Advanced Hair Clinics has the experts that will provide the right solution for YOUR hair loss issue.
...has always been troubling people leading to their pursuit for restoration
The first known testimony of hair loss treatment goes back to around 1550 BC. In the Ebers papyrus from ancient Egypt we can find the first written references to hair loss treatment. Even the Bible contains references to hair loss and the importance of hair for men. Everybody knows the story of Samson and Delilah, where the power of man is identified with long hair. There’s also a reference in the Books of Samuel to the prophet Elisha, who was bald.
In ancient Rome, it is mentioned that Julius Caesar used Egyptian recipes against hair loss.
Later, in Ancient Greece, around 400 BC the father of modern medicine, Hippocrates, makes the observation that eunuchs, if castrated before puberty, do not develop androgenetic alopecia, thereby documenting for the first time the relationship of baldness with the effect of male hormones after puberty. He also proposed methods of treatment with herbs known at the time.
During the Middle Ages, the drug of choice for hair loss treatment was cow saliva, a belief that has survived to this day. The modern era of hair transplantation starts in 1939 in Japan, with dermatologist Dr. Okuda who performed hair transplantation with skin grafts and published his results, covering 200 cases of patients, in a Japanese medical journal. Unfortunately, because of the language barrier and the intervention of the 2nd World War, the work of Dr. Okuda remained unknown for more than 20 years. Surgical scalp restoration to treat androgenetic alopecia was first introduced in the USA in 1960, by Dr Norman Orentreich. He studied the regions where hair follicles can be extracted and implanted and demonstrated that hairs taken from the occipital region of the scalp (back of the head) will not fall out after implantation, introducing the terms ‛donor’ and ‛receptor’ zone.
Hair Transplant - The Techniques
The first hair transplantation procedures that were introduced in the 1960s and continued to be applied for about 40 years, were characterized by their extremely invasive, painful and bloody nature as well as by their very poor cosmetic results.
Plastic surgeons were the first to use relocation of skin flaps from the scalp with intact blood supply (flap surgery) in order to cover skin defects or bald areas. In these operations, a portion of the bald part of the head was excised and covered by a flap of skin originating from adjacent areas of the scalp. These interventions were particularly painful and bloody, were usually performed under general anaesthesia, and the cosmetic result was usually very poor.
In Plastic Surgery, nowadays, the application of skin flap transplants is still continued for specific indications, such as major detachment of the scalp skin due to injury, extended damages of the skin due to full depth burns, in cases of extensive skin cancer, etc. The use of skin flaps for surgical restoration of androgenetic alopecia, on the other hand, has practically been abandoned and is referred to here for historical reasons only.
Another plastic surgery technique for the treatment of male baldness that has seen widespread use in the past, was the so-called scalp reduction. In this procedure, a portion of the bald skin was excised, the adjacent skin was stretched with proper undercuts, and the wound was then sutured with the objective to reduce the extent of the bald part of the scalp. These operations were characterised by the existence of large and malformed postoperative scars and poor cosmetic results.
A modern, improved version of the scalp reduction technique that is used for cases of extensive skin absence or extensive scarring of the scalp due to burns or injuries, is the use of tissue expanders. In this procedure, which is typically performed under general anaesthesia, a tissue expander in introduced subcutaneously into the healthy portion of the scalp, and the wound is sutured. Next, over a period of 8-12 weeks, the tissue expander is gradually stretched with saline, which also results in a gradual stretching of the overlying skin of the scalp. When the dilatation is completed, a second surgery follows in order to remove the tissue expander and to excise part or all of the bald or scarred portion of the scalp; the gap in the skin then covered using the excess stretched skin of the scalp. This complex, lengthy and painful process has certain serious remedial indications, but is not used to cover male pattern baldness for aesthetic reasons, because of its highly invasive nature.
In the 1980s, the technique of punch grafting appeared, in response to the growing need for less invasive hair restoration techniques, as it began to be understood that head hairs grow in groups. In punch grafting, a circular knife (punch) of a large diameter (typically 0.5 mm) is used to remove a total of 20 to 30 hairs, which are then placed into a hole with a smaller diameter (typically 0.4 mm) which has been drilled into the receptor area of the bald part of the head.
Punch grafting was widely adopted during the decade of 1980-1990 but was gradually abandoned, as it was quite traumatic and bloody, characterised by unnatural cosmetic results, as large grafts of 20-30 hairs (plug grafts) cannot be placed close to each other and do not mimic the natural follicles that are much thinner, especially in the hairline area. The unnatural appearance of these plug grafts is known as the ‛doll-like effect’. In recent years, punch grafting has practically been abandoned, but there are still numerous cases of patients who have undergone hair transplantation with the punch graft method. Those patients now resort to plastic surgery and the FUE technique in order to restore the scars and the unnatural hairline.
