ADVANTAGES OF FUE & N.I.T METHOD
Since it is done under local anesthesia, the patient doesn’t feel any pain during the operation and post-operative phase is quite comfortable
The operation doesn’t leave a long wide scar like in the F.U.T method
It is possible to reach more follicles compared to F.U.T method
You can go back to your normal life the very next day of the operation, you just need to wear a hat
Since very thin needles are used, it is possible to implant with very high density in 1cm2.
The biggest advantage of using needles is that it allows the surgeon to manipulate the direction and angle of the implanted follicles. This allows a more natural result
Since the skin is not harmed, small caves don’t appear in the bottom of the follicles
Op. Dr. Zekeriya KUL
Aesthetic, Plastic and Reconstructive Surgery
After graduating from Istanbul University Cerrahpasa Medical Faculty, he started his speciality in Aesthetic, Plastic and Reconstructive Surgery in Istanbul Vakif Gureba Education and Investigation Hospital. During this perioid, he participated and contributed in several national and international congresses. After completing his thesis on “The affect of fat tissue originated Stromal vascular fraction on the survivalibility of Skin Flaps.”
After the graduation, he completed his obligatory duty in Van State Hospital. After a brief time in Istanbul Bakirkoy Dr. Sadi Konuk Hospital, he started his own private clinic to accept both national and international patients. Dr. Kul is a registered plastic surgeon also in United Arab Emirates and occasionally accepts patients in Dubai.
During his speciality, he travelled to Brasil to learn from Dr. Cesar Arrunetaqui in Belo Horizonte Belvedere Hospital. They focused mostly on Breast surgeries, body contour surgery and facelifts. During his time in Brasil, he learnt about hair transplant thanks to Dr. Carlos Uebel. Dr Uebel was using the F.U.T to extract but he was using a new stick and plant needle technique to open holes and implant follicles at the same time.
After returning to Turkey in 2004, he start to use the same punches used by dermatologs for F.U.E operations. In the next years, he started to use even smaller punches with 0,7mm diameter and finally they were adapted for micromotor extraction. In the first year, he used slit method to implant however he quickly noticed that the results weren´t very different than F.U.T, the only difference was the extraction of follicles, so he decided to use needle to implant. Today he works with 1500 – 2000 grafts in 4-5 hours a day and using the technique named by Dr Kul N.I.T. (Needle Implantation Technique), perfect results can be achieve in suitable cases.
WHY F.U.E. & N.I.T IS THE BEST HAIR TRANSPLANTATION METHOD IN THE WORLD?
As in all surgical operations, hair transplantation is our main goal; using minimal traumatic methods to damage the tissues (the foliated planting area and follicles) and at the same time to obtain permanent and aesthetic results.
In F.U.E. and N.I.T. method, we do not damage the underside of the planted area by opening very small diameter channels with the needles we used when we implanted the follicles. Minimal trauma, however, provides a greater number of follicles than 1 cm2. In the slit methods (vertical or lateral slit method) used all over the world, the channels opened to place the follicles form a lot of trauma at the bottom and reduce blood circulation at the same time.
These channels both affect the outflow angle of the follicles and, as they heal, they heal in the form of small pits on the hair’s base, resulting in an unnatural appearance. Below are two videos; you are watching a hair transplant performed with the classic slit method on the first video. If you notice, the channels that are opened are quite long and the trauma that occurs at the bottom is quite high. In addition, the follicles are severely traumatized during implantation with a clamp.
After such a hair implant, it is inevitable to have a rare hair appearance, late healing and loss of existing hair in that area. The second video is the F.U.E. & N.I.T. It is a video of the method and you are watching the sowing done on an area of 1 cm2. Note that the needles we use to open the channel are quite thin, the bleeding in the skin and the tissue damage are almost insignificant, and we keep the follicles at the top of the pliers, without impinging on the hair roots.
Another important point is; it is quite easy to create the angle and direction of the hair in this technique. Whichever direction and angle the pillar advances, the follicles are implanted in that direction and at the angle. Thus, as if the hair is in the classic hair plantation, the right angle is raised to prevent the appearance of the grass man.
Classic Hair Transplantation
F.U.E. & N.I.T. Method of Hair Transplantation
WHO CAN DO WHO CAN NOT DO THİS OPERATION?
Hair transplantation is sufficient donor area, spill process is completed in large proportion, mathematically anyone who does not have incompatibility between the donor site and the recipient site can make hairplants. As a matter of fact, it is not possible to perform this operation in patients who can not make a sufficient number of grafts because everything in this operation depends on mathematical data. To give an average number; A minimum of 35 grafts for 1 cm2 should be implanted.
It is necessary to calculate the number of grafts to be implanted according to the size of the area to be cultivated and to look at whether or not the resulting number can be extracted from the field. For example, if the area to be sowed is 10×10 cm in size, we must have at least 3500 grafts in order to obtain a satisfactory slack frequency. In a patient who is not able to graft the graft in this way, either the operation should not be performed or the area to be sowed (by planning the frontal hair more conservatively) should be minimized.
Besides, at a point that should be known, the number of hair follicles contained in each follicle unit also affects the end result. For example, if each graft contains 1,5 hair follicles (follicle qualities may contain 1,2,3,4 hair follicles), we will have a total of 5250 follicles for the 3500 follicle unit, and 7000 hair follicles if they contain 2 hair follicles on average. In addition, the difference in contrast between hair color, thickness, hair color and skin color also affects the end result. For example, according to someone with a black-haired, light-colored skin we are transporting the same number of grafts, the hair density we will obtain from a visual point of view will be greater for someone with light hair and skin color.
HOW CAN WE HAVE A FINE AND NATURAL APPEARANCE HAIR?
There are two important factors that provide satisfaction after hair transplantation; one of these; frequent hair, the other is to be found with natural looking hair . The frequency, as we have already mentioned, is possible with a minimum of 35 grafts per 1 cm2 (provided each graft contains 2 grains on average).
The natural look is; It is possible with the correct design of the hair line, the outward angle of the hair and the orientation of the hair to the original hair. If we graft the grafts according to the direction and angle of the old original hair, and especially by adding grafts containing 1 hair texture along the front line, we can get the nearest result.
When designing the front hair line, the age of the patient, the level of spillage in the temple area, expectations, and so on. In an advanced age patient, if there is a clear spill in the temple area, it may be possible to plan conservatively and obtain an image change that satisfies the patient, instead of starting with a very low level of frontal line. However, it is possible to obtain the original hair line in a patient over 30-35 years of age, where the hair loss process is stopped and only the frontal region is shed.
HAIR TRANSPLANTATION IS A SURGICAL OPERATION, YOU SHOULD KNOW WHO WILL DO YOUR OPERATION
Hairplant is a surgical application, like all other aesthetic operations. Just as we perform rhinoplasty or face lift surgery as a plastic surgery specialist, we must also perform hair transplantation.
This is a medicoleal obligation. Of course, we will have an assistant during the operation, but the task of the assistant is only; collect grafts after extraction and sort them according to the number of hair pieces they contain. Therefore, the stage of extraction and implantation of the grafts will be carried out independently as a plastic surgeon. Please find out who or who will perform your operation. Hair transplantation is not done under the control of a plastic surgeon, it is done by the plastic surgeon himself.
HOW WE SHOULD DO THE LOCAL ANAESTHESIA DURING HAIR TRANSPLANTATION?
The hair follicle is an operation performed with local anesthesia and without any pain during the operation. After marking the borders for the donor site and the area to which we will transport the grafts, we will study the local anesthetic (lidocaine HCl + epinephrine) injected into the skin along these boundaries to ensure that we obtain full anesthetic effect on the field.
To facilitate donor site extraction after local anesthesia and to sow, we are injecting adrenaline saline into the skin under the skin to facilitate implantation. Unlike classical approaches, we inject injections into small, but deep, right-handed layers instead of excessively unnecessary liquid injections.
HOW TO OPERATE
We start with the design of the hairline, marking border of the donor site, and the operation after local anesthesia, primarily with the extraction of grafts. First we check the 50-60 extracted grafts and check whether the grafts are easy to extrude, how many grafts each graft contains, and whether the roots have undergone transection.
Depending on the density of the donor site, we can extract 15-30% of the grafts of 1 cm2. The area of 0,7-0,8 mm in this area can be easily camouflaged by the surrounding hair because the extruded grafts will not replace the hair again. However, after a high number of extractions, the white spots on the skin, especially those with dark color and hair, may become visible when the hair is shortened. The point that should not be forgotten is that; a scar tissue is formed in every aesthetic operation. What is important here is that the positive aesthetic result we obtain, as well as this scar can easily be ignored.
We prefer to have 1500-2000 grafts per day. The reason for this is that waiting times outside after the grafts have been extirpated are not so long as the F.U.E. & N.I.T method. Because of the high level of attention and concentration required in the, the extraction rate on this number will decrease with success. The total average time for both extraction and implantation for F.U.E. & N.I.T: 5 hours. 1500 grafts in a patient we will transplant 3000 grafts 1. We extract and implante the day, and the remaining 1500 we extract and implante the next day.
In terms of patient comfort, we also see that this approach is more preferred. The grafts extracted by the surgeon are collected by the assistant and classified according to the number of hair pieces they contain. The average duration of extraction for 1500 grafts is 1.5 hours. Then, local anesthesia and subcutaneous adrenaline infiltration of the area to be sown are performed and implantation is started.
F.U.E. & N.I. T method has several advantages:
1.It is not bleeding because the trauma is minimal and the healing process is progressing very fast
2.As the channel is opened with the needle and the diameter of these channels is very small, the blood circulation in the deep is not deteriorated, which means that the problem of grafts in the sowing region can not be fed can be avoided.
3. It is impossible for the graft to move in place or move out of the canal after it has been placed in the canal, because the third channel is in line with the graft diameter
If the channel is opened with the 4th needle at which direction and angle, grafts will show the output at this direction and angle.
After implantation, this area is left open and the donor site is closed with bandage. The patient can easily return to normal daily life by wearing a sports hat. After 48 hours, the donor site is switched off and the first washing operation is performed
Things to be aware of after the operation
After 48 hours of operation, you can do the first wash and donor site care in our clinic. However, there are some points that should be taken care of during washing for patients from abroad or from outside of the city and who have time constraints.
1. Bepanthol lotion (the form for dry skin should be preferred) is applied to the planted area before the washing process and it is waited for at least 1 hour to soften the blood and crusts of the dried lotion.
2. During washing, preferably bepanthol lotion is applied by using warm water at moderate pressure first, it should be soaked with shampoo and then foamed with shampoo. The wiped shampoo should be removed with its own strength for the first 3 days and by hand slight circular movements should be removed from bepanthol and shampoo residue
3. After the first bath, the bandages that are present in the donor area will get loose due to getting wet. The bandage may have been bleeding for a few minutes in some areas of the donor field, at first, and you should not be worried. Donor site can be left open after province washing. However, since this region can cause complaints of dryness and stress pain and burning, this region should be lubricated with bepanthol lotion even if there is a small amount during each bath.
4. Serum and edema fluid in the area can be displaced to the forehead region or even around the eye due to the effect of gravity. No worries, even if edema occurs, it will disappear within 2-3 days. After the operation to prevent this, we think that the application of ice to the forehead area in the first 24 hours is sufficient. We do not need any compressive bandages or tennis band to be applied
5. Because the technique we use is a minimal traumatic technique, healing will be rapid and all scaling will be cleared after 7-10 days.
6. After 2-3 week, they will enter the process of shocking and this process will continue for the first 2 months. Especially 2-3. Do not worry about the fact that nearly all of your hair has been dumped in months. The hair restoration process is 4-5months for FUE. This process continues until the end of 1 year.
Teşvikiye mah. Hakkı Yeten Cad. No: 23 Kat 5 Daire 515 Vital Fulya Plaza
İstanbul / Şişli / Fulya
© 2016 Dr. Kul
firstname.lastname@example.org +90 212 241 44 44