FAQs

What is the benefit of doing a PRP procedure alongwith the hair transplant?

When done alongwith the hair transplant-

  • It aids in healing
  • Anesthesia is already given for the hair transplant and PRP procedure will be painless.
I have read that the Neograft / ARTASRobot is the best for FUE?

The Neograft/ARTASRobot is for clinics that do not do FUE routinely. You will find them also in clinics where the modality is mostly FUT strip surgery.
In the Neograft, the assistants’ role is removed as a suction force extracts the grafts after the technician/surgeon has scored around the graft. The force is powerful and mostly injures the grafts causing poor growth.
You may be surprised to know that unlike what is touted, the FUE system does not do the hair transplant, It is the experience, dexterity and wisdom of the hands and mind behind the system that counts towards a pleasing result.

I would like to get a hair transplant of density like the hair piece I am wearing. Nothing less will make me happy. Is this possible?

Firstly, you will never be able to replicate the density of a weave that is more than natural density by twice the amount.
darling-buds-clinic
With a hair transplant we can give you 50% of natural density in the first session.
However this looks like natural since the placement of grafts is done in a manner that lesser grafts look a lot more.
Hair transplant simply stated is an illusion to the eye.
This illusion disappears when you wet the hair or trim your hair real short.

I can see from hairrestorationnetwork.com a lot of Dr Bhatti's work which is very impressive, but there are also occasional cases I have seen where the grafts are not densely packed at all, and where patients seems disappointed about this.

Are you able to explain why the density is low?

This is really the only concern I have as I want to have high density. I'm just curious as the reasoning behind placing the grafts like this as I do not want to have subsequent transplants in the near future.

Thank you for your question. I cannot discuss the cases that you reference as this would be breaking patient confidentiality. However, I can address the issue overall by saying that not all patients can receive equally high density in one session as some would like. It comes down to the patient tissue. When we are dense packing we have to place each incision close together but the challenge lies in that some patient’s tissue is brittle and breaks down more easily than that of other patients. This "bridge" , if you will, simply disintegrates and creates a wound that can be three times bigger than the intended size of the original recipient site so when this happens we must back off of the desired density and come in at a lower density, with additional adjustments.This is a physiological issue alone and is not dependent on tools or doctor skill. If anyone tells you differently then they are not experienced with density or they are not admitting to the issue that challenges every hair transplant doctor worth their diploma.

I have yet to determine if this is due to environmental factors such as nutrition or genetic factors but it is indeed an issue that exists for some patients. Others do not have this problem and where higher densities are indicated they are met without problems or complications. Be warned. No doctor can guarantee that you will not need a second pass for additional density. If they do, you should walk away as this is simply a fact of hair restoration surgery. Sometimes the desired density cannot be realistically met, either due to the inherent limitations of hair restoration surgery or the unrealistic, uneducated expectations of the patient, or both.

I hope this helps.

My little research also concluded that FUT grafts are way more healthier than FUE.

Yes they are healthier in the hands of FUT surgeons like FUE grafts are healthier in the hands of FUE surgeons. Provided you choose your surgeon correctly.

Besides my other pictures I have attached a picture of the donor area. Can you tell me if I am a good candidate?

Thank you for the mail with pictures of your type 3 pattern.
Reverse-balding-patient-Dr-Bhatti-India
You have reverse balding from the nape of the neck upwards which is going to continue its upward ascent and reduce your scalp donor.
Any hair transplanted from this region will not be permanent and will shed over time.

I feel you should allow the balding to progress for another year and then send me comparative pictures in the same angles these have been taken.
You should be cautious in your approach since whatever grafts available are precious in your case and a misadventure will cost you money and emotions invested.

I look forward to following up with you in future.

I have a history of keloid formation. Can I consider an FUE hair transplant?

I have not seen keloids appearing in the scalp donor or the recipient site ever even in patients with previous keloid formation and strong family history.

