Bierhanzl’s ointment – a cure for baldness! A magic hair-lotion that leads to a head full of hair – the dream of 55-percent of men that suffer from alopecia (the medicalk term for baldness.) Luckily there is a certain relief; the loss of hair affects 16-percent of women as well. However, magic lotions belong only in the movies. In the real world, we have to suffer for beauty.
So I put my bald head on the surgical table and have my forehead implanted with more resistant hair from the nape of my neck. I felt like a piece of cloth in the sewing machine but I was also wondering to what extent such a surgery can change a person. Physically, as well as perhaps, mentally….
To invent a lotion, that could treat baldness and allow for a fashionable hair-style the next day, is a dream of all cosmetic producers. And because they believe it may happen, every once in a while they bring out a new and this time totally guaranteed potion in which the bald head suddenly sprouts great hair after its application.
The making of a new person – more handsome and hairy…
“I do not trust too much these magic lotions and ointments for hair-growth,” says Petr Hajduk M.D., a surgeon at GHO Clinic. “If you have an inner problem, you can hardly solve it with an external application.” In other words – neither Bierhanzl’s ointment nor an ointment from duck’s eggs will work. One possible solution may be found in pills that contain finasteride – the so far only known agent that blocks the formation of DH-testosterone, which causes baldness. There are at least four commercial preparations of this type on our market: all of them have to be prescribed by a doctor following a blood examination. The cheapest cost for these pills is around 330 CZK a month; products made in the USA cost five times more. There is only one little problem: all these magic pills have to be used long-term, which means forever in reality.
There is really only one solution for those who are serious about foresting their bald head with hillsides of hair – hair replacement. Bierhanzl’s ointment used to be for men of all types, but this surgery, called Follicular Unit Extraction (FUE,) is not that common. One graft costs 95 CZK – and surgery usually needs a thousand grafts. Although this price does include everything, from the surgery to a baguette for lunch.
The first step is the most important – do I really need a hair transplant? My hair has been thinning for several years and has moved to the corners of my head. On one hand, I am not innocent any more and can eventually talk with any woman. So I don’t need it. On the other hand – why not become even better-looking? Or at least feel like I am…Moreover I am a curious person and curiosity hurts sometimes. So let’s do it! Nowadays it is a fashionable and common procedure, something like one of the many plastic surgeries for women. At GHO Clinic both men and woman have undergone this procedure and they have even more people coming for consultations.
Everything begins with a handful of various pills – if I were a drug addict I could not wish for more!
I look at my old head for the last time – it will be bloody but hairy in a few hours!
“We will take 500 hairs from here and transplant them into the bald corners,” says the surgeon Hajduk.
A picture for my memory and to archive for the GHO Clinic – smile and look kind, and bald.
“Basically, we can divide our clients in three categories,” says surgeon Hajduk at our first session. At first he checks my hair, and then he asks me about the hair thickness of my father, grandfather, great-grandfather and several ancestors fighting in the Thirty Years’ War, and then he approves my wish to undergo the hair transplant. “The first group is represented by very young men that find out the morning after a party that several of their hairs fell out and they start to panic. I mainly recommend them to wait for a while before having the hair replacement. The second category is men in their 30’s. They slowly discover that their hair doesn’t look the same as when they were 18, but they still want to look good and run after girls – they are mentally more grown, plus they can afford such a procedure; there is usually no problem. Men around 40-years-old and older belong to the third group. They don’t do it because of women anymore – usually they have wife and a lover, something like fifty thousand crowns for a new fringe doesn’t hurt them, they just want to persuade themselves that they can manage their ageing process.”
