• Hairline Design: This is the artistic phase. The surgeon draws the new hairline on the patient’s forehead. The design must adhere to the “Rule of Thirds” for facial symmetry and consider the patient’s age. A hairline that is too low or too straight will look unnatural.
• Local Anesthesia: The patient remains awake but feels no pain. The scalp is numbed using local anesthetic injections.
• Needle-Free Injection (Jet Injection): For patients with a fear of needles, high-pressure devices can deliver the anesthetic through the skin without a needle prick, increasing comfort.

Step 1: Extraction (Harvesting)

The first medical phase involves removing the hair from the donor zone.

• Micromotor FUE: The surgeon uses a low-speed, high-torque micromotor equipped with a tiny punch (0.6-0.9mm). The punch isolates the follicular unit, which is then gently extracted with forceps.
• Preservation: Once extracted, the grafts are incredibly fragile. They are placed in a chilled, nutrient-rich storage solution (like Hypothermosol) to keep the cells alive and prevent dehydration while they await implantation.

Step 2: Channel Opening (The Incision Phase)

Note: In DHI, this step is combined with Step 3. For standard FUE, the surgeon creates tiny incisions in the recipient area where the grafts will be placed.

• Sapphire Blades: At Liv Hospital, we prioritize sapphire-crystal blades over standard steel. Sapphire blades hold a sharper edge, creating smoother, cleaner channels. This reduces tissue trauma, minimizes bleeding (crusting), and allows for “dense packing” (placing hairs closer together).
• Direction and Angle: The surgeon must follow the patient’s native hair’s natural growth pattern. For example, creating a “whirl” pattern at the crown or angling hairs forward at the hairline.

Step 3: Implantation (The Placement Phase)

• Forceps Placement (FUE): Technicians gently insert the grafts into the pre-made Sapphire channels using micro-forceps.
• DHI (Direct Hair Implantation): In this technique, the graft is loaded into a hollow needle known as a Choi Implanter Pen. The pen punctures the skin and injects the graft.
  • Advantages of DHI: It eliminates the need to shave the recipient area (unshaven transplant), reduces the time the graft spends outside the body, and allows for very high-density implantation between existing hairs.

Post-Operative Recovery and Adjunct Therapies

The success of a transplant relies heavily on the first 10 days of recovery.

• The First Wash: Performed at the clinic 24-48 hours after surgery to teach the patient how to gently clean the scabs.
• Shedding Phase (Shock Loss): Between weeks 2 and 6, the transplanted hairs will fall out. This is normal and expected. The root remains alive under the skin.
• Regrowth Timeline: New growth begins around month 3 or 4. Significant visual improvement is seen by month 6, with the full result taking 12 to 18 months to mature.
• Supportive Therapies:
  • PRP (Platelet-Rich Plasma): The patient’s blood is spun to concentrate growth factors, which are injected into the scalp to speed up healing and stimulate follicle activity.
  • Mesotherapy: Vitamin and mineral cocktails are injected into the scalp to nourish the grafts.