FUT (Follicular Unit Transplantation) or Strip hair transplant technique came into use in the early 1990s and is performed with surgical resection of a portion of skin and hairs from a donor site at the back of scalp. The excised hairy skin section is submitted to a special treatment under the microscope and separated into grafts which are then inserted in the bald area. Depending on the technical training and experience of the team performing the FUT session, the grafts that are obtained in this manner can either be minigrafts (with 4-8 hairs) or micrografts (with 1-3 hairs). The skin in the donor site is sutured, leaving a permanent scar, the diameter of which depends on the suturing technique and the width of the missing strip, while malformed postoperative strip scars that need cosmetic restoration are not uncommon.
Better results in the final appearance of postoperative strip scar seems to be presented when the trichophytic closure technique is being used. The production with FUT or Strip technique of typically large diameter grafts with several hairs, which are not similar to the normal hair follicles of the scalp, often leads to unnatural aesthetic results, especially when multiple-hair follicles are implanted in the hairline area.
The most modern technique in hair transplantation today is FUE (Follicular Unit Extraction), which is done by transferring individual hair follicles from the occipital region to the thinned area. FUE was originally described in 2002-2003, when it was still in an experimental stage, and has since evolved gradually. Initially it was possible to transfer only a few hundred hair follicles, but today, with the use of automatic extraction devices, it is possible to perform sessions with several thousands of hair follicles in one day.
FUE has significant advantages over FUT, as the latter leaves huge, unsightly scars that remain permanently visible at the back of the head and possibly will remain painful for life. FUE, on the other hand, offers great aesthetic results without linear scars, pain or discomfort.
Advanced Hair Clinics has vast experience and expertise in the use of FUE, even in the most difficult cases. More specifically, we use Advanced FUE which includes extraction of individual follicular units with an automatic extractor (FUE Direct) and implantation of the hair follicles using an implanter device in one step, without the need to create sockets in the skin of the receptor site (One-Step Implantation), thereby substantially reducing bleeding, trauma, edema and postoperative pain after the FUE session.
In recent years, many promising robotic hair transplant systems have appeared (Robotic Hair Transplantation or ARTAS® Robotic Hair Transplant). Due to lack of sufficient accuracy, these systems cannot replace an experienced FUE hair transplantation team at present, but improvement of this technology in the future may at some point allow their generalised use.
Apart from hair transplantation, which up to date is the only scientific way to permanently restore hair growth in the bald part of the scalp, there are also various non-invasive and non-medical ways to cover bald spots that have been used at times or are still used today.
Hair prosthesis is a technique that can offer partial or total coverage of the bald part of the scalp by using a wig or special prosthesis made of natural or artificial hair in various colours, lengths or textures, depending on the person concerned and their facial features. The hair prosthesis is stabilised on the scalp with a special glue or with clips that hook onto the hair at the sides of the head (if any). The use of a prosthesis requires care and cleanliness of both the skin and the prosthesis itself.
Inadequate cleaning or bad application of the prosthesis may cause inflammation of the scalp, itching or chronic irritation. Due to pressure, the chronic use of a prosthesis gradually leads to atrophy of the bald part of the scalp, atrophy and loss of adjacent hairs that are partially covered by the prosthesis, and discoloration of the covered skin. The use of hair prosthetics and wigs for aesthetic reasons, which was particularly prevalent in the past in both men and women, is currently in rapid decline, firstly due to the progression of hair transplantation with FUE, and secondly because of the usually quite unnatural appearance of the prosthesis or wig.
One more factor is the high cost for the purchase and maintenance of a high quality (with natural hair) prosthesis, since the system needs changing on an annual basis, while the cost is close to that of a hair transplant. The main indication for use of a hair prosthesis today is the complete lack of hair on the scalp or total baldness, which can be observed in cancer patients who are undergoing chemotherapy or the very rare cases of Alopecia Areata Totalis. In such cases, the psychological shock caused by the rapid and total loss of hair is often unbearable, and the hair prosthesis can help substantially, both on a personal, psychological level and in social and professional context, especially since there is no indication of hair transplantation due to lack of a donor site.
Scalp micropigmentation or medical tattoo is a fairly popular technique to cover the bald part of the scalp or other special areas, such as post-surgical scars, eyebrows, etc. With this technique, a specially trained technician – theoretically under clean and aseptic conditions – injects dye into the patient’s skin, just like a conventional tattoo, with a very fine needle head, to simulate a hair print (micropigmentation).
From a relative distance, a tattoo can effectively camouflage the bald area, but from a close up view the final aesthetic result is rather poor, due to the lack of depth and volume in the painted ‛hairs’. One more disadvantage of the scalp micropigmentation is that it requires the application of several sessions due to the fading of dyes (bleaching); quite often, in areas that are exposed to the sun and have rich blood supply, such as the head, the pigments will gradually degrade, resulting in blurring, fading and discoloration of the tattoo, leading to a totally unnatural appearance which resembles a geographical map.
