Practical

Hair transplant surgery

How can I request a quote for hair transplant surgery?

The only way to accurately determine how many follicles you need to achieve your goal is to consult with a specialist and discuss your goal one-on-one. This can be done through a consultation in our clinic or you can request a quote here.

Hairline lowering

How to prepare for hairline lowering?

There is no specific preparation for this procedure.

How is hairline lowering performed?

• Incision — An incision that follows the pattern of the natural hairline is made two to three mm inside the hairline. Straight scars are more conspicuous than irregularly curved ones. The blade is also held in such a direction that about six weeks after the surgery, the hair starts growing through the scar, making it almost invisible.
• Removal — A section of forehead skin just in front of the hairline is removed.
• Mobilization — The scalp will be mobilized to the back of the head and pulled forward as much as needed. Normally 1-1.5 cm of advancement is no problem. If more advancement is needed, the placement of an expander needs to be considered.
• Fixation — The scalp is fixed to the bone using Endotines to prevent the skin from pulling back and so reducing the tension on the scar. Endotines are made of bio-absorbable material and dissolve over time.

What is the average treatment plan of a hairline lowering?

A hairline lowering is performed within a day as an outpatient procedure (no overnight stay in the hospital is needed).

What to expect and do during the recovery period after hairline lowering?

• The day of the procedure — The day of the procedure and the day after, the patient might experience slight pain or discomfort that can be well managed with the painkillers we will give you.
• The first week — During the first week there might be a bit of swelling and bruising but it should not be very noticeable. If staples have been used, they will be removed after seven days. Foreign patients can return home the same day. The staples can be removed in their home country by a general practitioner. The stitches we use are self-absorbable.
• Subsequent weeks:
  • Sutures — After two to three weeks, the absorbable sutures at the hairline will fall out.
  • Scar — The scar will remain red and elevated for a period of two to six months. After about six weeks, small hairs will start growing through the scar making it less visible. See the images below.
  • Numbness — All patients experience numbness of the front of the scalp. The sensation returns after a period ranging from three to twelve months. Sometimes there is an itching sensation during the recovery period.
  • Temporary hair loss — There can be some shedding of the fine hairs within two to four weeks after surgery. This is called an “effluvium” and occurs in about 5% of the surgeries. It is caused by the temporary reduced blood supply because of skin undermining. The hair normally comes back after three months. We sometimes suggest applying 5% Minoxidil to the front of the hairy scalp after surgery. This may lessen the possible fallout and promote a more rapid growth of hairs that might have been shed and those that will be growing through the incision.
  • Full recovery — Full recovery is to be expected after 12 – 18 months when the scar will have reached its full maturity. The scar remains, but it is usually too faint to even notice after one year.

What are the complications of hairline lowering?

• Hypertrophic scar; — Some patients have the tendency to develop hypertrophic scars. This can be treated with (repeated) corticoid injections or surgical excision of the scar followed by (repeated) corticoid injections.
• General hair thinning — This complication has been reported by 1% of the patients.
• Diminished scalp sensation — It is possible the scalp sensation is changed permanently. The patients who mention this do not experience it as a problem.

What is the average treatment plan of the expander assisted hairline lowering?

A two-stage hairline lowering involves two procedures performed within a day as an outpatient procedure plus the expansion that is planned to take six to eight weeks but may take up to three months in case of bad skin laxity.

What to expect and do during the recovery period after the expander assisted hairline lowering?

• The day of the first procedure — The day of the procedure and the day after, you might experience slight pain or discomfort that can be well managed with the painkillers we will give you. During the first week there might be a bit of swelling and bruising but it should not be very noticeable.
• During the expansion period — One week after the insertion of the expander, the patient can start the expansion. The aim is to inject 20ml of saline per day. This can be divided over one to four injections per day depending on what the patient prefers. The more injections per day, the lower the volume per injection and the less painful the injection will be. Normally one injection of 20 ml a day is well accepted by the patients in the beginning, but as the expander gets more filled after a few weeks, two to four injections per day might be preferable. Important: Do not rush things! If severe pain occurs, you must slow down! Otherwise you have a serious risk of skin perforations.
• The second procedure — The recovery after the second operation is the same as for a hairline lowering without expansion.

What are the risks of expander assisted hairline lowering?

• Shifting of the expander — This occasionally happens, especially if the patient prefers to sleep always on the same side, but the consequences are little.
• Skin necrosis — Skin necrosis should not occur if the patient carefully follows our instructions.
• Infection — Infection has never occurred after surgeries performed by Dr van de Ven. The longer the expansion process takes, the higher the theoretical risk though.
• Temporary diffuse hair loss — This is a logic consequence of the reduced blood supply that is caused by the pressure of the expander.
• Accidental surgical perforation of the skin during the undermining of the skin — This may lead to insufficient skin expansion being possible as the perforation would be expanded too. This could lead to extrusion of the expander.

How long can I expect the results of expander assisted hairline lowering to last?

Forever.

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