Keloids form in areas of tension (due to meeting of skin tension lines like ‘fault lines’) overlting bony prominences like the presternal region of the chest, front of knee and shoulder point.

Though the scalp lies over bone, the underlying bone is round and the skin is loose and mobile.
Theoretically keloids can occur over the occipital protuberance but we do not harvest from this region.
However, if keloid formation has occurred on minimal needle pricks before, it would be advisable to do a test procedure and wait for 6 months.

I am happy with the crown area result but the density is not like the hairline you gave me. I would not like to add more density to the crown to match the hairline you made. Please advise.

It is never a good idea to increase density in the crown. As they say it is the ‘black hole of hair transplant’!
This is since the crown expands circumferentially with ongoing balding and this greatly increases the surface area that will need further plantation.
If it were to be filled with the same density as the hairline, it would consume all grafts available.
If we are to do a high density plantation presently as suggested by you, when the crown expands we will not be able to replicate the same density in the surrounding and it will give a halo effect since we would have run out of grafts.
I strongly caution you against high density for the crown.

Can you advise me on which costing package you think would fit me best- Premium or Standard?

Most people coming from outside like to choose the premium package due to car transfers. Also the new punch gives lower transection rate.

This is of advantage only for extensive balding where we need greater yield. Even a 2-3 % higher yield is important.
Otherwise there is no difference in result.

Is there a direct flight to Chandigarh or do I have to buy tickets to Delhi?

Yes, there is a direct non-stop flight to/from Chandigarh.

understand extracting the donor hairs takes time in FUE procedure, so will it be a possible to have 4000-4500 grafts you have suggested to be done in a single day? Or will it require 2 back to back days to get this done?

All hair should go in within 6 hours of harvesting.
We do 3500-4000 scalp and body grafts almost every other day and have never exceeded the out of body time for grafts.

However if there is difficulty in harvesting and it is taking long, I will myself do the remaining procedure on the subsequent day.

I have this huge bald area in the crown. There are thin hair there too but it all looks plain bald. After the procedure will I suffer shock loss of these wispy thin hair?

Yes most likely there will be shock loss. It can be mitigated by starting Propecia in the dosage 1 mg a day atleast one month before the procedure.
However, even without Propecia, shock loss will happen only within the crown area and not around.
The thinning hair may permanently be lost but then why would you wish to preserve them since, as it is, they are on their way out.
We can avoid going too close to them but this will alter the overall result which will be less dense and when these thinning hair which are in the balding zone fall off, theer will be loss of density.
Propriety lies, therefore, in ignoring the thin hair and planting in optimal density.

Doctor, I already have had one FUT procedure done. My previous doctor has examined me and said I can go for another FUT procedure. But I am exploring FUE this time.

Since you have already got an FUT done, I will suggest you again go for an FUT procedure since the prime advantages of going for an FUE is now lost. You now have a linear scars. Another FUT procedure will not give you 2 scars!
Once the FUT procedure is done and when the scalp due to resulting tightness will not allow another you can contact me for an FUE procedure. This will be optimal utilisation of the scalp donor given that you already have a linear scar.

Other advantages of FUE in isolation are:

  1. Less downtime
  2. Less postoperative discomfort
Can I come in for the procedure the same day from another city?

That will not be possible since your counseling has to be done, blood tests have to be carried out and you are to be given medication the night before the procedure.
We would also like you to digest overnight the points discussed during the pre-consultation so the next day there are no surprises!

Also, I have seen that clients who come in the same day have anxiety and due to which we have had to on occasion cancel the procedure due to elevated BP.
One gets a procedure done once or twice in a lifetime and so I do not wish that you spoil your best chance to a great result by being careless with timings wherein if you reach late due to a traffic jam (or any other reason) we rush to finish your case against a time deadline.

I am a 35 year old African American man from Connecticut. I have been advised that I will require 3500 scalp grafts for my level of balding. Is FUT better for African races? What do you suggest?

