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Plastic Surgeon Beirut Lebanon
Hair problems - Hair loss and hair transplantation

  Hair loss and hair transplantation

While many people complain of excessive hair growth, others may suffer of hair thinning. Thin hair, or in extreme cases, baldness, is a common problem of both men and women, especially in the Middle East. Here dietary factors are by far the most common, but hormonal problems, medications, certain diseases or stress are often a triggering factor.

In men, hair loss begins in the late teens, becomes visible in the twenties, and may progress over the rest of one's life, eventually leading to recession and complete balding of the top and back of the head. In women, the problem is usually more subtle, may begin later in life, and leads to a progressively lesser density of the hair over the top of the scalp, with more and more of the skin of the scalp showing, especially when outdoors.

Hair transplantation after 2 sessions
  Crown hair transplantation 1 session
Hair Transplantation by Dr Touma
Hair transplantation after a face lift

In both sexes, once internal factors of hair loss are ruled out, the treatment is traditionally medical, using topical minoxidil applications, which has on effect of stopping hair loss, and in many cases can lead to hair regrowth. In men only, oral medications such as Finasteride can be taken to further address the problem, and improve on the hair growth.
These medications however need to be taken long term, since it takes between 3 and 24 months to see the full benefit, and results will be maintained as long as the medications are not stopped.

Hair Transplantation by Dr Touma

Hair transplantation is a very effective and safe method of restoring a natural hair density in both men and women. Ideal candidates are those that have cosmetically noticeable thinning that cannot be improved with medical therapy alone. Hair transplantation is a very simple and safe procedure.

The hair is usually taken from the back of the scalp were hairs are usually abundant, in the form of a strip or tiny follicular units (FUEs) are extracted once at a time. The hairs are then separated under the microscope and reimplanted into the balding areas, one hair at a time (micrografts) in order to obtain a natural result. The whole procedure is done under local anesthesia and with very little inconvenience port operatively. One or two sessions are generally enough for most people. Eyebrows, side burns (especially after face lift surgery) and other areas of the body can be treated as well.

Dr.Touma specializes in the latest, safest and fastest techniques of micrograft hair transplantation and combines his skill with his esthetic sense in order to obtain the most natural results of hair restoration.

Hair Transplantation by Dr Touma


Having undertaken extensive research into the subject and following subsequent treatment, I now have absolutely no doubt that Dr. Touma is the No. 1 dermatologist in Lebanon and indeed in the Middle East.
Both Dr. Touma and his excellent technical team immediately made me feel comfortable and relaxed in their beautiful, modern surgery that offers the latest technological and dermatological procedures.
World Class.

Paul P. MC I, Ireland

  Strip or FUE, Micrografting and Minigrafting

Natural, life-long hair restoration is now available thanks to the development of current, state-of-the-art techniques.

Traditional hair transplantation involves removing a strip of permanent hair-bearing skin from the back or sides of the scalp (donor area) and then, the strip is usually microscopically dissected into micrografts (containing 1-2 hairs) and minigrafts (containing 3-4 hairs) each preserving the integrity of follicular units. The strip is closed in a most refined way with sutures and heals as a very thin line of approximately 1 mm that is covered by hair 3 mm or longer.

Follicular Unit Extraction (FUE) is an exciting new technique whereby hair is removed from the donor back area of the scalp using a very small punch technique, instead of removing a strip. The donor area heals with no linear scar, and only small white points remain, that are covered with hair 2 mm or longer. FUE is useful for patients that need treatment of small areas or who don’t want a scar in the back of the head, but it only allows the transplantation of less than 50% of the total hair number possible with the strip technique. Dr. Touma was the first user of the Neograft® device in Lebanon, however he discontinued its use due to high transaction rate with this machine. He has since developed a meticulous hand punch technique that keeps all FUEs intact, and can do large FUE cases that routinely exceed 2000 hairs/session.

Many world class hair transplant experts still favor the strip technique because of the high yield of hairs it allows in a single session. However, FUE is a wonderful technique that is suitable for most people, especially if they like a short hairstyle or those who shave their head. With FUE, the donor area needs to be shaved while hair is left long in the strip technique and covers the linear scar.

