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Best Orange County Hair Restoration

Hair Transplant Surgical Methods

Thinning hair and hair loss affect millions of people, regardless of age or sex. Thinning hair and premature balding, which is heavily influenced by genetic and hereditary characteristics, can lead to low self-esteem and self-confidence. However, hair loss does not have to be permanent, and, in many cases, can even be reversed using hair transplantation.

There are two main types of hair transplant surgical methods for treating baldness patterns and hair loss at CosmetiCare: Follicular Unit Extraction (FUE) and Follicular Unit Transplantation (FUT). These hair restoration procedures work by taking hair from the back and sides of the head and move them to the areas where individuals are experiencing hair loss.

FUE is performed through using a small punch to cut each follicle, removing the entire graft. This procedure can cause minor scarring that is not typically visible, and it might take multiple procedures to gather the number of grafts required. Many individuals prefer FUE as it is less invasive than FUT, and it could provide more flexibility when it comes to hairstyling in the future, making shorter hairstyles more possible.

FUT, otherwise known as the “Strip Method,” involves the removal of a linear ellipse-shaped incision. This makes it possible to acquire a large number of grafts in one procedure, without the need for shaving of the head prior to the procedure. The wounds left behind are typically stapled or sutured closed and can leave linear scarring – although this can be covered by the surrounding hair.

While the methods for acquiring the grafts differ, transplantation is more straightforward. Our board-certified plastic surgeon will need to place the grafts where needed to ensure the most natural-looking coverage, and best lasting results. This is done by making incisions in the scalp and directly inserting the grafts manually.

With surgical hair transplants, it can take 3-4 months for new hair growth to begin. All new hairs should be growing 8 months after the procedure, and it can take up to 18 months for the hair to reach full maturity.

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Follicular Unit Excision (FUE)

The Follicular Unit Extraction (FUE) method removes individual follicular units from the scalp in their naturally occurring groupings of about 1-4 hairs and are then placed in the areas of the scalp where balding has occurred. The end result is a natural looking hairline with no linear scar on the back of the head like you get with the Strip method and your recovery time is quicker.

Lifetime total ability to extract grafts with this method is probably around 4000-5000 grafts. With the strip method, a 2500-3000 graft strip can be taken out on one or two occasions, each time removing the previous scar so you only have one scar of 1-4 mm width results. This scar is not apparent when your hair is longer than a buzz cut.

In persons with prior strip hair transplants, it is best to switch to FUE. In the FUE method, using the suction-assisted 1.0 mm – 1.25 mm punch, 1000-2500 grafts can be harvested from a full donor area at least once. Depending on the thickness of the hair, an additional 2000 can be harvested at a later date once the donor area has healed. If the patient has very fine or thin hair, unfortunately this will not be an option. It is also important to not take too much hair by FUE in a patient that has thin hair, as the donor will develop a thinned appearance. A Class 6 bald person requires 6000 to 8000 grafts to fully transplant his head. With the new Double Mega Procedure, this can be accomplished by one strip graft of 2500 to 3000 grafts, followed by a FUE procedure done at about two weeks later with an additional 2500 grafts, giving about 5000 grafts over a period of two and one-half weeks. As the years go by and a person with this type of transplant it will require some additional hair to fill out the hair’s appearance, this can be obtained by the FUE method.

For patients who are looking to treat scalp or hair thinning issues before undergoing a hair transplant procedure, or to assist in hair transplant aftercare, CosmetiCare also offers PRP and Keravive treatments to assist you in your hair growth journey.

Request a consultation online or call 949-718-6900 to learn more or to
schedule your complimentary hair restoration consultation at CosmetiCare. With a convenient location in Newport Beach, CosmetiCare makes it easy to look and feel your best.

Follicular Unit Transplantation (FUT)

Follicular Unit Transplantation is a method of hair transplantation sometimes called “The Strip Method.” During FUT, a strip of the scalp is removed from the patient’s DHT-Resistant donor area. The strip contains the donor hairs along with their hair follicles, sebaceous glands, and blood supply.

The strip is dissected under magnification to prepare individual grafts. Follicular clusters are segregated in their normal 1, 2, 3 and 4 hair units. The surgeon then meticulously creates the receptor sites at the correct angle, direction and pattern of your original hair. Each graft is carefully placed to allow enough blood to nourish every hair during the brief healing process (called recapitalization). You must follow your post-op instructions very carefully so that you heal correctly for maximum results.

