How to do hair transplantation

Hair transplantation is performed in a hospital environment by a team of hair transplant doctors and nurses, with operations lasting approximately 4-8 hours, by transferring the hair root taken from the neck area designated as the patient’s donor area and into the predetermined bald area.
How is a hair transplant performed by explaining the stages of hair transplantation? We will answer the question in detail.

You will find detailed information on hair transplantation in our article. Hair transplantation consists of 7 basic steps.

1. Preparation for hair transplant surgery
2. Preoperative anaesthesia
3. Collection of transplants
4. Preparation of transplants for transplantation
5. Opening the channels
6. Placement of the hair root

1- Preparation for the hair transplant surgery

Before the hair transplantation, the patient has some obligations during the preparation phase of the hair transplant to make the hair transplantation easier and more successful. Precautions before hair transplantation:

  • If you decide on a day of surgery, you should choose a day after which you can rest for at least 3 days after the operation.
  • On the day of the operation light meals should be taken and a light breakfast should be prepared before the operation.
  • In order not to damage your hair roots that have been transplanted, you should go to the hair transplant center on the day of the operation with comfortable clothes that are easily removable. You should prefer clothing with an open collar or clothing with buttons that can be easily pulled over your head.
  • You should go to the hair transplant centre at the agreed time and be careful not to be late. When you arrive at the Hair Transplant Centre, your patient advisor will welcome you.

The preparation for the operation in the hair transplant centre consists of 5 basic steps.

1. Blood test:

Before the operation your general state of health will be checked and some examinations will be necessary. The reason for this is to find out if there are any problems with hair transplants that could endanger your overall health. The examinations will show that you do not have any complaints that would prevent a hair transplant. In order to check the general state of health, the nurses take 1 tube of blood from the vein on the day of the operation using an injection needle and send it to the laboratory for analysis. Blood collection takes about 1 minute.

Your blood will be tested for diabetes, hepatitis B, C and HIV viruses, blood clotting rate and several other infections and viruses. Your blood counts are carefully checked for obstacles to hair transplantation. If there is no risk of hair transplantation, the preparation process will continue.

While some diseases are an obstacle to hair transplantation, certain diseases can be treated with hair transplantation by taking some precautions. To find out which diseases a hair transplant can be performed on or not, read our article “Which diseases can a hair transplant be performed on”.

How is a hair transplant performed? – For which diseases can hair transplantation not be performed?


2. Sign the Patient Permit Form:

EEven though signing the patient approval form is a fear at the first meeting, in our country it is compulsory to fill in a form stating that the patient has been sufficiently informed before the operation and that the patient’s consent has been obtained. You should read the form carefully.

There are some things you should know before signing the patient authorization form.

  • Do not hesitate to ask your doctor any questions about the operation. Ask your doctor any questions you may have before the operation.
  • Do not sign the form until you have read it completely.
  • In addition to the Patient Permit Form, you will also need to complete a form that contains some questions about your person. Please note that you must complete the information on this form completely correctly. This is very important for your health. Talk to your doctor in person if you are unsure.
  • It is very important for your health that you state your allergies and diseases that are known to you.
  • – Inform your doctor on the day of surgery or before surgery about the vitamins, aspirin, or medications you are taking.

3. planning the hair transplantation:

Once the approval form has been signed, a preliminary consultation is held with the doctor and the planning of the hair transplantation begins. In the preliminary consultation, the doctor will talk to you personally and give you the information you need about the operation. The planning of the hair transplant will then begin.

Do not have your hair cut before the operation to ensure proper planning of the hair transplant. The hair cutting process for hair transplantation takes place after hair transplant planning in the hair transplant centre. This is very important for the correct planning of a hair transplant.

The maximum amount of hair roots from the donor area of the patient is compared to the amount of hair roots needed to cover the bald areas of the patient.

To plan the hair transplant, the doctor examines the density of the donor site of the patient, the degree of baldness and the hair root structure. In addition, the most natural distance and shape of the forehead is calculated by examining the patient’s facial structure to best determine the anterior hairline. The anterior forehead line is determined together with the patient for the hair transplant to be performed on the forehead.

When determining the anterior hairline, make sure that the possibilities of your donor area meet your expectations. Rely on your doctor’s advice for a natural look.

For hair transplants, the planning of the forehead line is very important for a natural appearance. For more information on this subject you can read our article: ”Why is the hairline important?’’