Keratin microfibers is another modern way of hair thinning coverage, especially in cases of early or moderate scalp thinning. On the other hand, in cases of baldness with complete loss of hair, keratin microfibers do not provide adequate aesthetic coverage. Keratin microfibers are available in a variety of colours to resemble natural hair, and are being spread out over the area of thinning like talc or powder. By static electricity, they adhere to the existing hair, increasing its volume and density. The microfibers are stabilized by using a hair spray and can be removed with shampoo. It is obvious that they can offer limited coverage in certain patients and for a short period of time, either for psychological, social or professional reasons, but in no way keratin microfibers constitute an effective or permanent solution against hair loss.
If the donor site is insufficient, hairs can be also obtained from the beard or the body and can be safely transferred to the affected area. Facial hairs develop fast and grow back at remarkably high rates, exceeding 95%. Due to the specific texture of these hairs (they are wilder and curlier compared to scalp hair) and the fact that the shafts on average are twice as thick as that of scalp hair, they are unsuitable for placement in the front hairline. However, if the donor site of the scalp itself is insufficient, they are extremely useful for the densification of the middle zone or the crown, and highly sufficient for the restoration of postoperative strip scars.
Body hair is another alternative resource of hair follicles for transplantation, especially in men who have rich body hair but insufficient donor site on the scalp. All regions of the body can be used as donor sites for body hair, such as the chest, the back, the arms and legs, the pubic region, etc., but it has been observed that the most reliable and potentially usable area for harvesting body hair grafts are the chest and the sternum. The final regrowth rate of body hair is highly unpredictable and usually ranges from 70 to 80%. Due to the very different life cycle of body hair, which usually progresses more slowly than the life cycle of scalp hair, the regrowth of body hair is extremely slow and may even take two years to complete.
Facial and body hair can only be used in hair transplantation with FUE method, which permits extraction of individual follicular units without incisions and permanent scarring. FUT or Strip technique has been used in these areas only to a minimal degree. The reason for that is because FUT/Strip technique leaves an aesthetically unacceptable, visible scar on the face or the chest, just for the purpose of obtaining facial or body hair follicles for transplantation.
Hair transplantation by transferring individual hair follicles (FUE) is currently the most ideal method for male and female hair loss. This hair transplant method is also used for the restoration of eyebrows or facial hair, as well as to cover scars left by Strip or FUT technique.
is the method that is constantly gaining ground in our days
According to the ISHRS (International Society of Hair Restoration Surgery), the number of hair transplants performed worldwide is growing with approx. 18-20% per year, with the highest growth rates recorded in Asian countries (China ,India) and the Middle East.At the same time, hair transplants that aim to restore eyebrows or facial hair are becoming more and more frequent.
In recent years, the expansion of the modern FUE hair transplantation method, which allows hair restoration without causing permanent marks or linear scars in the donor site (as was the case with the older FUT or Strip technique), in combination with the natural-looking results that can be achieved, has contributed to even greater popularity of hair transplantation and has caused the decline of older, non-medical techniques whose goal is to cover the scalp such as prostheses or wigs, the use of which is constantly declining.
Hair loss has been troubling many men and women ever since antiquity, and still is a source of psychological issues, especially in today’s challenging times. Nowadays hair transplantation is the most common cosmetic procedure in men in the Western world. This field of medicine is evolving day by day at fast pace and with impressive, natural results.
Dr. Anastasios Vekris, Plastic Surgeon Scientific Director of Advanced Hair Clinics
REAL People - REAL Results
Why Choose Advanced Hair Clinics
At Advanced Hair Clinics we have vast experience, as Dr. Anastasios Vekris, internationally renowned in the field of hair restoration, and his team have successfully performed numerous cases, most of them quite demanding, both in Greece and abroad. All hair restoration surgeries are either performed or supervised by plastic surgeon Dr. Anastasios Vekris, guaranteeing the best possible results. Advanced Hair Clinics performs the largest by far FUE hair transplant sessions in Greece, which is also evident from the patients’ results.
Anastasios Vekris completed his postgraduate studies at Kyonpook University, in Korea, under the famous researcher in the field of hair loss Dr. Kim. Dr. Vekris was the first to introduce and develop Advanced FUE hair implantation and One Step Implantation, using a special automated hair extraction and implantation device without holes or injuries (Direct FUE).
Dr. Anastasios Vekris has trained most doctors who currently perform hair transplantation in Greece and many doctors and nurses abroad. He has founded several hair restoration clinics in Europe and the Middle East, at which he currently has an advisory and training role.
The hair transplant teams of Advanced Hair Clinics consist of professionals who are highly trained in the use of the FUE method to treat specific or rare cases such as eyebrow transplantation, beard transplantation, FUT (strip) scars restoration, and transfer of hair follicles from the face or the body.
Advanced Hair Clinics has been awarded as Best International Hair Clinic by the International Medical Travel Journal in 2016 & 2017, being recognized for the high quality of medical results and service that offers with dedication to its patients.