Frequently Asked Questions:

 1. What is happening during the first consultation?
You will be examined by a Hair grafting specialized surgeon who will honestly explain to you the details of the various treatments which can be performed keeping in mind the hairstyle you wish to have. Thorough council and estimate will be provided. The consultation is critical, of importance and lasts about 45 minutes.


2. What special care do I have to observe before the surgery?
As a general rule, a blood test is required in order to check your health. You should avoid aspirin 2 weeks prior to the surgery because aspirin favours bleeding. The hair of the crown should not be too short (at least 2 cm long). The day before the surgery, you have to wash your hair using your usual shampoo. You should not come to the clinic on an empty stomach, you have to eat normally.


3. Is long hair a problem for hair grafting?
No. On the contrary the hair of the crown has to be at least 2 cm long in order to hide the extraction scar. It is not necessary to cut your hair before the transplantation. Long hair is not a problem for us.


4. Is there any scalp preparation before the surgery?
There is no need for any scalp preparation. The scalp is treated normally with the usual shampoo.


5. Why isn't it possible to graft somebody else's hair on my scalp?
It would lead to a systemic rejection because somebody else's hair will be considered as a foreign body by your own organism.


6. Is there an appropriate time to do the hair transplantation surgery?
Not at all, you can have hair transplantation at anytime. However if you are planning holidays on the sea side, it would be better to have the graft done 2 weeks prior to any swimming. Sun is not a contraindication, but it is advisable to protect your head for 15 days.


7. Are grafted hair more fragile?
No, these hair are very strong and will grow forever. They will have the same structure of the one of the crown. You can treat your hair normally such as cutting, brushing, dying, etc


8. Is grafting appropriate to anyone?
No, some baldness patterns are very large with a very narrow crown and bad quality hair. Unfortunately, people suffering from this kind of baldness pattern cannot benefit from hair transplantation. However these cases are very rare.


9. Can women benefit from hair transplantation?
Yes, women can benefit as well as men from hair transplantation. They often have a hair fading on the top of the skull. Their hair can become thicker by hair grafting treatment.


10. Is there an age limit for hair grafting?
No, you can benefit from hair transplantation from about 20 years old till 85 years old. The most important thing remains, being in good health.



11. How many grafts can be transplanted in one single session?
This amount depends on the area to cover. It can go up to 3000 grafts that is to say more than 8000 hair in one single session, if the quality of the crown is good.


12. Is there any pain during surgery?
No, you do not have to worry about the pain, neither during nor after. Nowadays, the techniques allow us to locally anesthetize the skin and operate without any pain. During the session, you can chat with us, listen to music or watch a movie.


13. How long does the session last?
The session duration depends on the technique chosen and on the amount of grafts to be transplanted.

For the ultra micrografting technique, approximately 2 hours for a 500 grafts session will be necessary, 3hours 1/2 for a 1000 grafts session, 5 to 6 hours for a 2000 grafts session and about 7 to 8 hours for a 3000 grafts session.


14. Do you shave the hair already present on the top of the head in order to transplant the grafts?
Not necessarily, the remaining hair have to be preserved if any. The grafts will be inserted in between the existing hair. This is the way we proceed for partial baldness patterns with thin hair in order to recover hair density.


15. Is there any risk of infection or contamination?
There is absolutely no risk of infection or contamination. The grafted hair are your own hair. The surgery equipment used is sterile or one use only.


16. Can we go home safely afterwards?
Yes, you can go home safely. However, if you need to take your car for a long ride, it is advisable to have somebody with you.


17. Is it possible to have an air travel after the surgery?
Yes, travelling by air does not change anything. You can rest or sleep by leaning your seat backward.


18. Is there any treatment to follow after the surgery?
As a general rule, a light treatment (oral) is prescribed for 5 days.


19. When can I start my professional activities again?
You can go back to work normally as soon as the day after the surgery.


20. When can I start practicing sports again?
You can practice sports in moderation as soon as a week after the surgery. However some violent sports as well as swimming should be avoided for 15 days.


21. When can I shampoo my hair again?
Three or four days after the surgery, by using your usual shampoo.


22. Is there any special hair care to observe after the surgery?
No, hair grafting is a natural technique which does not need any particular care (product or lotion). If you are already using a capillary lotion with a Minoxidil base, you can start again one weeks after the surgery.


23. Is it necessary to remove the crown's suture?
Yes, the stitch used on the harvesting area is an non-absorbable suture and it will require removal at 10-14 days after surgery. We find that this material results in better scars than absorbable.