I think about which category I belong to with my 35 years – is it because of girls or the ageing process? Sometimes I feel like that mentally, I belong under the law for the protection of minors. Considering depression from progressive baldness, I have read somewhere that there are even women that are interested more in what a man has inside of his head than on it…
“Clients around 20-years-old that really suffer from heavy and genetic alopecia and they want to solve it through immediate transplantation are the worst. It is very hard to explain to them that they might have two problems in the future. One is visual, when they loose all their hair on the back of their scalp. There won’t be a donor area for other procedures. The second problem might be financial. The forehead will be full of hair because of the grafts transplanted from the nape that won’t fall out, while alopecia might proceed and they will need another transplant and another ten thousand crowns to hide it. The problem is that it is very hard to explain this to these young men – they usually have the feeling that they can buy anything today.”
I undergo surgery the next day. I put on surgical green cloths at eight o’clock, the nurse enters and gives me a handful of pills – antibiotics to relax, a pill against allergies, a pill against bleeding and a pill against pain – the heart of a drug addict would be pleased with such a dosage. After a while I lay down on a bed, on my stomach like during a massage. Theoretically I know exactly what to expect. The hair from the nape is genetically different than on the forehead so it doesn’t react to testosterone derivate (therefore even bald men have that well-known circle.) The hairs will be transplanted to the forehead; they will fill the empty corners, so that I won’t have to stand in the corner of society in the future. Practically, I am stressed about the expectations of future situations.
The pills are working already – the world is pink and the purple UFO in front of me seems to be in the right place
I spend hours like this. I drool uncontrollably – due to the pills and the surgeon’s legs.
The anesthesia is like at the dentist – except instead of one injection to the gum, here I get fifteen into the nape.
I lose up to 50 milliliters of body liquid during the surgery – such a blood loss!
The first step is anesthesia, a little bit like at the dentist. A syringe with supracaine is injected into the nape 15 times, each a centimeter apart. I am assured that it is a dental anesthetic that work very fast, is effective for about two hours and is low toxic. I am glad that no one can see my face doing the terrible grimace caused by pain. After a few minutes, the actual removal of grafts begins. It is helped along with a drill with 4800 rotations per minute and a small needle of 0.7millimeter average. Professionally said – the hair is cut to two millimeters in length and the needle is slid onto it; the drill screws out from the tissue the so-called follicular unit. It contains one to three hairs that are inserted into a saline solution; a mixture of glucose, vitamins and antioxidants. Described by feeling – I don’t feel anything until the anesthetics stop working and the drill starts to bite into the sensitive skin.
During the numbness, I hear something that sounds like if someone would tear thin linen. It is not an unpleasant noise, it doesn’t even touch me, I tell myself while staring at the ground. My eyes are staring at the linoleum and they touch the legs of the female surgeon that is screwing out the follicular units from the back of my head. In total five hundred of them will be removed within two hours, they are precisely counted by the nurse. The regular noise of the counting device and the heavy dosage of pills are slowly putting me to sleep. I am awakened by a quiet irregular smacking – saliva is pouring out of my mouth right onto the surgeon’s sandals. I murmur words of apology. “It’s ok, it is caused by the pills,” says the voice above my head.
Finally the last follicular unit is put into the solution, I can stand up. The surgical room is dancing in front of my eyes and a look at the trash can filled with bloody dressing makes my stomach sick. I was told that I won’t lose more that fifty milliliters of blood, which is double the amount in normal blood taking. So probably I haven’t bled to death yet. David Kraus is happy with my state and he takes pictures with pleasure. The nurse helps me to my room where I have lunch. I bite a baguette with cheese and stare into the corner of the room; I avoid anxiously looking into the mirror.
I return to the surgical room in an hour. The bed has been changed into a half-seated position, a little bit like at the dentist. And again I feel like I’m under a sewing machine. Needles are inserted into my skin and they fill my forehead with anesthetics. It even stays swollen for another several days, like if a cluster of bees would have had a picnic on it. I still recall the surgeon saying: “The anesthetics will numb the operated area, plus the contained substance will contract the vessels so the bleeding will be less. It will enable us to insert the grafts into your forehead.”
A bath for hairs that were drilled from the nape – a mixture of glucose, vitamins and antioxidants.
Unfortunately I had breakfast, the anesthetics cease to work too soon and other injections are necessary.