Firstly, afrotextured hair on the scalp has a very low density. if other racial groups (Caucasians, Asians, Arabs) have 100 hair per cm sq, Africans have a mere 15-20 per sq cm

and that too in those who are well endowed. Therefore it is impossible that in an African any doctor can take out more than 1200-1500 scalp grafts in one sitting using FUE technique. Further harvesting may not be possible since ‘skin show’ may result.

Secondly, with FUE technique around 60% afrotextured hair is not favorably disposed for a procedure due to the s-shaped bend of the shaft under the skin.

FUE being a blind procedure, the transection may be very high.
The best way to make sure that FUE is suitable for people with afrotextured hair is to do a test grafting of 50 hairs.

FUT may be ther better technique for African hair. However, since keloids occur more commonly in your racial group, this may be a problem.

Overall, African hair transplant is a challenge.

We do 10-12 such cases each year.

I have seen that Eastern Africans (Somalia and nearby countries) have a far straighter hair direction than other Africans. However the hair density remains the same.

Doctor, I hope the medicines I am taking do not have side effects?

There is no medicine in allopathy that does not have side effects.
If the benefits far outweigh the benefits and if side effects occur rarely and are temporary there is good reason to take them.

Doctor, I have suddenly within 30 days developed a bald patch in the crown. Can this happen, and what could be the reason?

1. Sudden stress.
2. Stopping of Finasteride and Minoxidil
3. Hair straightening, perming or hair spa.

What is the maximum density Bhatti can achieve per centimeter?

65 per sq cm. However how many grafts should be placed will depend upon-
1. Availability of grafts and likely future needs since donor hair are finite.
2. Skin condition- though some skin type can accept high density, others will just not. It all depends upon whether the grafts will survive when placed so close together. This can be assessed only during the procedure. If pushed beyond rational density, no grafts will survive. This is where the surgeon’s expertise and judgement plays a part. You must have heard of high density hair transplants with very poor eventual hair growth after 6 months?

Are there any other hair loss treatments that are efffective besides finasteride minoxidil and laser comb ?

Yes- PRP, SMP (scalp micropigmentation) and hair piece are alternatives.

Nothing is a substitute for a hair transplant where you get real hair and gives a natural look. Most other treatments are temporary.

Look out for Cloning which will be a big splash in the pond of hair transplant in the not so distant future.

I'm fair skinned and have noticeably scarring from a previous fue operation when I even have my hair at 1.5mm. Could this be the way my skin heals or reacts to the operation?

FUE is a minimally invasive procedure and if done with due care. the scars are barely perceptible and definitely not if hair length is 1 mm.
Your condition can  be due to any (or all) of the following reasons-

  • Overharvesting
  • Hypertrophic scarring- this happens in 0.5% individuals
  • larger punch size used
When people talk about FUE scarring, is it actual scar tissue or simply like that because the follicle is missing from that spot?
Scar tissue forms even if a needle pierces you.

The punch of an FUE system creates a 0.75 mm hole which heals by contraction and forms a pinpoint scar half the size of the original hole.

In fair skinned, it is difficult to detect even from up close.
The darker the skin, the more the contrast between the scar tissue and normal skin and hence greater the visibility.
However, with hair length 1 mm it is still not discernible.

To begin with, you are the first doctor to say that I only need 1500 grafts to cover the balding area. The minimum I've been evaluated with was 2000 grafts, to the extend of 3000 grafts or slightly more. How so?
I practice anagen selective hair transplant and with this technique I can cherry pick grafts that are of good quality. These hair once grown are thicker and they grow faster. They will cover the same area with the same result as would 2000-2500 scalp grafts taken by the strip technique.

Can I shave my hair and come for the proecdure?
The hair is preferebly shaved in the clinic so I have a visual assessment of how light and shadow plays on the scalp when the hair is long. This way I can strategically position the grafts for optimal coverage and utilisation.

A hair transplant company told me they do DHT. They said their Out of Body Time for Grafts is only 5 minutes as compared to yours which they said is 3 hours! Is this true? Is their technique better?
Hi! If out of body time is more important to you than good growth, you might as well let your grafts remain where they are! The hallmark of a great hair transplant is Out of the World Result, not Out of the Body Time!!