24. Do I have to meet the hair specialist to have a control check up after the surgery?
This is not compulsory. However, if you wish to come back for a control check up, you will be welcomed by us at any time. We are available by phone 24/24 hours. As a general rule, a control check up can be done after 8 months to assess the hair growth.


25. Can the scar be visible on the crown? Does hair grow on the top of the scar?
The extraction's scar is not visible and it is immediately hidden by the hair of the crown at the end of the surgery. That is the reason why the hair of the crown should be at least 2 cm long. It is just a horizontal line on the crown area. We use the Tricophytic closure technique and the hair will not only grow on both sides of the scar but also through the scar, giving better camouflage.

26. Is the new medicine preventing hair falling effective (Finasteride or Propecia)?
Finasteride or Propecia is a medicine which has been commercialized for several years. It is available in tablet form to be taken every day and all life long. Its efficiency is variable from one individual to another and slows down hair loss at the back of the head after several months of treatment. It seems to be less efficient on the top of the head. It can exceptionally lead to adverse reactions (gynecomastia, decreasing of libido and impotency) which disappear when the treatment is interrupted. When there is a good treatment tolerance, we prescribe it for young men with early baldness patterns or as a complement to the transplantation in order to save the primitive hair.


27. How long do I have to wait after the surgery for the hair to grow again?
As a general rule, 3 months are necessary before seeing the first hair grow. They will grow at a rate of 1 to 2 cm per month.


28. Is the result guaranteed?
Yes, if great care has been taken in extracting, cutting, and transplanting the grafts, the regrowth is guaranteed. Obviously, the hair will not all grow the same day. The regrowth takes time. But after several months, 98 % of the grafts will have grown! So the loss is insignificant.


29. Is it possible that transplanted hair might fall one day?
No, because they have been harvested from the hair crown and therefore they are planned to grow all life long. These hair are very resistant.


30. Is the quality the same between grafted hair and natural hair?
The growing grafted hair are identical to the original hair. The sole difference is that they will never fall again. They are resistant.


31. When is it possible to go back to the hairdresser?
It is possible to go back to your hairdresser 20 days after the surgery. Your hairdresser is a professional who knows well about hair transplantation. He/She will be able to normally wash, cut and brush your hair but he/she will not be able to dye or bleach your hair before one month after the surgery. After this time, your hair dresser will be able to give you any capillary treatment.


32. Some centers are offering artificial hair grafting. Is there any risk in doing this?
Presently, there is no material perfectly well integrated to the organism. Artificial hair are considered as foreign bodies by your organism. Not only artificial hair fall but they are cause of infections. We do not advise such treatment.


33. What is the use of Laser in hair transplantation?
Laser used in surgery allows tissue cutting. When applied to hair transplantation, it has been used by some clinics to prepare the transplantation area slits. Unfortunately, it destroys existing hair roots by burning them and it slows the healing process! Actually, Laser technique is a disadvantage! We strongly advise you against it. It has been given up by most of the hair specialists.


34. Are the consultation and the surgery practiced by doctors?
Some "capillary care centers" practice consultations and redirect the patients to hair specialists. At Surgeon Muhammad Nadeem Umar's Hair Transplant Institute, the consultation and the surgery are done by the same hair doctors. You will always have surgery by the doctor who knows your case requirements well, since he/she is the same doctor who welcomed you from the first consultation.


35. Do I have to be hospitalized after the surgery?
No, hair grafting is a surgery done under local anaesthesia. It does not require staying over night in the clinic.


36. Can I go back home the next day of the surgery?
Yes, if you wish to go back home the next day, you can spend the night at a hotel located near to NHTI. To book your hotel room, please Click Here to check in the Useful Information page.


37. Are there any surgical techniques other than hair transplantation to treat baldness?
Yes, apart from hair transplantation, other techniques exist, such as the flaps technique, scalp technique, and the tissue expansion technique (temporarily implanted balloon like device or expanders) but they are less and less used nowadays.

The scalp flaps technique consists in rotating large areas of hair-bearing scalp  from the back of the neck to the bald area. This technique is used only in very special cases. Despite giving a high hair density it does not allow homogeneous hair, therefore the result is far from being natural. Moreover this technique is prone to lead to high necrosis risks (cell death) and large scars. This heavy technique is generally used in plastic surgery (accident, burns...)

The scalp reduction technique consists in excising bald areas at the top of the head and the adjacent hair-bearing scalp can be stretched to fill in the defect. This can be called a "scalp lifting". The inconvenience of this technique is the scar which is left on the top of the skull. This technique can be advised when the skin on the top of the head is very loose but it does not exempt the patient from undergoing hair grafting afterwards, which is usually required to cover the scar.