What is done during hair transplant planning?

After the decision has been made, the areas to be transplanted and the number of hair roots to be transplanted are marked.

When planning the hair transplant, the following points are determined:

  • How many transplants are collected from the donor area?
  • How many hair roots should be transplanted into which region?
  • The shape of your forehead line and where to start,
  • Which hair transplantation technique should be used?

4. Shaving your hair:

As mentioned before, the most important point you should know here is that you should not get your hair cut beforehand. On the day of the operation, your doctor must check the natural condition of your hair at the Hair Transplant Centre for Hair Transplant Planning. After the hair transplant planning, the hair is shaved by the nurses in the hair transplant center.

Today, at the special request of the patient, hair transplants can be performed without completely shaving the hair. If you have such a request, you should discuss it with your doctor in advance.

A hair transplant without shaving prolongs the surgical process and complicates the operation. The ideal hair length for a hair transplant is the hair root which has been shaved to number 1. Hair cut number 1 means approx. 3 mm hair length. The cut hair length number 1 is the ideal length, especially for transplantation with a micromotor. This facilitates the collection process and prevents damage to the surrounding hair root during the collection of the hair root.

After shaving, the patient is ready to be taken to the operating room.

5. Admission of the patient to the operating theatre:

Hair transplants are performed with special sterile surgical clothing. The patient puts on the surgical clothes he has received before going into the operating room.

Hair transplants are long operations lasting 4 to 8 hours. The patient who is placed on a stretcher in the operating room is awake under local anesthesia. However, due to local anaesthesia, the patient does not feel any pain during this procedure, the patient can sleep, listen to music and watch TV with the consent of the doctor. The patient who gets hungry during the hair transplantation can have a light meal if the operation is interrupted, which does not disturb him during the operation.

2-Preoperative anaesthesia

  • Hair transplants are performed under local anesthesia.
  • Hair transplantation is not performed under general anesthesia as it is associated with various risks and is not necessary.
  • As local anaesthesia causes regional numbness, the patient is awake and fully conscious throughout the operation.
  • Some people suffer from phobias or fear of needles. In such cases, needle-free and short-term sedation can be used to anaesthetise the patient during local anaesthesia.

The patient who is admitted to the operating room first lies down on the stretcher with his face. The entire head area is disinfected for local anaesthesia. After disinfection, anaesthetics are applied to the neck, where the transplants are collected with an injection needle. During local anaesthesia, the patient may feel a slight burning sensation. However, this feeling disappears after a few minutes. The duration of local anaesthesia varies from person to person, but is about 15 to 20 minutes. Under local anaesthesia, the person does not feel any pain. If the person is afraid of needles, sedation via the airway is performed before local anaesthesia. The patient is put to sleep for 10-15 minutes with the sedation. This procedure prevents the patient from feeling the local anaesthetic process, which takes about 10 minutes. Thanks to sedation, the patient does not feel the needles made in the neck region for local anaesthesia. After local anaesthesia the treatment waits until the drug is effective and then the hair transplantation begins.

3- Collection of Grafts

How is a hair transplant performed if the FUE method is preferred?

Today, FUE is the latest hair transplant technique in medical literature. FUE is also the most widely used hair transplant technique in the world. FUE is a technique that determines how transplants are collected. The FUE technique has two different applications. These are manual punch and FUE with micromotor.

During graft collection, the first and most basic stage of hair transplantation, the hair roots in the neck are loosened individually by manual punch or micromotor activity.

  • Manual punch FUE

The hair roots are loosened with the help of needles attached to a tool similar to a pen called a piasema. It is not a device. It is therefore also called manual, i.e. manual removal by hand. After loosening, the hair roots are collected with another tweezer-like tool, the so-called micro-pen set. This manual operation requires more work and time than the FUE with micromotor. The manual punch method has now been replaced by micromotor applications.

  • Micromotor FUE

It is a much newer and improved method than the manual punch. The FUE micromotor is, as its name suggests, an electronic device. With the discovery of the micromotor device, many doctors began to use the micromotor and left the manual punch in the history. In the micromotor device, which can be adjusted to a certain application speed, the transplants are released by needles at the end of the device and collected again with the help of the micropen set.

The hair roots loosened by one of these two applications are collected with the help of a medical device similar to tweezers known as a pen-set. The collected hair follicles are stored in glass containers called Petri with saline solution in preparation for transplantation.