The other doctor told me only 1000 FUE grafts can be harvested in a day for good growth! Why did he say so??
With a few exceptions, the low graft harvest has more to do with inexperience than anything else. Also, manual means of harvest will yield lesser grafts since it is time consuming. But in my clinic though we harvest an average 3500 grafts a day, the yield is comparable to any other center of repute. Also in FUE you have to see whether the low speed doctor is offering FUE as a secondary procedure- his core competence being FUT which he offers as his primary procedure.

There is more to hair transplant than meets the eye; so I encourage you to take your time and do your research well and not leap blindly in good faith.

What is the survival rate of body grafts?
Any graft planted with due care in harvesting storage and plantation, whether from body or scalp, should grow with 95% survival.

It is not the low survival of body grafts but the late appearance of the result that may be of concern in the impatient patient.

Hair from the body have a longer growth cycle upto 18-24 months unlike 6 months for scalp hair.

Doctor, I wish an ARTAS Robotic hair transplant only. Do you do robotic hair transplant?
As a patient it is the result which you should aim at and not the technique.
No, we do not have the Robot. No center in India has it yet.
I will, however, be the first to buy it when the Robot surpasses results which I presently give to my clients.
However, if you wish a Robotic transplant, you can search doctors who have the Robot at-

www.artashair.com/choosing-artas/find-a-physician

Wishing you the best in your hair transplant journey.

Do you charge for in person consultations?
Yes we do.
If you choose to have a procedure with us, the fee charged for consultation shall be adjusted in the final bill. Once a patient is operated in the clinic, there are no future charges for follow up or consultation.
Given the fact that I have salt and pepper hair, should I color the hair and come?
Coloring if done days before is of no benefit since we need only a millimeter long hair. Due to this fact if coloring is done before 24 hours of the procedure, the root will grow and the base of the hair shaft will be without color at the time of procedure making the dyeing redundant. I usually color the hair the same morning of the procedure. This is also due to the fact that if there is color allergy, the color is washed off within 2 hours of the harvesting.
Do all hair transplants leave scars?
Any ingress into the skin by a sharp object howsoever small (even the smallest of all hospital syringe needles) shall leave a scar. However here we are talking only of scars that are not visible to the untrained eye and esp. when the hair grows back to even size #1.
FUT on the other hand leaves a linear scar.
When you say hair falls out does that mean the grafts fall out too ?
The hair after a hair transplant seems to grow and then begin to fall. This fall happens between the 3-6 week period and is due to the fact that the root has begun to grow a new hair which continues to push the old hair outwards till it loose support and falls off. This happens in the vast majority of patients undergoing a hair transplant. However, a small minority continue to grow hair. The shedding phase does not happen in this fortunate subset of patients. Reasons for this are unknown. The hair once shed begins to show at around 4 months mark after which the results begin to show at a brisk rate getting better with each passing day till one year after the procedure. Most of the result, however, has set in by the end of the 9th months after the hair transplant.
Why not a woolen cap till 5 months after a procedure?
The static electricity will make you look bald again very fast!
Also the thin new hair that grow at 3 months + mark will continue to get detached due to the strength of the strong electric charge emanating from your woolen cap..
Does the “STEM CELLS” injection help in getting my hair back?
There is no established study which proves this tall claim. The stem cell treatment is being unethically sold as the cure all for hair loss. However, a recent study of use of stem cells states those stem cells may actually cause cancer since we are too early in the understanding of how these work for various ailments. Whatever the benefits of taking injections of stem cells, genetic problems like genetic baldness can only be solved by changing the genetic composition to which there is no answer yet.
Doctor, why do you charge INR 99 per graft when in your country centers even charge INR 15 / 20/ 25/ 30/ 45/ 50/ 60 per graft?
Hair transplant is not removed from the forces of the market. You pay more for a better product and less for a lesser product. A manufacturer of a product will never sell his at a lower rate if his product is good and will stand in the competitive market like hair transplant. Also be aware of whether you are paying per graft or per follicle! I hope you understand.
Placing beard grafts in the hairline- will it not give an unnatural appearance?
The beard grafts are not placed in the first few rows of the hairline and even where it is put; it is admixed in the right proportion to dull its seeming coarseness. It is surmised that after 2-4 years of plantation due to “donor co-dominance” the hairs take on the textural and linear characteristics of the scalp hair.
How many grafts can one expect to be available from the safe zone of the scalp donor area during a lifetime?
My thinking is that an average person can get 20% of his strands/grafts from the scalp donor area’s safe zone during a lifetime. Since the strands (grafts) in an average male in this permanent region are around 20,000 we can take between 5000-5500 grafts in one lifetime without it showing! However, this can be 15-20% more or less depending upon-
1. Age
2. Density
3. Racial characteristics
4. Previous strip procedure
5. Dimensions of the head
Doctor my crusts are not separating even on Day 15. What do I do?
Take a bowl of water and pour a cap full of baby shampoo creating lather.With one hand keep pouring this over the areas with crusts and with the other (while under the shower with a rapid strong jet) with gentle rotary movements of the forefinger and middle finger try teasing away the crusts. They shall go off in a day or two if the procedure is done properly.
Why is the crown still looking somewhat bare while the hairline is very dense after the procedure?

