How is Hair Transplantation Performed? Step-by-Step Process
Although hair transplantation surgery may seem like a simple cosmetic procedure from the outside, it is actually a sophisticated tissue transplantation surgery requiring microscopic precision, with each step meticulously detailed. Based on the principle of taking healthy hair follicles from the nape of the neck and transferring them to the bald area, this process is a marathon lasting approximately 6 to 8 hours and requiring medical discipline. The answer to the question “How is hair transplantation performed?” encompasses not only surgical techniques but also the preparatory phase, the artistic design during the operation, and the subsequent biological healing process.
Phase 1: Preparation and Artistic Design
The operation day begins with a detailed analysis long before the surgical procedure. The first procedure performed when the patient arrives at the clinic is blood tests and a health screening. It is checked whether the patient has any condition that would prevent the operation (infectious diseases, bleeding and clotting disorders, etc.). After medical suitability is confirmed, the most critical aesthetic stage of the operation, “Planning,” begins.
The surgeon determines the new hairline, taking into account the patient’s facial features, the structure of the forehead muscles, and age. This line should be in harmony with the person’s face according to the principles of the “golden ratio.” It should be neither too low (looking artificial) nor too high (not covering the bald area). After the drawing is made, the donor area (nape) is shaved, and the area from which the grafts will be collected is sterilized. This stage is where the foundation for the success of the operation is laid.
Stage 2: Local Anesthesia and Comfort
The “pain” factor, which patients fear most, is eliminated at this stage. Hair transplant operations are performed under local anesthesia; that is, the patient is awake, but the scalp is completely numb. As an alternative to traditional needle anesthesia, “needleless anesthesia” devices using pressurized spray technology have become widespread today.
In some clinics, “sedation” is also used to maximize patient comfort. Sedation is the process of creating a mild sleep state in the patient by administering medication intravenously under the supervision of an anesthesiologist. This ensures the patient doesn’t even remember the local anesthesia procedure and begins the operation with zero pain.
Stage 3: Graft Harvesting (Extraction)
After the scalp is numbed, the FUE (Follicular Unit Extraction) stage begins. During this stage, the patient is in a prone position. The surgeon or specialist team uses special medical devices called “micromotors,” with tips 0.6-0.8 mm in diameter, to individually separate hair follicles (grafts) from the donor area.
The most important detail here is “Homogeneous Harvesting.” If excessive density of follicles is extracted from a particular area, gaps or “moth-eaten” appearances may occur in the nape area after healing. In a professional procedure, follicles are harvested in a scattered and balanced manner; thus, thinning in the donor area is not noticeable to the eye. The harvested grafts are kept in special nourishing solutions (Hypothermosol or Isotonic) at +4 degrees Celsius to maintain their viability and are grouped according to the number of hair strands (single, double, triple).
Stage 4: Channel Opening (The Moment the Art is Performed)
After the harvesting process is complete, the stage that determines the aesthetic fate of the operation begins: Channel Opening. In this stage, the patient is in a supine position. The surgeon opens the sockets (incisions) where the harvested roots will be placed. While steel scalpels are used in the classic FUE method, the modern “Sapphire FUE” technique uses tips made from real sapphire.
Why is the channel opening process so important?
- Angle Determination: The angle of the channel is what ensures that the hair grows at a natural angle (40-45 degrees) instead of vertically (like a grass man).
- Direction Determination: Whether the hair can be combed to the right, left, or forward depends on the direction of the channel.
- Density: How frequently the channels are opened determines the density of the hair transplant.
Technical Distinction:
If the operation is performed with the DHI (Direct Hair Implantation) technique, this “Channel Opening” stage is skipped. Thanks to the “Choi Pens” used in the DHI method, the roots are placed on the tip of the pen and injected directly into the skin. In other words, drilling and root placement are done simultaneously.
Stage 5: Implantation
After the channels are opened, the final stage begins, where the team works in the largest and most synchronized manner. The grafts, waiting in the solution, are placed one by one into the opened channels using special forceps. This stage requires patience and precision. It is vital that the root is placed at the correct depth without bending inside the channel.
Strategic placement comes into play here: To ensure the most natural look, “single” and fine grafts are always placed in the front row (hairline). “Double” and “triple” grafts are transferred to the back areas to create volume. This gradient transition is an imitation of the natural hair structure.Hair Transplantation and Timeline
The average time flow of a hair transplant operation is summarized in the table below:
| Time Period | Procedure Step | Application Performed |
|---|---|---|
| 08:00 – 09:00 | Welcome and Preparation | Blood test, hair shave, hairline design and photo shoot. |
| 09:00 – 12:00 | Graft Harvesting | After local anesthesia, the roots are taken from the donor area Collection. |
| 12:00 – 12:30 | Lunch Break | Patient rest and eating. |
| 12:30 – 13:30 | Channel Opening | Channels are opened to the recipient area with sapphire tips (by the surgeon). |
| 13:30 – 16:00 | Transplantation Procedure | Placement of grafts into the channels. |
| 16:00 – 16:30 | End and Dressing | Bandaging of the donor area and discharge procedures. |
Post-Operation and Discharge
When the procedure is complete, the donor area (the nape of the neck) is covered with antibiotic ointments and bandaged to protect against infection. The transplanted area is left open because it should not come into contact with anything. The patient is given the necessary post-operative medications (antibiotics, painkillers, anti-inflammatory drugs) and detailed information about the sleeping position.
Conclusion: A Journey Requiring Patience
Hair transplantation surgery is not a process that ends when you leave the clinic; on the contrary, it is just beginning. The transplanted hairs are living tissues and it takes time for them to adapt to their new location. The first 10 days involve crusting and healing, the first month is shock shedding, and the regrowth process begins from the third month onwards. The most accurate answer to the question “How is hair transplantation performed?” is; It is a process of “building self-confidence” that combines science, art, and patience. When performed with the right techniques and by expert hands, this process is a safe procedure that permanently changes a person’s quality of life.
