In recent years, hair transplantation has been an operation that has been gaining popularity. In 2021, according to figures from the International Society of Hair Restoration Surgery (ISHRS), more than 613,000 men used it. According to his predictions, one in thirteen men will choose to have a hair transplant during their lifetime. Riding on this new trend, more and more clinics are opening all over the world, creating a real race for money. So much so that it is sometimes difficult for the patient to navigate the multitude of options available to them.
Are you thinking about hair transplantation but don't know who to contact? “ Word of mouth is the best advertising,” assures us Dr Lionel Choukroun, plastic surgeon and co-founder with David Benaïm of the Clinique du Grand Paris (Paris 16), specializing in hair transplantation. To better understand this phenomenon that everyone is talking about today, the Top Santé editorial team attended a hair transplant live. Who is a hair transplant for and how does it work? In this paper, we will answer all the questions you had on the subject.
Our journalist, Raphaëlle de Tappie, sent to the site, tells you everything (or almost)
The day before the operation, Dr Choukroun explains to me the process leading to a transplant. “Before launching, we first see patients for an initial consultation. During the latter, our hair expert will determine if the person is a candidate for a transplant.” That's to say ? “ If all types of hair and skin are eligible for transplantation, we cannot transplant people who are too thin because we need a sufficiently dense donor area to take hair from. Because this is an autograft,” specifies the specialist. “Conversely, we cannot intervene in a person with beginning baldness because we risk destroying the hair still present. We have to graft areas that are already very bare. »
A person experiencing homogeneous hair loss across the entire skull will therefore be referred to a colleague who will direct them towards medical treatments in the hope of slowing the loss, specifies Dr Choukroun who says he has almost abandoned hair transplant. hair in women due to poor results.
The transplant takes place with the Saphir FUE technique, originally from Türkiye
“In men, almost all cases are androgenic baldness, linked to hormonal implications. In women the mechanisms are different. Apart from very specific cases (very localized baldness), transplants in women give disappointing results and we more often resort to non-invasive adjuvant treatments (PRP, multivitamins, derma roller, * minoxidil etc…).
The first consultation is therefore an opportunity to determine whether the patient is eligible for a transplant or not, to assess the density of the donor area, of the area to be grafted and to estimate whether an operation will be sufficient or whether it is necessary. plan for two, or even, in very rare cases, three or four. The intervention will be carried out with the Saphir FUE technique, which comes from Türkiye. “Most people go to Türkiye because it is cheaper than in France of course but above all because the Turks have real expertise in hair transplantation. To prevent people from going abroad and finding themselves without any medical follow-up, we decided to import the technique used in Türkiye,” explains Dr. Choukroun.
“I grew up with my hair and I care about it”
On the big day, I was asked to come to the clinic at 8 a.m. The transplant must start early because it will be a long day. When I arrived, I met Hillel, 30 years old, who is now on his second transplant. “I can't wait to see how it grows back, enthuses the one who waited a year and a half between his first and second operation. I could have returned after eight months because I had no healing problems but I preferred to wait a little. It's good that it happens in winter, it's less restrictive because I don't have to expose myself to the sun after the operation. The first took place in May, just before summer, it was complicated. »
Indeed, after their operation, patients are asked to avoid hats, caps or “any other accessory that could cause friction with the grafts” for at least one month. During this period, it is also forbidden to expose yourself to the sun. Why not wait until winter to have your first hair transplant? “I couldn’t wait to get started,” Hillel explains to me.
“I started losing my hair when I was 25. For three years, it was gradual, then suddenly, devastating. I didn't really know what to expect because some in my family lost hair, others didn't, and I didn't look like anyone else in terms of hair…But when it started, I immediately considered a transplant. I grew up with my hair and I care about it, I was just waiting for the right moment. There, I would like to do it for my wedding photos, I malaugh soon”, says the young man, sitting down in an armchair so that his head can be shaved before the operation.