It is often said that the crown area is the “Black hole” of hair transplant. It consumes too many grafts without even giving the semblance of coverage like the planted hairline. The reasons are 2 folds-

1. The crown is seen end-on while the hairline is seen side-on. In the hairline we see the illusion of greater density since the images of hair at a distance overlap with those of the front few rows making it look a lot denser. This is akin to seeing the forest from the road and then from the top of a mountain- when you see it from the road, the density appears much better while when seen end- on from the mountain top, the density is lesser. Hair transplant is creating an illusion of density. We can never match God’s creation. With minimal grafts we can make the bald spot look denser. It’s also common sense- when the crown/vertex area looses around 30,000 grafts before becoming bald, how can we create the same density with 5000 grafts alone!

2. The density in the crown area is 30 per sq cm while that at the hairline is 55-65 per sq cm. The density has to progressively decrease as we go back towards the crown otherwise we shall run out of grafts just midway to the crown. These are the reasons why hair transplant surgeons are never as gung-ho about the crown area.

How many grafts can be harvested through your “no shave” technique?

We routinely do the “no shave” technique procedure for cases requiring an average 2000 grafts. The term “no shave” is a misnomer since it is a must to have hair awaiting extraction to be shaved down to 1 mm in length in order to accomplish an FUE procedure. However, these stripes (not to be confused with strips) are not visible due to overlapping of hair from above and hence the donor site looks the same after a hair transplant procedure. The common denominator for a “no shave” technique is long hair at the back of the scalp long- enough to cover the shaved stripes from where the grafts are going to be extracted. The following are the number of average grafts that can be taken based on given hair length over the donor area in an individual with 100 hair per cm sq- ½ inch length- 1000-1200 1 inch length-1200- 1500 1½ inch length- 1500-1800 2 inch length- 1800-2000 2½ inch length- 2000-2500 It is impossible to extract more than 2500 grafts in this technique since the hair lower down over the neck are spared and so are the thin hair bearing stripes which go untouched.This limits the extraction of greater number of grafts. If a patient with the same variables were to get a “full shave” FUE, up to 4000 grafts can be extracted.

Do I need to treat my transplanted hair any differently?
The hair that are transplanted are neither someone Else’s nor artificial. Since they are your own hair they will be treated in the same manner as your other hair. But during the first 6 months after the procedure there are some precautions that need to be taking. Please note that we are merely transplanting hair from one place to another. This does not change its characteristics like texture, curl, length, life, color, etc.
How much time does Dr. Bhatti spend doing the procedure himself?

