Hair Transplant: The permanent solution for hair loss
At the Hair, Skin & Wellness Clinic (in Dublin, Ireland and London, UK) we understand hair-loss and would like to help you restore your self-confidence and self-esteem with our professional and confidential approach. Our treatments are tailored for both men and women. For private consultations, call click here.
We offer 4 types of restoration and transplant treatments:
- Follicle Unit Extraction technique (FUE) – this is where single hair follicles are harvested from the donor area and transplanted into the recipient area – This is our speciality. It is the most modern technique in hair restoration surgery.
- Follicle Unit Strip Transplant surgery (FUS / T) – this is where a strip of hair is removed from the donor area and hair follicles are isolated and transplanted into the recipient area. This is the more traditional approach.
- Combination FUE and FUS/T technique, allowing us to maximize yield from the donor area without over stretching the capacity of either FUE donor follicle supply or FUS/T donor follicle supply, thereby providing a balanced and safe approach with maximum donor yield in carefully selected cases.
- Mesotherapy techniques – entails growth factor injections into the scalp. This can be done as a stand-alone treatment or in combination with both FUE and FUT/S techniques.
You are in safe hands with us:
Dr. Andre Nel originally trained in emergency medicine and general medical practice. Since 2008 he has been working in Hair and Skin Restoration, learning first hand from world leaders in the field.
Before and After Pictures
Click here for before and after pictures.
Dr. Nel trained in Hair Restoration with:
- Dr. Bijan Feriduni (Hasselt, Belgium)
- Dr. Mark DiStefano (Boston, USA)
- Dr. James A. Harris (via FUE Palooza, Denver, Colorado, USA)
- Dr. John P. Cole (via FUE Palooza, Denver, Colorado, USA)
He also visited the practices and learnt from several other world leaders in the field:
- Dr’s Ron and Paul Shapiro (Minneapolis, USA)
- Dr. Willam Magdalin (New Hampshire, USA)
He trained in Skin Restoration with:
- Dr. Zein Obagi (Beverly Hills, USA)
- Dr. Clara Santos (Sao Paulo, Brazil)
- Prof. Bob Khanna (Reading, U.K)
Dr. Nel says, “ Because of their absolute mastery in their fields, I consider Dr. Bijan Feriduni my mentor in Hair Restoration and Dr. Zein Obagi my mentor in Skin Restoration”. Dr. Nel also worked in Hair Restoration at The Private Clinic on Harley Street in London.
Dr. Nel’s qualifications:
- Qualified at the University of Pretoria Medical School, South Africa.
- ABHRS, “Diplomate of the American Board of Hair Restoration Surgery”
- Registered to practice medicine in South Africa, the United Kingdom, Canada and Ireland.
- Member of the ISHRS (International Society of Hair Restoration Surgeons)
- Member of the ESHRS (European Society of Hair Restoration Surgeons).
- Qualified in ATLS, AMLS, ACLS, BLS Certification (full registration as an emergency physician)
- MBA from the University of Pretoria School of Business Management (majoring in Information Technology systems)
- Co-founder / director of two successful healthcare IT companies, Easyscript (Pty) Ltd and Prognosis Health Services (Pty)Ltd.
- Dr. Nel currently practices Hair and Skin restoration in Ireland, South Africa and the United Kingdom.
Other transplant procedures:
Hair Transplant Questions and Answers
For private consultations, click here.
FUE or FUT? What do I need?
The decision whether you should go with FUE (follicle unit extraction) harvesting technique or FUT (follicle unit strip surgery) harvesting technique is dependent on a number of factors which include:
- The size and density of your Donor Area;
- The laxity of your scalp;
- The number of miniaturized hairs and distribution within the Donor Area;
- The number of follicles planned for harvesting;
- Your hair characteristics;
- Your personal preferences and goals.
If for instance you don’t want to shave your donor area to 0.8mm in order to facilitate FUE harvesting, due to work or social circumstances, then you can keep your hair unshaved or uncut and a FUT Strip Harvesting procedure would be required. In this instance a 1.2cm strip of hair will be shaved in the area where the strip harvest will be done and on average a 8mm to 10mm strip of tissue is removed within this area and when the wound edges are approximated (with closure of the wound), the hair will be easily cover the area and there would simply be a 2mm unshaved area which will soon grow back the shaved hairs and the harvesting area would be completely out of sight from the moment you leave the surgery.
Some patients are not concerned about shaving their donor area hair short and in addition to that, they have strong and large donor areas and FUE harvesting works well for them.
