The Transplant and Hair Medicine Units at Ruber International, located at Mirasierra and in Paseo de la Habana, are made up of experienced specialists in the diagnosis and treatment of hair conditions, as well as in the most advanced techniques of hair micro grafting and eyebrow transplant.
-
- We have a team of dermatologists specialising in trichology, the only physicians specialised in the diagnosis and treatment of alopecia (hair loss), as well as of all conditions of the scalp and hair follicles.
- ·Our specialists have treated more than 20,000 patients with hair conditions, and they have performed more than one thousand hair transplants throughout their professional careers.
- We have our own research team formed of experienced specialists in hair medicine, who, apart from carrying out R&D projects, create exclusive formulations that give the best outcomes to our treatments and mesotherapy procedures.
- We use cutting-edge technology for the diagnosis and follow-up of our treatments.
We are experts in:
-
- Diagnosis of alopecia
- Trichology treatments
- Hair transplants
- Eyebrow transplants
Alopecia (hair loss)
Alopecia is a problem that affects a large part of the male population and, to a lesser extent, the female population. Although in principle it is an aesthetic difference, for many people, especially for women, it has significant psychological consequences that will lead to difficulties for social, love and work relationships.
Loss of hair can be seasonal, temporary, or it can be a more complex condition.
Hair Phases
The hair's life cycle involves three phases that occur at the same time in different areas of the scalp:
-
- 1st phase, anagen or growth phase that lasts approximately between 2 and 8 years. We can say that 90% of hair is found in this phase.
- 2nd, the transition phase that in medical terms is called catagen. It is a transition/involution phase that lasts between 2 and 3 weeks in which hair growth stops. 1% of hair remains in this phase.
- 3rd and final resting phase or telogen, in which the hair dies and remains on the head until it is pushed out by a new hair that emerges and begins its anagen phase. It is a resting phase that lasts 2 or 3 months. 9% of hair is in this phase and that is why a loss of up to 100 hairs per day is considered normal, considering that the average person has about one hundred thousand hairs on their head.
Patients who have severe hair loss suffer changes in the growth phase.
Types of alopecia
There are multiple reasons for which hair can fall out. Some are temporary and will recover over time, and others are permanent. It is essential to diagnose correctly the type of alopecia since the success of treatment depends on this.
-
-
Androgenetic alopecia
It is the most common type of hair loss and in which a hair transplant offers the best outcomes. Hair gradually turns thinner and lighter until it becomes an unnoticeable hair. This is known as follicular miniaturisation.It is of genetic origin and is triggered by the presence of an enzyme called 5-alpha-reductase which will be present only in certain areas, those in which the hair falls out.
The mechanism is as follows: In the presence of the enzyme 5-alpha-reductase, testosterone becomes dihydrotestosterone (DHT). When this happens, the hair life cycles speed up. Instead of being approximately 3 years, the life of each hair is shortened significantly, giving way to the emergence of a new hair long before normal. The problem is that an indefinite number of hairs do not emerge from one follicle. There is not an infinite number of cycles. When the number of cycles that is programmed genetically has been reached, the follicle will die and, therefore, no more hairs will emerge.
Male and female hair loss patterns are very different. Whereas in men alopecia usually begins from the forehead and the crown of the head advancing gradually, in women alopecia is presented in a much more diffuse pattern on the upper part of the head.
On a botanical level, we highlight the use of natural extracts of saw palmetto or serenoa repens, pumpkin seeds, green tea, Reishi mushrooms, red stinkwood, Angelica gigas and Pygeum africanum. The botanical active 5-alpha-reductase inhibitors are generally used in combination with vitamin and mineral complexes such as group B vitamins, or zinc, copper and selenium.
-
Alopecia areata
This is characterised by the presentation of localised round bald patches on the head or in the beard. Although it is not known exactly what the causes of alopecia areata are, it seems to be related to the autoimmune system, which attacks its own hair follicles.
In this case, a hair transplant is not indicated since healthy follicles that were implanted into the affected areas would also be destroyed.
-
Cicatricial alopecias (Scarring alopecias)
These occur as a result of illnesses, burns and traumas.Alopecias caused by illnesses are considered primary. This means that hair follicles are attacked directly by the condition. Some of the conditions that can cause these primary cicatricial alopecias are:
-
- Follicular lichen planus (FLP)
- Chronic cutaneous erythematosus lupus (CCLE)
- Pseudopelade of Brocq (PPB)
- Folliculitis decalvans (FD)
- Acne (different varieties)
- Erosive pustular dermatosis
- Secondary cicatricial alopecias
The original tissues have been lost as a result of traumas and burns and, therefore, hair follicles have been destroyed.