The expander's technique is very like the scalp reduction technique. It needs several surgeries. It consists in implanting under the scalp lateral hooks linked by rubber bands. These rubber bands will progressively move closer together the hairy sides of the crown after several weeks. The hooks and the rubber bands are then removed as well as the skin excess. It does not exempt the patient from doing hair grafting afterwards. This is a heavy, painful technique hardly practiced by surgeons.

The implanted balloon like device technique is very like the expander's technique except that a balloon like device is implanted under the skin instead of a rubber band. It is weekly filled with fluid to stretch the adjacent normal hair bearing skin. The major disadvantage of the technique is the unsightliness of the bulge during the expansion process which stops the patient from any normal social life for several weeks. This heavy technique is generally used in plastic surgery (accident, burns...)

38. I am having capillary prosthesis; is it possible to plan hair grafting?
Hair grafting is possible for the patients wishing to get rid of their prosthesis. It is obvious that hair grafting can be done depending on the good quality of the crown's hair and a mild baldness pattern. Once hair grafting is planned; your usual prosthesist shall fix the prosthesis with clips or mini hooks without using any plaiting or glue. Then you will be able to take it off and put it back whenever you feel like. Your prosthesis can be taken off permanently once your hair has grown enough. You should know that the capillary density of the prosthesis is artificial and you should not expect the grafted hair to give you the same appearance you had with the prosthesis.


39. How do you calculate the cost of the surgery?
The surgery cost depends on the exact amount of grafts that will be transplanted in one session. The more grafts there are the more the price will increase. A flat fee meaning "we will do our best..." without specifying the exact amount of grafts does not seem to be a good solution. Indeed a good scalp examination will determine the minimum amount of grafts to be transplanted.
 

40. How do you calculate the amount of grafts obtained in the course of the surgery?
While the grafts are dissected, every ten minutes each assistant counts one by one the grafts he has dissected. This amount is recorded on a special count sheet. At the end of the intervention, the total amount is calculated from the individual count sheets. Most of the time, this amount is far higher than the one planned previously without adding extra charges and this to our client's great satisfaction!
 

41. Why does the cost of surgery vary from one center to another?
This is due to the freedom of cost. The cost should depend on the precise amount of grafts transplanted per session. In NHTI, state of the art technological equipments along with our know-how allow us not only to increase the amount of grafts but also to reduce the surgery duration without bringing down the quality of the results. Therefore the cost is decreased and there is no "intermediary". Don't hesitate to get other information from other centers, to compare similar techniques and never forget to get a detailed written estimate specifying the exact amount of grafts and the price.
 

42. I have already had a hair transplant surgery to treat my baldness. Is it possible to improve my appearance as my grafts can be seen on the front of the head?
Yes, it is possible to improve the aesthetical appearance of patients who have already been treated with older techniques. Ultra micrografting is particularly indicated to correct a "Barbie Doll" look by hiding the frontal line with a natural hair border once it has started to grow again.


43. 10 years ago, I underwent a hair surgery called scalp flap technique which worked very well and satisfied me but my head's frontline does not look natural because it is too thick and too sharp. Is it possible to improve my appearance?
Yes, a dense or sharp frontline can be improved by implanting ultra micrografts on the flap's scar line.


44. Do we have to do several hair transplant sessions to treat baldness?
Not necessarily, a baldness pattern can be corrected in one session depending on its width, its stability, the remaining hair quality, height and flexibility of the crown, and also it depends on the hairtyle you wish to have. However, it is not rare to undergo several sessions in order to obtain a bigger hair body. There is no objection in grafting an already transplanted area.


45. I am planning to have several hair transplantation sessions. How long shall I wait between two sessions?
Usually, the average wait between two grafting sessions is about 3 to 6 months. Normally, this period allows you to assess the hair regrowth as well as the flexibility of the crown. Then you can plan a new session. Be that as it may, everything that has been acquired in the first session remains. The sessions are independent. They are added one to another.


46. Is it possible to do another hair grafting on an area which has been already transplanted?
Yes, it is possible to transplant new grafts between the grafts previously transplanted without any damage. This is the case when someone wishes to make a fading hair thicker.


47. Why other clinics do not offer such a large amount of grafts in one single session as NHTI?
Hair Transplant Institute is practically the only center in Pakistan to offer safely very large hair grafting sessions up to 3000 grafts (i.e. more than 8000 hair) as long as the crown has all the required criteria .This is due to our very special know how that has been acquired through requirement and research that go beyond orthodox hair transplant techniques.