Because we exclusively use naturally occurring follicular hair clusters of 1, 2, 3 and 4 hairs, any future hair loss will not result in unnatural appearing “islands” of transplanted hair. Your donor area is closed with sutures or sometimes, surgical staples, and then covered with a bandage. The resulting scar is very thin and when healed, very difficult to detect with a haircut longer than a buzz cut.

The FUT hair transplant procedure has some important advantages and disadvantages when compared to the other leading method, Follicular Unit Extraction (FUE). We are proud to offer both, and you can view the side by side comparison below.

For patients who are looking to treat scalp or hair thinning issues before undergoing a hair transplant procedure, or to assist in hair transplant aftercare, CosmetiCare also offers PRP and Keravive treatments to assist in your hair growth journey.

Request a consultation online or call 949-718-6900 to learn more or to schedule your complimentary hair restoration consultation at CosmetiCare. With a convenient location in Newport Beach, CosmetiCare makes it easy to look and feel your best.

The FUT hair transplant procedure has some important advantages and disadvantages when compared to the other leading method, Follicular Unit Extraction (FUE). We are proud to offer both at CosmetiCare, and you can view the side by side comparison below.

How Will I Look and Feel After

FUT Hair Transplant / Strip Method Advantages:

  • Cost-Effectiveness: FUT/Strip Method is typically less expensive than FUE simply because it is less time-consuming.
  • More Grafts Per Session: A physician can transplant a greater number of hair grafts in a single session of FUT than is possible using FUE. Typically, with FUT, a physician can transplant 4,000 follicular units or more in just one session.
  • Maximum Grafts Harvested
  • No Need To Shave Head
  • One Fine Linear Scar
  • Less Surgery Time
  • Cost Less
  • Scarring: The FUT procedure produces a long, linear scar where the strip of donor hair is removed. Although the scar is usually very thin and nearly undetectable when fully healed, it is still there.
  • Longer Recovery: Due to the nature of the Strip Method, the donor area will require a longer time to heal, depending on your characteristics. Approximately 10-15 days.

Post-Operative Care- Hair Restoration

Below are our general after-care instructions following a hair transplantation. At the bottom are specific instructions for each day following your hair transplant.

Before you leave our facility, we will make sure that all bleeding has stopped. It is unusual for any bleeding to occur after leaving. However, if you observe any bleeding at any time after leaving, put firm and continuous pressure over the area using the palm of your hand, for 20 minutes, or until the bleeding stops. Although it is highly unlikely, if brisk bleeding should occur, maintain firm and continuous pressure directly over the area and call us at 949-718-6900.  It may be necessary to return to our medical facility to simply place a suture over a bleeding point. If bleeding cannot be controlled by pressure and you are unable to contact our medical facility by telephone, please go immediately to the nearest urgent care or emergency hospital.

Medication Instructions – See Post-Operative Care Details Below

You will have some scabbing or crusting in both the donor and recipient areas. To help minimize the duration of each and to expedite healing, we recommend following the routine below. These two items are very important for the proper healing of your grafts, and to minimize the chances of excess scaring.

Is there a fee for your hair loss consultation?
No, we do not charge for a hair loss consultation.
Care of Donor Area
CARE OF DONOR AREA (the sutured or donor area in the back) – Apply a thick coating of antibiotic ointment, Aquaphor or Vaseline (purchased over the counter at a drug store) across the donor area two times a day starting on Day 4 following your procedure. When the wound stops forming scabs and the wound looks clean and the sutures are easily seen, you may stop the daily ointment treatment. Keeping your wound greasy and covered with any of the above ointments will shorten the healing time and minimize the size of final appearance of the scar. Do not put the ointment on the grafts.

You may shampoo your scalp 36 hours following the start of your procedure (the evening of the day after your procedure).  For the first seven (7) days you must use the Cup Method to wash your hair and scalp.

The Cup Method: To wash the recipient (where the grafts were placed) area, pour a small amount of baby shampoo into a large clean cup and then fill the cup with water and stir creating a soapy solution. Gently pour the solution over the grafted area and repeat at least two times. Then fill the cup with non-sudsy water and pour it over the grafted area and rinse the area until all the soap is washed out.For the first two weeks use a mild dandruff shampoo or baby shampoo.

Extremely important: Do not allow the shower stream to hit the grafts directly for 7 days (use the Cup Method of rinsing). On the 7th day, you may shower normally, allowing the shower stream to hit the grafts, as long as the stream is gentle. You should gently massage your donor area while shampooing, but any vigorous massaging is discouraged as it can damage the donor site.

