General Hair Transplant FAQs
Below is a list of Frequently Asked Questions about hair loss and hair transplantation surgery in general. You can also find answers about other procedure and treatments that our clinic is providing to our patients such as B.H.T (body hair), Scar grafting, PRP, Acell and more.
Yes, surgeons remove grafts from one area of the body (the donor site) and transplant it another area (the recipient site). The transferred tissue is not “rejected” as it is not foreign tissue. The transplanted hair maintains its own characteristics; color, texture, growth rate, and curl, after transplantation and regrowth. You can learn about hair transplant Surgery and the available options.
There is no absolute best hair transplant type. Without question, though, results improve as the discipline evolves. Follicular Unit Transplantation (FUE) is the latest transplant type available. More personally demanding for the surgeon than any other option, the best FUE results leaves zero noticeable scarring and an all-natural appearance.
FUE takes years to master, however. Patients should be aware that results depend on their surgeon’s experience and aptitude. Inexperienced and fledgling FUE surgeons can have major transection rates, the measurement of follicles irrevocably harmed during the procedure. Masters of FUE, meanwhile, typically have a transection rate of 5% or under. Dr. Cole himself has an average transection rate of around 3%, if not under.
The type of FUE also matters. For instance, Dr. Cole’s namesake FUE hair transplant variant, Cole Isolation Technique (CIT®), brings unprecedented results. Among the least invasive options available, CIT® leaves little to no noticeable scarring and stem cell remnants in extraction sites. With the application of ACell, an extracellular matrix, 30% to 40% of extracted follicles regenerate. Put simply, this means that patients gain 300 to 400 more hairs in their donor section for every 1000 individual extractions.
Some people advocate for Follicular Unit Extraction (FUT), an older procedure, over FUE. Some of these specialists genuinely believe FUT is more worthwhile. Most who claim FUT is better FUE, though, are either lackluster at FUE or unscrupulous. In the hands of an expert, FUT can turn out well in the transplant sites. However, the procedure itself will always leave a large scar impossible to predict in size or scope. Most FUT patients keep their hair a certain length to prevent anyone noticing said scar.
Another alternative to FUE are Body Hair Transplants (BHT). A fallback for patients who lack sufficient donor follicles on their head, BHT blends grafts extracted from the scalp with those from the body. Body hair typically has a different texture than head hair. So long as head hair grafts constitute the hairline, though, body hair grafts can work to thicken the area. Comparatively rare, BHT results vary from person to person. To ensure a BHT is viable, Forhair typically requires candidates undergo a trial procedure involving a small amount of grafts. If the results are viable than patients can commit to a larger procedure.
Read more about different hair transplant types on our website’s Hair Transplant section. Those with questions or comments, meanwhile, are welcome to contact us.
The hair on everyone’s scalp grows in small groupings called follicular units. The normal adult has follicular units consisting of 1-5 hair follicles. With the FUE technique, Dr. Cole can isolate grafts or follicular units that contain higher hair counts. This is advantageous when working behind the frontal hairline, in the top, and in the crown region of the scalp because a single graft containing more hair provides more coverage. Last week we had a patient that had many grafts that contained high hair counts. Take a look at these groupings and notice the one’s with 7 hair follicles!
On the following patient, we averaged 4.1 hairs per follicular group. The patient has a large number of 5 hair six hair groups along with multiple 3 and 4 hair groups. With our FUE procedure, we average 2.7 hairs per follicular group. Strip surgery averages 2.0 hairs per graft. As usual, FUE offers a greater value for your money. Our version of FUE is called CIT.
- Before consultation, female patients must show documentation that they have seen both an nutritionist and an endocrinologist, a reference for hair transplantation by their physician, and recent results of hormone, blood, and skin tests.
- We also need to know if the patient grows facial hair without dehydroepiandrosterone, has children, weight fluctuations, or has any rash or joint problems.
- Conditions we must consider include hyperactive or hypoactive thyroid, anemia, and hormone levels. Such conditions are rare. Any children, for instance, suggests an average range of hormones but we still look for conditions that encourage hyper-androgen states, such as overactive adrenal glands.
- The tests necessary to screen for transplant viability are as follows: Hormone levels (DHEAS, Testosterone, Androstenedione, Prolactin, Follicular Stimulating Hormone, Thyroid Stimulating Hormone (TSH), VDR receptors, Land Leutinizing Hormone) Serum Iron, Serum Ferritin, TIBC (Total Iron Binding Capacity), and Complete Blood Count (CBC).
- Additionally, you need two 4mm biopsies with some hair follicles read carefully by a dermatopathologist or trichologist. The inclusion of some hair follicles is necessary; if there is no hair, only skin, then the biopsies will not indicate anything. Ask your doctor or our staff for recommendations, as specialists familiar with hair loss conditions are preferable.
* Are you on or have you recently stopped any medications? If so, what medications and why?
* How long has the hair loss been occurring?
* Is the hair falling out fully intact, or is it breaking?
* Family history of diabetes, asthma, arthritis, lupus, vitiligo, anemia, or Addison’s disease?
* Have you recently given birth, or gone through menopause?
* What has been your recent stress amount?
A number of new treatments are also encouraging hair growth, retention, and thickness. Ask us about Cytokine Rich Plasma (CRP), Stem Cell Therapy, and Exosomes Therapy . Ask us about Cytokine Rich Plasma, Stem Cell Therapy, and Exosomes Therapy.Discomfort may arise during post-op recovery. At the procedure itself, though, patients do not experience any pain. Near all of today’s hair transplant procedures use local anesthesia, injections that numb a certain section of the body. In select cases, specialists may offer general anesthesia to patients who request it, which numbs the entire body and induces a loss of consciousness.
The truth is that even patients unconcerned with mild discomfort are surprised by how little hair transplantation hurts. Some mention a mild pulling or tugging sensation during CIT® or FUE donor extraction, but nothing like pain. Dr. Cole’s team of specialists always make sure patients have enough anesthesia, as well routinely re-administer it during long procedures. Patients with concerns, such as an allergy to a specific type of anesthetic, should mention them during the consultation.
Local anesthesia is most often still active when patients leave. Depending on the procedure type, we may recommend several medicines and post-op recovery treatments. Similarly, most post-op recovery discomfort depends on the type of the procedure. Those who undergo FUT, for instance, must use different care and deal with different symptoms than those who choose CIT®. No matter the procedure, avoid analgesics besides those we recommend if pain or discomfort does surface. Such recommendations help prevent swelling, alleviate recovery symptoms like scabbing, and encourage follicular retention. Both the donor and recipient areas will be tender, but following post-op instructions will hasten recovery and minimize the chance of complications. These include:
Swelling: If swelling develops, it will do so 48 to 72 hours after the procedure. We recommend using an ice pack on any swollen areas. Most patients say post-op swelling causes little, if any, discomfort, All patients with swelling should continue to stay elevated for its duration, typically two or three days. Cases of swelling outside the norm can also vary, but near all patients recover within a week.
Throbbing: Some patients may experience throbbing pains in the FUE donor areas five to seven days after the procedure. Most doctors recommend applying vitamin e and massaging the area. Doing so will hurt but overall pain will subside within 24 hours.
There are other possible symptoms, but they are exceedingly rare.
The grafts form small scabs in the days after the procedure. If one has enough surrounding hair, these scabs can be camouflaged with creative styling. If not, the small scabs may be visible. By keeping the scalp moist, the scabs usually come off in about a week or so. The return time to work really depends on you, some wear a hat and go back to work after one to two days and some take a week off.
Hair transplantation is typically patients’ most expensive option. Even then, cost a transplantation varies a great amount. The surgeon’s experience and reputation, transplant type, and size of the transplant all effect the final bill.
There is a range of transplant types patients can choose from. Near all reputable surgeons, though, primarily offer Follicular Unit Transplantation (FUT) and/or Follicular Unit Extraction (FUE).
- FUT is the older and less expensive of the two transplant types, but it also leaves noticeable linear scar and, depending on the surgeon, a plug-like appearance in the recipient area.
- FUE is the more recent and more expensive procedure but produces less noticeable scars, if any, and never leaves a plug-like appearance in the recipient area.
The type of FUE also effects cost. ARTAS, a robotic device some clinics use for transplantation, can cost over $15 per graft. Neograft, an automated device some clinics use for transplantation, sometimes charge over $10 a graft. This is significant because such devices automize hair transplantation and are typically offered by surgeons with less skill or experience.
Cole Isolation Technique (CIT®), Dr. Cole’s namesake FUE variant, is among the most cost-effective options available. Patients enjoy a number of unique benefits that, with the addition of several treatments, leads to the thickest, fastest growing transplants currently available.
Procedures by hair transplant experts can be expensive, but remember that cost alone never indicates quality. Many doctors are offering hair transplantation but lack training or expertise in it. Often, they relegate the procedure to their technicians nurses, and other subordinates. An entire hair transplant team’s skill matters, but technicians and nurses lack essential training critical for a successful hair transplant. There is no real indicator of what these shams charge: sometimes they bill an exorbitant amount and other times a supposed “bargain.” Always make sure to do serious research into a surgeon to ensure the best chance of a result you are proud to have.
Forhair offers a range of hair transplant types. Contact us to learn more about what options are best for you!
The amount of necessary hair transplant sessions varies by clinic and patient. Hair transplant type, target density, surgeon speed in particular effect the number of sessions. Patients should remember that the duration of a session both reflects procedure size and overall scheduling. Depending on the work, patients’ session may last the entire day, half a day, or less.
Hair transplant type has a major impact on the number of sessions. For instance, FUT requires less time than FUE for the same amount of grafts. Whereas FUT leaves a very noticeable scar, however, FUE leaves far less noticeable scars, if any at all. FUE also typically requires more time, though a few surgeons including Dr. Cole now conduct FUE within the same timeframe as FUT.
Target density is the amount of transplants to be put within a certain target area. The more grafts the surgeon needs to place within a certain area, the more time a session will require. That mentioned, transplant density may be important but it is not the be-all, end-all of quality results. In fact, too many transplants in the same area can lead to shock loss: the temporary loss of hair. One of a hair transplant expert’s skills is balancing target density with the amount of punctures they make, the trauma of which facilitates shock loss.
The amount of sessions for a hair transplant is important yes, but so is the amount of grafts per session. The ultimate goal should be productivity: surgeons want to extract or transplant the most amount of follicles in the least amount of time with least amount of errors. Of course, results matter most of all. Surgeons who overemphasize the speed of their procedure may compromise on results or have higher transection rates.
Like many surgeons, Dr. Cole has a set amount of grafts he is willing to perform in each session:
Shaved CIT® (Cole FUE): Depends on the patient, procedure, and scheduling
Patch Shaved CIT®: 3000 grafts per session
Non-shaved CIT® (C2G): 2500 grafts per session
Body Hair Transplant: Depends on the patient’s amount of viable donor follicles
Plug Redistribution: Extraction and redistribution of 50 plugs, maximum, per four hours
Those transplant options mentioned, Dr. Cole also excels at general hair transplant repair. Over 40% of Forhair’s patients seek correction from a transplant by previous clinics or surgeons. Contact us or set a consultation to learn about what Forhair can do for you, and in how many sessions.
Hair transplant healing time depends on the method. Older hair transplant methods would require months of total downtime. New methods like FUT and FUE require significantly less time. Still, transplant type matters: FUT requires three months or more to completely heal while most FUE patients fully recover within two weeks. FUE continues gaining prevalence, and is the latest hair transplant method available, so the below answer will go further into healing times for FUE.
The least invasive hair transplant method yet, near all FUE patients are completing most work-related tasks after the procedure. Dr. Cole’s namesake FUE variant, Cole Isolation Technique (CIT®), is among the least invasive hair transplants and patients’ ability to continue their schedule, with some temporary adjustments, the day after the procedure is yet another benefit of the transplant type. Such minimal invasiveness also limits the chance of swelling or shock loss (temporary loss of non-transplant hair), to potential complications from the procedure.
Whatever the FUE transplant type, grafts currently require 10 days minimum to fully take root. For that duration, patients should avoid strenuous activities or touching the head (unless for care and/or maintenance).
Transplanted hair will start falling out two or three weeks after the procedure. Avoid panic! This is perfectly normal and is not the shock loss that can occur in non-transplant hair follicles. Transplanted follicles will reinitiate growing hair around two to five months from the procedure. Transplanted follicles will continue activating and growing six to nine months from the procedure and will be 100% active within a year.
Patients who would rather have their hair sooner than later have options. Cytokine Rich Plasma (CRP), Dr. Cole’s unique variant of the popular Platelet Rich Plasma (PRP) treatment, has five to eight times the growth factors as generic PRP. Transplant patients who receive CRP treatments the day of the procedure enjoy follicular activation significantly sooner. 99% or more of CRP-treated transplanted follicles activate within four and half months, less than half the time as recovering from FUE without CRP.
Throughout the healing time, and after it, expect Forhair to actively follow up with you. We want to know the current state of your recovery, as well answer any questions you may have. Please, look at our CIT® recovery timeline on the Procedure Overview page. Alternately, contact us if you have any questions.
Post-operative healing from a hair transplant depends on the procedure type. Older hair transplant methods require long durations of convalescence. More recent hair transplant methods like FUT and FUE are not nearly as demanding in the post-op process. However, there are still major differences.
A FUT hair transplant involves extracting a large swath of follicle-dense tissue, typically from the back of the head. Patients must take major considerations to care for and treat the extraction site, which requires three months or more to heal. Care, maintenance, and paying overall attention to the extraction site are challenging, as it typically is at the back of the head and requires some mirror work, or help from a friend or loved one, to remain aware of its state.
FUE, meanwhile, involves a myriad of small extractions. Such a small extraction size enables far quicker healing. Additionally, Dr. Cole’s namesake FUE variant, Cole Isolation Technique (CIT®), is among the least invasive forms of FUE available. CIT® is in fact so minimally invasive that it is the only FUE type that leaves follicular stem cell remnants; 30% to 40% of which regenerate with the addition of ACell, a post-operative healing aid, an unparalleled increase in a transplant’s average yield. CIT® extractions also leave less scars and, typically, require less time to heal in comparison with generic FUE.
Patients must still be cautious, however. The first few days after the procedure are critical and may require some serious adjustments in the patient day-to-day: think sleeping at an upright angle for half a week, avoiding direct sunlight, and abstaining from strenuous activity. Adhering to any and all post-op instructions is critical for a good result: FUE follicle transplants do not fully anchor into the scalp until 10 days to two weeks; when patients may start lightly rubbing away at any scabs with a moisturizing lotion.
That mentioned, most people after a FUE procedure can complete near all work-related tasks the very next day. Within two weeks they can safely pursue whatever activities they choose without risk of dislodging grafts. Some complications may develop in a small portion of patients, especially swelling or shock loss. Swelling varies in severity but can effect the scalp, forehead, eyes, and cheeks, and almost always subsides within 72 hours of rest. Shock loss, or the temporary loss of non-transplant hair, happens within a minority of patients but experts such as Dr. Cole take precautions to limit this side-effect.
Within two to three weeks the transplanted hair will begin to shed. This happens to all patients and is not shock loss. In most instances, transplanted hair starts to grow between two and five months after a procedure. The transplanted hair will thicken, and grow at a faster rate, six to nine months after the procedure.
Dr. Cole’s unique variant of Platelet Rich Plasma (PRP) with five to eight times the growth factors, Cytokine Rich Plasma (CRP), is dramatically hastening recovery times. Most transplant patients who receive CRP show follicular activity within a few months and 99% activity in four and a half months, five and a half months faster than patients recovering without CRP.
Click on the links to learn more about the CIT® healing process, the effects of CRP, or to contact us with your unique questions.
The time patients need to wait between hair transplant procedures depends on several factors. These include the type of hair transplant procedure, rate of recovery, and necessity of such.
Hair transplant procedure type can, in part, set when, or if, patients should have their next procedure. Another hair transplant procedure is not always a possibility with older hair transplant methods, such as scalp reductions. Thankfully, patients who choose between the two most prominent hair transplant methods today, FUT and FUE, do not have such restrictions.
Even though patients can undergo multiple FUT and FUE procedures, there are differences to consider. FUT leaves a large, orbital scar that both decreases the amount of viable donor follicles and, if FUT scars stack, can be very noticeable. FUE does not leave such scars, but each procedure uses patients’ finite amount of grafts and, after a certain amount of extractions, additional FUE procedures can cause noticeable thinning in donor regions. Many patients who choose FUT for their first procedure choose FUE for future ones, as it still may deplete donor follicles but does not cause an overt scar.