Second and final transplant
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“We shave the donor area to be able to take but itIt's also easier to shave the entire head because itThis allows us to have more visibility and have cleaner healing”explains Céline Turguttas, hair specialist, between two sizzling clippers.« IHere, the challenge is that this is the second intervention and the Hillel donor area has already been exploited. The chaThe challenge will therefore be to extract again from this area and obtain enough grafts to cover the new one, that of the vertex in this case. For a cleaner result, we will improve the connection between the two grafts by replanting with a small touch-up of the first, Céline explains, showing me the areas circled with felt-tip pen on Hillel's now completely hairless skull. But whatever happens, this will be his last transplant: his donor area will not allow us more. »
The first phase
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Shaving and these explanations finished, Hillel returns to the operating room for the first phase. The patient lies on his stomach and prepares to receive anesthesia injections on the skull. “In a few minutes he will feel like a helmet, like his head is very hard and big,” they explain to me. And Hillel confirmed shortly after: “It hurts a lot!” »
“It's almost finished, Céline Turguttas reassures him in a soft voice, putting music in the background to take his mind off things. To distract him, we talk about his upcoming wedding. But at the moment T, he tells me above all that he is thinking about “Golden Retriever babies”.
“Some patients are more difficult than others to anaesthetize, this is the case of poor Hillel,” Céline explains to me. Especially since anesthesia of the donor area tends to be more painful during the second transplant.
Fortunately for the young man, the anesthesia injections only last a few minutes and the specialists move on to serum injections., mixed with adrenaline (a substance which helps reduce local bleeding). “Now, the goal is to inflate the scalp, raise it a little so that we can work on it in a more malleable way. This will allow us to check if the patient has pain in certain areas. »
Core the bulbs to extract the grafts
Fifteen minutes later, it's time for phase 2, that of extraction. “I have an ultra-zoomed video of this step, so you can understand better, Céline said to me, inviting me to watch a short film forbidden to the faint of heart. An expert comes to core the bulbs to get them out. With pliers, his colleague comes to collect them, extracts them and places them on a small damp compress. We take one in three or one in four. A graft is equal to two, three or sometimes even four hairs. We make sure not to take them all from the same place so that the donor area maintains its density. »
Each compress can accommodate up to 250 grafts. “ In the tray, there is a protective serum which allows the grafts not to die before being re-implanted because they do not like being out of their natural habitat.Céline explains to me as I watch the tray in question become soaked in blood. Once all the grafts have been extracted, it will be completely filled.
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Extractions completed, “we will make micro-incisions between the hairs and then re-implant them in these incisions”, says Céline, inviting me to come back two hours later for the last and third stage.
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“Post-op doesn’t hurt”
© DRAt the appointed time, Hillel is invited to lie on his back. Experts now anesthetize the recipient area, which is less sensitive. As they then work to re-implant the hair, graft by graft, I ask him about what happens next.
“Starting today, I have five days off. Then I'm going to try to work remotely, the patient explains to me that, once he returns home, he will have to lie down for 48 hours. This night, I'm afraid I won't sleep well like the first time, because I'm not allowed to sleep on the donor area, I have to sleep on my back. »
“The patient’s head is full of serum. Not moving allows you to avoid friction with the graft, especially when, as with Hillel, the area that was implanted is in front. If the patient sleeps on their right side, they may wake up with swelling on that side. If he sleeps on his left side, he may wake up with swelling on his left,” explains Céline.
In addition, alcohol and tobacco should be avoided for the next two weeks. Intense physical activities, swimming, sauna and hammam are strictly prohibited for one month.
“But at least I know that post-op doesn’t hurt, Hillel reassures himself. The first time I just felt scratching at the back of my head, from the third day until the seventh. »
What follow-up?
Once today's operation is completed, a bandage will be placed on her donor area. Tomorrow, Hillel will have to return to the clinic where it will be taken from him to do his “first shampoo”. The latter, with a specially adapted PH, will be applied at home for ten days following the operation, with a healing cream.
Because scabs will form two to three days after the procedure, this is normal. Don't panic, they will fall about a week later. During a second post-intervention appointment where the “last shampoo” will take place, the medical team will ensure that everything has healed well.
In nine months, Hillel will be entitled to its final result
For at least a month and a half, Hillel will not be able to use any gel, spray or product not indicated by the doctor.
Most of the hair from the implanted follicles will fall out by the end of the first month. In four months, Hillel should start seeing the fruits of her second transplant. “The results are not instantaneous, you have to be patient,” explains Céline. In nine months, the young man will finally be entitled to his final result. Right on time for her wedding photos!
More information on: https://www.cliniquedugrandparis.com/clinique-iena/