Within one (1) week after your procedure, the crusts will begin to come off while shampooing. At the same time, or soon thereafter, the short shafts of your transplanted hair may begin to drop out. This is expected, normal, and usually occurs between weeks one through six following your procedure. You may encourage the removal of the scabs by gently rubbing your recipient area(s) with your fingertips (not fingernails) while shampooing. This will also help to loosen the scabs over the grafted area. Begin this process on the 8th day following your procedure.

You will begin to see growth in the transplanted area approximately four (4) to six (6) months after your procedure. It’s important to note that the hairs go dormant for three (3) – four (4) months. You may not experience full regrowth of your hair for 9 to12 months after your procedure. Each person is slightly different. After your hair begins growing, it normally grows approximately one-half inch per month (six inches per year).
 

  • A warm (not hot) hairdryer and mild hair spray may be used carefully after shampooing, beginning on day 8 after the procedure. Do not use hair or scalp coloring agents for fourteen (14) days after your procedure.
  • You will be able to continue most of your usual activities immediately, but strenuous or excessive exertion should be restricted for fourteen (14) days.
  • Days 1-10 after the procedure: NO EXERCISE. Do not bend over at the waist. Keep your back straight and bend at the knees to pick something up. Walking is fine; keep the head above the heart.
  • Days 10-14: Light exercise, like walking. (NO profuse sweating).
  • Day 15 and on: You may resume all activities including getting a haircut, using minoxidil (Rogaine and others) on the transplanted area, using sunblock, “perming” or coloring the hair and wearing a hairpiece with adhesive. If you have other specific questions, be sure to ask before leaving.
  • No swimming for four(4) weeks after surgery.
  • Do not tan (or sunburn) your recipient areas for three (3) months after your procedure, this will help avoid possible hyperpigmentation (discoloration) of the recipient sites. Cover your head when in the sun for longer than 15 minutes.
  • Typically, when the frontal hairline is being grafted, swelling occurs over the forehead and eyelid areas. This swelling usually peaks on day three (3) or four (4) after your procedure and typically resolves itself. Sleeping sitting up in a recliner with your head elevated along with icing and massaging of the forehead will help minimize the swelling (see instructions below).
Ice and Massage to Reduce Forehead Swelling

Take an ice pack or a package of frozen vegetables and apply to your forehead for no more than 20 minutes at a time. DO NOT let the ice pack touch the grafts – use some type of cloth to cover and protect your new graphs. Following the icing, use your fingertips to lightly rake fluid away from your forehead and toward your temples. Do this ice and massage routine four (4) to five (5) times per day with each session separated by about 90 minutes (1 ½ hours).

Numbness, tingling or similar sensations may occur temporarily on your scalp and are the result of cutting tiny nerve endings in the skin during the course of taking donor grafts and creating recipient sites. This all most always disappears within a few months, as nerve endings regrow.

If, at any time after the second day following your hair transplantation, any raised or red areas occur in your donor or recipient sites, please contact us at 949-718-6900.
Your first check-up appointment is at the time of your suture removal, if we used the Strip method for your donor site, but we will be happy to see you at any time if there are any problems.

Hiccups can be a rare side effect of the medications used during the procedure, usually mild and limited to two (2) or three (3) days following the procedure. If the hiccups become severe enough to interrupt your sleep or cause pain, please contact us at 949-718-6900 or your primary doctor.

Post-Operative Care Detailed Instructions By Day

First Night

Pain

FUE – the non-steroidal, non-narcotic Ketorolac (Toradol) pain medication given during the procedure should prevent any significant pain.

  • If you have breakthrough pain, take 1 narcotic hydrocodone/acetaminophen (Norco) tablet.
  • If the pain persists after one hour, take one more tablet
  • You may take up to two tablets every six hours if needed

STRIP (FUT) – the incision in the back will hurt once the anesthesia wears off

  • Please take one narcotic hydrocodone/acetaminophen (Norco) tablet after eating prior to the anesthesia wearing off- within several hours after the procedure
  • If the pain persists after one hour take up to two tablets every six hours as needed

Swelling

You may be prescribed steroids to help with swelling if need be.

Sleep

You should be able to sleep by just taking your pain medication.