The rate of recovery also matters a great deal. Near all patients’ follicles begin activating around two months and will continue activating for the whole year. Dr. Cole typically suggests a follow-up appointment after 10 months to check in on progress. Cytokine Rich Plasma (CRP), Dr. Cole’s unique variant of Platelet Rich Plasma (PRP), has five to eight times the growth factors as generic PRP and can significantly hasten the post-op recovery process. Transplant patients treated with CRP enjoy 99% follicular activation within four and a half months, more than twice as fast as transplant patients who choose against CRP. Convenient, this faster rate of recovery also potentially allows hair transplant specialists to perform another procedure in a shorter window of time.
Last, patients should ask themselves if they need to undergo another procedure. Results matter most. Some patients who planned for a string of additional transplants decide against it after finding their current results satisfactory. As a general rule, patients should take on additional procedures if they want to bring their hairline forward some more or if they want to add further density to any thin areas.
Contact us if you have questions about concurrent transplants or anything else.
One of the most common complications observed after hair transplant surgery is forehead edema (swelling) and subsequent periorbital ecchymosis (bruising around the eyes). This occurs as fluid from the recipient area migrates downward along tissue planes from the top of the head to the upper forehead, then to the area above the eyebrows and eventually down around the eyes, where the appearance of bruising can be cosmetically distressing to the patient.
Several therapeutic modalities have been utilized to prevent or ameliorate this phenomenon, including the use of corticosteroids, ice packs to the area, massaging the fluid laterally once it accumulates, and sleeping in a semi-upright position. None of these techniques are universally successful.
A novel technique involves the use of a headband; the most optimal results seem to revolve around two factors. First, a channel of least resistance needs to be provided. This can be achieved by simply inserting a rolled-up gauze beneath the headband at the level of the temples; thus, the fluid migrates laterally and the downward, rather than directly down into the orbital region. Secondly, the edges of the thumbs may be used to mechanically massage the fluid laterally in a sweeping motion, from the midline outward toward the temples.
A hair transplant procedure’s duration depends on the transplant’s size, scope, type. Though an older technique that requires more convalescence time, and guaranteed to leave a visible linear scar, FUT typically demands less hours than FUE. Dr. Cole, however, is one of the few surgeons available who can perform FUE at close to the same pace as FUT. Among other reasons, this is why so many patients opt for CIT® when given the option.
Even though Dr. Cole’s CIT® pace can match FUT, though, each technique is still different. Here is a list of current transplant techniques that Forhair offers:
CIT® – Donor amount sets the maximum number of transplants and Dr. Cole can do multiple procedures over consecutive days.
Patch-shaved CIT® – Maximum 3000 grafts per procedure.
No-shave CIT® – Maximum 2500 grafts per procedure
BHT (Body Hair Transplant): Graft amount per procedure depends on the patient’s amount of viable grafts at the back and sides of their head.
Strip (FUT or FUG): 3000 grafts per procedure session.
Plug Redistribution: A max of 50 plugs per four hours. Results are far more discreet than plugs, both due to even distribution and Dr. Cole’s renowned artistry.
Each of these considers a whole day procedure, or eight hours +. As mentioned above, however, transplants do not have to be over a single day. Many patients who want larger procedures decide to undergo consecutive sessions until they receive their target of grafts.
Near all patients find the procedure long, but bearable. Anesthesia ensures the patient feels minimum pain throughout its duration. Patients, meanwhile, can chat, enjoy media on a tablet, or message/talk with people through their phone. Patients can also enjoy a few breaks, but should remember that the overall objective is to finish the transplant in a timely manner.
Have more questions about transplant procedure durations? Contact us today and find out!
People rarely request eyelash transplants, and for good reason. Forhair recommends against eyelash implants for several reasons.
Risk in an eyebrow transplant is high. Patients risk damaging the eyelid, which in turn can effect ocular functioning and vision. In fact, eyebrow transplants using artificial hair have been banned in the U.S. since the 80’s. Then, surgeons were transplanting artificial hair into the eyelid. So cases of severe scarring developed, however, and there is a major chance of infection as artificial hair implants are essentially implant devices. Modern Day eyelash transplants that typically use hair from the scalp. However, their implantation still carries risk for the eyelid and complications can develop if the hair is not implanted into the exact right angle.
Cost, considering what patients gain, is also an issue. Eyelid transplantations are exceedingly rare and specialists even more so. Correspondingly, these types of transplants can be very expensive. Doctors on RealSelf quote $15 to $20 a lash, leading to a minimum of $2000 for both eyes. If present-day eyelid transplants offered more in the veins of effectiveness, safety, and upkeep.
Upkeep is essential for contemporary eyelash implants. Modern Day techniques involve transplanting head hair. There is some evidence that head hair transplants will eventually localize as eyelashes. However, the time this requires and the degree of localization varies according to the patient. In the meantime, patients must routinely cut and curl their eyelashes so the do not overgrow or irritate the eye.
Expertise in eyelash transplants in exceedingly rare. Very few doctors have the regular opportunity to conduct eyelash transplants, and only with actual surgical experience can surgeons improve their skills and technique.
Patients dead-set on an eyebrow transplant should always look for a renowned specialist. Specifically, any surgeon who offers lash transplants should already be an acclaimed hair restoration surgeon. Always to make sure to ask for before-and-after cases, if not outright references from patients.
Any type of FUE hair transplantation with very curly hair requires special considerations. Very curly follicles are, in effect, very curly. Conventional instruments for FUE can easily damage these follicles without a specialist’s expertise. Even with said expertise, however, some FUE techniques or instruments still do not create ideal results.
Many patients with very curly hair have undergone Cole Isolation Technique (CIT®) and the results are impressive. Skill and technique are essential for a successful CIT® procedure, but so is artistry. During consultation expect our team of experts to note subtle details in patients’ photos of their previous hairline, important for a convincing and unique result. Further, very curly hair also enhances coverage, enabling patients with the hair type to achieve the same results with less grafts. Near all experts also agree that curly and very curly hair is ideal for excellent results.
People with very curly hair also have incentive to choose CIT®. A FUE variant offering unprecedented results, CIT® leaves unnoticeable scarring and, additionally, is the only hair transplant type that leaves donor stem cell remnants. These stem cells, with the addition of ACell, regenerate in yields of 30% to 40% of the extractions. Put simply, this means that 300 to 400 additional hairs grow for every 1000 single extractions. Forhair’s unique Cytokine Rich Plasma (a variant of Platelet Rich Plasma), meanwhile, compliments any transplant with a follicular activation rate of 99% in four and a half months; transplant patients without CRP must wait around a year for 100% follicular activation.
Results depend on the patient’s hair and how a technique or set of instruments effects the follicles. As a precaution, most African American patients undergo a test session of 50 grafts. This enables Dr. Cole to determine if CIT® can safely extract the patients’ follicles. If successful, most patients opt for a larger transplant. Contact us or schedule an online consultation today!
Hair transplant quality is obvious to the naked eye. Photographs, however, are another story. Specialists depend on hair transplant photos to showcase their results, just as patients are often reliant on said photos when deciding on a clinic.
Reasonably, patients can expect a bit of cleanup in the photo: faces can be airbrushed, for instance, to make them appear more attractive. While technically okay for promotional images, through, photoshopping faces can have the opposite effect: instead of inspiring confidence such images can inspire cynicism. After all, it is reasonable to expect those who view said images to assume that photoshopped faces will also lead to photoshopped hair. Such patients are smart to be weary; a bad hair transplant requires manual correction and sometimes is unsalvageable. Over 40% of Forhair patients request we correct previous work done by other clinics.
For these reasons, we emphasize photos that fully showcase the patient and his or her results. This is important both to highlight the caliber of skill Dr. Cole and Forhair offer, but also to set a standard for other hair transplant clinics. Always expect our before and after photos to truly present the actual result in its entirety. One of the most important aspects of said results is encouraging patients to recognize that a positive result, excellent as it is, should never be a generic result. Each person’s hairline is unique as their face and Dr. Cole’s artistry convincingly replicates the former.
Dishonest hair transplant photos use a number of effects to make a transplant seem more promising:
Low resolution
“Blur” distortions
Darkening
Selective lighting
Hairstyle
Toppik or other concealers
Hair transplant photos are great for showcasing a surgeon’s skill, sure, but it also serves as a frame of reference. Prospective patients would do well to look at the before and after photos of patients with a similar degree of balding and transplant amount, as it gives them an idea of coverage. Each patient’s results are different, however, so patients should also consider the thickness, color, and texture of their own hair before concluding their result will be identical as that in the before and after photos.
Body Hair Transplantation (BHT) is one way that patients with a small donor supply can significantly improve their hairline. A broad range of skills and experience are crucial in this procedure, as the surgeon must both be familiar with FUE (or CIT®) and body hair harvesting/grafting. Even more essential, the surgeon must be able to blend the two hair types convincingly.
Skilled surgeons should make BHT appear uniform with FUE (or CIT®). Doing so requires blending the body hair with the head hair. Doing so helps preempt the noticeability of any coarseness of the body hair. Coarseness itself usually dissipates with time according to Dr. Woods, the pioneer of BHT, as he finds transplanted body hair tends to take on the characteristics of where it grows. Results, of course, can vary a great deal but body hair does not always take on the desirable traits of head hair -it may remain coarse and short for the duration of the transplant. Blending and other placement, therefore, is the most integral skill of any BHT surgeon.
Blending itself can take on different forms, as it depends on the patient and procedure. Almost always, however, a BHT involves placing head hair at the hairline or other noticeable parts and then, slowly, blending it in with body hair. Transplants involving the back of the head, meanwhile, usually involves an even blend to promote thickness without evident coarseness.
Perhaps the greatest element that a BHT depends on is donor availability. BHT is an emerging option still, but the transplant type is primarily meant to enable patients who would otherwise be viable for CIT® or FUE. CIT® is actually ideal with BHT as the former can regenerate, with ACell, 30% to 40% of all follicle remnants from extraction: the equivalent of 300 to 400 new hairs for every 1000 single extractions. No other transplant type is so complimentary for BHT, as it maintains a higher level of density in donor areas. Learn more about BHT and CIT® on their respective pages and schedule a consultation today!
Platelet Rich Plasma (PRP) is a blood serum with a heavy concentration of platelets. The exact amount varies by how it is processed, but quality ranges a drastic amount. PRP, to be effective, must have a high concentration of platelets, growth factors like PDGF, and cytokines.
As a treatment, PRP is used often used in medicine for quicker healing and better tissue repair, particularly sports medicine. Clinical studies range in endorsing PRP, however, because its production is not standardized though it nearly always
PRP is typically produced through devices that centrifuges the patient’s blood, dividing platelets and other materials from the blood to concentrate it. The treatment is also combined with an activator, such a saline or calcium gluconate, to open the growth factor’s alpha granules. Both the centrifugation and activator is why effectiveness can range so dramatically.
Dr. Cole has done specific research into the effectiveness of PRP. Evidence shows that the growth factor and cytokine count matters tremendously. Using two kits that led to different concentrations of growth factors, Dr. Cole found the one with significantly greater growth factors led to a 50% increase in hair density while the one with less growth factors led to a 25% decrease in hair density.
Further experimentation with processing led to Dr. Cole using sonication within a soundproof box. The results, what Forhair calls Cytokine Rich Plasma (CRP), has five to eight times the amount of growth factors and cytokines. Results are also unprecedented. Transplant patients who received the treatment enjoyed 99% follicular activation within four and a half months; more than double the rate of transplant patients who did not receive CRP.
PRP and CRP also have a longer duration with the addition of ACell, making the treatment more cost-effective. CRP + Acell Treatments lasts between half a year and a year while maintaining PRP’s effect alone requires injections every month or season. PRP and CRP are great with transplants but also as standalone treatments. Learn more on our CRP and PRP page!
ACell is a regenerative treatment common in many types of medicine, including hair transplantation. A type of extracellular matrix, ACell regulates cell behavior and stimulates cells through numerous types of growth factors and nutrients. The products has great reputation for regenerating skin tissue that promotes faster, improved healing following a hair transplant procedure.
CIT® stands for Cole Isolation Technique and refers to Dr. Cole’s proprietary FUE technique and instruments.
Dr. John P. Cole, MD has performed hair restoration surgery since 1992 and opened his current practice, Forhair, in 1997. You can get more information about Dr. Cole on his bio page. Dr. Cole began developing his CIT® variant in 2002 as a technique to remove individual follicular units. At the time, there was only one other physician in the US actively pursuing the procedure and only a handful worldwide. By 2003, 90% of Dr. Cole’s procedures involved CIT. Throughout the years, Dr. Cole has consistently performed CIT procedures; 90% to 100% of his transplants each month use CIT®.
Candidacy for a hair transplant varies from patient to patient. The first step, and the most important, is receiving a consultation from a specialist. They will typically assess your current hair loss and its rate, family history, personal health, type of hair, and other factors.
One of the most intrinsic elements of a consultation is evaluating donor hair availability. Hair transplants, properly implemented, adds the appearance of thicker hair but, in fact, is actually the relocation of hair from one area of the head to the other. Dr. Cole’s namesake FUE variant, Cole Isolation Technique (CIT®), is the sole exception; with the addition of ACell, 30% to 40% of CIT® extractions regenerate, the equivalent of 300 to 400 new hairs for every 1000 single extractions. This significant yield happens in donor sites, so the increase in density is often unapparent. However, it is ideal for patients with limited donor hair as such regeneration increases their overall supply for future procedures.
Patients with a low hair donor supply do have options. Body Hair Transplantation (BHT) is an emerging method that combines regular FUE, or CIT® in Forhair’s case, with body hair extractions. BHT absolutely requires a skilled surgeon that effectively blends body hair grafts with head hair grafts. Head hair grafts will always encompass the hairline, where texture is most noticeable, while body hair transplants enhances overall coverage. Done successfully, head hair grafts obfuscates the coarser, often shorter body hair behind the hairline. Dr. Woods, the pioneer of BHT, claims to have noticed body hair transplants take on characteristics of head hair with time. However, such changes vary by patient. BHT results can be exceptional, but not every candidate is right for it. Responsible specialists always conduct a test procedure on each patient before committing to this transplant type.
There are other factors that influence one’s candidacy for a successful transplant. Personal health can be a major factor, as can the reasons for hair loss and the hair type. Curly and very curly hair sometimes easily transect, or become irrevocably damaged, due to the curly hair follicle’s shape; one reason why, like BHT, we often have patients with very curly hair undergo a test procedure. Forhair, unlike most clinics, will never commit to a procedure if the patient is a bad candidate. Doing so compromises the interests of the patient and the integrity of the clinic. At Forhair we believe every patient deserves the best results possible and sometimes that means acknowledging a procedure is likely more a hazard than a boon. Schedule a consultation today to learn if you are a good candidate for hair transplantation.
FUE grafts range from one to a few follicles. Transection occurs when the follicles are cut or otherwise damaged during removal. These grafts will not develop and grow after a transplantation.
FUE transection rate, therefore, is a common way to measure a technique’s, procedure’s, or surgeon’s effectiveness; the higher the rate, the less effective a result. Dr. Cole’s transection rate averages 3% or under, exceptional within the hair restoration industry. There are a few different factors that effect transection rates:
Instruments or devices have a major role in transection rates. Specialists should replace their punch, the instrument most common for extracting follicles, every 400 to 1000 extractions, as after this amount the blade irrevocably dulls. Punches are both very small and very sharp, making it impossible to resharpen them after dulling. Automated and robotic devices also varying transections rates; ARTAS, for instance, has an average 10% transection rate. Dr. Cole’s specialty devices and instruments, Cole Instruments, features the sharpest punches available with a transection rate of less than 3%. That over 500 specialists use CI devices and instruments is a testament to their quality.
FUE Technique also can effect transection rates. Dr. Cole’s namesake FUE variant, Cole Isolation Technique (CIT®), true minimal invasiveness decreases the chance of transections. Both manual and automated FUE techniques have varying transection rates. Results largely depend on a specialist’s mastery of a select technique and familiarity with its latest advancements.
Specialist involvement during the procedure will effect transection rates. Some clinics relegate certain elements, or the whole procedure, to technicians or other surgical staff. This is most common with clinics that offer hair transplantation as a periphery service, or by doctors unfamiliar with specific hair transplant methodology.
Skill and experience of the procedure team can effect transection rates. The specialist should be present throughout the procedure, but the experience of the entire team matters a great deal. Their involvement effects ths successful extraction, storage, and transplantation of follicles.
Specialist experience and qualifications has a major impact. FUE takes years to master, one reason why the method took a decade to grow in availability. A FUE surgeon’s results, including transection rate, largely depends on their skill, training, and experience. Experts typically have a transection rate of 5% while less capable FUE surgeons range from 20% to 75%. A specialist of global renown, Dr. Cole is among the first pioneers of FUE. His innovations range from techniques and treatments to specialty FUE instruments.