Dr Bhatti does one large case (3500 grafts) and one small case (1500-1800 grafts) on a typical day. This is so planned that the 2 cases finish by 7 PM. Dr Bhatti does the counseling, hairline design, trimming of hair, anesthesia, harvesting of grafts, anesthesia over the recipient site and slit making. The plantation is done only by his trained staff. The world over the best centers have planters who perform this part. If you say how much time Dr Bhatti is actually with the patient- A typical patient’s case(3000 grafts) starts at 7.30 AM

7.30 AM- 8 AM: Counseling, hairline design, trimming (Dr Bhatti)
8 AM- 8.30 AM: Anesthesia (Dr Bhatti)
8.30 AM- 11.30 AM: Harvesting of grafts (Dr Bhatti)
11.30 AM- 12 noon: Anesthesia and 8Slit making (Dr Bhatti)
12 noon- 12.30 PM: Break
12.30 PM- 2.30 PM: Plantation (Team of Planters)
2.30 PM- 2.50 PM: Lunch
2.50 PM- 5 PM: Plantation (contd.)
6 PM- 6.15 PM: Dressing change and instructions for the evening ( Dr Bhatti)

If one’s hair transplant procedure was done via FUT method and now wants to undergo a second hair transplant after how long do you need to wait and which method is preferable?
It takes a linear scar one and a half years to mature and be amenable for a repeat strip procedure. However if he opts for FUE, the procedure can be done after 3 months since the donor area is removed from the scar. However after an FUE procedure if a patient wishes to get another FUE done, he needs to wait for minimum 6 weeks if the same donor area is to be harvested.
Does every FUE transplant cause some white scar spots on the back of the head in the donor area? Would it help to choose manual over motor?
Every surgical assault on the skin leads to scarring. This is inevitable. However since scars are pale in color, they stand out more prominently in darker skin types than they do on white skin. In Caucasian white skin, it is difficult to make out any difference in the donor area even with head completely shaved. Non-whites (Indians, Africans, etc.) need to keep their hair minimum #1 length to look normal over the donor area. Manual or motor technique has no bearing on scarring which is determined only by the size of the punch and the skill of the surgeon.
Do you give warranty of Hair Transplant?

Warranty/ guarantee is an illegal practice in medicine and we do not engage in commercial behavior like this. However if you research us well you will know where our clinic stands as far as hair transplant results and consequent satisfaction is concerned and where others who offer questionable “guarantee” do. If you wish you can name the surgeon and I will show you a host of his dissatisfied clients whom we have revised. I personally stand by all my results.

My employment allows me, only 2 - 3 weeks of leave at a stretch. Would this be sufficient for consultations, pre-surgery requisites, post-surgery requisites and healing?
This is more than enough. The crusts usually come off at 2 weeks post procedure after which all looks normal.
Post-surgery, how does one take care of further hair-loss of natural hair? I have tried various medicines earlier which has yielded very little results.
Medicines do not help in male pattern baldness since it is a genetic malady.
Does hot and humid climate conditions of the country affect the result of HT. what measures are advised to maximize HT results?
There is no difference. Climatic conditions do not play a role in the type of results you will obtain. A person from the Tundra region will obtain the same result as another residing on the Equator.
I sweat a lot around my scalp area when-
a. Wearing a cap/helmet (even in Bangalore)
b. When there is lack of cool air at the place.
c. While taking meals (Even in a decently air conditioned environment)
Does any of the above reasons, make me a non-candidate for HT or diminish HT results?
None at all. Actually after a hair transplant you are required to keep spraying the planted grafts with saline solution. And sweat is also a saline solution.
How is it that transplanted hair remains permanently on the same area, which couldn’t retain the natural hair? Is there any extreme possibility of losing the transplanted hair?
The donor area chose for a hair transplant contains follicles which do not have receptors to DHT a metabolite of the male hormone which when combines to the receptors shuts off the blood supply to the follicle making it wither away leading to baldness. These areas are the back of the scalp and side and body hair. Once these hairs are transplanted they are for life.
Read in a hair forum that “Manual FUE indeed has higher successful rate than motorized”…. what’s your comment on this, would you know what is your survival rate in percentage for your motorized grafts.
It depends upon what you are used to. I use motorised since I do wholly FUE and with the speed of a manual punch I can barely do 800 grafts a day. My transection rate if 4.75 at the present moment. Survival, though not assessed, seems to be above 95%.
Are the hair transplant results permanent?
During the procedure donor hair is taken from the “safe zone” hair of which are considered permanent in nature since their roots lack DHT receptors which is the root cause of baldness. Safe zone is found at-