Other patients have tight scalps that makes it difficult to close the wound without incurring tension on the wound margins after surgery, which increases the chances of post-operative shock loss, and in these cases FUE harvesting will be a better option.
In some cases where relatively large amounts of hair follicles are required for harvesting it is a good idea to combine FUT strip and FUE harvesting techniques during one procedure of hair transplantation surgery (read more about the hair follicle cycle growth). This option provides the best of both techniques allowing for a relatively small strip harvest and a relatively small FUE harvest. So neither technique places a lot of stress on the scalp and it minimizes the chances of shock loss post operatively and it is a balanced way to harvest a relatively large number of grafts (3000 to 5000) without compromising the donor area for potential future graft harvesting. More about FUE vs FUS/T.
What other options do I have for hair restoration?
In addition to surgical hair restoration, which includes FUE (follicle unit extraction); FUS/T (follicle unit strip surgery) and combination FUE/FUS there are also medical treatment options. The vast majority of patients who undergo hair transplant surgery also make use of the medical treatment options to further enhance their results and to prevent progression of AGA (Androgenetic Alopecia).
Mesotherapy treatments such as PRP (platelet enriched plasma) injections into the scalp and also LLLT (low level light therapies) such as Lasercap, Capillus and Lasercomb and also the Help Hair Shake (whey protein shake with multivitamins and trace elements supporting hair growth). Some of these medical and mesotherapy treatments are FDA approved and others are used “off label” by the hair restoration community of specialists such as PRP, Lasercap and other micro-needling techniques. In some cases where neither hair transplant surgery nor medical treatments are options to consider hair systems are used. In some rare situations patients may suffer from scarring alopecia’s which are treated by immune-modulating medications to prevent the immune system from destroying hair follicles.
The best advice would be to make an appointment with an experienced hair restoration surgeon in order to get the best advice and treatment options right from the start when you first become concerned about your hair loss. That way you will have the best chance of minimizing or stopping ongoing hair loss and restore your hair existing hair loss to the most natural and aesthetically pleasing result.
Do products like Rogaine provide the same results as hair transplantation?
Rogaine or Regaine which is a FDA approved medical treatment for both men and women who suffer from Androgenetic Alopecia (AGA). These medications are also used “off label” for treating other types of hair loss in conjunction with an array of other medications. Mostly Rogaine is used as medical adjuncts in addition to hair transplant surgery in order to maximize the hair shaft calibre and therefore the hair volume for the best possible results. Their purpose is also to prevent future progression of AGA.
In many cases of where younger patients in their early twenties show the first signs of AGA it is good practice to start those patients on medication in order to “arrest” the progression of AGA and improve areas of early miniaturization of hairs and thereby not only preventing progression of AGA but also improving the hair mass index (hair volume) by reversing the AGA process of miniaturization and increasing the total hair volume. In these cases many young patients may significantly restore their early hair loss in up to 48% of cases or at least contain it from progressing further in up to 90% of cases.
So there definitely are situations where medical treatment alone can improve the hair loss and keep it in check as long as the medication is taken for the long run. These are mostly prescription medications and therefore all patients require a thorough pre-assessment by an experienced hair restoration surgeon prior to starting these treatments and then also follow up regularly with their doctors to monitor their results and also to check for potential side effects.
Is hair transplant surgery the most effective way to restore hair?
There are many different causes of hair loss. The most common form of hair loss would be Androgenetic Alopecia (AGA) which includes Male Pattern Baldness (MPB) and Female Pattern Hair Loss (FPHL). So we have to exclude firstly what causes the hair loss because that will determine the best way to treat it. Hair transplant surgery applies mainly to AGA, but it is not the only option. Medical treatments for AGA play a very important role in the management of AGA and is often very successful as a stand-alone-treatment without doing hair transplant surgery, provided it is started early enough in the AGA process. Mostly medical treatments are given in conjunction with surgical hair restoration in order to maximize the results of hair restoration and to prevent progression of AGA.
Other causes of hair loss include hair breakage via chemical or physical manipulation and also hair shaft genetic abnormalities. Then there are scarring (cicatricial) alopecias where the immune system damages hair follicles permanently (primary cicatricial alopecias) and also cases of secondary cicatricial alopecias caused by burns, infections, inflammation, traction, and trauma to the skin that damage hair follicles and in each of these cases the treatment is different and may not include hair transplant surgery at all and often medications are used only. Then there are hair loss causes due to increased hair shedding, such as Telogen Effluvium (mostly stress related), Anagen Effluvium (caused by chemo and radiotherapy treatments) and Loose Anagen Syndrome (genetic abnormality in the hair shaft attachment to the outer root sheath).