This is a case of scalp hair transferred by FIT to a small region of the scar. Only a small region was transplanted because the patient was very frightened about surgery due to the donor strip scar he received from his prior hair transplant. He was also very concerned about the appearance of his “pluggy”, unnatural looking grafts on top of his head. Therefore, we took out a few of the unnatural grafts and we put some hair into the donor scar. Some of the hair in the donor scar is from the old plugs in his recipient area that was transferred to the donor area scar. He wanted to do a very small session to see how it would look in the long run. He was understandable “gun shy” after his first bad experience with hair transplant strip surgery.
It would be helpful to have a photo of the donor area pre-operatively to assess the growth here, but I recall the case well since I did the procedure in Greece. The grafts were extracted very cleanly and were very good. The area of scar at the end is wider and as is often the case. The end will widen when a suture is tied over the incision line. This is quite common and generally is due to poor technique though I’ve seen it occur occasionally even when the technique was good.
This case brings up a few good points worth making. First, when you transfer head hair to the head you expect a 75 – 90% yield. When you transfer head hair to the body, you can expect a 40 to 60% yield. The first-year survival rate of body hair to head hair is about 40 to 60%. We can expect it to approach 90%, but it is still too early to know for sure.
What is going on here? The number of hairs in the growing phase, anagen, varies from one region of the body to another. We find that it varies from 40% to 60% on the body though we recently found a much higher anagen rate on a patient who had 5400 grafts taken from his chest alone. He was quite hairy so it may be that the percentage of hairs in anagen is much higher in individuals who are quite hairy. Many of his grafts were two hair grafts, which is not as common on the chest. He also had a much higher percentage of three hair grafts on his chest. The anagen rate on the scalp is much higher. Here we see a rate of about 90% though it may be as low as 75% and still be within the normal rate. I don’t think I’ve seen a rate this low, but I have seen a few guys with a rate in the 80s. The percentage of hairs in anagen also tends to decrease in the lower regions of the scalp.
When you move hair from one region to another, the hair tends to take on new characteristics. We know from studies that the percentage of hairs that grow and are in anagen is much less from head to the body. the one good study showed the rate was only 60%. It follows that we should see a much higher rate of growth from body to hair. the percentage of growing hairs should increase toward the 90% range though it may only get to 75%. It does not mean the hairs did not survive or that they will not grow. It means that they will not grow until they switch from resting (telogen) to growing (anagen).
When we do body hair transplants, the percentage of hairs in resting (telogen) is much higher. We still plant these hairs, but it may take them 2 or 3 years to grow. Woods has found that the percentage of growing body hairs increases in the second year. This is very interesting. We have seen up to 80% growth from body hairs (20 out of 25), but in this case, we transplanted only anagen hairs. This seems to confer our belief that the telogen hairs will not grow in the first year in most instances. We have also seen that the region we graft into tends to control the rate of growth. For instance, we transplanted hairs from the leg to the region above the ear on one patient. This patient had a lift and the scalp lift from Brandy elevated the region above the ears and gave him “white walls”. We add the leg hair and a very high percentage grew from the beginning and it grew longer than when it was on the leg. Therefore, there appear to be factored in the dermis which controls the anagen ratio, the length of growth, and the time from transplantation to growth. Perhaps this is why some individuals get a much higher rate of growth immediately following transplant surgery. there is something in the dermis.
In this case, I count up to 11 growing grafts in the area of the scar. This is a growing rate of 85%. Of course, number 6 could be only a shadow so the rate could be slightly lower. I took this photo and zoomed in. I then circled the individual grafts. From many transplant studies done in the past, a rate of growth in the 70 percent range has been seen for the scalp to scalp transplant surgery. In some individuals, you will find that the rate of growth will continue to increase up to the 18-month mark. Therefore, it is possible that the rate will increase higher into the 80% range though I do not suspect it will hit the 90% range.
The next point is that the donor scar is taking on more of the color of the surrounding donor area. You can see that the non-grafted area is more white or pink. The grafted area of the scar takes on a different color more similar to the natural donor region. This is important for many reasons. The donor scar has a different color than the surrounding area. If the hair in the scar were not capable of changing the color of the scar, it would result in a much greater contrast from the surrounding donor area even if it were covered by new hair grafts. Taking on the surrounding color rather than the scar color helps to eliminate this contrast and create a more natural result that one can conceal with shorter hair.
All of these grafts were done with FUE so there is no new strip scar. By the way, this strip scar is about 2 to 3 mm wide (except for the grafted area which is much larger and is at the end of the strip scar). Two to three mm is the average width you can expect from strip scars. The best strip scars are 1 mm wide and these are quite less common. I outlined the strip scar in the zoomed-in photo so you can see it more clearly.
Scar grafting, as the name implies, is a procedure grafts hair in and around a scar to obfuscate its appearance and improve its pigmentation. Patients should know that transplants onto scar tissue do not have as high of a retention rate as regular tissue, sometimes requiring Dr. Cole to schedule several procedures to deliver the best possible results.
Any scalp scar is a candidate for scar grafting; accidents, hair transplants by other clinics, and aging hair transplants. The latter two also pertain to plug redistribution, when a specialist redistributes transplant plugs that are either apparent after another clinic’s procedure or have become obvious with time. Many patients require both procedures to revamp or update their transplant, but scar grafting is currently more common due to the prevalence of FUT.
Hair transplants have come a long way in the last 20 years. FUE, the most recent transplant method and the least likely to leave scars, is now prevalent enough that almost every patient can enjoy it. FUT, though, which leaves a large orbital scar, was prominent before and during FUE’s proliferation. Many surgeons still advocate for FUT; Dr. Cole even still conducts the procedure on occasion for those who prefer it over FUE or CIT®, though, cases where he recommends the procedure over other transplant types, are rare. Several other types of transplants can leave noticeable scars too, often far more severe than FUT.
Dr. Cole uses Cole Isolation Technique (CIT®), his unique FUE variant, to graft follicles around scars. Uniquely suitable for scar grafting, CIT® extraction leaves follicular stem cell remnants that can then, with the application of ACell, regenerate 30% to 40% of donor follicles. The added density is of substantial benefit to anyone in the middle to later stages of hair loss: just imagine 300 to 400 new hairs for every 1000 single extractions. CIT® is the only FUE variant that leads to follicular regeneration, making Forhair a prime clinic for this reparative work.
Hair Transplant Preparation FAQs
Common questions and answers about the first steps to contact our clinic and prepare for hair transplant surgery, how to make contact, ways to schedule a consultation, Financing questions and answers, prescriptions for Propecia and more…
Dr. Cole’s trained techs will shave the donor area, most often consisting of the back of the head and over the ears. Of course, this depends on what type of CIT® the patient undergoes. Forhair offers shaved CIT®, patch-shaved CIT®, and no-shave CIT® (C2G).
Patch-shaved CIT® consists of shaving a small patch or strip over the donor area. while C2G consists of cutting each hair strand upon extraction. Techs will always shave portions of the hair for patch-shaved CIT®. C2G, on the other hand, will involve Dr. Cole or whoever else is extracting the follicles to cut each strand of hair upon extraction. Both patch-shaved CIT® and C2G are excellent for busy professionals, though many also opt for shaven CIT® as it offers a few advantages: namely, time vs. the total amount of transplants.
Questioning a Clinic’s work assignations and roles are important for prospective patients. FUE, in particular, takes years to master, leading many less scrupulous surgeons to assign technicians a far greater role in the procedure, if not to have them handle the procedure itself. Surgical techs in hair restoration must be very skilled, but they still lack the expertise and background of hair restoration experts. Finding out who at the clinic conducts the procedure is an excellent first step toward finding a clinic. Another is inquiring about the surgeon and surgical staff’s training and expertise.
Hair prep for patch-shaved CIT®, for instance, may seem like a simple task. However, surgical techs must be aware of several intricacies: size, scope, and location. The entire point of patch-shaved CIT® is that, with many haircuts, its selective shaving allows patients to cover the transplant’s initial appearance. Techs, therefore, must accurately shave the right region, they must shave it at the right size to ensure enough donor follicles. Mastering such necessities to ensure a smooth procedure, in part, is what makes skilled assistants so vital in a hair restoration clinic.
Everyone leads busy lives and Forhair offers numerous ways to receive a consultation. First off, patients must fill out our consultation form and submit several photos of their current hair. The photos should be properly lighted, have a high resolution, and showcase all instances of hair loss or thinning by wetting the hair and combing it in different ways. Most patients have someone else take the actual photos to ensure that all images are adequate.
Patients should also be prepared to gather medical records and doctor’s recommendations, as well to answer questions about their personal history of health. These are never purposefully intrusive or exclusitory but assessing the patient’s health and viability is important for both their safety and to predict results.
Dr. Cole prefers to assess patient consultation photos himself. On occasion, this can require some time, as he is often busy with procedures, conferences, and other obligations. If you submit photos, though, and want to know when they will be reviewed then please contact us and we will connect you to one of our patient coordinators.
Consultations can also take place via webcam, great for those who are busy with life, in-person. Far as webcam consultations, specialists such as Dr. Cole only require a 720p stream to examine your hair. Those who prefer an in-person consultation, meanwhile, can either visit our office or schedule a time to meet Dr. Cole or a Forhair representative at a location of your choice. Ask about this latter option when contacting us but also be aware that a nominal fee may be attached, depending on the location.
After receiving a consultation, or series of such depending on the circumstances, Dr. Cole or a specially trained, vetted specialist will then examine you in-person. This is critical for verifying what they concluded in their initial consultation and also to gather more specifics. Forhair often uses Hairmes, a specialized French program, to calculate the patient’s amount of viable donor hair.
You should send your patient coordinator shots of your hair wet and combed to fully showcase, in turn, the front, sides, temples, top, and back. Those with scars or specific spots that require attention should also send photos of those areas. Your back of the head is important since it will determine if you have enough donor to proceed. Those considering a Body Hair Transplant should send photos of the body hair they prefer for surgery. (Note: If the pictures are not in focus and clear Dr. Cole will ask you to take them again, so do not send poor quality photos) *You can also use the free online photo consultation form to submit your photos.
Patient referrals are essential for a number of reasons. Premier hair transplant specialists such as Dr. Cole enjoy a great amount of esteem within the field. Concepts and practice are two different things, however. Techniques change, new treatments become available, and sometimes, but rarely, skillsets erode. Recent patient referrals ensure prospects that a given hair transplant surgeon is still running a good clinic and delivering solid results.
There can be any number of patient referrals. Overall results are essential, of course, and a good hair transplant should always add to coverage and thickness without there being any signs of it being a transplant. The simple truth, though, is that transplants take time to grow out.
Typically, all follicular transplants are actively growing within a year. This is when patients can feel comfortable offering a referral about overall results. Dr. Cole’s variant of Platelet Rich Plasma (PRP), a blood treatment that encourages growth, that we call Cytokine Rich Plasma (CRP), has five to eight times the amount of cytokines and growth factors of PRP and thereby spurs excellent growth in a shorter time frame. Patients that receive CRP can enjoy full activation of their transplants within four and a half months, less than half the time of transplants from all other clinics. This is the only reason Forhair can feasibly offer patient referrals within a smaller time frame. A seemingly small difference, half a year can have a big impact on how a clinic operates or a transplant surgeon performs said procedure.
Also of critical importance is the trustworthiness of said referrals. Clinics should never offer a commission to referrals but shadier businesses will do so. For this reason alone patients should also consider the total amount patients a surgeon has helped, their overall reputation within the field, and the amount of work they commit to the procedure itself.
Referrals can take on different forms as well, of course. Referrals will often comment on a clinic’s hospitality, the surgeon and surgical staff’s personableness, and duration of the procedure. These things matter too and, generally, are also signs of a clinic’s aptitude. Please, contact us today to receive a list of referrals!
A premier hair transplant clinic with global repute and a policy to consider patients’ best options based on their budget, Forhair receives numerous consultation requests every day. Dr. Cole often prefers to do consultations himself, and has a very large stack of photo consults on his desk at all times. He reviews patient photos whenever possible but obligations such as scheduled procedures, which he performs Monday-Friday, as well traveling for in-person consultations, conferences, and training workshops can slow review of photo consultation requests. We thank patients for their patience in advance!
Specialist consultations are vital for any transplant’s success. The degree of hair loss, age when hair loss began, and other factors are essential for planning and follow-through. Specialists with Dr. Cole’s acumen can often eyeball a series of photos and immediately predict the best course of action. However, a consultation at the Forhair office or a place of the patient’s choice is also essential to notice any fine details unapparent in photos. A clinic that emphasizes the latest innovations, Forhair also uses advanced programs like Hairmes, specialized software from France, to calculate patients’ total amount of viable donor follicles to ensure the best results possible.
Photos are an excellent way to assess the best type of procedure. As technology proliferates, however, new options arise. 720p webcam footage is perfectly adequate for most initial consultations, not to mention are perfectly ideal for busy patients. Depending on the case, though, an in-person consultation may still be necessary. This is usually to verify what seems obvious on-screen, though sometimes specialists must also run diagnostics and other tests that require a patient’s physical presence.
Consultations are a critical part of planning for a hair restoration. More essential, however, is making sure to receive the right type of consultation from the right specialist. Some patients prefer going to a specialist consultation for a recommendation and then shopping around for the best values well-regarded surgeons offer. Finding a second opinion can be a smart move, but continuity also matters a great deal. Patients should always make sure the surgeon they choose for their procedure also does a consultation. Contact your Forhair patient coordinator or our clinic if you have any questions!
Options for hair loss treatments increase each year. Some are effective, to some degree, while most are not. Whatever their marketing messages, however, near all hair loss treatments use common ingredients rather than unique synthetic chemicals.
One of the biggest examples of synthetic treatment is finasteride. Initially developed as a treatment for prostate enlargement called Proscar, it launched as a hair loss treatment called Propecia in 1997. Dutasteride often sold under the brand name Avodart, is another treatment for prostate enlargement that most physicians believe is less effective but can serve as a substitute for those who cannot take finasteride for whatever reason.
Receiving a prescription for finasteride or dutasteride is easy. Patients merely need to ask their physician, who will then in all probability sign off on it. Side effects can happen though, including depression and, in less than 5% of cases, sexual dysfunction. Dutasteride’s side effects can be even more severe. Females considering finasteride should also know that it can dramatically alter hormones: many physicians recommend they not even physically touch the capsules when pregnant.
Finasteride is the first oral treatment that encouraged hair retention and growth. Minoxidil, a topical hair loss treatment launched under the brand name Rogaine, became available in the late eighties. Effective for some people, minoxidil’s main strength is encouraging hair retention and growth. Doctors are still figuring out how it exactly encourages results, but most believe it facilitates circulation to the scalp.
Meanwhile, finasteride is the first anti-androgen released to the public to prevent hair loss. Androgens are “male” hormones that both sexes have, testosterone being the most popularly recognizable. Testosterone converts to a number of chemicals through perfectly natural processes, one of them being DHT: a major cause of hair loss. Finasteride blocks this conversion, thereby enabling better hair retention and fostering some growth.
Hair restoration specialists continue to experiment with finasteride to optimize growth. Dr. Cole is working on a topical finasteride treatment that is showing substantial results. Learn more by reading a recent blog post. Alternatively, contact us to learn more about finasteride, dutasteride, and other take-home hair loss treatment.
Forhair is always attentive to patients’ schedules when arranging procedure times. First, though, candidates must undergo one or more consultations to ensure hair transplantation is right for them, and, further, which hair transplant method best meets their needs. Such consultations may require physician recommendations, medical records, and other documents. After the consultation(s) patients will receive a recommendation as to the type and size of transplant most productive for them.
After our specialist’s recommendation, and any feasible adjustments made at the patient’s request, Forhair will then schedule a procedure time. Larger transplants can require multiple sessions, so patients that decide on substantially large transplants may have to plan on dedicating at least a few days to undergo procedures.
Patients should also consider planning their days post-procedure: most patients return to work, excluding strenuous tasks, the very next day but minor complications such as post-procedure swelling may require up to a week’s rest. Such instances of swelling are rare, however, and even most patients who experience it can still accomplish work. Similarly, patients should pick their social engagement wisely post-procedure, especially if the transplant type requires shaving the donor area.
A premier clinic with a global reputation for excellence, many of Forhair’s patients must fly into Atlanta and book lodgings. We are happy to offer suggestions, if not outright arrange travel and board. The Atlanta area has plenty of great hotels, attractions, and sites, and we always enjoy offering recommendations to visiting patients.
Crucially, patients should also remember that they themselves must prepare for the procedure. Present-day hair transplantation is both safe and relatively undemanding on the patient. However, little things can make a big difference for a hair transplant result. Read more about how to prepare for your hair transplant procedure, and when, by checking out our Procedure Overview page or contacting us.