Back and sides of the scalp
Body hair- chest, beard, underarms, groin, etc.

These hairs from the permanent zone when transplanted grow for a lifetime.

How do I know if I am a candidate for hair transplantation?
The salient criteria we at Darling Buds follow are:-

You should be above 21 years of age if you are suffering from male pattern baldness.

Your density in the recipient area (area of balding) should be less than 50% or else there might be a risk of shock loss.

You should have an adequate donor site and for this you need to take an online consultation.

You should have realistic expectations from a hair transplant.

What causes hair loss?
Hair loss can be divided into:
1) Pattern Baldness
2) Non-pattern baldness
we deal with maximum number of pattern baldness (99.5%) and hence we shall discuss this malady. Pattern baldness is hereditary and if it occurs in the male it is termed as Male Pattern Baldness. Usually the gene comes from the mother’s side of the family in 80% cases. To determine what pattern you are going to land up with if you have started to thin, you can see how the balding is with your maternal grandfather and maternal uncle. There is a high chance that yours shall be even more. Once a person is predisposed to balding due to his genes, the hair roots end up being born with DHT receptors. These receptors attract DHT ( a metabolite of the male hormone testosterone) which binds to the receptors and thereby cuts off the blood supply to the roots. This leads to decreased nutrition and the hair shaft begins to thin. Eventually it gets worse and the thin hair shaft looses length and eventually the roots disappear. This happens mostly over the vertex and not on the back of the head.

What do you think of the ARTAS Robot FUE Hair Transplant machine……. Few clinics around the world have this machine now; do you think you will adventure into this machine?
To add salt to the controversies that exist regarding FUE, companies with commercial interests have vitiated its scientific climate and therefore amateur hair restoration physicians do not know which FUE system to choose. There are a host of machines some overly priced and some not worth their salt. Since there is no industry standard as far as an FUE System is concerned there is a plethora of companies associated with FUE surgeons across the globe innovating their version of the best FUE system. ARTAS is one of them. I do not think the robot is capable of achieving FUE harvest and plantation speeds equivalent to the human hand. The ARTAS today cannot harvest more than 500 grafts an hour whereas we at our center harvest more than 1200 on a routine basis in an hour’s time. The James Harris system and its simpler variants shall soon be the industry’s standard tool and a semi-sharp variant of the dull punch would be most commonly used. However, the Harris FUE technique, being painfully slow, shall not last. Also,we do need to remember that it is not the machine which does the work in FUE. It is a mere tool in agile, discerning hands with an alert adaptable mind behind them. Remember the surgeon is not a slave in the hands of the tool he uses- it is the other way around. No magic wand exists in any field of medicine and hair restoration is not an exception.

Why 0.85mm for Indians and 0.75mm for Caucasians?
The clustering of follicular units in an Indian graft is wide apart and hence a wider punch size is used to prevent transection.

