What we do
What we do at INSTA. Art or medicine?
What we do at INSTA. Art or medicine?
Our aim is to meet your expectations and ensure your complete satisfaction by performing state-of-the-art hair transplantation using cutting edge techniques. Our highly experienced full-time staff is of the belief that for successful results, every aspect and every step of hair transplantation must be taken into account.
Positive results depend on good communication with the patient, hairline design, graft extraction, graft survival, incision and insertion, post-operative care and adjunct therapy.
On the first day, the reception staff greets you prior to meeting with your assigned advisor. Preceding your consultation, high-resolution photos are taken in our photography room, a room especially designed with special equipment strictly for this purpose.
The consultation and examination are crucial to the evaluation of your case. During your consultation, you will have an adequate opportunity to have your questions satisfactorily answered. Your consultation consists of an evaluation by the doctor, taking into account all of your goals and desires, your family's history of alopecia, your age and medical history, as well as your facial features and hair characteristics. At Asmed, we believe that every patient must be fully informed of the pros and cons of surgery. It is for this reason that the doctor examines each patient carefully and identifies non-candidates and non-ideal candidates.
- The scalp and hair are studied under high power magnification with a hand-held microscope that makes miniaturization and hair abnormalities easier to see.
- The hair density and the follicular density are calculated.
- Hair diameter is measured with a micrometer
- Donor and recipient areas are measured.
- Donor capacity is calculated.
During the examination :
According to your hair type, hair loss, ethnic background, gender and expectations, the doctor will share the surgical results of another patient whose characteristics are similar to yours.
You will also be informed about any medication that is deemed necessary for complete treatment of your condition. A decision regarding the use of medication can affect surgical planning in a number of ways.
Tests and Analysis
Your blood will be taken for analysis followed by the performance of an electrocardiogram. The anesthesiologist will subsequently consult with you and review your test results. According to your preferences and your situation, he will plan your program.
Your hair is shaved to a measurement of 1 - 2 mm in length.
The details of the donor area are documented in a digital image and are used by the technician to perform measurements in a computer program. The hair density, the follicular density and the number of hairs per follicular group (a calculated density) are evaluated for different scalp regions.
The design and location of the hairline is determined through an extensive consultative process. Since every person has a unique bone and facial structure, the purpose of this step is to create a unique hairline that will be exclusive to you. At this point, the doctor will identify your goals and expectations, and will evaluate the all-inclusive 3-dimensional qualities of your head and face. Then he will balance them with considerations such as donor hair availability, potential future hair loss and the suitability of a particular style for your facial features.
A pen that is used exclusively for you, is utilized to draw your frontline design. After receiving your approval, the hairline is established and stabilized. A final series of photos is taken from different views. Following all these procedures, you will be invited to return to your hotel for a rest.
Pre procedural meeting
At the end of the day, the Asmed staff normally meets in the meeting room to review all pertinent patient information and to make plans for surgery the following day.
The day of procedure
Your day begins with a greeting by the reception staff and your advisor.
You are then escorted to the surgery suite and are prepared for surgery. Before surgery you are invited to the recreation room. The anesthesiologist visits you, and according to your situation and desires, he makes changes to your pain management plan. You are able to pick out movies that you may wish to watch during the day. Asmed also offers major TV channels and Internet options. Our masseur offers you a back massage to ease tension and you may also opt for a foot massage during surgery. During surgery, it is possible to take a break for the restroom and to have snacks or stretch.
Operating Room Supplies and Preparation
In the surgical rooms, only sterilized or disposable instruments are used. In concurrence with the decisions reached during the pre-surgical meeting, the room is prepared along with the instruments that will be used during your particular surgery.
You change into a surgical gown and are asked to sit in a comfortable surgical chair designed specifically for hair transplants. It is coated with a disposable material for surgical use.
Your vital signs are monitored before and during the application of local anesthesia. However, if an anesthesiologist decides to further monitor your situation, the procedure may be repeated during surgery. According to your comfort, he can adjust your plan by adding medication.