Scheduling a hair transplantation procedure requires forethought and, often, follow-through. Before scheduling a procedure, though, prospects must undergo a specialists’ consultation.
Consultations with a hair transplant specialist are critical for appraising viability for any type of hair transplantation. Patients must be ready to talk about their overall health, current age, diet, age when hair loss began, progress of said hair loss, and more. Initial consultations rarely require medical records. However, follow up consultations may require documents or recommendations from other physicians. These are necessary to verify what patients say about themselves, to verify that their other physicians endorse the procedure, and to adjust the procedure to address any special needs for the patient.
In the recent past, all consultations took place in person. Busy persons will be glad to know that specialists can consult online thanks to the advent of 720p video streaming. Outpatient consultations, however, are very useful for a number of reasons; most specifically to gauge the candidate’s current amount of viable donor hairs. Forhair currently uses Hairmes, a unique program from France, that calculates scalp area vs. hair count to find the right amount of donor hair in the right area. This is actually quite important for ensuring a quality transplant. Procedures that have too many donor extractions can lead to visible thinness in donor areas. Too little extractions, meanwhile, can unnecessarily limit a procedure.
To date, the only hair transplant technique that encourages an increase in hair count is Cole Isolation Technique (CIT®), Dr. Cole’s namesake FUE variant. CIT®’s unparalleled minimum invasiveness leaves stem cell remnants in donor areas that, with the application of ACell, enable between 30% to 40% of donor follicles to regenerate: 300 to 400 follicles for every 1000 individual extractions. All other transplants exclusively allow relocation of hair from one area to another. Of course, Forhair offers other hair transplant types: FUT and Body Hair Transplantation in particular.
After consultation, scheduling for the procedure can happen. Forhair is a busy clinic and patients must sometimes book their hair transplant several months ahead. Depending on the patient’s needs and Dr. Cole’s schedule, though, they can undergo their procedure within a shorter time-frame. Contact us or book an online consultation.
FUE / CIT Hair Transplant FAQs
Common questions and answers about CIT (FUE) hair transplantation vs. other techniques, learn about the procedure and it’s advantages
All present-day transplants have one common tenant: to extract follicles from a donor area and transplant them to a recipient area. Seemingly simple, hair transplantation is actually quite complex and requires years to master. The greatest factor in a hair transplants’ success is the clinic and surgeon themselves.
Follicular Unit Transplantation (FUT) is an older method that involves extracting a swath of scalp, dividing it into grafts of follicular units, and then transplanting those grafts into a recipient area. Follicular Unit Extraction (FUE), meanwhile, involves diffuse extractions of follicular grafts and then their transplantation to a recipient area. Far less invasive, FUE has a repute for its precision, discreteness, longevity, and less noticeable, if at all visible, scarring.
Regardless of the major hair transplant method, recovery, and results, depend on the body’s natural ability to heal. Hair transplant grafts themselves are all natural -bits of adipose with one or more follicles. They also must originate from the patient themself or the body will reject the graft due to cellular dissimilarities.
Physicians often research formulas to better nourish follicles when outside the body, as this is integral to their viability before transplantation. However, the follicular grafts themselves presently receive no alteration. The scalp then naturally incorporates them upon tissue repair.
A number of FUE variants are available. None, though, currently surpass Cole Isolation Technique (CIT®), Dr. Cole’s namesake FUE variant. Among the most minimally invasive options available, CIT® consistently leaves little to no visible scars and allows exceptional precision for graft placement. Most scientifically notable, CIT® is the only FUE variant that leaves stem cell remnants in donor areas. The addition of ACell, an extracellular matrix common in wound recovery, facilitates these stem cell remnant’s regeneration; 30% to 40% recovery of donor follicles is the result. Put simply, that means CIT® + ACell enables patients to regenerate 300 to 400 hair follicles for every 1000 extractions. This both ensures less thinning in the donor areas and enables future transplants if necessary. Learn more about CIT® by visiting our Procedure Overview page.
We use a variety of needle gauges to make incisions for my single hair grafts. The reason we use needles instead of the scalpel for these incisions is for the staff to know where to place grafts of a specific size. I use the needle incisions to direct my staff, like a roadmap.
Needles cut a larger surface area than scalpels. The needle incision looks similar to the character from the game called Pac Man with his mouth open. A needle with a 1 mm diameter cuts a surface area of 3.14 mm. This is much larger than the surface area from a scalpel that is 1mm wide.
Another thing we don’t like about the needle is that it can be more traumatic to the grafts to place into the needle site if the gauge is very small. We know that Dr. Woods likes to use 23 and 25 gauge needle sites for his grafts. We know that you will have much greater trauma, slower placement of the grafts, long time out of the body, and no advantage cosmetically. In fact, if the incision site is too small, the risk of compression increases.
We prefer to make incisions that are always custom made for the specific graft. We know that every individual has grafts that are of different size. Therefore, we must individualize the graft. Also, some individuals have very hard skin, while others have elastic skin that allows for greater ease of placement. More elastic skin expands and accommodates the graft better. Harder skin is not elastic. It does not expand and dial ate in response to the larger graft. Therefore, you will need a slightly larger incision for a larger graft in the individual with less skin elasticity.
Larger diameter shafts require larger incisions. If a person has finer hair, we can make smaller incisions. Again, all incisions must be customized to the individual patient.
We believe that a recipient site incision should allow ease of placement and provide for a snug fit so that the grafts are less likely to pop out during the procedure or after the procedure. Since each individual has a specific hair characteristic and specific skin character, all individuals must have recipient sites specifically tailored to their individual characteristics. We have several individuals in our staff who are very adept at placing grafts.
Forhair is based in Alpharetta, Georgia, and New York, NYC. All clinics feature excellent equipment and expert staff. Forhair’s presence in Italy reflects Europe’s current reputation for top-notch FUE. Dr. Cole is an early contributor to the field but, regionally, Europe was the first area to practice FUE before Asia and the U.S. also began.
An innovator of the field, Dr. Cole’s expertise reflects itself in both excellent results and excellent techniques. Forhair clinics are some of the only in the world to offer Cole Isolation Technique (CIT®), a patented FUE variant that brings excellent results. Applicable for most patients, CIT® offers many benefits over most FUE options:
- Least invasive
- Last likely to leave scars
- Greater precision
- Easier on the scalp
Such advantages, in addition to the clinics’ overall skill, leads to top notch results. With CIT®, patients enjoy an average success rate of at least 97%. Other clinics in good standing, meanwhile, average 90%. This is due to a few reasons, including the equipment or devices they are use, the surgeon’s and team’s proficiency, and the patient’s needs.
Forhair most often performs CIT® but offers other transplant options as well. These include FUT, if the best option for them, as well Body Hair Transplants (BHT) for patients who have less donor hair. A patient’s viability for such transplants depends on a number of factors but Forhair also offers hair growth treatments, including a superior variant of PRP, CRP. Featuring five to eight times the growth factors and cytokines as regular PRP, CRP in fact enables Forhair patients to enjoy 99% follicular activation in four and a half months. This is more than twice the average, which is around a year.
Forhair clinics put the patient first, meaning they also emphasize consultations. This is to ensure hair transplantation is right for you.
As with all other elective procedures, Forhair has every patient sign a consent form. This form is not a legal disclaimer. Instead, it is a document that outlines everything that can possibly go wrong, rare as those instances are. Reputable clinics should consider such consent forms a patient right; disreputable clinics, meanwhile, over-rely on sales and will gloss over possible complications.
Legal disclaimers, meanwhile, are documents that protect the designated party from legal proceedings. Patients should avoid clinics that require legal disclaimers, as their role is often to protect the clinic from negligence or awful results. These are not consent forms.
Consent forms are just one way Forhair advocates for patients. Hair transplantation is more established than ever and a growing amount of surgeons are offering procedures. However, with greater expansion, and the development of new techniques such as FUE, there is greater risk of unscrupulous surgeons abusing patients’ confidence.
Hair transplantation is a specialty field that requires years of training and experience. A demanding technique, FUE specifically requires training, experience, and talent. Reputable hair transplantation clinics prioritize informing the patient on both hair restoration and available procedures.
Genuine hair restoration specialists will have differing opinions and preferences regarding hair transplant surgeries, yes. This advocacy, however, should never lead to blurring the facts. This is one reason why strip (FUT) surgeons are specifically suspect: strip procedures have consistently proven an inferior option compared to FUE. Patients should also be cautious of unscrupulous FUE surgeons, however. The increase in demand for FUE has led to surgeons without proper training to offer it, also leading to bad results and complications.
Patients must do their research when considering a hair transplant clinic. Reputable surgeons will always outline their experience, including surgeons they trained with and their total amount of patients. A competitive field, clinic websites often contain a detailed information about each transplant or treatment option.
Hair transplantation is a complex procedure and results depend on the surgeon’s skill. Always make sure the surgeon has proper training and experience and that the clinic is reputable. Complications often result from clinics cutting corners or otherwise using subpar techniques or equipment.
An innovator of FUE with global renown, Dr. Cole takes a number of measures to lessen any chance of complications. This includes developing his namesake FUE variant, Cole Isolation Technique (CIT®), as well as specialty instruments trusted by over 500 surgeons. For instance, Dr. Cole uses a unique solution at a specific temperature to keep FUE grafts; this maintains their cellular framework and prevents decay, thereby enhancing results and decreasing the chance of shock loss.
Complications from a hair transplantation can happen for any number of reasons. Clinics, of course, must follow the best practices of any medical provider. A specialty field, hair transplantation also requires pacing and considerations to both ensure the best result and decrease the risk of complications; as like all medicine.
Reputable clinics will always use a step-by-step routine for each patient. This will include a consultation, when they will typically use advanced programs to chart current hair density, and other important steps before the procedure even begins. Reputable clinics, in fact, will often have a full schedule and patients will have to wait several months, at least, to receive their procedure. Disreputable clinics, that both offer worse results and a greater chance of complications, will typically pressure for a procedure within the near future.
Forhair has global repute because of its consistently excellent results. As such, we take complication very seriously and offer free treatments when appropriate. Forhair policies are so stringent, in fact, that the very few patients who receive noticeable scars enjoy scalp micro pigmentation for free.
Reputable hair transplant clinics will always include genuine before and after photos. That mentioned, it is essential prospective patients also research each clinic’s reputation and standing. Patients will often post reviews or feedback online, as well offer references socially.
Surgeons active in hair transplantation also receive training from experts in the procedure and typically reference these surgeons. The amount of patients of a surgeon also indicates their experience. Above all else, prospective patients will want to do research into the latest proven trends and techniques and select the appropriate clinic: there can be a lot of material to absorb and, further, patients should ask select clinics about the details of their procedures and techniques.
Still, patients will want to review before and after photos. These photos, at the least, should leave not alter the patient’s scalp and hair. There are many ways for a disreputable clinic to present results as better than they are in reality. This includes photo editing techniques such as blur, shadow effects, and lighting. Such alterations can make a transplant appear thicker or otherwise a higher quality.
That mentioned, clinics always are grateful towards patients who volunteer before and after photos. Medicine is a private matter and most patients do not want to share their experiences or information. Clinics with a large amount of patients are more likely to find volunteers. Before and after photos from dishonest clinics, however, can even feature models or altered photos from rival clinics. The more glossed over a photo seems, however, and the more distinct its lighting, the more likely it is a result of alterations.
Patients should also be conscious that hair transplant before and after photos are static. Hairstyle effects the appearance of density, as well the appearance of the transplant’s quality itself. Motion capture and talking to transplant recipients in person always provide a better idea of the transplant’s quality.
We do not know where this concern over density has arisen from although it is most probably comes from the physicians who promote strip harvesting (FUG, FUT). The truth is they are scared to death of CIT® and FUE or they should be. Follicular unit extraction (FUE) is now mainstream and they have no choice except to learn CIT® or FUE. If they do not learn these procedures, they will soon have far fewer patients to work on.
If anything, the potential density and the potential total number of grafts available from CIT® are both greater than from strip harvesting. Typically, in a single pass, we are able to achieve densities that are 25% greater than from strip harvesting. This is because the grafts are smaller so we can place more of them into a smaller surface area. In addition, although the CIT® grafts are smaller, they generally contain more hairs per graft than most physicians’ staff are capable of producing from graft preparation subsequent to strip harvest removal. Finally, our grafts do not have the same high risk to telogen hairs that are seen from graft preparation after strip harvest. All of these factors- the greater potential number of total grafts, higher single pass density, more hairs per graft, and less risk to telogen hairs – essentially assure a much better density from CIT® than one can obtain from strip harvesting.
There are other factors that contribute to the greater potential density of CIT® hair transplant. With strip, harvesting grafts are allowed to soak in a solution of saline or lactic ringers along with hundreds to thousands of other grafts for prolonged periods of time. A case of 2000 grafts will take at least 4 ½ hours to accomplish, but most patients will require 6 hours and even up to 8 hours for a higher quality procedure. Yes, you can do any strip procedure faster, but you will sacrifice quality and you will have a much higher transaction rate with greater damage to the hair follicles. While these grafts are all soaking in the same solution, they are releasing toxic chemicals that are injurious to one another and to the recipient area. Time out of the body and the exposure to other grafts within the same solution is far less with CIT®. Thus, CIT® grafts have a significant reduction in exposure to these toxic metabolites. This essentially ensures a higher yield from CIT®, although we have not performed scientifically conclusive studies yet. We have found that our CIT® methods often result in a much faster re-growth rate than we saw from strip harvesting. Still, it may take 8 months to 1 year before you have full re-growth. From CIT® you will generally have a higher percentage in the growing phase at any given time.
Peak restoration or temple restoration comes in many different varieties. Basically, it depends on the amount of loss you have or the total surface area that needs treatment. It is safe to say that peak or temple restoration requires a minimum of 400 grafts, but could require up to 1200 grafts. The location of the hairline has an effect on this number. If you are comfortable with a higher hairline, you will require fewer grafts. If you want the lower hairline, you will need more grafts. The hairline extension adds surface area to the recipient area at an exponential rate. A 1 mm extension increases the surface area by 3.14 sq. mm, a 2mm extension adds roughly 12.56 sq. mm, and a 3 mm extension adds about 28.26 sq mm. Small changes can require significantly more grafts. To fill in the frontal area, you may want to add another 100 to 300 grafts. If this area is much weaker, we may require more grafts.
Age is very important to the hair restoration procedure. We find that working on individuals with minimal hair loss in their mid-thirties is a safer bet that we can provide full coverage over the lifetime of our patients. Patients who begin to lose hair in their early 20s will most likely have more excessive hair loss and may not be able to achieve full coverage. Of course, there are many factors governing potential coverage. Density, Diameter, Wave, and many additional factors are important. We look forward to seeing your photos and a hair sample is often times a good thing to send, as well, so that we can assess your hair caliber.
Few hair restoration patients undergo shock loss, but it does happen and its frequency can reflect the surgeon. Shock loss’s cause is most likely dependent on each patient’s reaction to the procedure. The level of the procedure’s invasiveness, however, does decide the overall level of trauma. Any physical trauma, especially sustained trauma on the scalp, can lead to shock loss.
Seasoned hair restoration professionals are wary of shock loss. A temporary problem, shock loss can create complications with future growth. Hair follicles’ longevity depends on the amount of growth cycles they undergo. With balding and thinning, hair strands first begin to miniaturize, or lose its diameter, length, and pigment, and then, after further cycles, become vellus hair. If the follicle is on its last legs then shock loss can affect coverage. Hair transplant results, however, should have the same aesthetic placement and overall quality.
There are numerous ways to minimize shock loss. FUE is less invasive than strip surgeries, or FUT, and therefore less likely to cause shock loss overall. However, there are numerous FUE variants and these range in intrusiveness.
Cole Isolation Technique (CIT®), Dr. Cole’s namesake variant, is among the least invasive FUE options in the world. As such, CIT® patients are less likely to undergo shock loss at all. For this same reason, CIT® is less likely to scar. FUE has the least chance of scarring of all hair transplant methods. However, scarring depends on both the variant’s intrusiveness and the skill of the surgeon.
Along with being an innovator of FUE, Dr. Cole is a globally renowned hair restoration surgeon whose own transection rate is below 3%. As such, Dr. Cole uses a number of precautions to further limit trauma. These include limiting the size of incision sites, calculating the area between transplants, and using an instrument with a small width and length.
The most recent method for hair transplantation, Follicular Unit Extraction (FUE) involves extracting individual follicular grafts and then transplanting them to the donor area. So long as the surgeon is adequate, FUE’s results will almost alw0ays be superior to that of Follicular Unit Transplantation (FUT), an older type of hair transplant technique that always leaves a visible scar and often leads to lousy results; over 40% of Forhair’s patients seek us to repair transplants by other clinics.