Also when you are extracting 2-3 grafts, what size is your punch?
0.85mm in Indians and 0.75mm in Caucasians.
I have looked more closely at my leg hairs, I have got alot of 2 grafts, is leg hair any good for BHT?
Useless donor area.
Can the beard hair used in the crown area?
NO. It’s too thick wiry and sometimes curls when used in that area.
Does beard, chest and leg hair grow the same length as native hair once planted on the scalp?
If they don’t are they used as fillers. Beard hair is better than scalp hair for density and even the length is more. If you have ever been to a Gurudwara you would realise what I mean! However any other hair is less thick and will not provide good density. They are good for the crown if the patient otherwise is depleted. For other areas they are best used as fillers. Chest hairs soften the hairline best.
You don’t inject the PRP into the scalp, would you inject it in other parts of the body?
I do not believe in injecting. I have seen that if I store grafts in PRP the following are the advantages-

  • Less popping in tight packing
  • Better survival
  • Most grafts transplanted grow
  • Crusting is less
  • Shedding of grafts is lesser
I have seen a lot of talk about BHT-Body hair transplants. However, I have not seen anything address what happens to hair that is transplanted from areas other than the head (beard, chest, legs, back etc) once transplanted into one’s head i.e. does it sort of transform into head hair? I mean what good is it to transplant leg hair, that grows about ½ an inch long or chest hair that only grows about an inch long with different texture into one’s head? Can Scabs Be Harmful on Hair Transplant Two Weeks Post Procedure?
No, it is not harmful. If follicular units were used for the hair transplant, the grafts should be durable for 10 days. After this time, one can scrub as much as one need to get the scabs off.
Is Shedding in Three Months After a Hair Transplant Abnormal?
Shedding of some of the patient’s existing hair in, and surrounding area of a hair transplant is a common occurrence post hair transplant. The mechanism is a normal response of the body to the stress of the hair restoration surgery as in site creation, adrenaline in the anesthetic etc. Using very small recipient sites and limiting the use of epinephrine may mitigate shedding to some extent. Shedding is a normal part of the hair transplant process and the risk is unavoidable.
Post Hair Transplant Is There Shock Hair Loss In Donor Area?
Shock hair loss in FUE is common, but is generally not significant and should eventually completely recover. Yes it can be significant if hair is planted amidst a density of over 50%.

How does a hair transplant work?
It works because hair removed from the permanent zone in the back and sides of the scalp continue to grow even when transplanted to the balding area in the front or top of the head. The reason is genetic predisposition to an inherited sensitivity to the effects of DHT. When DHT resistant hair from the back of the scalp is transplanted to the balding area, it will continue to be resistant to DHT in its new location and grow normally and progressively.
Is transplanted hair more delicate?
There is nothing delicate or fragile about transplanted hair. They can be permed, coloured or straightened. It is your own hair. You can engage in vigorous activities without fear of washing or blowing your new hair away.
Can I swim after my hair transplant surgery?
Please avoid swimming in a pool (chlorinated water) or the beach for 3 weeks after the procedure. Remember there are acids, chlorine and bacteria in the pool or in the ocean. You might get redness and increased itching if you are not cautious.
Does my head have to be shaved for surgery?
No, it is not necessary that the recipient area be shaved, the incisions in the transplanted area can be made parallel to the natural growth of the hair, but this will definitely take more time. Please watch the video.

Can patients suffering from some medical condition undergo hair transplantation?
Patients having, hepatitis, blood disorders and cancer or uncontrolled diabetes are usually not taken up for surgery.
Is there any difference in the number of follicles extracted by these methods?
Since FUE does not restrict itself to the scalp donor area, there is no limit to the number of grafts one can harvest in a single session. An average FUT harvest gives 2500- grafts whereas in a similar person we can get upto 6000-10,000 grafts in the same sitting from scalp and body. However if the donor area is deficient grafts will be much lesser. In such cases they would be even lesser by the FUT technique.
What is the difference in the post operative precautions for both techniques?
In strip method sutures are put on the back of the head, so special precautions like sleeping in a particular position, refraining from strenuous work and exercise are required till the stitches are out. In FUE the patient leaves the clinic, reclines for a while and is free to continue his day to day activity. Even the bandage at the back of the head is removed the following day. There are no stitches which makes it minimally painful post operatively.
What is the time gap between individual sittings?
What is the time gap between individual sittings?

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