The method called FUE (follicular unit extraction) is a method of transfer which is described in 2004 and used in hair transplantation. The first time it was defined, it was done with a special pencil-like tool as shown in the picture below.
With a pencil-like apparatus used in this method called Punch Biopsy, the follicle unit was removed as a whole and the hair was removed to the root. If the patient needs 2000 grafts for example, this should be done exactly 2000 times. In terms of time, this method, which is costly to both the patient and the physician, there are physician friends who insist on using this method even though they leave the place to the motor systems over time.
This new method, known as the Fue Motor, differs from the old method only in that the implementer does not have to manually remove the follicular unit. In fact, the basic logic is the same, but with the new method, the implementer gains a considerable amount of time. The apparatus at the end of the Punch Biopsy structure is connected to a motor and the motor can be set as desired. The thickness of the tips is changed and the tip of the desired lumen is attached according to the donor site. The only advantage of the Fue engine is, of course, it is not the time to provide it. In addition, the tissue depth can be standardized as desired by the motor and this eliminates the need to constantly check the depth of the tissue. With the Fue Motor, grafts can be taken more frequently and, when compared to the same amount of field scanning, more grafts can be removed from the area taken with the engine. Another advantage of the engine is that it is less likely to break up grafts with multiple roots, ie 2-3 or even 4, which means that the follicular unit is more likely to have a better protection of the integrity of the follicular unit.
For this reason, it can be said that thanks to the Fue Motor, hair transplantation has become a more comfortable operation. Although the way the roots are taken varies, the opening and transplantation of the channels are the same as in other methods.
PLANNING
It is the most important part of the operation. It is important to know how many grafts will be added to the patient, how many sessions will be done, which blood tests will be requested, what other doctors will need to look for, what to look out for before operation, where critical questions such as where hairline will start, where to attach single, double and multiple grafts all answers are determined during planning. After the planning, the photograph of the patient should be photographed from many fronts for the photo archive, and the graft distribution planning should be photographed again after the hair is processed with the pencil. Good planning provides a relaxing operation for both the patient and the physician. The physician must carefully plan the above headings to ensure all the necessary comfort and safety for his patient. Many patients do not know about the importance of this topic. For this reason, the operation may fall into the fault oversimplifying. The duty of the physician is to inform the patient about this and to encourage him to do all the necessary preparation. Because the patient is more susceptible to laziness in subjects such as going to another doctor or doing different tests. It is therefore important for the patient to be informed that all of these measures are beneficial to the patient.
ANESTHESIA DISCUSSION
An anaesthesiologist consultation is a big deal for a group of risky patients. Patients who are both asphyxiated and at risk, should be monitored by an anaesthetist before the operation and even during the operation. The importance of this in the operation of patients who need regular treatment, such as those with drug allergy, those with cardiovascular disease, and those with diabetes, are greater. As the anesthesiologist may need other surveys, the illness that anaesthesia must look at needs to be done the day before this planning.
LOCAL ANAESTHESIA: In order for the patient not to feel pain, both the area where the roots will be taken and the site where the implantation takes place will be treated with local anaesthesia. During this procedure using a special needle, the patient does not feel pain and it takes about 3-5 minutes for the related areas to become anaesthetised. The patient, who does not feel any pain during the operation, will not have to use a pain reliever most of the time after the operation.
During the operation
REMOVAL OF THE GRAFTS: For this process made by Fue Motor, the pre-anaesthetised area must be inflated through a special liquid. Thanks to this surface-expander fluid, both roots can be freely freed and more roots can be obtained. It is possible to take about 1000-1500 roots per hour on average. This depends on the tissue condition of the patient, the amount of bleeding, and whether the general conditions are ideal and experienced tissue remover.
OPENING OF THE CANALS
Opening of the canals is done to the open area of the roots. A predetermined number of canals must be opened to the pre-drawn area. It is also determined how many channels are to be opened during planning, which should be done without shortening the hair of the patient. Though minor changes are made during the operation, opening of the channels in general sticks to the plan. By means of a special kit, the planned number of holes, that is to say, the roots, are opened in the area which has been previously anaesthetized with local anaesthesia. The number of canals must be equal to the number of grafts to be added. During the opening of the canals, the current hair outlet angle must be observed. This angle can be understood by the specialist or can be determined by sticking to the previous hair condition. The concentration of the expert is very important when the channels are opened. It is not enough to open a certain number of channels in a proper way, but it is necessary to pay attention to many very critical issues such as creating a natural hairline, ensuring that transitions are natural, the desired frequency and consistency. For this reason, the channels need to be made by an expert who has aesthetic concerns and who can do this work by adding something to himself. The patient can listen to music, watch TV because he is sitting on his back, it takes an average of 2500-3000 hours.
TRANSPLANTATION OF THE GRAFTS
It is the last step of the operation and the planting of the roots taken in the first stage to the channels opened in the second stage. There is no pain when the area is numbed by local anaesthesia before. Grafts are placed in containers that contain a nourishing liquid, which sterile and protective. Thanks to this process, which is done in a regular order, both grafts are separated into single, double and multiple roots and the number of grafts obtained with a precise number becomes clear. The importance of separating grafts into single, double, and multiple is of great importance because not all types of grafts can be implanted anywhere in the transplantation area. For example, it is crucial for the operation to be natural, as it is very important to plant single grafts on the frontal hairline, especially on the back side with more bilateral and multiple grafts, so this is especially important for special issues such as the introduction of fewer channels and more bilateral and multiple grafts. In addition, in order to avoid suspicion in the patient’s mind, it is necessary to perform procedures such as displaying the grafts before transplantation, giving brief information about how to count them, photographing the graft array and putting it in the patient’s archive. transplantation is usually done by two or even three specialist staff. Particularly in the frontal hairline, the channels are narrower and the grafts are single, so more careful transplantation should be done. It is very important for the team to be an expert and to plant the grafts in the channel in a single pass. The fact that it is not played with the graft is very important for the quick drying process after being taken from the special liquid. I should mention that many details which are very important like the graft hold place and the angle at which to take the hand, and which I will not go into too much detail only because it has entered the limits of expertise, has a vital prescription at the transplantation stage.