Cole Isolation Technique (CIT®), meanwhile, is Dr. Cole’s namesake FUE variant. A pioneer of the technique, Dr. Cole developed CIT® with the hope of facilitating donor recharging: the regrowth of follicles extracted as grafts. His belief, which was proven correct, is that if the extraction did not penetrate too deep then it would actually leave stem cell remnants. In fact, the application of ACell, an extracellular matrix used for post-op recuperation, enables an average of 30% to 40% of donor follicles to regenerate: this means 300 to 400 new donor hair for every 1,000 single extractions. CIT® is the only hair transplant technique, currently, that enables such recharging: all other hair transplants only transfer hair from one location to another.
CIT® offers numerous benefits aside from donor recharging. Minimal intrusion also decreases the amount of trauma to the scalp, thereby improving recuperation time and lessening the chances of swelling or other side effects. Another prime benefit of CIT® is a substantially decreased chance of scarring. FUE can leave scars that resemble moth-eaten cloth. The minimal intrusion of CIT®, however, helps ensure that patients rarely deal with any noticeable scars. Should patients have any noticeable scars, and this is quite rare, then Forhair will offer Scalp Micro Pigmentation (SMP) for free. An all-natural tattoo that lasts for five to seven years that Forhair regularly uses for scar repair, SMP creates the appearance of hair that is actively growing.
CIT® is among the best options for hair transplantation.
Yes. CIT (Cole FUE) is more time and labor-intensive for the physician, making it a more expensive procedure overall. However, with CIT, Dr. Cole averages 2.9 hairs per graft versus the 2.0 most strip physicians yield. This means that you are getting almost 1 hair per graft more with CIT than you would with a strip procedure (or 30% more hair for the number of grafts you are paying for).
Follicular Unit Extraction (FUE) offers a substantial amount of benefits over Follicular Unit Transplant (FUT). The latter is an older method that is more inconsistent and, in fact, can cause substantial problems for the patient as the transplant ages. FUE, meanwhile, is the latest available method available to patients.
FUT involves extracting a donor strip for follicular grafts, typically from the back of the head, and then segmenting them into grafts for transplantation into donor areas. Patients must carefully tend to the extraction site for months after the procedure, one reason fewer patients are opting for FUT. The donor strip is not typically that large but will still leave a noticeable scar that short haircuts cannot always obscure. Further, FUT transplants can age, leading the plugs to become more noticeable and have an appearance similar to doll hair.
FUE, on the other hand, involves individual extractions of follicles. Patients do not have to worry about a large, orbital scar on their head nor months of caring for an extraction site. Depending on the procedure and surgeon, though, FUE can lead to scars similar to moth holes in a garment and may not yield the best results.
A pioneer of FUE, Dr. Cole and Forhair offer some of the best results the world over. His namesake FUE variant, Cole Isolation Technique (CIT®), is among the least invasive techniques in the world and offers a number of benefits over most versions of FUE. Selecting CIT® from Dr. Cole means enjoying:
- Minimal to zero visible scarring
- 30% to 40% donor regeneration with application of ACell
- A much shorter recovery time than FUT
- A transection rate of under 3%: most surgeon’s transection rates range from 5% to 10% or 20%
- Precise placement of grafts, leading to better aesthetic results
One of the most important elements of choosing a FUE technique is recognizing that some variants are more effective and some are less effective. Many surgeons are resorting to automated or robotic options that typically have a higher transection rate and, typically, offer less impressive aesthetic results. Read here to learn more about the differences between FUT and FUE.
Follicular Unit Transplant (FUT) is well known for offering a large graft count. However, the quality of a hair transplant depends on far more than just the amount of grafts. Surgeons must consider placement, longevity, overall aesthetics, and much more. The best hair transplant surgeons, in fact, know how to distribute grafts to maximize their effectiveness. This is actually essential to prefer donor grafts for patients that may opt for future hair transplants.
While FUT offers a large graft count, however, the donor area is limited to the strip of skin surgeons extract to create grafts for transplanting into recipient areas. Similarly, every future FUT procedure will also require a similar extraction. Patients should also be aware that the extractions from FUT will always leave a noticeable scar, that the scar’s size is impossible to predict, and that the scar can become more noticeable with age.
Follicular Unit Extraction (FUE), meanwhile, is a more recent technique that involves extracting individual or very small groups of follicles as this leads to substantially less, if any, scarring and better aesthetic results. Harvesting grafts, therefore, can require substantially more time unless in the hands of a master; Dr. Cole finds that most his procedures equal the time of a FUT procedure in terms of graft placement and extraction.
Of course, graft count and efficiency also depend on the technique itself. Dr. Cole’s namesake FUE variant, Cole Isolation Technique (CIT®), is available in three different versions: fully shaved, patch shaved, and no-shave. Each has its own limits for the maximum amount of grafts they enjoy and this ranges from 3,000 grafts to 5,000 or even more.
FUE also has the added benefit of allowing surgeons to gather grafts from a range of donor areas. They most often focus on the sides of the head but, depending on the case, specialists may also harvest from multiple regions of the head and/or the body. Learn more by reading about CIT® and BHT.
The overall amount of grafts patients can receive per hair transplant sessions depends on both the surgeon and the hair transplant technique they use. Many other factors govern the size of a hair transplant session, including the patient’s amount of viable donor hair, the clinic’s scheduling, and the patients’ willingness to stay still for a long session.
Follicular Unit Transplants (FUT), or strip-style transplants, have a reputation for allowing large sessions. The truth, however, is that such procedures require less time and therefore allow the surgeons to implant a larger amount of grafts in a shorter amount of time. However, FUT also has a number of disadvantages. These include a large, orbital scar at the extraction site, a longer recovery time, and a much greater chance that the transplants will show with age.
Follicular Unit Extraction (FUE), the most recent type of transplant available, brings a number of greater benefits to the patient. These include a faster recovery time, far less scarring, and, in the hands of a skilled surgeon, far superior results. FUE, however, does typically require much more time to conduct.
A pioneer of FUE who has innovated his own techniques and surgical devices, Dr. Cole is exceptionally quick at conducting his namesake FUE variant, Cole Isolation Technique (CIT®). Most sessions reflect the speed of FUT, though it depends on the patient and type of CIT®.
Shaven CIT®: Patients’ heads are shaven for the procedure and Dr. Cole can do up to 5,000 grafts per procedure, though this depends on scheduling and availability
Patch-shaven CIT®: Patients’ donor patches are shaven, allowing patients to hide the donor area with at least mid-length hair, and Dr. Cole can do up to 3,000 grafts per procedure.
No-shave CIT®: Dr. Cole individually cuts each donor follicle’s hair strand, extracts it, and then transplants it, and can do up to 2,500 grafts per day and typically requires two days per procedure.
The grafts per square centimeter that patients receive depends on its location, the patient’s available donor amount, and areas that are thinning as well their amount. How a surgeon layers the number of grafts by each centimeter depends on their technique. Almost always, however, they will first assess which areas require the most grafts and then make a decision from there.
Most studies indicate that the average, natural average density per square cm is 80 to 100 FU. However, thinning only begins to appear noticeable at 40 FU. Any hair transplant surgeon’s objective, therefore, is to increase recipient areas’ density to at least slightly above this level.
There are also risks involved in placing too many grafts per square centimeter. Some studies indicate the even exceeding 30 FU grafts per square centimeter can significantly decrease the overall yield. However, surgeons use different techniques and must consider each patient differently. Dr. Cole’s namesake FUE variant, Cole Isolation Technique (CIT®), enables him to transplant up to 45 grafts per square centimeter.
Among the least intrusive hair transplant options available, CIT® causes less trauma to the scalp than most FUE variants. It also brings a number of other benefits too, not the least being the only FUE option with an average of 30% to 40% donor regeneration with the application of ACell. Put simply, this means for every 1000 single CIT® extractions patients regenerate 300 to 400 donor follicles. Along with maintaining the overall appearance of density, such regeneration also allows patients to undergo future hair transplants if necessary.
One reason Dr. Cole typically prefers never exceeding 45 grafts per square centimeter is finite donor supply. A pioneer in hair transplant surgery, Dr. Cole’s overall skill at planning for a patient’s aging and future hair loss is one reason his results are so spectacular.
Scarring from hair transplantation was common and pronounced until the advent of Follicular Unit Extraction (FUE) variants that minimize it, of which Cole Isolation Technique (CIT®) is one. In fact, CIT® is actually among the least intrusive methods available, adding a number of unprecedented benefits.
After results, of course, scarring is probably the first concern that patients voice. They are also right to ask about scarring. FUE, conceptually, is far superior to the second most recent option, Follicular Unit Transplantation (FUT) because the latter’s visible lateral scar and inferior precision in graft placement.
However, the effectiveness of FUE depends on both the surgeon and clinic. Less experienced or incompetent FUE surgeons will almost always leave a pattern of scarring that patients like to moth hole patterns in garments, not to mention have less success implanting the actual grafts themselves.
A pioneer of FUE since before the 2000s, Dr. Cole is among the most experienced and renowned hair transplant surgeons worldwide. This is due to the top-caliber results his patients enjoy, of course, but also his emphasis on research and innovation. Cole Isolation Technique (CIT®), Dr. Cole’s namesake FUE variant, is among the least intrusive hair transplant options in the world. This emphasis on the slightest amount of invasion possible offers a number of unique benefits that only CIT® recipients enjoy. Minimal to no visible scarring is one such advantage.
Scarring from CIT® by Dr. Cole is very rare to nonexistent due to a number of factors. First, and as already mentioned, Dr. Cole’s acumen means he is very familiar with good practices that minimize scarring. This is perhaps the most critical part of choosing a surgeon: demonstrable skill. Further, Dr. Cole has both researched and clinically tested a number of instruments and post-procedure haircare to further minimize scarring. In the very rare case that patients have noticeable scarring, however, Forhair offers Scalp Micro Pigmentation, a technique excellent for masking scars, for free.
Follicular Unit Extraction (FUE) is the newest hair transplant technique to gain prevalence. At first available through pioneering physicians, of which Dr. Cole was one, FUE initially was far less consistent than it is nowadays. Surgeons were still adopting the technique and many preferred Follicular Unit Transplant (FUT), an older technique that leads to a major scar, only because it was more proven.
One of the common defenses of FUT surgeons in the early 2000s is that FUE still left scarring. Diffuse and far less invasive than FUT, FUE scarring still has the potential of leaving a scar pattern similar to moth holes in a garment. However, such scarring depends on both the surgeon’s skill and the technique. As FUE gained prevalence and demand more and more surgeons adopted the method, with those who popularized it, including Dr. Cole, both contributing important research and establishing finer or more efficient techniques.
There are now numerous FUE variants to select. Cole Isolation Technique (CIT®), Dr. Cole’s namesake FUE variant, is among the least likely to leave noticeable scars. This is due to the variant’s unprecedented lack of intrusiveness, which adds a number of unique benefits that only Forhair clinics offer:
- Minimal to no noticeable scarring: As mentioned, the minimal intrusion of CIT® radically decreases the chance of scarring.
- Donor regeneration: CIT® is the only hair transplantation technique that leaves stem cell remnants that, with the application of ACell, have the chance to regenerate.
- Faster, better recovery: Minimal intrusiveness decreases the chance of adverse, temporary symptoms and typically demands less time to recuperate.
Many CIT® patients say donor regeneration is the most significant advantage they enjoy. Hair transplants make foster the appearance of better hair coverage but, at base, it is a procedure that relocates hair follicles from one scalp location to another. CIT® with ACell, on the other hand, enables 30% to 40% donor regeneration: 300 to 400 new strands of donor hair for every 1000 single extractions. Adding to overall hair density accomplishes two things: the ability to extract more hair than previously feasible and, with the replenishment of donor hair, the greater option to undergo future CIT® transplants in the future.
CIT®, in fact, so consistently leaves little to no noticeable scars that Forhair promises Scalp Micro Pigmentation, an all-natural scalp tattoo that appears like actively growing hair follicles, to any patient that has scars as a result of a Forhair CIT® procedure.
Over 40% of patients request we change transplant work from other clinics, and for good reason. Hair transplant clinics range a great deal in the quality they offer. A premier clinic with a global reputation for excellence, it makes sense that patients who first tried a more convenient or affordable option, and who found the result disappointing, would then arrange for a transplant repair at a clinic like Forhair.
Not all hair transplant repair procedures are a result of bad clinics, however. Sometimes patients are merely looking to correct older transplants for whatever reason, particularly variants of Follicular Unit Transplant (FUT). An older technique than the more popular Follicular Unit Extraction (FUE), FUT always leaves a noticeable lateral scar and, with age, plugs can become noticeable and have a “doll-like” appearance.
A number of surgeons offer hair transplant repair. FUE, in particular, is useful for it, as the ability to extract individual follicles make ideal for redistributing plugs. However, such hair transplant repair depends on both the type of FUE and the skill of the surgeon.
Patients looking to handle a bad transplant opt for Forhair for a number of reasons. First, Dr. Cole’s proven track record and experience speak for themselves. Second, and as important, his namesake FUE variant, Cole Isolation Technique (CIT®), is among the least intrusive and most precise options available today. There are several reasons why CIT® specifically offers superior results in the case of hair transplant repair:
- Minimal or no visible scarring
- Unprecedented ability to for 30% to 40% of donor follicles to regenerate
- More precise, advantageous for plug redistribution
FUT scars can also lead to complication. First off, they are always noticeable with shorter haircuts. Second, and more importantly, such scars can expand with age. There are few ways a surgeon can simply eliminate such scars. Instead, they must obfuscate them. Dr. Cole and his team particularly excel at creating effective, unique solutions that effectively prevents any noticeability of the scar. Such cases typically involve combining CIT® with Scalp Micro pigmentation, a natural tattoo that appears like growing hair follicles and lasts up to five years.
The duration of a hair transplant procedure depends on the hair transplant technique and surgeon. Follicular Unit Transplant (FUT), an older technique, has a reputation for being faster but it always leaves a lateral scar and requires more recuperation time. Follicular Unit Extraction (FUE), meanwhile, is the newest technique in popular practice, leaves far less noticeable scars, if any, but has a reputation for necessitating more time for the same amount of transplants.
The procedure’s length, however, depends on more than just the technique. One of the first pioneers of FUE and an innovator in the field, the combination of Dr. Cole’s custom-made instruments and expertise enable him to complete shaven CIT® procedures in the same amount of time it typically takes to complete a FUT procedure. This is exceedingly rare, however, and most FUE procedures do require more time than FUT procedures.
The length of a procedure, or the number of procedures, will always depend on the transplant’s size. Any worthwhile hair transplant surgeon is concerned about fatigue, as it can affect results, and therefore limit themselves to a certain amount of grafts each day. Further, some techniques work best with a limited amount of grafts. Dr. Cole, for instance, typically does not do more than 3000 grafts for the shaven-patch version of CIT®: any more would require such large shaven patches the entire procedure might as well be shaved.
Further, sometimes CIT® transplants can be so large they require multiple days to complete. Luckily, they are among the least intrusive transplants in the world. Large-scale transplants do cause more trauma to the scalp, increasing the chance of side effects, but the minimal invasiveness of CIT® decreases the chance of swelling or shock loss in comparison to regular FUE. Patients can expect any session over eight hours to require procedures on at least two days.
That FUE grafts have a bad survival rate is a rumor left over from the early 2000s. Instead of the technique itself being at fault, the survival rate of FUE grafts depends on a number of factors. Though viable since at least the early 2000’s, proficiency at FUE takes time to build and the technique did not gain prevalence, or become standardized, until a few years later, leading to less consistent results in FUE’s early stage of adoption.
Before going further, it is important to differentiate between transection and graft survival rates. Transection is when a follicle is irrevocably damaged during the extraction or transplantation phase. Graft survival rate, meanwhile, is how many grafts survive after recuperation.
Since FUE has become more mainstream, however, it has proven to be just as effective as FUT. For this to be the case, however, depends on the surgeon, clinic, and patient all. Hair transplantation may happen at the clinic but proper recuperation is vital for graft survival, almost as much so as the surgeon’s proficiency and clinic’s practices.
The growing demand for FUE has led to any number of surgeons offering the technique. However, not all surgeons have sought the necessary training or are practiced enough in the technique: as mentioned, building mastery in FUE can require years. Surgeons who offer FUE but lack competence will either botch the procedure themselves, or, worse yet, assign it technicians with practical experience but little medical knowledge. Such procedures can have a graft survival rate of 50% or less. If FUE is conducted by a surgeon who is actually competent, however, the story is different.
Cole Isolation Technique (CIT®), Dr. Cole’s namesake FUE variant, has a transection rate of under 3% when conducted by Dr. Cole. Masters at FUE generally have a transection rate of around 10% or less. Other FUE surgeons who range in competence, meanwhile, can have transection rates that range from 20% to 80%.