Baguette with cheese and water for lunch – under the pills I have no idea what I am chewing.
The second round begins – 500 holes are cut into the forehead and the same amount of grafts are inserted inside of them.
Then I fell asleep. I woke up when one of the surgeons straightened my falling head. I found out only afterwards what was happening while I was asleep: Two surgeons at each side of my poor head were implanting simultaneously. “The shorter time the grafts are outside of the body the better – saving time is important, therefore two surgeons,” explains surgeon Hajduk at my checkup one month later. Five hundred bleeding small holes are made with the same titanium needle like when the grafts are drilled from the nape, but just with a smaller average size of 0.65 millimeters. I would not wish to see my head at that point! After that, the new lawn is made with the help of two forceps in this prepared bed. The first forceps serves to widen the hole and the second one to insert the graft inside. The skin is elastic, it contracts around the graft and the bulb is sucked inside. The blood drop from each wound acts like glue – the graft is strongly fixed into the skin within two hours.
The chief surgeon Hajduk looks over his job. He is satisfied and takes pictures of me looking like the Leaning Tower of Pisa; him for documentation and Kraus for the article. I don’t mind it; I am still under the pills. I can go and change my clothes. The surgeon reminds me before I leave to wear just shirts for two days not t-shirts that have to be put on over my head. I cannot drink juice, carbonated water, coffee or tea the day after the procedure. I cannot eat citrus fruit, and for three days after the procedure avoid alcoholic beverages, no sport activities for two weeks and no work – at least something positive – I mean the job!
I get home by taxi – it is four o’clock in the afternoon but the driver stares at me like I’m from the nightmare on Elm Street, luckily he doesn’t ask me anything. In the apartment, I tumble into bed and fall asleep immediately. The gauze moves from my head during my sleep and changes the white pillow into the flag of the workers’ movement. My forehead is on fire and the top of head is itching so bad that I can’t think of anything else other than scratching it; I start to read the tabloid newspaper instead.
The situation changes the next morning – itchy crusts start to form on my forehead, the marks from the holes on the nape have almost disappeared. Five days later my head looks like I fell asleep on a cactus. I leave my house only to go to the store for necessary food, in a jumper with a hood up like a hip-hop singer. Finally I can start to peel off the crusts – gently! I have never touched any women so gently as I touch the dried blood around the very short hair. Reddish brown small crusts are snowing into the sink – together with small hair! I count quickly: 56 hairs in total, with a size of two days old hair on face! Was I insensible or should I have waited another day or two? Has my aggressive haste destroyed the result of several hours’ surgery? I call the clinic immediately. “Those were only hairs that fell out, the bulbs stayed in the skin. It was caused by the shock from the change of position from the back of the head into the front, they opened and the hair fell out. It is normal even if half of the transplanted hair falls out. In women almost all of the hairs fall out. After some time new hair will grow from the bulbs, don’t be afraid.”
Not many people have their hair counted but in case of grafts everything is precisely counted – 95 CZK per piece!
Now I don’t lose blood uselessly –this time it will serve as glue for the inserted grafts.
With the speed of a sewing machine and the help of two forceps hair from the nape is inserted into the front of the head.
I see in the Czech movie “Rozpuštěný a vypuštěný,” they call it a zero stage – the rest of the old hair disappears in order to give place to new hair of a greater quality.