After collecting the amount of hair roots to be transplanted, the donor area is cleaned and connected. The dressing in the donor area is not removed until the first wash. In the case of hair transplants, the first washing can take place on the 3rd or 4th day after consultation with the doctor. The opening of the bandages and the first washing takes place on the respective day by the hair transplant centre.

4- Preparation of transplants for transplantation

After collecting the transplants, these transplants should be prepared for transplantation. While transplants are collected during hair transplantation, hair roots are taken from the transplants collected by nurses and properly placed. To ensure that the hair roots, which are separated one by one, remain alive until the transplantation stage and are not damaged, they must be kept at a certain cool temperature and specially stored. The preparation of the collected transplants for transplantation consists of two basic steps. These are: preparing the collected grafts for transplantation by separating them and preparing the correct grafts. This is the separation of transplants and the preservation of hair roots.

Separation of transplants

The collected grafts include hair roots and skin, fat or tissue fragments. Once these grafts have been collected using the Micropen set, they are carefully separated from unnecessary pieces of saline tissue. The hair roots are removed and prepared for transplantation. The separated grafts are placed in a special solution on gauze and stored.

The storage of hair roots

It is well known that hair transplants take 4 – 8 hours. The removal of the transplants takes between 2 and 4 hours. After removal, the hair roots should be stored as properly as possible without losing their vitality. Because every hair root is very important. The most preferred method in our country is the “saline method”. In the saline method, hair roots are stored in a saline solution called “saline solution” or better “serum”.

hair transplant

5- Opening the channels

Opening the channels is the most important step in hair transplantation. Before anaesthesia, a local anaesthetic is applied to the area to be transplanted to avoid pain. It is also important to note that local anesthesia is not limited to certain hours. Depending on the pain threshold of the patient, local anesthesia can be performed again during the operation if necessary. Of course, all stages of hair transplantation are very important, but the way the canals are opened is directly related to the natural aspect of the hair root as it is directly related to the growth directions of the hair root. In other words, the hair roots to be transplanted should be transplanted at a natural angle so as not to look like a grass person. For this reason, the opening of the canals is the most important phase in the question of how a hair transplant should be performed…

What is the natural angle?

Today, the concept of the Grass Man, which has been forgotten due to successful hair transplants, is based on channels that have not been opened at a natural angle. If you take a close look at your hair root, you will notice that it has growth directions and angles. The hair roots to be transplanted should be transplanted with your existing natural angle and the canals should be opened at the most appropriate angle, depth and direction. There are 3 basic points that doctors pay attention to when opening the canals.

  1. width and depth of the canal to be opened: for a natural appearance, the hair roots to be transplanted at the front forehead line should be transplanted at an angle of 30 degrees and the inclination of the hair root should point to the face. The canals should be opened at a depth corresponding to the size and structure of the hair root.
  2. angle of the canal: The temple areas should be opened laterally at an angle of 45 degrees. In your skull area, this degree increases slightly and can reach up to 60 degrees. Finally, the backward opening channels are directed towards the neck;
  3. canal direction: The natural direction and cycle of the hair root are achieved by straightening the canal. Whether the natural structure of your hair is right or left, vertical or forward depends on the direction of the canal.

Exact depth, angle and direction are very important when opening the channels. If the channels are not opened at the right angle, in the right direction and at the right depth to your scalp, the appearance of the grass person is inevitable.

6- Placement of the hair root

In the first stage the hair roots were collected, in the second stage separated and in the third stage channels were opened. In the fourth and final stage, the hair roots held in a cold environment are placed in the open canals. Once the hair roots have been placed, the operation is complete. After the hair roots are placed, the operation is completed. The duration of this procedure depends on the number of hair roots to be transplanted, it can take about 1 to 2 hours.

Once the hair roots have been placed, the transplanted area is left open. After the transplantation, the transplanted hair roots are very sensitive. It must be well protected from pressure and shocks. Most patients can push their upper transplanted area against the car roof as they get into the car. We would like to stress that you should pay attention to this issue. After the hair transplant the patient does not have to stay in the hair transplant centre and can rest at home. Since the patient has been in surgery for a long time, it is preferable that a person be with him when he returns home.

The correct performance of the patient’s duties after a hair transplant contributes to healthier hair growth.

In this article we have shared with you the topic “How to do a hair transplant” in detail.


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