- Neograft is an automated system that, unfortunately, is notorious for subpar results as surgical techs often run the device and administer the transplant.
- ARTAS is a robotic system that some surgeons use to save time during the extraction phase but also increases the chance of scars and transection rates.
- Body Hair Transplant (BHT) is an emerging transplant type that that uses FUE techniques to extract hair from the scalp and body hair donor region.
- Almost always no visible scarringFar more precise in extractions and graft placement
- The only hair transplant variant capable of donor recharging
- Quicker recuperation times with less chance of swelling
Hair transplantation has advanced a great deal, including variants that allow patients to not shave their head for the procedure. This is actually quite unusual; most procedures in the 90s required shaving.
The introduction and prevalence of Follicular Unit Extraction (FUT), however, enabled hair transplant surgeons to keep near all hair by only necessitating that the patient’s donor area is shaved. If the hair over the donor area was over an inch and half or so it can easily cover the extraction site as it heals. FUT, however, also has plenty of drawbacks, including the inevitability of a noticeable scar and long recuperation time, and this is exactly why there was a minor commotion when Follicular Unit Extraction (FUE) began having no-shave variants.
FUE initially required that all patients shave their heads. This was to aid in the extraction of follicular grafts, as surgeons lacked the instruments or techniques to effectively remove follicles or transplant them into recipient areas with some degree of hair. Innovation, though, has led to several options since then and Cole Isolation Technique (CIT®), Dr. Cole’s namesake FUE variant, now has several no-shave options.
No-shave FUE – C2G, or CIT®, exists in several forms. The type a patient selects typically pertains to the number of transplants the require and their hairstyle. CIT®, of course, also has a shaved version and it confers one major strength over other options: transplant size, as Dr. Cole can clear a larger amount of transplants in less time due to accessibility. This is not to say, however, that no-shave CIT® also doesn’t also lead to excellent results. Patients can select from two types of the variant.
- Patch-shave CIT® involves selective shaving of donor areas to ease extraction, though there is no shaving of recipient areas
- No-shave CIT® involves Dr. Cole and his team selecting individual donor follicles and cutting the hair strand upon each extraction.
Both patch-shave and no-shave CIT® bring major strengths to patients concerned about recovery or their immediate presentation after work.
The size of punches Dr. Cole uses in a procedure depend on the patient. A highly specialized cosmetic surgery, near all hair transplant surgeons use specialized tools. Follicular Unit Extraction (FUT) does not require individual extractions and therefore does not use a punch. Follicular Unit Extraction (FUE), however, does use punches to extract either one follicle or a cluster of them.
One of the first pioneers of Follicular Unit Extraction (FUE), Dr. Cole has found that many hair transplant surgeons’ early work was stymied by the lack of instruments to the trade. He innovated a few specialized punches for his own use and, after seeing the difference they make, released them under the brand Cole Instruments. He has continued to invent a number of instruments and updates since then, and now uses over 30 different instruments during his procedures, according to the patient’s needs.
Punch size in hair transplant surgery is always dependent on a few factors. First, in actuality, is the size of the procedure and location of the recipient areas. Dr. Cole will use larger punch sizes and extract clusters of hairs, sometimes up to five, for certain portions of a transplant; almost always areas that in no way impact the hairline. Precision matters, however, and the patient should expect that Dr. Cole will implant either very small clusters or individual hair at the hairline and neighboring areas for authenticity’s sake. This system both decreases the time of the procedure, Dr. Cole’s times conducting his namesake FUE variant Cole Isolation Technique (CIT®) matches the rate of FUT at this point, and leads to stellar results.
Far as actual punch sizes, Dr. Cole typically ranges from 0.8 mm to 1 mm, depending on the extraction. Some surgeons will decrease the size to 0.6 mm in an effort to prevent scars. However, the depth of penetration is what actually causes most scars -wider punches merely increase the chance of it because of the penetration’s width. CIT® may use slightly larger punches but it is also one of the least invasive FUE variants in the world and is well known for leaving minimal, if any, noticeable scars. The benefits of CIT® are actually quite numerous and include donor regeneration, a first in hair transplantation, and far greater control in graft placement. Visit our CIT® page to learn more about their unique FUE variant.
Many elements are important for a successful hair transplantation. One of the most overlooked is storage mediums: how grafts are kept outside the body. The truth is that there is no set standard for how grafts are stored and this can a great amount of damage to the graft.
All human tissue begins degrading after it is taken out of the body. The major reason is lack of oxidation and nourishment: tissue grafts outside the body begin ischemia, or begin cellular deterioration due to via lack of blood flow. The end result is cellular death, or when the graft’s cells die and the tissue becomes damaged, complicating the transplant itself and decreasing its chance of survival. For this reason, hospitals and clinics involved in any graft collection must consider two elements of storage.
Temperature can greatly effect ischemia by slowing down the metabolism: the human brain’s ischemic tolerance at 37 degrees Celsius is six minutes but at 17 degrees Celsius it is nearly 60 minutes. The same applies to all bodily grafts, though ischemic tolerance depends on the body part.
Holding mediums is also tremendously important. These suspend the grafts and offer any number of benefits, depending on the type, but the ultimate goal is to halt any deterioration of the follicular grafts.
Hospitals and clinics range tremendously in the holding mediums they use and their temperature. Generic storage mediums include normal saline, phosphate buffered saline, and Platelet Rich Plasma (PRP). While adequate, there is a number of more advanced solutions that also make decent holding solutions due to their composition, nutrient content, or ability to oxidize the graft.
A premier clinic with a global reputation for excellence, Forhair makes the point to use one of the best holding mediums available. Our variant uses liposomal, a storage medium known for its ability to transfer nutrients, drugs, and oxygen and transfuses it with adenosine triphosphate (ATP), a compound clinically proven to oxygenate the skin, encouraging blood flow and nutrition, and therefore also better preserving follicular grafts. Few clinics use such a high-quality holding solution but our research indicates it helps decrease the chance of follicular transection, or when follicular transplants do not grow after a procedure.
Temperature is less challenging to achieve but it also requires special equipment. Dr. Cole has designed an Electric Chilling Device that pumps cooling propylene glycol to maintain grafts at a constant temperature. The ideal temperature is still up to speculation, as little clinical research has gone into finding the optimal temperature for hair follicles. Kidney transplants, however, show that 10 degrees Celsius is better than 5 degrees Celsius, which in turn is better than 0.5 degrees Celsius. As mentioned, though, going too warm can damage the follicle.
Hair Loss FAQs
Below is a list of Frequently Asked Questions about hair loss related issues exclusively for men and women. How to stop hair loss, Propecia, Avodart, Androgenetic Alopecia in Women, you can post any topic here.
An early statistics show that 10,000,000 people over the world are suffering from Thyroid Disease (usually low thyroid-hypothyroid ).
Hair can be considered a barometer of health because hair cells are some of the fastest-growing in the body. When the body is in crisis, the hair cells can shut down to redirect energy elsewhere. The types of situations that can cause hair loss include hormonal changes, poor diet and nutritional deficiencies, a variety of medications, surgery, and many medical conditions, but noticeably, thyroid disease.
It is widely believed that thyroid sufferers lose hair due to decreased metabolism in the scalp follicles, resulting in the early release of the shaft, root and all. sometimes the hair becomes just too brittle, and there is a great deal of loss from split ends and breakage. As you know, the thyroid is intimately involved with hair function, witness that early graying and loss of outer eyebrows, is a cardinal sign of low thyroid in oneself or in the family.
Many people notice rapid hair loss as a symptom of their hyperthyroidism or hypothyroidism. Some people actually say this is the worst symptom of their thyroid problem — this thinning hair, large amounts falling out in the shower or sink, often accompanied by changes in the hair’s texture, making it dry, coarse, or easily tangled. Interestingly, some people have actually written to tell me that their thyroid problem was initially “diagnosed” by their hairdresser, who noticed the change!
As far as what can be done, the first and primary step is to restore full normal thyroid function. Consider that in general, the body’s wisdom directs it to conserve energy when possible, from nonessential areas, shunting repair, and regeneration power to those functions considered more essential. Another mechanism is that when thyroid function is low, intestinal absorption and utilization of vitamins, minerals, and other nutritional cofactors is compromised also. Not only are there not enough of the raw materials available, but the enzymes and sometimes temperature required for optimal chemical reactions is lessened.
As to restoring full function, don’t be misled into utilizing the TSH test alone as a terrific barometer of full restored function. This one laboratory determination is in no way up to that important task, regardless of what you may have been told by your doctor or HMO. A great many thyroid sufferers need more thyroid hormone replacement than most current endocrinologists are comfortable with giving.
We have seen people whose hair loss is only finally reversed, after years of unsuccessful treatments, with a fairly high dose of thyroid medicine, resulting in a very low TSH. Sometimes it is a mixture of thyroid pills (T3, T4, and/or natural all combined) that eventually does the trick.
First step!
- 1. Get an Evaluation. First, to deal with hair loss, before assuming it’s your thyroid, always have any hair loss evaluated by a dermatologist or hair loss expert to rule out any other causes — such as infection. For a hair loss specialist, visit the American Hair Loss Council to find a doctor who focuses on hair loss.
- 2. Be Patient
If you’re experiencing hair loss and are just starting treatment for a hyperthyroid or hypothyroid condition, it’s likely that for most of you, the loss will slow down, and eventually stop, once hormone levels are stabilized and in the normal range. This may take a few months, however. But rest assured, I’ve had many thousands of emails from people, and have yet to hear from anyone who lost all his or her hair or became bald, due to thyroid disease. But people — including myself — have experienced a significant loss of hair volume. In my case, I’d guess at one point, I lost almost half my hair. I had long, thick hair, and it got much thinner at various times.
Genetics are the most common hair loss causes behind hair loss. The hair loss gene is inheritable from either or both parents. Men are most commonly effected by this genetic factor as testosterone activates the hormonal reaction that causes follicles to stop producing terminal hair. Despite frequently perpetuated myths, causes of hair loss do not solely include wearing a hat, cheap haircare products, or lack of circulation, through these and other factors can further aggravate naturally occurring hair loss.
About The Surgery FAQs
Common questions and answers about the hair transplant surgery process, details about the techniques, medications involved, and what to expect from the procedure.
Hair transplantation is a long procedure so patients should choose comfortable clothes. Most hair transplant clinics keep their temperature low, so said clothes should also be warm. Patients should also avoid taking valuables with them; this is not due to the trustworthiness of the staff but, instead, due to the risk of the patient losing said valuable.
That mentioned, patients should also consider some caveats in regards to what they wear the day of the procedure and during recovery. Perhaps of greatest concern is the dislodgement of grafts. A risk for the first 10 days or so, graft dislodgement always adversely affects results. This is why Forhair and other reputable clinics stress sleeping upright for the first half week, avoiding heavy exercise or strain for the first 10 days, as well avoiding tight hats in favor of loose ones.
One often overlooked cause of graft dislodgement, however, are pullovers; t-shirts, jumpers, sweaters, etc. These types of garments are more likely to put pressure over the recipient site, thereby increasing the chance of graft dislodgment. To put it simply, imagine that putting on or taking off a crewneck each time leads to the further loss of follicles. Instead, patients should opt for upper garments that do not require stretching over the face. Button-downs are the safest bet, though polos or shirts with a partial button-down also suffice in most situations.
Avoiding follicular dislodgement falls squarely onto the patient. Forhair and reputable clinics make the point to offer detailed post-procedure instructions. Complying with these instructions is vital for the best possible results. A clinic’s quality and the surgeon’s skill is of primary importance for a transplant’s quality. However, all the surgeon’s effort can go to wast if the patient is not careful during the immediate recovery; right down to the shirts they wear and their sun exposure.
Hair transplantation’s continuing progress has led to significantly less intrusive treatments. Follicular Unit Extraction (FUE) and Follicular Unit Transplant (FUT), FUE’s less effective predecessor, are both done under local anesthesia and almost always painless. However, this is where the similarities between FUE and FUT stop.
FUE, and particularly Cole Isolation Technique (CIT®), is the least intrusive hair transplant method currently available. The procedure involves extracting follicular grafts individually and placing them in the recipient sites, usually the hairline. Patients will not experience any pain during the procedure itself but they will feel some soreness, tightness, and numbness the day following it. There also may be some blood and other fluid. By the third day, or fourth day, however, such discomfort is usually gone.
FUE patients may also deal with mild swelling on the forehead, one reason most clinics prescribe a steroid to lessen or prevent its development. Patients should sleep in an upright position for at least the first half week to help counteract any swelling that happens. Patients prone to swelling, occasionally, may find it increases in severity and spreads to their cheeks and nose. This is very rare, but if it happens, should subside within half a week.
FUT, on the other hand, is more intrusive than FUE. This older method involves extracting a swath of skin from the back of the head and dissecting it for grafts. These grafts are then transplanted to recipient sites. The quality of a FUT transplant’s recipient depends on both the surgeon’s placement and their skill at dissecting grafts. However, the extraction of the skin itself requires staples to close and will always leave a noticeable scar that alters hair growth patterns.
Healing from FUT is typically more complex and requires more patient attention. They must monitor and clean the extraction site, which is typically more painful than a FUE extraction site, as well as sleep upright for at least a week and contend with more severe swelling. The staples used to close the wound are typically removed after two weeks but will not fully heal until a few months afterwards.
Hair transplantation is less invasive than ever before. FUE patients can typically resume most normal activities the day after the procedure. However, each case is different and some patients may deal with side effects like swelling or shock loss. Such side effects are far rarer for Forhair patients, though, due to Cole Isolation Techniques’ (CIT®) minimum invasiveness. Not only does it typically lead to minimal or unnoticeable scarring, but it also limits the chance of swelling and its impact.
All patients will experience mild swelling after the procedure, typically around the forehead. This is absolutely normal and should dimish within the first three days. Patients of Forhair also receive prednisone, or a similar steroid, to help check against further swelling. Following all post-procedure instructions is essential for success; this includes sleeping upright for at least the first three nights. Along with protecting the implants, doing so will decrease the chance of swelling and prevent fluid buildup.
Handling the swelling itself, meanwhile, simply requires putting an ice pack on the area for 10 minutes on and ten minutes off. Be careful not to push too hard onto the forehead, as it can effect grafts that consist on the hairline.
Rarely, swelling from FUE can increase in severity. This has little to do with the method itself, particularly in the case of CIT® due to its minimal intrusiveness. Instead, patients prone to swelling from injuries have a small chance of moderate swelling. This will typically begin three to four days after the procedure and should decrease within a few days to half a week.
Everything considered, patients should remember to not panic if swelling occurs. Its duration may vary somewhat for patients, but it never leads to complications. Icing it and continuing to sleep in an upright position, along with steroids if recommended, is patients’ best bet for it diminishing as soon as possible.
Follicular Unit Extraction (FUE) has progressed a great deal since the early 2000s. An advancement over Follicular Unit Transplants (FUT), which led to less convincing results and a noticeable scar, correctly executed FUE leads to both better results and significantly less, if not unnoticeable, scarring.
This mentioned, early FUE also required the patient to shave their head. The quality results made doing so worthwhile but many patients shied away from the procedure due to the momentary inconvenience. FUT, meanwhile, did not require the patient to shave their head. Over time, as FUE has consistently shown better results and more surgeons have trained into the procedure, FUE finally became predominate.
FUT, however, is still a popular second option for many patients. This is both due to their personal medical factors as well as their budgets. However, it also has to do with FUT clinics’ marketing tactics. The truth is that FUE’s expansion has led to an increase in bad results; many surgeons without training are offering it to increase their competitiveness. FUT surgeons are seizing on these bad examples, though they are far from the norm, while also downplaying the negative effects of FUT and advertising that patients do not have to shave.
The truth, though, is that there are also FUE options that do not require shaving. Dr. Cole’s namesake FUE variant, Cole Isolation Technique (CIT®), is one of the top options in the world. It also comes in shaven, patch-shaven, and no-shave options. Shaven is how it sounds. Patch-shaven, meanwhile, is when only the extraction site is shaved. No-shave, meanwhile, involves cutting each strand of hair and extracting it.
Each type of CIT® has its different strengths. Dr. Cole can offer more extractions to viable patients through shaven CIT®. However, patch-shaven and no-shave CIT® are very appealing for busy professionals and those who would prefer to keep their current hair.
Forhair patients typically receive 1500 to 3000 FUE grafts in four to eight hours. While time intensive, Dr. Cole has a reputation for quickness that only a select number of FUE specialists can claim. There are a number of reasons why Forhair procedures are quicker than average; Dr. Cole’s and his team’s experience and skill, specialized instruments, and superior consultations.