Prior to the commencement of surgery, the physician will check your file and checklist, then examine the donor area and mark the entire safe donor region of the scalp to provide homogenization.
Local anesthesia is administered to the the donor area by using a series of small local injections and a very small needle.
Grafts are extracted in a sitting position for the purpose of utilizing all parts of the donor site.
The magnifier, worn on the head of the doctor, is of an innovative, patented, cross-polarized technology, so that the doctor can see approximately 1 millimeter below the surface of the skin.
High quality surgical punches are used that are ideal for manual use. The thin-walled punches are of different styles, and are available in multiple sizes designed to reduce friction. It is our belief that the inside bevel cutting edge is optimal for extraction. Punch diameters (varying from 0.6 mm to 0.85 mm) are placed in a handle that allows precise depth control. Moreover, the combination of depth control, punch type and punch size varies according to the patient's characteristics, thus allowing for the minimal risk of follicle injury.
At Asmed, we implement our own original technique to extract grafts called "sequential or DES technique". This allows us to literally feel the path of each follicle, an important factor in extraction.
Although speed is far from the essence of our objective, in some patients, a thousand FUE's per hour can be extracted without creating damage.
During surgery, graft parameters are observed and reported using a program that was especially developed by Asmed to check quality and, when necessary, to make adjustments and give timely reports to the surgeon.
Donor limitations and graft preservation, as well as the safeguarding of homogenization are carefully considered during punching. In order to guarantee results with this approach to harvesting and to maintain control, only a manual punch is used.
Once the grafts are extracted, the donor area is covered with antibiotic ointment.
The parameters that potentially damage the viability of grafts are carefully controlled by the latest technological improvements. Grafts are assessed with a magnification device from the commencement of surgery. They are then selectively separated, put into petri dishes that contain hypotermosol + liposomal ATP solution, and are placed over an electric chilling device during extraction.
Hair recipient sites are the locations of hair graft insertion. Pre-made recipient sites provide control of the transplant design and ease in follicular unit sorting, thus creating less popping and bleeding.
The surgical chair is adjusted to create maximum comfort. Then the recipient area is anesthetized.
According to the length of the hair and the distribution of the grafts, sterilized custom-sized blades are prepared.
The doctor makes incisions that allow the hair to move in the most effective way possible utilizing patterns, distributions and techniques that create the greatest appearance of fullness.The doctor also mimics the changes in the angle and direction of the hair to create a more natural flow and look, to limit transection and damage to neighboring hair, and to create a shingling effect.
The incisions are placed though a lateral slit technique used in combination with custom-sized blades. Openings are specifically tailored to accommodate the dimensions of each individual graft, while a specific blade handle that limits the depth of the blade is utilized. All of the sites are created under loupe magnification.
After this phase of surgery, lunch will be provided. Please let us know, if you have any dietary restrictions.
After lunch, the surgical team will place the follicular unit grafts into the pre-made sites.
The graft can only be inserted in the same direction and angle as the incisions that were made. Different size grafts are used according to the established aim for the creation of density and naturalness. Original one-hair follicular units are used in the frontal hairline area to give a natural, soft appearance.
It is critical to the survival of grafts to keep them moist up until the time that they are placed. The ring graft storage device provides a convenient, temporary holding place for them. Grafts are inserted using only fine forceps.
Each graft is handled with the minimum forceps trauma possible.
While grafts are being placed, one technician is assigned to watch and evaluate and at the
end of the procedure, the position of all of the grafts is double-checked.
The surgical areas are cleaned thoroughly before the application of LLLT.
Then, the doctor carefully inspects the recipient sites to be certain that the position and placement of the grafts are perfect.
Upon completion of the surgery, the staff provides you with post-operative instructions. An after-care kit containing post-operative medications, gauze, an ice pack and a bottle of liposomal ATP spray is provided for you as well.
After completion of these steps, you are ready to leave the clinic wearing a cap that was especially prepared for this surgery. The next day, you will return to the surgical center for a hair wash and check-up.