Then there are non-shedding causes of hair loss such as patterned hair loss as found in Alopecia Areata (auto immune reaction); Traction Alopecia (due to braids and hair extensions causing follicle fatigue); Trichotillomania (an anxiety state causing people to pull their hair out); Triangular Alopecia (present from birth with genetic origin). Then there are the causes of diffuse hair loss such as systemic illnesses, eg Hyper or Hypothyroidism; Low levels of Zinc and Biotin; Chronic Telogen Effluvium; Diffuse Alopecia Areata; Stable Scarring Alopecias; Polycystic Ovarian Syndrome and shortages in Iron; Vit D25OH; Chronic Illnesses; Medications taken for 6 months or longer; and heavy metal poisoning with Mercury; Thallium; Cadmium; Arsenic; Coper and Boric Acid. In all these situations, the underlying cause needs to be identified first and then treated appropriately. This demonstrates that hair transplant surgery is not a blanket treatment option for hair loss in general but is mainly used in cases of AGA in conjunction with medical treatment.
Are hair transplants painful?
Hair transplants are performed under local anaesthetic ring blocks that provide complete anaesthesia of the scalp and no pain is experienced by the patient. The local anaesthetic dose (Lignocaine) is enhanced from time-to-time throughout the procedure to ensure a pain free experience for the patient. The local anaesthetic is mixed with adrenaline which enhances the efficacy on a localized level and diminishes dissipation of the product into the general circulation. We make use of local anaesthetic creams rubbed onto the skin prior to the initial skin puncture to provide complete blocking of pain sensation.
Thereafter a small amount of Lignocaine is injected to form a “bleb” of completely anaesthetised skin. From there a blunt cannula is used to deposit the local anaesthetic under the skin surface pain free to create a ring block. During the process we also use a vibrating device on the skin that activates the touch and vibration receptors of nerve fibres which register stronger sensations in the brain compared to the slower conducting pain nerve fibres, and this distracts the patient and lowers the sensation of any potential pain even further. Additional measures include buffering of the local anaesthetic by making it more alkaline and less stinging, also by warming it up to body temperature and using the smallest needle size to puncture the skin and administering the local anaesthetic via a slow rate of administration diminishes painful sensations. The use of needle-less injections and blunt cannulas further diminish any painful sensations. We also give our patients a sedative before starting the process of a local anaesthetic ring block. The process is essentially pain free.
Do hair transplants work?
Hair transplants work extremely well if all the conditions of a good hair transplant procedure are met. This would most importantly include an experienced surgeon and his staff. There are multiple factors that need to be adhered to in this process of which some of the most important include the management of grafts (hair follicles) during the hair transplant process and specifically the harvesting of follicles, the storage (graft storage solutions and temperature control) of the follicles and the management of the follicles during the process of implanting into the pre-made incisions. The comparative size, depth and angle of the incisions and how snugly the grafts fit into the incisions are all important factors which remain a function of the experience and expertise of the surgeon and his technical team.
The principle of donor dominance is why hair transplants are possible in the first place. That means that follicles harvested from the back and sides of the head, that normally do not have Androgen Receptors can be transplanted into the Recipient area and won’t be affected by male hormones and therefore continue to grow in the same way after transplantation as the hair follicles did in the donor area from where they were harvested. Other important factors include the ongoing use of medical treatments after hair transplant. Hair transplants work extremely well if both the patient and the surgeon are in agreement with the patient’s goals and expectations, the patient is on-board with regard to ongoing long term medical treatment and the surgeon and his team are experienced.
Are hair transplants worth it?
The overwhelming and continued increase in demand for good quality hair transplants are a testimony to the fact that patients feel hair transplants are worth it. The experience however is subjective and only the patient can provide the full answer. Many patients find a hair transplant surgery a life-changing experience. This is indeed the case when the patient’s goals and objectives are met. The critical factor is to establish patient expectations beforehand and to determine if they are realistic and achievable.
This can be fairly easily established by an experienced surgeon who has the patient’s best interests at heart. That is why a good pre-operative consultation is essential. During such an interview and assessment the surgeon is able to determine donor versus recipient area ratios and make future projections based on the patient’s current age. Thereafter proceed with realistic expectations that support a well thought out transplant strategy that will stand the test-of-time. The demand for good hair transplant surgery is growing all the time. A good hair transplant has to meet the basic criteria of being undetectable (natural looking) and having achieved adequate density within the patient’s expectations, and that will certainly be worth it.
How long does a hair transplant procedure take?