Modern hair transplantation techniques, while effective, are time-consuming. FUE, the most current hair transplant method, involves extracting small follicular units, typically a single follicle or small cluster of two to four follicles, and then transplanting them to balding or thinning areas. As patients may expect, such a procedure is both time-consuming and labor-intensive.
However long a FUE transplantation may require, though, patients should always value quality over convenience. Dr. Cole helped refine and popularize FUE exactly because the method is capable of leading to a hairline indistinguishable from a natural one without any noticeable scarring. Of course, the quality of a FUE transplantation should always take priority over its duration.
FUE specialists will typically build into faster procedures as they gain experience, but not always. Clinics can average procedure times vs. graft amount, of course, but each procedure and patient are also unique. Patients should always keep in mind that reputable clinics will advertise quality before they advertise the speed at which they complete a surgery.
The type of FUE and clinic’s instruments or devices also matter. Cole Isolation Technique (CIT®), is Dr. Cole’s namesake FUE variant and he typically uses an advanced motorized device of his own design to extract follicles. Other clinics may use robotic devices, such as ARTAS, or automatic devices, such as Neograft. While quicker that motorized or manual FUE, robotic and automatic devices have not yet developed to the level that they offer comparable quality.
Hair transplantation offers better results than ever. That mentioned, the intricacies of a FUE procedure requires more time than previous hair transplant methods, such as FUT. Because of the duration of the procedure, which can last eight hours or longer, it is customary for most FUE clinics to offer some type of refreshment.
Forhair typically provides sandwiches from a local caterer, chips, and juice. Of course, patients can make requests as well, due to diet or preference. There are plenty of options nearby but it is unusual for patients to want to eat heavily. Patients have to stay still for extended amounts of time. Trips to the restroom are allowed, of course, but each one also prolongs the procedure.
Offering refreshments to the patient is a courtesy that makes sense; hunger does make people restless, after all. However, patients should always keep in mind that such services are periphery; what matters is the quality of the hair transplant. Unfortunately, disingenuous clinics and those that do not offer the best results typically advertise periphery elements. This can include the clinic’s location and, yes, the food it offers.
Medical tourism is particularly vogue right now and involves enticing patients with some sort of vacation package or showcasing a luxuriant-seeming clinic. However grand a clinic may seem, though, patients should always prioritize research; look into the surgeon’s reputation and training, the clinic’s standing and age, as well seek patient references. Such research should always be through valid sources as well; many sites push marketing rather than truths so patients should be wary of sites without a known advocate in good standing or do not attract the notice of established and respected surgeons.
Of critical importance, as well, is that patients follow up on pre-procedure requirements. This includes no alcohol three days before the procedure and no caffeine the day of the procedure. Those taking dietary supplements such as ginger, ginseng, vitamin E, etc. All food, however, is okay, so patients should feel fine eating what they choose.
Many patients are fine acknowledging they have had a hair transplant surgery. Some will even offer themselves as references to other patients or contribute before and after photos. However, many patients, most in fact, are not as keen to share that they have enjoyed a hair transplant surgery.
Want to maintain one’s confidentiality makes total sense. Patients may feel insecure about people knowing about the hair transplant, or otherwise may feel knowledge of such could jeopardize some opportunity or another. That mentioned, hair transplantation is becoming more and more commonplace. There is also far less stigma attached to the procedure nowadays, with many public figures and celebrities acknowledging they have received a transplantation.
All reputable clinics, nonetheless, always respect the patient’s confidentiality. Forhair is no different. Patients looking to minimize knowledge of their transplantation should know they will only interact with a patient coordinator, the surgeon or consultation specialist, and surgical team. Aside from the patient’s primary physician, who must provide Forhair with a recommendation, no one else need know the patient is receiving a transplant.
A hair transplant clinic with global renown, Forhair is also quite used to patients traveling long distances. The clinic makes the point to recommend several hotels for the patient to use during the visit. Aside from being quality lodgings, these hotels are also quite used to Forhair patients. Expect lodging staff to both respect confidentiality and to be aware of the patient’s special needs, such as additional towels or a sheet for the recliner.
Patient confidentiality is a right, not a privilege, and Forhair takes it seriously. Established clinics such as Forhair have also served tens of thousands of patients, at the least. Those who volunteer for before and after photos, or to be a patient reference, always have the clinic’s thanks. However, for every patient that decides to showcase their results, there are plenty who decline but are perfectly happy about their transplants.
Hair transplantation is a complex procedure. As such, it requires a few steps before the actual day of transplant. Receiving more grafts than scheduled depends on what these steps indicate, the type of procedure, and if there is available time.
The pivotal step is the consultation. This is when your surgeon or specialist will examine a number of factors involving your hair loss and viability for transplantation. One of the most essential is knowing the amount of available donor hairs.
Every patient has a certain amount of donor hairs. The goal for surgeons, typically, is to calculate the largest number available without decreasing the donor area’s appearance of density. Such calculations are actually vital for the success of the procedure. Harvesting too many donor hairs, for instance, can lead to a sparse appearance in the back. Forhair and reputable clinics will typically use a software program, Hairmes in Forhair’s case, and other advanced equipment to calculate the amount of viable donor hair.
Second, the procedure itself matters. Cole Isolation Technique (CIT®), a unique variant of FUE developed by Dr. Cole, comes in several options; shaven, partial shave, and no-shave. Patch shave and no-shaven, due to the intricacies of the procedure, do not allow for the same amount of grafts as shaven. However, they are ideal for busy professionals and those wishing to simplify the recovery phase.
Forhair also offers two other procedures: Body Hair Transplantation (BHT) and FUT. BHT typically is for patients with too little viable donor hair. Instead, specialists calculate how much donor hair the patient can spare and then compliments it with donor body hair, which is placed behind the hairline to add a thicker appearance; adding more body hair grafts is possible, time permitted, but could have an adverse effect on the result. Forhair only recommends FUT in special circumstances and the grafts come from a strip, meaning that all will be transplanted.
Forhair has one clinic in Alpharetta, Georgia and second in New York, NYC (starting from November 2024. All the clinic locations maintain the top bar for excellence. Equipment is the best available, as are the surgeons and techs. Further, patients that select Forhair are some of the few who can enjoy Cole Isolation Technique (CIT®), proven to be one of the industry’s best options, and advanced hair growth treatments superior to generic options.
Patients should be aware that a clinic’s location is not indicative of its quality. However, regional standards can vary a great deal. Patients looking into specialty clinics of any type should always conduct thorough research. Hair transplants are no exception. In fact, to remain competitive, many clinics, both new clinics and those offering generic cosmetic surgery, are offering hair transplantation in record numbers. However, because of the widespread adoption, there has also been a decrease in quality and increase in explosiveness.
A clinic with global repute, many patients of Forhair travel long distances. Forhair and other reputable clinics, due to their reputation and patients, often facilitate lodging for their patients with hotels in good repute. However, clinics vying to be competitive are increasingly using medical tourism as a marketing tool. There is a big difference between traveling to a reputable hair transplant clinic and opting for a questionable clinic offering a vacation package to an interesting locale. Never select a clinic off location alone.
The truth is that a clinic’s quality, no matter its location, matters in the complete. All elements are important; the clinic and equipment itself, the surgeon’s and staff’s skill, and patient management. Clinics that lack in any of these factors will lead to less desirable results. Patients of Forhair should always expect top quality service, advice, and medical expertise. Far as the clinic is concerned, all three are vital parts of patient advocacy; Forhair’s primary value.
Any reputable clinic typically, at the least, suggests places near the clinic to lodge. Forhair, for instance, has positive relations with several hotels. Most offer discounted rates to patients, as well are familiar with their needs. Further, they understand that pillows and sheets may become stained so patients needn’t be self-conscious as with a generic hotel. Check out our Travel to Atlanta page for more info.
Of course, lodgings matter post-op. Forhair only selects lodgings with a reputation for quality service. Further, these hotels are conveniently located for the patient’s convenience. Alpharetta, Georgia is half an hour from Atlanta, so patients also decide if they’d prefer their lodgings in an urban center or somewhere quieter.
Dr. Cole has a global reputation for excellence. Patients will travel long distances for a procedure, and, as such, Forhair is quite used to assisting patients with lodgings. That mentioned, hair transplantation is a growing industry. One result of this upsurge is the increasing difficulty in selecting an established clinic. Further, many clinics are turning to medical tourism as a way to market their services. Some are reputable but many are not, leading to some patients becoming victim to awful transplants that require multiple repair procedures.
Therefore, patients must first distinguish between reputable and non-reputable clinics. Deciding on a clinic hinges on a number of factors. The surgeon’s reputation, the instruments they will use, and the clinic’s results matter most. Disingenuous clinics will fabricate results or photoshop them to appear more impressive than usual so patient references are also important.
A leading advocate for patients within the industry, Forhair believes in a great patient experience. That mentioned, helping a patient find lodgings is easier than becoming a world-class hair transplant expert. Clinics that cater to medical tourism typically are using their region as an incentive, rather than the procedure’s quality. Clinics like Forhair, meanwhile, attract local clientele due to the outstanding results.
Having a surgeon perform the majority of a hair transplant procedure is vital. Hair transplantation is a complex procedure that requires surgical techs and other specialists. Only a surgeon, however, and a surgeon trained and experienced in hair transplantation, should both perform most of the procedure and oversee it.
An early innovator of FUE, Dr. Cole has personally performed tens of thousands of transplants. He emphasizes teamwork and training, of course, but will always perform the vast majority of the procedure himself. All reputable hair transplant clinics, to maintain a competitive reputation for results, have a skilled hair transplant surgeon do the same.
Dr. Cole’s system is to do all the graft extractions and incisions himself. Then he and his team of surgical techs place the grafts in incision sites. This helps ensure a top quality result for patients, as well actually speeds up the procedure due to Dr. Cole’s decades of experience.
Of increasing concern are clinics where surgeons perform a minimal amount of work. Instead, they have surgical techs or other professionals perform the procedure. This is most typical of unscrupulous clinics that exaggerate results anyhow. However, it is also becoming more common in run-of-the-mill cosmetic surgery clinics. Such clinics typically underestimate the training and experience hair transplantation requires, relegating the surgical tech to the majority, if not all, of the procedure.
Another, and unfortunate, trend are for clinics to invest in expensive hair transplant equipment. Such equipment, primarily Neograft, advertises itself to surgeons as easy to use and understand. However, such equipment is actually still inferior to manual and mechanical FUE. To make matters worse, many surgeons relegate the use of such devices to surgical techs. The best policy when selecting a clinic, for the time being, is to avoid clinics that use robotic or automated FUE devices.
Before Surgery Pre-Operative FAQs
Common questions and answers on how prepare yourself for the hair transplant surgery, Things you can do, what to avoid and ways to prevent complications, what to prepare prior to your surgery.
We suggest that you arrive the day prior to your surgery and leave the day following your surgery. The traffic in Atlanta can be extremely heavy and if you arrive the day of surgery you may be very late for your appointment. If this happens, you will not receive the number of grafts you have paid for and there is no refund.
You must follow these steps before surgery:
- Do not take Aspirin or any other anti-inflammatory medications 7-14 days prior to your procedure. Many prescription or non-prescription, over-the-counter products such as Advil, Alka-Seltzer, Bufferin, Excedrin, Empirin, Nu-Prin, Motrin, Ibuprofen, etc., should be avoided. If you are unsure, ask the doctor or your pharmacist.
- Do not take tricyclic antidepressants such as Desyrel or Trazadone, blood thinners such as heparin and coumadin, niacin, Accutane, beta blockers, and MAO inhibitors 10 to 14 days prior to your procedure. PLEASE LET US KNOW IF YOU ARE CURRENTLY TAKING ANY OF THESE MEDICATIONS WHEN SCHEDULING YOUR PROCEDURE.
- If you have ANY medical conditions, please notify the office immediately! do not wait until the week prior to surgery. Medical conditions include but are not limited to High blood pressure, heart murmur, diabetes, blood disorders (easy clotting etc.), Hepatitis, Asthma, Epilepsy, Liver problems, or any condition that you are under a doctors care for.
- The morning of your procedure take a bath or shower and wash your hair thoroughly using regular shampoo. After shampooing, please rinse thoroughly and use a fresh clean towel to dry your hair. Do not apply sprays or gels to your hair. If you wear a hairpiece or hair system, please make sure it is removed prior to your morning shower and not replaced before your procedure.
- Be certain to eat breakfast the morning of your procedure. If you are scheduled for surgery in the afternoon have a light lunch before you arrive.
- Try not to smoke any tobacco products at least 24 hours prior to your procedure as smoking will slow down healing and increase the chances of wound infection and scarring.
- Do not drink any alcoholic beverage at least 3 days prior to your procedure. In addition, do not drink coffee or any other caffeinated or carbonated beverages the day of your procedure. Carbonated drinks are to be avoided for 3 days following the procedure. These substances will increase bleeding and your sensitivity to medications used during the procedure.
- Do not take any multivitamins including vitamin B and vitamin E for one week before your procedure as they will increase bleeding. In addition, do not take any herbal or botanical products one week prior to your procedure.
- If you are to have a STRIP procedure or shaven patches CIT procedure, it is best to leave your hair long in the back and sides so that it will cover the area of extraction after your procedure. Your donor area will be shaved with below a #1 clipper at the surgery center if you are having a CIT procedure – shaven method. If you are having a CIT –shaven patches method – it is best to let the hair grow out to 3-6 inches long to cover the shaven ‘patches’ where the FU’s are extracted from.
- You may be receiving medications during the STRIP procedure that can make you drowsy. Because of this we strongly recommend that you do not drive the day of your procedure.
- If having a body hair transplant or a CIT Farming procedure you must wet shave “shave all the body hair with shaving cream and a blade razor” 4 days prior to starting surgery date.
- Wear comfortable clothing the day of your procedure, and bring a sweater & socks for warmth, as you may find our surgical center is very cold.
- Please do not bring any valuables to the office on surgery day.
Please follow the following instructions:
- Do not take Aspirin or any other anti-inflammatory medications 7-14 days prior to your procedure. Many prescription or non-prescription, over-the-counter products such as Advil, Alka-Seltzer, Bufferin, Excedrin, Empirin, Nu-Prin, Motrin, Ibuprofen, etc., should be avoided. If you are unsure, ask the doctor or your pharmacist.
- Do not take tricyclic antidepressants such as Desyrel or Trazadone, blood thinners such as Heparin and Coumadin, Niacin, Accutane, Beta-blockers, and MAO Inhibitors 10 to 14 days prior to your procedure.
* PLEASE LET US KNOW IF YOU ARE CURRENTLY TAKING ANY OF THESE MEDICATIONS WHEN SCHEDULING YOUR PROCEDURE.
Yes, It is extremely important to mention all of your medical conditions, it needs to be in the consultation stage. The clinic will then collect all your medical history and contact information prior to your hair transplant surgery, the reason we need this information is to ensure there are no conflicting conditions or medications that might complicate the hair transplant operation. Again, If you have ANY medical conditions, please notify the office immediately! Do not wait until the week prior to surgery. Medical conditions include but are not limited to high blood pressure, heart murmur, diabetes, blood disorders (easy clotting etc.), hepatitis, asthma, epilepsy, liver problems, or any condition that you are under a doctor’s care for.
The morning of your procedure take a bath or shower and wash your hair thoroughly using regular shampoo. After shampooing, please rinse thoroughly and use a fresh clean towel to dry your hair. Do not apply sprays or gels to your hair. If you wear a hairpiece or hair system, please make sure it is removed prior to your morning shower and not replaced before your procedure.
Be certain to eat breakfast the morning of your procedure. If you are scheduled for surgery in the afternoon have a light lunch before you arrive. Your hair transplant will be a long procedure, so arriving with some food in your stomach is a good idea. There also will be breaks when refreshment can be requested throughout the procedure.
The idea is to stop at least 3 days prior to surgery and for at least 3 days after your hair transplant procedure. Try not to smoke any products, tobacco and weed included, at least 24 hours prior to your hair transplant procedure as smoking will slow down healing and increase the chances of wound infection and scarring.
Smoking (nicotine) inhibits blood flow to the skin and scalp by constriction of blood vessels, the blood carries more oxygen than in normal circulation.
All this can result in bad healing, increased scarring, and can also make the whole procedure very bloody and messy for the surgeons.
Some even suggest stopping 2 weeks prior and continue smoking only 1-month post-op. Each doctor to is own if you’re coming to Dr. Cole for surgery, the surgical team will give you full pre-op instructions.
By the way, no alcohol and coffee 3 days prior to your hair transplant procedure as well. Coffee also increases blood flow.
Do not drink any alcoholic beverage at least three days prior to your procedure. In addition, do not drink coffee or any other caffeinated or carbonated beverages the day of your procedure. Carbonated drinks are to be avoided for three days following the procedure. These substances will increase bleeding and your sensitivity to medications used during the procedure.