48. I have heard about "hair cloning". Is it possible?
It is true that science allows us today to clone identical ewe, but it is much different than reproducing hair which would have been harvested from one patient and reproduced by thousands in laboratories! A hair is not a cell but it is a very complex and genuine organism constituted of tissues from various origins. Dreaming of growing a hair would be equivalent to clone a complex organism such as a human eye. For the moment, this comes close to being science fiction...


49. Does it really work?
Yes! Hair transplant surgery redistributes existing, healthy hair, which is usually genetically encoded to virtually last a lifetime. Conventional hair transplant growth rates are at about 90-95%.

 

50. Will I get a full head of hair?
No. remember, the technique redistributes existing, healthy hair. It does not create any new hair. So it is not possible to provide a full head of hair. However, a comparatively small amount of hair transplanted expertly can produce the illusion of substantially more hair than there actually is. The results will improve how you look to others and to yourself.
 

51. How long will it take to grow?
Your transplant will be fully grown approximately 9 months after your All Follicular Unit Megasession.
 

52. Will this procedure mean time off from work?
Little or no time off from work is required. But if you are sensitive about how you will look during the days immediately following, you can wear a hat, or, if that's not possible in your work environment, Dr. Muhammad Nadeem Umar  recommends beginning the process just before your holidays. Many patients return to work the next day. In fact, many play a round of golf the day following their procedure!


53. Is the procedure dangerous?
No. It is minor surface surgery, literally only skin deep, and one of the safest surgical procedures ever performed. You are under the care of qualified medical staff at all times. Your transplant takes place (using equipment kept to hospital standards) in a private office.
 

54. Is the surgery expensive?
Comparatively, no. While there are costs involved, the benefits of growing your own hair make hair transplantation much more cost-effective than other methods, because afterwards no further expense is incurred. There are no expensive chemicals to be bought or used continually. There are no expensive hair pieces to be maintained, repaired, tinted, conditioned and replaced regularly every 18 months in order to look natural. So, weighed in the light of all possible alternatives, the hair transplant solution is not only the best, but is also the most economical overall.
 

55. "I've heard from other hair transplant doctors that mega-sessions don't often grow or can produce disastrous results. Is this true?"
Some doctors who have not kept abreast of these new advanced techniques (They perhaps don't want to go through the extra trouble and expense of purchasing the microscopes, hiring and training the extra staff- and handling the tremendous amount of administrative problems that come with it) often make untrue statements denigrating megasessions. They also probably don't wish to face the learning curve of this obviously more exact procedure.

Be that as it may, many of these doctors won't consider the Binocular Stereoscopic Dissecting Microscope procedure purely in terms of how it will affect their profit margin. Let's face it- these All Follicular Unit Megasessions typically run from 8-12 hours to complete, with the painstaking effort of a large attendant staff. To the average hair transplant doctor, this would greatly increase their workload and overhead. Of course, for them, it would be much easier to say"you can't do over a thousand grafts at one session" or "megasessions produce poor growth and waste hair", or "megasessions produce too thin a result".

However, in fairness to some of these other doctors, it must be stated that without highly skilled technicians, adequately trained and practiced in the most advanced dissection techniques using the binocular stereoscopic dissecting microscope, and without extreme attention paid to detail at every step along the hair transplant process- other hair transplant facilities, especially those without a lot of experience with megasessions, may well frequently obtain poor results.
 

56. What steps should I take before surgery?
Maintain an adequate length of hair on the back of your head. This should be at least one inch long, or you may have a problem covering up the sutures after the surgery. Your donor grafts will be removed from here and you should expect coverage following your procedure.
 

Two weeks before surgery
 

NO ROGAINE®
NO ASPIRIN (acetylsalicylic acid - A.S.A.) or anti-inflammatory medications containing Aspirin. Note: these medications are included in many over-the counter medications.
NO VITAMIN E tablets.
Day before surgery

NO ALCOHOL
Make arrangements for someone to take you to and from the clinic.
Operating day

Wash your hair in the morning using your regular shampoo
Wear a button- down shirt and comfortable, easily laundered pants. You should also bring an adjustable baseball cap or scarf along with you.
No tight sweaters or pullovers.
No tight hats or caps.
Do not wear anything that will have to be pulled tightly over your head.
Eat a light meal just before coming to the clinic
 

57. Is the hair transplant surgery painful?
You may have heard that the process is very painful. But with the proper technique in the application of anesthesia, it does not have to be a painful process at all. It all depends on how the surgeon applies the anesthesia, and our office uses the least painful process available for the comfort of our patients. For a hair transplantation process, every surgeon uses either a nerve blocking process or a local anesthesia; general anesthesia is never used in this case. Any pain at all during our procedure would be during the initial needle injection. Our office uses several techniques to reduce even this small pain. The anesthesia is warmed to reduce reaction time, the skin is pre-numbed before each localized shot and the finest gauge needle (30 gauge) is used to minimize this pain. Initially, the patient is given a sedative. This sedative puts the patient into a relaxed, "twilight zone" state to minimize any pain there might be from the subsequent injections. The tumescent technique is used for pro- longing anesthesia time.