If we are talking about illnesses, it will be necessary to treat the condition in order to subsequently consider a hair transplant. In any case, it will be necessary to assess the state of the scar tissue, if there is sufficient irrigation, etc. to see if a transplant is suitable.
-
-
-
Other alopecias
There are other reasons for which a person can lose their hair:
-
-
- Due to chemotherapy treatments
Normally the hair comes back after the treatment, although it is not rare for its colour and structure to be altered. - Alopecia due to stress
In situations with a lot of pressure and worries, such as a job loss or the death of a loved one, it is normal that the autoimmune system is destabilised, as well the production of hormones. This destabilisation can lead to all types of symptoms, including loss of hair, which will generally come back after the stressful episode. - Telogen effluvium
This is not really a true form of hair loss. What happens is that sometimes a large quantity of hairs enter into their final, or telogen, phase simultaneously.
The causes can be as varied as the menopause and after childbirth in women or even the arrival of autumn.
- Due to chemotherapy treatments
-
Diagnosis and follow-up of alopecia
The basis of a good treatment lies in a specialised diagnosis.
After the medical assessment, we use TrichoScan technology which allows our specialists to analyse the actual origin of the hair loss.
It is a digital analysis that measures in a non-invasive manner the density of the hair, and the proportion that is found in the growth phase (anagen) or in the resting phase (telogen).
It is the only method that combines epiluminescence microscopy with the automated analysis of digital samples. Thanks to its image archive, our specialists can analyse and demonstrate the progression of the treatment and adapt it according to the patient's response.
Hair Transplant
Before and after a hair transplant
Before considering a hair transplant, a thorough and personalised diagnosis on the type and degree of your alopecia must be obtained, since not all alopecias are candidates for a hair transplant.
If the patient corresponds to the transplant profile, all the required pre-operative tests are carried out and the number of follicular units to be transplanted and the number of approximate hairs that this will result in is agreed on with the patient.
After agreeing on the number of follicular units, the first line of the transplant is designed in a personalised way. For this, our surgeons take into account the natural emergence of our patient's hair, their physiognomy, as well as their personal needs.
Patients who are considering a hair transplant must be aware that the final outcome of the transplant will not be visible until approximately 9 months from the date of the transplant, and that during the 15 days following the procedure it is recommended that you do not do any sport or contact activity.
One of the factors for the success of the transplant is the post-operative treatment. Our unit carries out post-transplant reviews after 24 hours, after 3 days when the first wash is done and our patients are shown how they should wash their hair during the following washes to promote the survival of the hair follicles, after 15 days and after 3 months, 6 months, 9 months and 1 year when the check-up TrichoScan is performed again.
Hair transplant techniques
The mechanised manual transplant follicular unit extraction (FUE) technique that we use allows us to extract hair from the donor area of the head, and, if it is not very abundant, from other areas such as the legs or arms. The intervention using the FUE technique does not involve stitches or scars.
Within the FUE technique we differentiate:
-
-
- NON SHAVEN FUE TRANSPLANT: Minimally invasive technique that goes completely unnoticed since the hair is not shaved. The patient resumes their routine almost immediately.
- FUE TRANSPLANT: Minimally invasive technique where the patient's hair is shaved.
- NON SHAVEN FUE TRANSPLANT: Minimally invasive technique that goes completely unnoticed since the hair is not shaved. The patient resumes their routine almost immediately.
-
Non shaven FUE technique
-
-
-
- With this technique, the extraction of follicular units is carried out in a less invasive manner. With a 0.8 mm punch, the grafts are extracted one by one leaving a small wound that does not require stitches and that will heal spontaneously, without subsequent visible scars.
- After extraction of the follicles, implantation then takes place in the recipient area, following the design previously agreed with the patient.
- This intervention is longer in terms of time, due to the individual extraction of each one of the follicular units.
- The NON SHAVEN FUE hair transplant technique allows an individual extraction of follicles from various areas without it being necessary to shave the donor area. This technique is performed without stitches or cutting the donor area, and without invasive surgery being necessary.
- This technique allows the patient to resume their daily routine a few days after the transplant since, as the hair has not been shaved from the donor area, the transplant goes completely unnoticed.
-
-
-
FUE Technique
- With this technique, the extraction of follicular units is carried out in a less invasive manner. With a 0.8 mm punch, the grafts are extracted one by one leaving a small wound that does not require stitches and that will heal spontaneously, without subsequent visible scars.
- After the extraction of the follicles, it is proceeded to the implantation in the recipient area, following the design previously agreed with the patient.
- This procedure is longer in terms of time because of the individual extraction of each one of the follicular units.
- The FUE hair transplant technique allows the individual extraction of hair follicles from various donor areas after the area has been shaved. This technique is performed without stitches or cutting the donor area, and without invasive surgery being necessary.