Do not take any multivitamins including vitamin B and vitamin E for one week before your hair restoration procedure as they will increase bleeding. In addition, do not take any herbal or botanical products one week prior to your procedure.
You may receive medications during the FUE or FUT procedure that can make you drowsy. Because of this we strongly recommend that you do not drive the day of your procedure.
Patients either receiving a Body Hair Transplant (BHT) or CIT Donor Recharging Procedure must wet shave the donor areas four days before the surgery date. The shaving itself should be done with shaving cream and a blade razor.
As hair transplantation progresses new options become available. The advent of Follicular Unit Extraction (FUE) is particularly versatile, leading to a number of variants. BHT, a relatively new procedure, is particularly useful for patients who lack the donor follicles necessary for FUE or, in Forhair’s case, Cole Isolation Technique (CIT®).
BHT functions very much like FUE. During the patient’s consultation, reputable clinics will conduct a follicle count; the French program Hairmes in Forhair’s case. Clinics learn how many donor follicles are available from this count; essential for counting possible grafts without making the donor area too sparse. Patients who do not have enough donor hair, or would like a more significant graft count, can then decide if they would like to consider BHT.
BHT grafts have a different texture than head follicle grafts; typically coarser and curlier. However, they serve as filler for behind the hairline. This allows the surgeon to lower the hairline further without the obvious appearance of a different texture behind it. The overall effect, if done by a skilled surgeon such as Dr. Cole, is indistinguishable from a regular head of hair.
BHT, however, is different for each patient for a number of reasons. Because of this, Forhair requires BHT candidates to undergo a small test sample. If the grafts are successful and convincing then a large procedure can commence.
BHT from Forhair is particularly beneficial due to CIT®. Among the least intrusive FUE variants the world over, CIT® in combination with ACell leads to 30%-40% donor regeneration; or the regrowth of 300 to 400 donor follicles for every 1000 extractions. This is very useful for maintaining density if patients should want to undergo another procedure.
After Surgery (Post-Operative) FAQ's
Common questions and answers about post op surgery information, Learn how hair grows and how hair cycles after surgery, how to treat your hair, how long it takes for the hair to grow and what to expect.
A normal appearance after a hair transplant depends on the procedure method and the patient. Significantly less invasive than past hair transplant methods, today’s options still leave superficial wounds. Patients must follow all post-procedure instructions to both foster recovery and, thereby, encourage the best results possible.
Most patients pick between two major types of hair transplantation: Follicular Unit Transplant (FUT) and Follicular Unit Extraction (FUE). FUT is the older and requires greater invasiveness, leaving a large orbital scar from the graft extraction that requires upwards of three months to heal. FUE, meanwhile, uses diffuse extractions that cause far less trauma but still require care.
FUT and FUE both also have no-shave options. These variants are perfect for busy professionals and patients with longer hair, as hairstyle alone can cover extraction and recipient areas. No-shave FUT has been around for awhile while no-shave FUE is comparatively recent. This makes the latter particularly important, as it allows for better precision and is less burdensome to the patient post-procedure.
Whatever method the patient picks, they must be active and aware to encourage recovery. FUE will leave scabs in both the donor and recipient areas, the latter naturally falling off after three to five days and the former falling off in seven to ten days. A hair transplant specialist well aware of the importance of recovery, Dr. Cole also has designed a clinically-tested, all natural hair care line, Hair Cycle, that facilitates faster and better healing from hair transplants while also encouraging overall hair retention and health.
Hair transplant recipients should also be aware of temporary discoloration. All patients will have a pink tinge in the recipient area. Severity depends on complexion, but some lighter skinned patients will have to wait up to three months for this discoloration to fully fade. After a month most patients of these patients can comfortably dab some concealer for a more uniform tone. No patient, however, deals with permanent discoloration in the recipient area. Questions? Contact us today!
Patients can typically return to most work-related tasks the after a hair transplant procedure, but they also must take numerous precautions in the first few weeks of recovery. Hair transplantation results primarily depend on the surgeon and clinic but they also depend on the patient after the procedure. Inability to follow post-procedure instructions can significantly impact a hair transplants’ success via dislodged grafts, follicular damage, scarring, and more. That mentioned, hair transplants require less recuperation than ever before.
While significantly less invasive than in the past, all current hair transplant methods leave superficial wounds that patients remain aware of during post-procedure recovery. The amount of precautions patients must take decreases over time; as grafts heal there is increasingly less chance of hair follicles dislodging, scarring, or other complications.
Precautions include sleeping in an upright position as well not rubbing the scalp, undergoing physical strain, allowing much UV exposure, or even wearing a hat too tight. Thankfully, there are time constraints for how long patients must take such precautions before transplants recover. The type of hair transplant method also affects the type of precautions and how long patients must take them.
Follicular Unit Extraction (FUE) is the least invasive method popularly available, and involves minute extractions of follicles and then their transplantation into a recipient area.
Follicular Unit Transplantation (FUT), meanwhile, is an older technique that involves extracting a swath of donor tissue and subdividing it for follicular grafts.
Patients heal much quicker from FUE than FUT. The latter’s donor area requires months more healing, as well regular attention from the patient. The wound’s overall size also increases the risk of infection or other problems, such as added scarring. Goes without saying, FUT patients must receive a different set of post-procedure instructions than FUE patients.
Most patients at Forhair receive Cole Isolation Technique (CIT®), Dr. Cole’s namesake FUE variant, among the least invasive techniques available. It offers numerous benefits, including next to no chance of visible scarring and the exclusive ability to regenerate donor follicles. The addition of Cytokine Rich Plasma (CRP), Dr. Cole’s specialized variant of Platelet Rich Plasma (PRP), speeds recovery a tremendous amount: follicles fully activate within four and a half months rather than the typical year.
We recommend patients wait at least 48 hours before shampooing, and in a select manner initially, for good reason. Hair transplant surgery is less invasive than in the past. However, all current options still require recuperation time. Patients who do not follow post-procedure instructions significantly risk transplant dislodgement, or when transplanted grafts leave or are unanchored from the scalp.
Transplant dislodgement can happen through any number of reasons. Excessive rubbing of the scalp, sun exposure, strain, wearing hats too tightly, and failing to initially sleep in an upright position can all negatively effect transplants. Shampooing innately involves rubbing the scalp, and therefore poses a risk immediately after the procedure.
The initial risk of dislodgement or similar damage is exactly why we instruct patients to wait 48 hours, at minimum, before shampooing. Transplants require time to heal: most will not even activate as normal follicles for at, minimum, a few months without Cytokine Rich Plasma treatment: a unique serum from Frohair that hastens transplant recovery, growth, and health. However much time they need to fully recover and activate, however, any rubbing of the donor or recipient areas can impact results.
How patients initially shampoo is also critical. Shampooing in the shower is fine, but water pressure alone can effect transplants. As a precaution, therefore, patients should avoid directly rinsing their scalps with the shower stream. They should avoid letting it drench their scalp at all, in fact.
For initial shampooing, instead, patients should mix a cup of water with a gentle shampoo and pour it over the head several times, lightly rubbing the donor areas but not touching the recipient zones because doing so can, as mentioned, dislodge grafts.
Further, not all shampoos are as equally effective. Most surgeons recommend patients use baby shampoo, as it is free of irritants. Baby shampoo may be safe but it also lacks any ingredients that encourage hair health or retention, not to mention nutrients or protectants that facilitate fast hair transplant recuperation. For this reason, Dr. Cole has formulated a line of all-natural, clinically tested hair care products under the brand Hair Cycle.
These products are both ideal for hair retention and transplant recuperation, and include everything from shampoo and conditioner to specialized lotions and sprays. Learn more by visiting our Hair Cycle page or website.
Bumps in the recipient site of transplants are normal and should not impact results. They happen across all today’s most prevalent hair transplant methods, as significantly less invasive as these methods are in comparison with those from the past. Put simply, superficial scalp wounds are a natural part of hair transplant surgery. Such wounds happen in two ways.
Extractions: The part of the procedure that poses the greatest risk for scars, donor harvesting involves using a method to extraction of viable follicular grafts.
Transplantation: Significantly less invasive, transplantation involves placing donor grafts into recipient sites, causing superficial damage to the area.
Of emerging options, Follicular Unit Extraction (FUE) is the least invasive and offers the fastest recovery. Forhair most often uses Cole Isolation Technique (CIT®), Dr. Cole’s namesake FUE variant and one of the least invasive options available. CIT® almost never leaves noticeable scars and, with the addition of ACell treatment, exclusively offers the chance of donor regeneration: stem cell remnants from extraction sites regenerate 30% to 40% in total, or 300 to 400 new follicles for 1000 single extractions. Even CIT®, though, requires some invasiveness in both extracting and transplanting grafts.
Follicular Unit Transplant (FUT), the next most recent option, involves extracting a swath of scalp that always leaves a noticeable orbital scar. Recovering from this procedure requires more time than FUE, as well more care and attention from the patient. In addition to the extraction site, patients must also mind recipient areas that will have a similar reaction to FUE or CIT®.
Bumps after a hair transplant surgery almost always involve recipient sites. These are actually retained hair fragments: pieces of hair strands that have disconnected themselves from their grafts but have not yet fallen out. They typically exit the transplant wounds naturally but can sometimes become stuck.
Patients who attempt to purposefully remove hair fragments should always follow post-procedure instructions. Damage to grafts can significantly impact results. When instructions, or Forhair specialists, indicate patients can remove hair fragments they should first try lightly scrubbing their head with a soap and a washcloth. Doing so can dislodge any hair fragments. Stubborn hair fragments, meanwhile, can easily, and without blood and pain, with a pair of tweezers. Such removal is easy enough but patients should still be cautious of damaging the grafts.
Each hair transplant method, even in the hands of a master, will offer different results. Some transplant types are less invasive, decreasing the chance of scars, offer better coverage, enable a better hairline, or is quicker to perform. All of today’s hair transplant methods, however, also demand patients to actively follow post-procedure instructions for the best possible results.
Hair transplant surgery is now significantly less invasive than it was in the past. Still, there are differences between hair transplant methods. They range in invasiveness, efficacy, and coverage. Patients often can pick between a few different types of hair transplant types, though this depends on available donor hair and medical history.
Follicular Unit Transplantation (FUT) involves extracting a donor area and then subdividing it into grafts, always leaving a scar but, if done properly, next to no indication of a hair transplantation unless hair continues to recede or thin. The lateral scar’s size is unpredictable, though experts’ work often leaves a smaller scar, and it is always noticeable with a short enough haircut. The transplants may require additional work as they age.
Follicular Unit Extraction (FUE), meanwhile, is the most recent hair transplant method gaining prevalence. It involves extracting one or more strands of hair individually and then transplanting the graft to the donor area. FUE variants range in their invasiveness, with some more prone to leave “moth eaten” scars than other types. Cole Isolation Technique (CIT®), Dr. Cole’s namesake FUE variant, is among the least invasive options available, with nearly all patients enjoying scars so small they are undetectable.
Recovering from FUT takes a longer time than FUE, with FUT patients needing to monitor and clean their donor site for more than three months. FUE patients, meanwhile, can often return to work the next day. FUE patients may deal with light swelling, while a very small amount may deal with moderate or severe swelling after 48 to 72 hours. Typically painless, such swelling often recedes within a week.
Patients will also have to start shampooing their scalp, we recommend Dr. Cole’s Hair Cycle line, as well sleep in an elevated position, forgo physical exertion, and take other measures until post-procedure instructions say otherwise.
Most clinics recommend hair transplant recipients use baby shampoo. Free of irritants, it keeps the scalp clean and moist without aggravating the skin. However, baby shampoo does not have a formula specific to the scalp’s recuperation. Many products will claim to be healthy or encourage scalp health. That does not mean, though, that they are correct for scalps recovering from superficial trauma.
Modern-day hair transplants are far less invasive than those from the past but they still cause superficial wounds to the epidermis. Cole Isolation Technique (CIT®), Dr. Cole’s namesake FUE variant, is among the most minimally invasive techniques available, decreasing recuperation time and almost always leaving undetectable scars, unlike less advanced FUE options.
Preventing scars, however, and obtaining the best results possible also depends on the patient’s adherence to post-procedure instructions and the hair care products they use during and after recuperation. Dr. Cole and his team have researched specially formulated, post-procedure hair care products and released them under the brand name Hair Cycle.
Hair Cycle products are all-natural, absolutely safe, and proven to be effective. Excellent for hair transplant recipients, anyone who wants to foster better hair retention and healthier, thicker strands should try applicable products. The Hair Cycle Shampoo, for instance, includes saw palmetto and other select extracts proven to encourage hair health and retention.
The Hair Cycle line, of course, include products specific to recuperation. For instance, nourishing and protecting the scalp is essential. The Post Surgical Gel includes growth stimulants, antioxidants, and other ingredients that encourage quicker, faster healing that further protects transplants. The Post Biotin Spray, meanwhile, includes a number of beneficial antioxidants that promote hair health and protection from UV, essential for all hair but particularly important for transplants that are beginning to grow.
Hair growth after a hair transplant can range dramatically, and is dependent on recuperation from the procedure. Follicular Unit Extraction (FUE) and variants like Cole Isolation Technique (CIT®), Dr. Cole’s namesake FUE variant and Body Hair Transplant (BHT), an emerging technique, are, at present, the least invasive procedures and typically enjoy full transplant activation, without additional hair growth treatments, in twelve months. Follicular Unit Transplant (FUT), meanwhile, is a less invasive procedure that leaves a linear scar and, without additional hair growth treatments, often enjoys full follicular activation within twelve to eighteen months.
Hair growth after a transplant, before all else, depends on the surgeon’s skill. Follicular transection is when a follicle is irrevocably harmed during extraction, preventing its growth after placement in the recipient area. A premier hair transplantation specialist, Dr. Cole’s transection rate is usually under 3%. Experts, meanwhile, typically have a transection rate of under 5%. Surgeons gaining experience in hair transplantation, meanwhile, have transection rates between 20% and 80%.
After transection rates, patients must be cautious about damaging or dislodging transplant grafts after the procedure. This can happen through any number of ways and Forhair offers detailed post-procedure instructions to help maximize results. Dr. Cole and his team has also personally researched and formulated a number of products to help spur recovery and protect transplants. Learn more by visiting HairCycle.com.
Dr. Cole has also personally researched improvements for Platelet Rich Plasma (PRP), a common blood treatment used in healthcare. Injected into the scalp, it can encourage growth. PRP’s effectiveness, however, depends on its processing. Through sonication and other measures, Dr. Cole has increased PRP’s potency, or concentration of growth factors and cytokines, by five to eight times the amount and calls the serum Cytokine Rich Plasma (CRP). Results are truly impressive, with transplant recipients enjoying 99% transplant activation within four and a half months rather than eight to twelve months.
Only at Forhair can transplant recipients receive such quick, and superior, results. Learn more by contacting us today!
A patient’s ability to return to work depends on the transplant type. Strip surgeries such as FUT, for instance, require more time for recuperation. FUE is generally less invasive; near all patients can return to work the day following the procedure, though they should avoid strenuous activities. Dr. Cole’s namesake FUE variant, Cole Isolation Technique (CIT®), is additionally one of the least invasive variants of FUE. This provides numerous benefits, among them less severe effects from the transplant during post-op recovery.
Returning to work after a recent transplant often requires some adjustments. Patients must still follow post-op instructions at work. These include avoiding strenuous activities, bending over, and direct sunlight while remaining upright and using post-op treatments and medicines at the correct times. Different work environments and roles have different obligations, yes, but proper post-op maintenance is critical for successful results. Post-op instructions become far less restrictive within a week and ease increasingly the week following.
Some transplant options are also more discreet. No-shave CIT®, for instance, minimizes the transplantation’s initial visibility. Pre-existing hair of all but the shortest lengths cover the extraction areas and, with a bit of styling, the recipient areas. This discrete appearance is great for busy professionals, though those who opt for No-shave CIT® should still cover their heads outside to protect against sun exposure.
Complications may interfere with some work-related tasks or scenarios. Initial swelling, for instance, may go down within the first 24 hours only to recure the following 48 hours. Worse yet, such swelling can more severe, spreading from the forehead to the eyes and cheeks. Near all cases of swelling subside within 48 to 72 hours after it develops, though more severe instances may require up to a week. Patients who experience swelling will probably want to reschedule any professional or social engagements. The swelling itself, though, is rarely so severe to inhibit mobility, sight, or the ability to communicate.
Overall, most patients start completing work-related tasks the day following their procedure. They may adjust their schedule a bit, considering post-op instructions or their appearance, but by and large enjoy their normal day-to-day.