One hour after completion of the FUE procedure

The carefully dissected grafts are then meticulously implanted into the bald or thinning area of the scalp (recipient area). Implanting micrografts in the hair line has allowed very natural, feathered hairlines, and avoids an abrupt, "pluggy look," that was typical many years ago. A minigraft can be used behind the hairline for added density. Depending on the degree of balding for the frontal area and similarly for the crown area, 1-3 procedures involving several hundred or up to 2000 or more grafts may be required to achieve the desired density (of course, more procedures could be done if hair loss progresses or greater density is desired). Many of our strip sessions technique range between 4000-6000 hairs/session with some sessions reaching 8500 hairs. Within 24 hours small crusts will form on each graft which are shed in approximately 7-10 days. The grafted hairs will start to grow by 6-12 weeks after the procedure and will continue to grow for a lifetime.

Using medical therapy as prescribed by Dr. Touma will enhance hair growth and preserve as much of the pre-existing hairs as possible, so as to reduce further need for hair transplantation.

  Who benefits from hair restoration surgery?

Anyone who has experienced permanent hair loss may be a candidate for hair restoration surgery, including:

1)      Men with male pattern baldness,

2)      Some women with thinning hair - female pattern thinning,

3)      People with areas of scarring from injuries or hair loss after face lift procedures

4)      People who want to thicken or restore eyebrows, eyelashes, and beards.

Eyebrow Density
  Eyebrow Transplantation and Scar Revision

  What happens during a hair transplant surgery?

Hair transplant procedures generally take from 3-6 hours and are performed using local anesthesia on an out-patient basis. Patients are often awake but feel relaxed as they are given a mild sedative. There is usually little or no pain during the surgical procedure. If a turban -type bandage is placed on the scalp at the end of the procedure in order to keep the grafts snug and secure overnight, it will be removed the next day. Many surgeons use no dressings. In case of a strip removal, the donor area, where the permanent grafts are taken from, is closed with either sutures or surgical staples that are removed in 7-12 days. Dissolvable sutures may be used in order to eliminate the need for you to return for suture removal.

  What happens after hair transplant surgery?

Hair transplantation is a very safe, relatively minor surgical procedure. Patients are provided with a mild analgesic to relieve any discomfort felt the night following the procedure. Patients may be asked to use moist compresses or sprays and to sleep in a semi-upright position for 2-3 days following the procedure to minimize swelling and bruising. Small crusts may form on each graft that can be camouflaged by any existing hair that can be combed over the recipient area. These crusts will flake-off by 10-14 days after the surgery. The transplanted hair seen above the scalp will initially be shed, however the roots will remain dormant for 6-12 weeks, at which time the new hairs will all begin to grow. Numbness that may occur in the donor or recipient area usually disappears in about 2 months following surgery.

Complications are rare. Minor infections can occur around a newly transplanted hair follicle, similar to an infected ingrown hair or pimple, and responds easily to antibiotics. Minor scars that occur in the donor scalp as a result of the removal of donor skin are usually painless, 1-2 mm thin, and can be easily hidden by the surrounding hair. The graft sites in the recipient frontal area heal with almost no visible scarring and are covered by the transplanted hair. Patients may experience mild swelling to the forehead area for a few days following surgery if the frontal scalp is transplanted.

one year after crown hair transplantation
Hair Transplantation by Dr Touma

  When should I start treatment?

Patients may have hair restoration surgery at any age. It is often better to start when you are not completely bald so that you can use existing hair to help camouflage the procedures.

Medical treatments such as Finasteride and Minoxidil may be offered to men with mild to moderate hair loss to help preserve thinning hair in the crown. Hair transplants can be used to fill-in the front hairline and thicken the front half of the scalp, and medical treatments can be used to maintain hair behind the transplants and to possibly enhance the long-term results of hair restoration surgery. We will work with you to design an individualized plan to fulfill your specific needs.

  How do I know if I am a good candidate?

An ideal candidate is someone with dense hair in the permanent fringe of hair-bearing scalp. A patient with light-colored hair and pale skin (as opposed to dark hair and light skin) may appear to have a denser look. Patients with very wavy curly hair may require fewer sessions than someone with straight hair. While hair transplants look very natural, the end result may not achieve the density or total coverage that you had when you were a teenager.

Dr Touma has developed a comprehensive approach to hair restoration that includes very refined techniques tailored to individual needs, a professional team of technicians, a complementary medical approach to enhance hair growth before and after hair restoration surgery, and a very high sense of esthetics and personalized care.

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