Reminder

  • Sleep with your head elevated above your heart – propped up on pillows, or in a recliner.
  • For strip patients, a neck pillow support takes pressure off the incision, making sleep more comfortable. DO NOT bending over.
  • If you do not tolerate Ketorolac (Toradol) or hydrocodone/acetaminophen (Norco), you may substitute with non-prescription plain acetaminophen (Tylenol) by itself or in combination with a nonsteroidal such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn). Follow the label dosing directions.
  • If you need a sleep aid and do not tolerate Zolpidem (Ambien) for sleep, you may substitute diphenhydramine (Benadryl), 1-2 tablets.
  • If you feel the headband bandage is too tight, with pain/redness/swelling, unwrap the outer self-sticking bandage, and rewrap less tight, keeping the underlying gauze non-stick dressings in place.
  • If you are still having significant pain despite taking two (2) Norco every 6 hours, please contact us at 949-718-6900.
  • If you have bleeding that does not stop after your hand compression for 20 minutes or distinct swelling under the strip incision, contact us at 949-718-6900.

Days 1, 2, and 3

  • HEADBAND BANDAGE – Maintain for at least 3 full days post-op
  • PAIN PILLS – Take as directed, only if necessary. FUE patients typically require only a few days of Tylenol or Ketorolac. STRIP patients typically require Norco in addition to ketorolac (Toradol).
  • SLEEPING PILLS – Take only if necessary
  • SWELLING PILLS – Continue daily decreasing the dose
  • EXERCISE – No vigorous exercise for at least 10 days. Walking is fine. ALWAYS keep your head above your heart during the first 10 days.

Days 4 and 5

  • HEADBAND BANDAGE – May remove to take a shower. Use warm soapy water; clean scalp gently using baby shampoo using the Cup Method.
  • Reapply ointment (antibiotic, Aquaphor or Vaseline) over donor punch sites and/or incisions for faster healing.
  • Put a clean towel over your pillow each night. Finish steroid anti-swelling pills (if prescribed).

Days 7-10

  • You may wear a loose-fitting hat during this timeframe, but make sure it doesn’t rub your incisions or grafted area.

After Day 10

  • If we used the STRIP method during your procedure – suture removal needs to be completed between day 10 and 14
  • Contact us if you develop pimples in the donor or recipient area, increasing swelling, redness, or pain
  • May resume vigorous exercise after two (2) weeks and/or swimming after four (4) weeks
CoolSculpting Before & After

FAQs

Is there a fee for your hair loss consultation?
No, we do not charge for a hair loss consultation.
Is transplanted hair permanent?
Yes. Hair placed in balding areas will keep their native characteristics and remain permanently, but it may take up to one year to see your full results
Will I get all my hair back with one procedure?
Typical thinning occurs over years or even decades. The answer depends on the extent of your hair loss and the quality of your donor hair available. Most people have between 80-85 hair follicles per square centimeter. During your procedure, we can safely place approximately 25-30 hairs per square centimeter. So, if the top of your head is completely bald, then we can get you back to about 30% density in one session. If you’re thinning, then you have hair already in the area and we can add more density and it may look like a full head of hair in typically one procedure. Many patients are very happy after one procedure, as they see strong improvement after 12 months. If you are completely bald in specific areas, most patients require two (2) to three (3) surgeries over two (2) to five (5) years in order to get back a full head of hair and replace what they’ve lost over the years.

It’s important to keep in mind that a hair transplant does not prevent you from continuing to lose hair. You’ll keep the newly transplanted hair, but the other hair in the transplant area will continue to fade, hence the need for more procedures down the road.