58. How will the surgery affect me when I return to work the following day?
For the first twenty- four hours, there will be a strip of bandage around the head. After that, you will be able to remove the bandage and shampoo your hair as usual. If you have the surgery done on the hairline, the small scabs will remain for seven to ten days. Some patients may want to cover the area with a cap or even a hairpiece at work if they desire. If you have partial hair, it is much easier to cover up the area, or you can use a camouflage product.

When the small scabs fall off after seven to ten days, the freshly implanted grafts will be a pink, slightly shiny, skin which is usually a similar color to the surrounding normal skin and is minimally obvious at first. After approximately six weeks, the areas where the grafts were transplanted are barely visible.

Pre-existing hair adjacent to the transplanted grafts may shed, giving a thinner look, but hair will begin to grow back within a few months. This temporary thinning of pre-existing hair is called Telogen Effluvia. Unfortunately there is a time lag between this increased thinning of pre- existing hair and re-growth of transplanted hair.
 

59. How many sessions of surgery will I need?
If you have a completely bald area, it may take two to three surgeries to cover your entire head. If you have an area partially covered with hair, it may take only one surgery to fill in the area. Our goal is to restore about twenty-five percent of the donor's original density in each surgery. After two surgeries, the density is at about fifty percent which is often adequate coverage to satisfy the patient. The time between each session is usually four to eight months in order to see how the hair is growing out and to provide more equal distribution.
 

60. How long does it take the transplanted hair to grow out enough to fill in the balding area?
Usually it takes three to four months for the hair to grow out. After that it will grow about half an inch per month which is the same rate as the donor hair. Initial hair quality is usually very thin, like baby hair. Then, it becomes coarser over time. Sometimes the initial hair is curlier, then it straightens in about one year. The color of the initial hair may also be darker and later will be lightened by the sun.
 

61. How long will the transplanted hair continue to grow?
Basically, the transplanted hair is the hair from the back of the head. Even though it is transplanted, it will still have the same life span. Normally, a hair follicle sheds every three to six years and then grows back from the same root. The transplanted hair continues the same life circle.

62. Can hair transplantation affect the rest of my hair?
Hair roots are very tough and can tolerate surgery or any irritation

63. What are some possible complications?

Hiccups
It may last several hours to several days, if at all. If left untreated, the hiccups may interfere when you eat and sleep, but there is a medication that the doctor can prescribe to ease the hiccups.

Itching
Some itching commonly occurs but is rarely troublesome and lasts only a few days. Shampooing the hair daily will help the discomfort.

Swelling
There is some swelling in nearly all cases. It affects the forehead and the area around the eyes and lasts two to five days, being maximal on the fourth day. In about one in hundred cases, a "black eye" develops. With particular patients, swelling can be considerable and temporarily disfiguring, especially after the first session. However, it does little harm and lasts no more than a week. A drug called Cortisone can be given to reduce these symptoms for those who are concerned about swelling, but Cortisone can be harmful if used often; it has rare but potentially serious side effects.

Infection
This happens in one in several thousand cases and is easily cured with antibiotics.

Scarring
Keloid scarring occurs only in pre-disposed individuals, and even more rarely (1/1000 cases) has this keloid scarring been hypertrophic to the point of "ridging."

Cysts
One or more cysts may occur in the recipient area when many mini-grafts have been inserted. They usually disappear by themselves after a few weeks or immediately with various simple treatments. They are not usually more than 2 or 3 mm in diameter, i.e., the size of small pimples.

Neuralgia
When a medium-sized nerve, such as the occipital nerve, is either cut or bruised, patients can get either numbness, tingling or "pins and needles" sensations, sometimes even "shooting pains" and hypersensitivity of skin in that part of the scalp. Once in a while someone reports varying combinations of the above, usually lasting for one to four weeks. Very rarely have patients had neuralgia last a longer time period. Prolonged or severe symptoms are exceedingly rare and virtually always disappear within a few months.