The transplantation process takes time as well as root ingestion. However, it is usually done by two people, sometimes by three people, which results in shorter time. During transplantation, the patient is often relieved. This period in which the patient does not have pain, the patient is held in position halfway down and can watch TV, is also easily overcome by the patient because it is the last stage of the operation.
DISCHARGE OF THE PATIENT
All patients are discharged after the operation, except patients who come from abroad and do not want to stay in the hotel. They do not need to in in the hospital. The area where the tissue is taken is covered with a special liquid silicone. There is no need for any bandage. Thus, it is aesthetically possible to cut off contact with the outer region. With a specially designed hat, both the transplantation area and the roots are closed to hide until the home of the reception area.
AFTER THE OPERATION THINGS TO DO AT HOME
After you get home, you need to remove the hat inside. This is important both in that the wounds are oxygenated more quickly and that the feeling of pressure created by the hat is lifted. It is important not to go out on the day of operation and the next day, and to rest at home. The patient should not engage in any other work unless it is very necessary. However, these can be done if there are non-exhaustive tasks such as desk work, computer use, etc.
SLEEPING
Sleeping is a bit of a problem for the first night. In fact, it is prone to fall asleep immediately because it is not painful and tired, but curiosity and fear interrupt this natural process. The fact that the patient has not slept in a quality sleep does not indicate a problem. It is necessary for the patient to adapt to the supine position without touching the planting area anywhere. In the first night, it is useful to be checked several times during the night by a close relative of the patient, supported by a special pillow. The patient should not lie on his side and never face prone. After the first wash, patients usually relax and sleep more comfortably. Sleeping without problems is usually possible after 7-10 days.
FIRST WASHING
It is beneficial to do the first wash after checked by specialists in the hospital and clinic. At the earliest 24 hours and the last 72 hours after the operation hair required to be washed. First, some softening lotion should be applied on the hair planting site and this lotion should be left for 20-45 minutes. After this process to soften the dried blood, the hair is rinsed with a warm water and purified from the lotion. Then a special medical shampoo is frothing in the palm of the hand or other areas of the hair and both the planting area and the intake area are washed. Washing should be done with fingertips and palms, and never use fingernails. After the wash is finished, the hair should be dried with a paper towel only and by taking humidity without rubbing it in any way. The area where roots are taken should be cleaned with rifampicin ampoule or antiseptic solution for the first 3 days. In the following days, there is no need to do anything for intake area. Every day, the dose of washing should be increased a little more and after 7-10 days on average no scales, sediments, dried blood should be left behind with hair. This process should be repeated every day and return to normal washing habits on the 15th day. From day 15 onwards, the patient may continue to wash his hair or wash it less frequently every day. You may shower more than once a day, but it is not recommended to shampoo your hair more than once. It should be reminded once again that the shampoo to be used here is a medical shampoo and that it has been recommended by a doctor.
USAGE OF THE MEDICATIONS
All drugs that may be needed with the serum inserted during the operation should be given to the patient from the vein. Emotional relievers, pain relievers, antibiotics and anti-oedema medications should be present in the serum. At this point, the patient will not feel any pain or discomfort during the operation and will be away from the risk of infection. This is important both in terms of comfort provided during operation and in terms of precautions taken by the patient against the possibility of not using the drugs that should be used after the operation for any reason. Despite all advantages, the drugs used during the operation will not be able to protect the patient 100% after the operation. For this reason, antibiotics prescribed by the doctor, analgesic and anti-inflammatory, anti-oedema preparations and antiseptic medicines to be used in dressing must be used absolutely. The use of antibiotics should be 5-7 days for the patient, 1-3 days for the painkiller, 4 days for anti-oedema treatment and 3 days for antiseptic treatment. Once the antibiotic is used, the patient will not have to use any medication for the rest of the time.
HAIRCUT
It is beneficial not to have haircut during the first 2 weeks. From the second week, you can shave your hair with a shaving machine or scissors. Hair can be shaved as desired from day 60. It is beneficial for experienced hairdressers who have previously done hair transplantation or have done hair transplantation of their patients to do their first haircuts of hair transplant patients.
THE PERIOD OF THE GROWING
The hair is shed in the first 3 weeks after transplanting so that the roots remain inside. In fact, it is better to say splitting. The roots waiting for 90 days after the transplantation start to grow after this step. Every day, some hair grows out of the process in a natural and understated way. After about 8-10 months, all the hair (3% of the possibility of loss in ideal conditions) is all grown.
SECOND OR THIRD SESSIONS
Planning for a second or sometimes third session can be done for patients who can not cover all the hair with a single session. In this case, the ideal is to wait around 8 months. If the patient wants to top up two sessions, he has to know that the amount of graft to be implanted will be less. On the first day, 2000 grafts are given, 1000 grafts the next day and 3000 grafts in total. If a waiting period of 8 months is put together for the first session, the amount in the second session will increase further, for example around 1800 roots. Thus, the total number of grafts added will be 3800, not 3000. This will mean an average of around 1500 hair transplants. It is obvious that the patient who can put this time interval between two sessions is more advantageous. The ways that will be followed are the same for the patient who will do the second session immediately the next day or the patient who will have the same 8-month time interval.