- With this technique, the extraction of follicular units is carried out in a less invasive manner. With a 0.8 mm punch, the grafts are extracted one by one leaving a small wound that does not require stitches and that will heal spontaneously, without subsequent visible scars.
-
Phases of the FUE and non-shaven FUE hair transplant
-
1.- DESIGN: The surgeon makes a design on the patient's scalp, and determines the areas that need to be implanted. This prior study is based on the degree of alopecia and the possibilities that the donor area offers.
2.- ANAESTHESIA FOR DONOR AREA.
3.- EXTRACTION OF GRAFTS: The medical team extracts grafts individually using a punch.
4.- ANAESTHESIA FOR RECIPIENT AREA.
5.- IMPLANTATION: Grafts are introduced in the recipient area according to the design created by the surgeon.
6.- POST-OPERATIVE: We carry out a comprehensive follow-up of the patient.
Hair transplant outcomes
The time of the procedure depends on the number of follicular units to be implanted. When the procedure has been completed, patients will not be able to carry out any physical overexertion for a minimum of 15 days, and they will be able to wash their head on the date that the surgeon indicates after the transplant. The transplanted hair will fall out a week after the procedure, and two months after it will begin to grow one centimetre every month. The final outcome can be seen from 9 months.
We stand out for guaranteeing a comprehensive post-transplant treatment. Our trichologists carry out a follow-up of the transplanted follicular units to ensure their future vitality. Our hair transplant specialists are members of the International Society of Hair Restoration Surgery (ISHRS), a benchmark international body in the field.
Eyebrow trasplant
This technique is used for the partial or total repopulation of eyebrows both in men and in women. The FUE technique that we use guarantees a natural result and total survival of the transplanted follicles.
Trichology Treatments
Once the hair diagnosis has been established, and the TrichoScan has been carried out, our specialists prescribe the most rigorous, least invasive and most effective trichology treatments.
Depending on the patient's profile, a personalised treatment may consist of:
- Next-generation drugs of proven medical efficacy.
- Topical use treatments to strengthen, delay and slow down hair loss.
- Magistral formulas for topical or oral use.
- Hair mesotherapy, formulated exclusively for each patient, where micro-injections of Platelet-Rich Plasma (PRP), drugs, amino acids and vitamins that are delivered through the intradermal route directly accessing the follicle, can be combined.
- Natural origin tablets that combat hair loss.
Our trichologists have developed MesoActive IMR, a magistral formula that we inject into the hair dermis made up of a cocktail of vitamins and drugs of proven efficacy in androgenetic alopecia that stimulate tissue regeneration and the growth of the hair follicle.
MesoActive IMR is injected through small infiltrations into the scalp using a very fine needle that does not require anaesthesia. The patient can resume their normal routine immediately after the mesotherapy session.
In our Hair Treatments Unit, we work and actively research to always offer the most innovative, least invasive and most effective treatments.
Hair Transplant Areas
The recipient area of the hair transplant is normally the head, but transplants are increasingly being carried out in other areas of the body.
The head
A good design is fundamental so that the outcome is as natural as possible. In addition to the design a good hair transplant surgeon will take into account the availability of hair follicles in the donor areas, as well as the predictable advance of androgenetic alopecia to leave follicles in reserve for future touch-ups.
In men, the destination of the grafts will be mainly the forehead and the crown.
In women, androgenetic alopecia is presented in a much more diffuse way, thinning out on the upper part of the head. This upper part, together with the forehead, will be the priority recipients of implants.
Eyelashes
The expression of eyes with eyelashes is completely different to eyes that do not have them. The number of grafts that are usually carried out is between 25 and 40 per eye.
As the hairs of transplanted follicles grow faster than the original ones on the eyelids, it will be necessary to trim the eyelashes regularly and to give them suitable curvature. Surely this is not a disadvantage for people who have decided to have long and abundant eyelashes.
Eyebrows
Their original function, as with that of the eyelashes, was to protect the eyes from sweat and foreign objects. However, currently they above all fulfil a primary aesthetic function.
As with grafted eyelashes, they will require regular maintenance as they are hairs which grow faster.
Beard and moustache
Many people attribute it to the fashion of hipsters. The truth is that beard and moustache implants have continued to increase in recent years. The perception that the majority of women have is that a man with a nice and tidy beard is more attractive and manly.
On other occasions, the aim is to hide scars on the face with which many men doubly improve their image.
The pubis
This is the least well known hair transplant. It is usually women who opt for this treatment. Generally, it is to recover the hair density that they have lost after the menopause or due to illnesses.
Unlike the other transplants in which the donor area is the back of the head, in this case follicles from the groin area and the underarms are also used.
