One Week Before Surgery

Medication
Continue your usual medication unless stopped by doctor.

Blood Thinner
Stop Plavix, Aspirin, Vitamin E, Chinese herbs

Blood Pressure Tablet / Antihypertensive
If you take Propanolol please discuss with your family doctor to temporarily change to something else

Hair Cut
For FUT / Strip, please leave hair long enough (about 1 inch) to cover donor wound.
For FUE, please trim short the hair at the back of your head, or you can leave it to us.

Smoking
Stop or cut down

Hair dye
You can colour you hair few days before

The Night Before Surgery

Hair Wash
Shampoo your hair with our antiseptic shampoo

Minoxidil
Do not use your usual Minoxidil Lotion (G Hair, Rogaine, Headway…)

Alcohol
Do not drink alcoholic beverages

Sleep
Do not sleep too early, as we want you to sleep though the whole procedure.

Day of Surgery

Breakfast
Take a light breakfast, but no tea or coffee

Locker
Will be provided but do not bring along valuables

Clothing
Wear comfortable Button shirt or Polo Shirt. Do not wear T-Shirt

Sickness
Notify the doctor in case of fever or any other sickness

Music
Bring along your I-pod or MP3 (with headphone).

Hat
We will provide a custom made cap but you can bring a clean loose hat, baseball cap, or bandana to wear home

Payment
All balance payment must be settled before surgery

Tumescence

Specially prepared fluid called Tumescence is injected to lift the skin up and away from the bone. This prevent any possible damage to the deep seated nerves and blood vessels, and provide good skin turgor for easy dissection.

Graft Harvesting By FUT / Strip

We dissect the strip with a single blade using magnified loupes. The blade is angled parallel to the hair follicles to minimize transection. Excision is made quite superficially with minimal bleeding. We use the Trichophytic Technique described by Dr Frechet with 2 layers suturing to maximize approximation and to minimize scar.

The strip is then sent to our assistants to be dissected under 10X microscopic magnification into individual graft. Each graft contains 1 hair ( 1-hair FU-graft ), 2 hairs ( 2-hair FU-graft ), or 3 hairs ( 3-hair FU-unit-graft ). The intact follicles are stored in ATP enriched saline to maximise graft survival.

Graft Harvesting By FUE

We use our own designed titanium FUE punch. Size 1.0mm in diameter is used for Asian thicker Hair, whilst 0.8mm is reserved for Caucasian. This size keeps grafts intact yet leaves minimal scar. Depth control is set to avoid graft transaction. We use bothe manual and automatic FUE depending on hair character. Every graft is extracted one-by-one carfefully not to damage any follicle.

The extracted grafts are sent to our assistants with all redundant tissues trimmed under 10X microscopic magnification. The follicular unit grafts are then sorted into 1-hair FU, 2-hair FU, 3-hair FUs. Follicles are stored in ATP enriched saline to maximise graft survival.

Tumescence

We inject tumescence to lift the skin from the bone. This avoids damage to the deep seated nerve and vessels when making incisions. Our solution is formulated to prevent Ischaemic Reperfusion Injury to the grafts and postoperative facial swelling.

Incision

Incision is the creating of small pockets in the skin (called a slit) to accommodate the graft. Slit sizes range from 0.7 to 1.2mm. The doctor studies the angle, direction, and orientation of your existing hair in the recipient area. Incision and insertion must be planned to mimic your natural hair flow. Loupes are worn to magnify the surgical field and prevent damage to existing hair follicles. Incision is the most important step in the entire hair transplant procedures as the slits determined the final hair direction.

Grafts outside the body has a limited survival time and must be implanted ASAP. Currently we are using 3 different Isertion Techniques.

1. Forceps technique

Fine tips jeweler's forceps are used to gently grasp the fat beneath the follicle to avoid trauma. It's our preferred method.

2. Stick and Place

For dense packing we have to eliminate any empty spots between hairs. We keep about 10% of grafts at the end to fill in these spaces. After creating a slit a graft is inserted immediately. This technique of Stick and Place allows more grafts to be inserted per area.

3. Implanter Technique

This is commonly used in Korea and Japan, especially for those using FUE. The follicle is first dragged into its metal tube before inserting the implanter into a slit. On withdrawal the graft is pushed out and left in the slit. We have abandoned implanter because of 2 reasons:
•  More tissue trauma - the metal tube has thickness so holes larger than grafts have to be made
•  Popping - insertion of an implanters will pop-up neighboring grafts, very difficult to dense pack.

How Long The Procedure Takes ?

Obviously that depends on the number of grafts. Even 3,000 grafts may just take 8 hours. However if you have to take frequent breaks or cannot keep still, more time is required. We reserve the whole day for you to ensure the procedure is accomplished to full satisfaction.

Final Check

Some of the grafts may be dislodged during the procedure. On completion we spend another 20 minutes double- checking every graft. Any loosen ones will be re-inserted to ensure maximum survival.

Dressing

For large session or the crown we may put a dressing overnight. Otherwise a head band will be applied.

Going Home Safely

Most patients are fully awake by the end of the procedure. A cup of coffee usually helps. We will check and make sure you are in good condition before letting you do. There is a taxi stand within 2 minutes walk just across the street.