The length of time it takes to perform a hair transplant surgery is mostly dependent on the number of follicles transplanted. For the most part the procedures take between 8 hours to 10 hours to complete and the average amount of follicles transplanted during this time frame would be 2000 follicle units. In my practice the average procedure comprises 2000 follicle units transplanted within an eight to ten hour time frame. In some cases the time will vary for 2000 follicles and factors that influence this mostly would be shaving of the recipient area hair versus not shaving the recipient area hair. The presence of more than average bleeding and also popping of grafts after placement. Other factors that could extend the duration of the hair transplant would be the type of harvesting technique, whether FUE, or FUT strip harvest or FUT/FUE combination harvesting. In a more general sense the experience and competence of the surgical team would have a definite impact on the time it takes to transplant a specific number of follicle units. Read more…
Do hair transplants look real and natural?
The main objective of having a hair transplant done is for it to look realistic, natural and yet unnoticeable as a hair transplant. Equally important is to create adequate density. These two factors can be achieved with adequate preparation, planning and via skilled implementation by an experienced hair transplant surgeon and team. Multiple factors play a role in achieving an optimal result and it comes down to paying careful attention to the detail involved in each and every step of the way. More on the topic: Do hair transplants look real?
Can a change in my diet prevent hair loss?
Just as your diet is important to help maintain your everyday health, it plays an essential role in promoting healthy hair and hair growth. So if you are seeing more strands of hair in your brush that usual, or feel that you are losing more hair than you normally do when washing, then you might want to analyse your diet. Read more about diet and hair loss.
Can hair loss be prevented?
Before we advise you on a few simple steps to avoid hair loss and prevent baldness, it is important that you understand what happens when a person (most likely older males) goes bald. The most common perception is that the individuals that experience receding hair lines or baldness on the temples or back / crown of head, are simply losing hair in these areas. This is however not the case. More about prevention of hair loss.
About Hair Follicles – What Makes Hair Grow?
Have you ever wondered what determines the state of your hair, in terms of thickness, health and growth? There are a number of factors that contribute to the condition of your hair. If you’re suddenly experiencing more hair loss than usual, or if your hair has become dry or brittle, it might be time to look a little deeper to determine the root cause of all your hair-related problems (unfortunately this does not include bad hair days!). More on the topic: What makes hair grow?
When is a hair transplant the best solution for hair loss?
Having a hair transplant is a very personal thing. Other people really don’t care if you’ve got hair or not. There are many bald men who are not bothered by their hair loss, who feel confident and are very successful. So nobody really needs a hair transplant, except for those people who think it might make them feel a bit better about themselves. In general, most young men are concerned about losing their hair. There is more social pressure amongst younger people to look their best and also because a hairline frames the face and changes the aspect ratio of a face, a thinning or receding hairline can make someone look older or somewhat “different” compared to others in the same age group. More on the topic: When is hair transplant the best solution for hair loss?
Does Caffeine promote healthy hair growth?
Having a hair transplant is a very personal thing. Other people really don’t care if you’ve got hair or not. There are many bald men who are not bothered by their hair loss, who feel confident and are very successful. So nobody really needs a hair transplant, except for those people who think it might make them feel a bit better about themselves. In general, most young men are concerned about losing their hair. There is more social pressure amongst younger people to look their best and also because a hairline frames the face and changes the aspect ratio of a face, a thinning or receding hairline can make someone look older or somewhat “different” compared to others in the same age group. More on the topic: Does Caffeine promote healthy hair growth?
How does the physiology of hair work?
Understanding the physiology of hair will help you to understand why hair loss occurs, and also what can be done to prevent or even cure it. Hair loss can be quite distressing, especially if it is sudden and extreme. Determining the root cause of your hair loss will help to provide suitable treatments and solution. Some solutions are as easy as amending your diet, or taking oral medication. More extreme solutions for more severe cases include FUE or FUT/S (hair transplant surgeries), as conducted by Dr. André Nel. Read more about the physiology of hair.
Are you too young to go bald?
