience, technique and expertise of the surgeon, up to 5% of the grafts can be lost due to smoking.
9.- On the procedure day, have a normal shower with your shampoo, but be sure that any product like gel hair or hairspray is removed.
10.- Don’t shave your hair, that will be done at the clinic.
11.- Wear a buttoned-shirt or some clothes with a zip.
12.- On breakfast, avoid caffeinated drinks and take a light meal. This will help to tolerate the anesthesia.
13.- It is recommended not to drive after the transplantation, you can receive some relaxing medicine.
14.- A blood test is needed before the procedure, as well as an electrocardiogram. In case of being over 60, the ECG must be taken up to 2 weeks prior the intervention. These two are included in the price.
The estimated duration is from 7 to 12 hours. It is a precise and delicate intervention, so you will have to be patient. Try not to move; if you need to do so, please, tell the surgeon first. If you feel some pain, keep calm and say it to the surgeon.
What are the follow-up days like?
Normally, the patient recovers fast from the hair transplantation. The night of the procedure they can feel pain on the donor area, which is solved taking a regular painkiller.
The day following the hair transplantation is normal to have a facial edema. This is due to the fall of the anesthesia from the scalp. This does not require treatment and it will disappear in one to two days.
In the receipt area, the grafts are seen on the first days like little scrumbs upon a red base. On the next few days, we taken them out in the clinic.
From the 5th to 7th day after the procedure, the look of the patient is back to normal and they can go back to a regular life.
What shall I do after the hair transplantation?
The main indications after the hair transplantation are (in chronological order):
1.- Avoid driving just after the surgery, as the medication taken during the procedure can make you feel sleepy.
2.- Have a light lunch with aliments of easy digestion and avoid saturated fats.
3.- Avoid alcohol and smoking for the next 48 hours.
4.- Start taking the prescribed medication as indicated by the doctor. It is uncommon to need painkillers, but take them if you need them.
5.- Wear comfortable clothes to avoid redness, as they can hurt the grafts.
6.- Apply cold to the forehead as prevention to inflammation.
7.- Sleep elevating your head and resting the back of the head, in order to avoid brushes on the grafts. You can use the cervical pillow included on your capillary restoration pack.
8.- Sexual activity can be retaken a week after the procedure.
9.- Don’t expose yourself to the light. You should reduce as much as possible the direct exposition to the sun during the first 15 days after the procuder. The use of hats or caps is recommended.
10.- Bathing in pools is prohibited during the first 2 months after the procedure. Bathing in the sea is allowed after a month.
11.- After 10 or 15 days we can do aerobic exercising again. High performnce, groupal or extreme excersices will still be prohibited until, at last, two months later.