Am I a good candidate for a hair transplant procedure?
It depends. There are many factors involved in order to determine if you are a good candidate for a hair transplant. Some of these factors are your age, the cause of your hair loss, supply vs. demand (i.e., how much you’ve lost and the quality/quantity of your remaining donor hairs), and your expectations. However, you will need to set-up a consultation and walk through the process with our patient coordinators and Dr. Adair for a final determination of your cadency and options for improvement.
Are the procedures painful?
A properly performed procedure should be nearly painless. After you are numb, you shouldn’t feel anything during the procedure, if by chance you do, just tell your doctor and he will numb the area some more. After your procedure, there will be some slight discomfort over one (1) to three (3) days immediately following the procedure and the doctor will prescribe medication to help alleviate your pain. We’ve had patients explain to us that after an FUE procedure it feels like a sunburn on the back of your head for a day or two. Each method, FUE or FUT/Strip, will have specific post-operative care and different timeframes to fully heal.
How long is the healing and recovery period?
There will be some redness and crusting/scabbing where the grafts were placed that gradually resolves over the first few days and is mostly unnoticeable within eight (8) to 10 days after the procedure. With FUT/Strip surgery, the donor area usually looks normal immediately after surgery as the area is stitched up after the strip is removed. We will also schedule a suture removal appointment for you between 10 – 14 days after surgery. For FUE, it takes about a week for the donor area scabs to heal. Within 30 days you are nearly completely healed with most scars and scabs completely gone.
How long does it take to see results?
The newly transplanted hairs go dormant for three (3) to four (4) months. After this, new hairs will grow at a rate of about half an inch per month, or six (6) inches a year. The new growth is very gradual and does not all grow at the same rate. We often see small sprouts at about the six to eight month mark, but it normally takes 12+ months to see full growth.
How much does a hair transplant procedure cost?
This is one of the most common questions we get. Our grafts are priced in small, medium or large areas and your patient coordinator can walk you through what your costs will depending on (FUE or FUT/Strip) used. Typical costs run between $8,000 to $12,000+ depending on the above factors.
How long does the surgery take?

This depends on the number of grafts being placed and the type of procedure. Smaller procedures (<1500 grafts) will take about four (4) hours. Larger cases of 2,500 – 3,500 grafts can take all day (6-12 hours).

Is financing available?

Yes. We work with Care Credit, GreenSky and Alphaeon. All of these providers offer a variety of options including 0% interest, on approved credit. There are also other options to pay over 48-60 months at a lower monthly fixed rate.

Can I drive home after surgery?
We require that each patient has driver to get them home after their procedure. This is for your safety as you are given sedation medication during the procedure which may make it unsafe to operate a vehicle after your procedure.
Will other people notice that I had a surgery?
For a few days after the surgery, you will have some tiny scabs and other evidence of surgery. These typically subside after five (5) to seven (7) days. You can conceal these with a hat (must be loose and not rub your donor area or new grafts) or existing hair in the area, but you will need to be careful of the surgery site. If you are adding density to existing hair, then it will be very difficult for people to see unless you let them inspect the area. If you are adding grafts to an area that is completely bald, then people will be able to see evidence for up to two (2) weeks after the surgery.
Compare Surgery Types FUE Extraction FUT Strip Method
Surgery Invasiveness Minimally Invasive Moderately Invasive
Donor Harvesting Extracted one by one Extracted from strip
Donor Scarring Tiny circular scars Long fine linear scar
Donor Healing Time 5 to 7 days 14 to 30 days
Donor Size Requirement 50 – 70 sq cm area 1 sq cm wide
Donor Closure type None required Sutures
Pain Discomfort None to Minimum Minimum to moderate
Return To Work Next day 2 days
Exercise or Activities Minimal activities for 14 days None for 14 to 30 days
Haircut Length Shave donor area Any length
Graft Harvest Limits 3000 max per session 5000 max per session
Procedure Time 4 – 12 hours 4 – 7 hours
Cost Per Graft Range Small, medium, large area Small, medium, large area

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Verified Patient Reviews

When it comes to your face you have to be very selective and so we went to the best. Dr. Niccole and the staff helped me feel comfortable through the entire process. I wanted to straighten the bridge and the tip was large and too long. He was honest about expectations and results. I was surprised at how minimal the pain was, more pressure than pain, and didn’t need to rely on the pain medication. I look in the mirror now and I’m just amazed and what he was able to do.

May 12, 2020


I had my very first cosmetic procedure for a Rhinoplasty with Dr. Niccole. He made me extremely comfortable through the whole experience and gave me the natural result I was hoping for. I broke my nose two times so not only did he smooth out my bump, but I can breathe so much better now! If you don’t want people to notice you’ve had a surgery but would like a more refined nose that fits your face, I highly recommend you to see Dr. Michael Niccole.

May 12, 2020

Cosmeticare is outstanding!!! I first had a breast augmentation and rhinoplasty about 10 years ago. I interviewed several Drs., and on the recommendation of a friend, went to see Dr. Niccole. It was a “no brainer.” The treatment, professionalism and atmosphere were leaps and bounds above the norm. I was so happy with the advise and my outcome, I return a few months ago for a Tummy Tuck and Lipo. I am approaching 60 yrs. old. Great decision! I am thrilled with the results and the whole experience

Aug 23, 2019


Absolutely love Cosmeticare! The staff members and providers are amazing, I could go on and on about the talent of the providers. Five stars all the way!

October 11, 2019

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