Androgenetic Alopecia, or male pattern baldness, is a common hair loss condition amongst men, and can start occurring as early as your teens. This can be a distressing experience for young men, especially in today’s day and age where thick locks of hair and beards are quite popular. More on the topic: Are you too young to go bald
Stages of Male pattern Baldness
Male pattern baldness is the most common hair loss condition amongst men. The age of onset and rate of hair loss experienced can differ widely. For some men hair loss can start in their teens, other early twenties and thirties. In other cases, Alopecia only hits at the age of 50, or not at all. Find out more about Stages of Male pattern Baldness
Solutions for baldness through the ages
Male Pattern Baldness is definitely not a recent occurrence. Men have suffered from Androgenetic Alopecia (Male Pattern Baldness) throughout the ages, leaving them frustrated and distressed. Many bizarre remedies originated to treat hair loss conditions, showing little success (which isn’t surprising). Read more about Solutions for baldness through the ages
Causes of Androgenetic Alopecia
In this article we’re going to talk about Androgenetic Alopecia, in laymen’s terms it’s called male pattern baldness or hair loss. This is the most common type of hair loss in men. This is caused by a genetic process called Androgenetic. This is a tendency that we inherit from our parents, from both sides and from multiple generations back. Its polo-genetic and a complex pattern of inheritance, so you can’t say it comes from your dad’s side or mom’s side exclusively. Find out more about the Causes of Androgenetic Alopecia
The Role of Genetics in Hair Loss
Have you ever wondered if your genetic build-up has anything to do with your hair loss or sudden balding? It is a common question amongst hair loss patients, who wish to understand the cause of their hair loss condition a little better. It is also a concern for many young men who see their fathers balding at an early age: will they too go bald like their fathers? While there is a correlation between your family’s history of hair loss and your genetics, the answer isn’t as simple as it seems. Find out more about The Role of Genetics in Hair Loss
Hair Transplant Techniques
If you are considering a hair transplant surgery to cure your progressing hair loss condition, and would like to know more about the techniques used by Dr. André Nel, read more below for a better understanding of how the surgery and techniques work. Read more about Hair Transplant Techniques
How many hair grafts are needed for a hair transplant?
There are a number of different factors that determine how many hair grafts will be required to provide the desired outcome. For this reason, the number of hair grafts needed will differ from patient to patient. The amount of grafts required vary between 800 and 5000 (and even more in some cases), which is quite a broad scale. More on the topic of How many hair grafts are needed for a hair transplant
Do you get non-surgical treatments for hair loss?
Before discussing the different non-surgical treatments for thinning hair / hair loss, a quick look into the causes of hair loss is required. Most cases of hair loss such as Androgenetic Alopecia (Male Pattern Baldness) and female pattern baldness is caused by a hormone called DHT. DHT is produced when testosterone interacts with the enzyme 5-alpha reductase. This reaction occurs in tissues in the prostate gland, seminal vesicles, skin, hair follicles, liver, and brain. Find out more about non-surgical treatments for hair loss.
What is the LaserCap® LCPRO™ & LaserCap® LCElite™?
The LaserCap® LCPRO™ and LaserCap® LCElite™ are both devices used to help promote healthy hair growth, and are used by individuals across the world as a non-surgical treatment for hair loss conditions. Read more about The LaserCap® LCPRO™ & LaserCap® LCElite™.
What can you expect from hair transplant surgery?
Each case of hair loss amongst individuals is unique, which is why a thorough assessment will be completed before proposing the best solution. Patients that visit Dr. André Nel, hair restoration specialist in Dublin, Ireland, usually have certain goals they wish to achieve regarding their hair loss pattern, density and hair growth. Once Dr. Nel has conducted a thorough assessment, a treatment plan will be put into place and discussed with the patient. It is essential that the patient and doctor are in agreement about the goals that can be achieved, and Dr. Nel will aim to achieve the best realistic goals for each individual. More on the topic of What to expect from hair transplant surgery.
What is a CRL Medical Hair System?
A Medical Hair Systems is the latest technological innovation when it comes to non-surgical hair restoration solutions. A CRL Medical Hair System is a hair replacement system developed by Cesare Ragazzi Laboratories in Italy, and is basically a medical grade prosthesis that covers the area on the scalp where hair loss has occurred. Read more on the topic What is a CRL Medical Hair System?.
The Fundamentals of Hair Loss – Understanding Androgenetic Alopecia
Male pattern baldness is a common condition amongst men, causing their hair to thin gradually with age. Medically known as Androgenetic Alopecia, this hair loss condition is genetically inherited from genes carried over by the mother and father. Read more about The Fundamentals of Hair Loss.
Hair Transplants in Younger v. Older Patients
Thinning hair, hair loss, baldness – conditions no young man wants to be diagnosed with. Hair loss can be a devastating for men, especially when showing at an early age. For some men, going bald is inevitable, as male pattern baldness is mainly inherited from our parents. More on the topic Hair Transplants in Younger v. Older Patients.
About the Donor Area for Hair Transplantation
For some individuals, going bald is inevitable. This gene is inherited from our parents, and if the gene is carried over, there is little you can do to stop the process of hair loss. Read more About the Donor Area for Hair Transplantation.
Other useful information: