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Hair Transplant Planning and Procedure

Explore hair transplant planning stages and procedural steps performed by experienced specialists.

Beginning your hair restoration journey? Understand the planning stages, including graft needs, hairline mapping, and detailed FUE/FUT procedure steps at LIV Hospital.

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The Art of Microsurgery

A hair transplant is not merely a redistribution of follicles; it is a permanent alteration of your facial aesthetics. The difference between a “pluggy,” unnatural result and a masterpiece lies entirely in the planning. At Liv Hospital, we treat hair transplantation as a fusion of mathematical precision and artistic vision.

Our Hair Transplant Procedure is a full-day experience (typically 6–8 hours) conducted in a sterile hospital operating theater. Unlike clinics that rush through “mega-sessions” with technicians, our process is physician-led, ensuring that every graft is treated as a vital organ. We utilize the Golden Ratio to design hairlines that suit your unique bone structure, ensuring that your new hair looks as natural at age 60 as it does at age 30.

The Design Consultation

Before a single hair is touched, we must define the blueprint. This happens in the morning, face-to-face with your surgeon.

  • The Golden Ratio (1.618): Nature follows a specific proportion. In a perfectly balanced face, the distance from the chin to the nose, the nose to the eyebrows, and the eyebrows to the hairline should be equal (1/3, 1/3, 1/3).
  • Drawing the Line: Using a laser leveler, we draw your new hairline. We do not draw a straight line (which looks like a wig). We create “micro-irregularities”—tiny zig-zags that mimic nature.
  • Muscle Check: We ask you to raise your eyebrows. We never place hair on the forehead muscles (frontalis). If we do, the hairline will move when you talk, which looks unnatural.
  • Density Mapping: We calculate the surface area (cm²) of the recipient zone and multiply it by the desired density (e.g., 50 grafts/cm²) to determine the exact graft count needed.
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Pre-Op Preparation

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Once the plan is approved and the consent forms are signed, you enter the preparation phase.

  • Blood Tests: A final check for HIV, Hepatitis B/C, and coagulation markers.
  • The Haircut: For standard FUE, we shave the head to Grade 1 (1mm). This allows us to see the angle of every donor hair clearly.
    • Note: For women or DHI patients, we may perform “Unshaven FUE,” shaving only a small window in the back that is covered by long hair.
  • Sterile Field: You change into a hospital gown. The surgical site is cleaned with antiseptic (Betadine), and you are brought into the HEPA-filtered operating room.
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Anesthesia and Extraction

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The first stage of surgery involves harvesting the grafts from the donor area (back of the head).

Needle-Free Anesthesia (Comfort-in™)

We know patients fear needles. To eliminate this pain, we use a Jet Injector.

Micromotor Extraction (FUE)

  • The Tool: We use a motorized punch with a diameter of 0.7mm to 0.9mm (depending on your hair thickness).
  • The Technique: The punch surrounds the hair follicle and rotates, loosening it from the skin. The surgeon then gently pulls it out with micro-forceps.
  • Graft Preservation: Once extracted, the grafts are fragile. 

Channel Opening

This is the most critical artistic step. The surgeon creates the tiny incisions where the new hair will live.

Why Sapphire Blades?

In the past, steel slits were used. At Liv Hospital, we exclusively use Sapphire Blades.

  • V-Shape vs. U-Shape: Sapphire creates a sharp, V-shaped incision. This heals faster because the skin edges touch perfectly.
  • Angle and Direction: The surgeon determines the angle of every single hair.
    • Front Hairline: 15–20 degrees forward.
    • Top: 45 degrees forward.
    • Crown (Vertex): A “whorl” or spiral pattern that mimics your natural cowlick.
  • Density: Sapphire blades are thinner than steel, allowing us to pack channels closer together (60–80 incisions per cm²) without cutting off the blood supply (necrosis).
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Implantation

Now, the team places the harvested grafts into the opened channels.

  • Sorting: While the surgeon opens channels, technicians sort the grafts under a microscope into “Singles” (1 hair), “Doubles” (2 hairs), and “Multiples” (3–4 hairs).
  • Strategic Placement:
    • Singles: Only single-hair grafts are placed in the very front hairline. This creates a soft, natural transition.
    • Doubles/Multiples: These are placed behind the hairline and on the top/crown to create volume and density.
  • Technique: The graft is held gently by the “bulb” (root) and slid into the channel using jeweler’s forceps. We never touch the “stem” cell area.

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The DHI (Direct Hair Implantation) Method

If you choose DHI, Steps 4 and 5 are combined.

  • The Choi Pen: Instead of opening channels first, the graft is loaded into a hollow needle (the Choi Pen).
  • One-Step: The surgeon presses the pen into the scalp. The needle pierces the skin and deposits the graft in one motion.
  • Advantage: This allows for extreme density and creates less bleeding, as the hole is plugged immediately by the graft. It takes longer (8–10 hours) but offers faster healing.

Post-Op Immediate Care

The surgery is finished. We clean the donor area and apply a sterile bandage. The recipient area (top) is left open to air-dry.

  • PRP Therapy (Platelet-Rich Plasma): Before you leave the OR, we often inject PRP (derived from your own blood) into the scalp. This acts as a “fertilizer,” speeding up wound healing and waking up the new follicles.
  • The Meal: You are taken to a private recovery room for a hearty meal. Your blood sugar may be low after a long day.
  • Discharge: We provide you with a Post-Op Kit containing:
    • Antibiotics (infection prevention).
    • Painkillers (Paracetamol).
    • Anti-swelling medication (Steroids).
    • Neck pillow (for sleeping upright).
    • Special shampoo and lotion.

The "First Night" Rules

The first night is crucial. The grafts are not yet “anchored.” If you touch them or rub them against a pillow, they will pop out.

  • Sleep Upright: You must sleep at a 45-degree angle (in a recliner or propped up with pillows) to prevent swelling from traveling down to your eyes.
  • Use the Neck Pillow: This prevents your head from turning sideways while you sleep.
  • Do Not Touch: The recipient area will itch. You must not scratch it. A dislodged graft bleeds and leaves a permanent empty spot.

FREQUENTLY ASKED QUESTIONS

Can I take a lunch break during surgery?

Yes. We typically take a 30-minute break between the Extraction and Channel Opening phases. You can eat, use the restroom, and check your phone. The anesthesia lasts for hours, so you will not feel pain when we resume.

Just raise your hand. You are awake and mobile. We will unhook your monitors and escort you to the restroom. It is very common given the IV fluids you receive.

Yes. DHI is more labor-intensive and requires a larger team (2–3 nurses loading pens constantly) and expensive disposable Choi Pens. It typically costs 20–30% more than Sapphire FUE.

  • FUE (3,000 grafts): Approx. 6–7 hours.

DHI (3,000 grafts): Approx. 8–10 hours. We ask patients to block off the entire day (8:00 AM to 5:00 PM).

Only the back of your head (donor area) will have a white bandage. We cover it with a loose black headband or a special surgical hat provided by the hospital. The top of your head will look red and scabby but will be open to the air.

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