This stage of treatment usually shocks the patient – needlessly. It is possible to calm yourself in a sanatorium for the mentally ill and to wait until the second stage, which leads to a surprising effect – new hair flourishes on the head like on a well-fertilized field. Moreover there are the few cases with an unforeseeable development – I still have the chance that I won’t be able to psychically stand my unexpected beauty and have to leave for San Francisco where I would start a reckless life. So I wait, months pass, and I try to hide my unpleasant reactions from the apathy of others. Not even my closest friends and family noticed that I had new hair on my head; enough to definitely get me into the musical Hair even without any singing talent. So just in case, three months after the surgery, I ask the chief surgeon Hajduk during the checkup, when the surprising result would appear and I would become the handsome man that leaves for San Francisco, and lives like a gigolo. “Until the hair gets some shape, until the skin gets back to normal, until the blood vessels grow again and the bulbs start to be fully working, it takes a while – around half a year.” I am patient. The sad thing is though that really the only person who has noticed the changes on my head was my hairdresser. In spite of the broad image of barbers, he is not gay. His interest in my hair was only professional…
Exactly half a year later, I undergo second surgery – another 500 grafts, let’s call it a thickening procedure. One month later at the checkup I complain that no one has even noticed my hair change. The surgeon calms me with a story of one patient from Slovakia. “He underwent three surgeries; he was very bald – a circle on the top of the head and corners. Luckily he had a good donor place, from where there was enough to take. » Today he has a fringe almost to the middle of his face. When he meets his friends they wonder what has happened to him. He just laughs, before he tells them that he has new hair. They wonder: “Hair? You have always had plenty of hair!” He laughs even more, finally he shows them his ID with the old photo of him bald. “Oh yes, you are right, you were bald and now you have hair! But if you didn’t tell me, I would really never think of it!” So do not expect great attention from others, in case of this surgery it is mainly for your own psychological feelings. I had one slightly overweight patient from Moravia, in his 40’s, but he looked more as if he was 50-years-old. He was just about to divorce, his self-confidence was zero; he only had money left. We did several surgeries, the corners and circle disappeared. I have met him recently – he lost 30 kilos, he has a new girlfriend and he shines with self-confidence. We do not save the lives of people, but at the cost of minimum pain, we try to raise their self-confidence. Because we treat only to the depth of a maximum five millimeters and we do not cause any scars. And if we manage once in a while to improve someone’s destiny, then we are more satisfied than from all the money.
Within an hour the surgeons will plant both my corners, while I dream about my future as a gigolo.
In spite of the painful grafts I almost slept during the whole procedure – the pills are good ones!
My nape looks like this the day after surgery – the grafts disappear slowly, but they itch more.
My forehead looks as if I slept on a cactus. For the next week, I will leave my house only at night with a hood over my head.
I can confirm the statement about the surgery without scars. Nobody has noticed any change; on the other hand nobody has noticed that I have undergone hair replacement. In this respect medical science has made a great step forward. It is not that long ago when patients after hair transplant looked like they had been shot with a scattergun. For your imagination, a punch of nine millimeters average was used back then. Circles of almost one centimeter were shot from the nape and they were put into the bald part of head – without sewing, with a strong belief that the body will heal itself! And the body did – sometimes it accepted the foreign skin, sometimes not. The hair bulbs didn’t get have time to acclimatize, so only about half of the 100 nine millimeter circles survived; the rest rotted. It was necessary to come up with a new solution. So whole flaps of skin, 10 x 2 cm were cut! The cutting was then sewed with stitches and the patient looked like a samurai after a careless exercise with his sword. No hair would naturally grow at the donor place. “Sometimes there remained a small scar at the place, thin like the top of a pencil, sometimes the size of six millimeters, but I have seen a scar of ten millimeters, and once even three scars above each other, each one and a half centimeters long! The skin is elastic, so it lifts in time, but until then the patient walks permanently bent towards the sky,” surgeon Hajduk shares his experiences. I look through a book with pictures from hair surgeries that were common even recently. Such results wouldn’t be embarrassing to a makeup person for horror movies. “Truly said, not everyone was able, with this older method, to withdraw hair so that he or she wouldn’t get deeper into the skin and cut some nerves or muscles,” adds surgeon Hajduk. No wonder that even this type of method soon ended!
We live in a world of permanent minimalization, so that even the flaps of skin were gradually getting smaller and smaller – they were counted in millimeter strips but still it wasn’t right. It was difficult to insert the cut skin from the nape to the forehead – shapes and sizes of the transplant often didn’t fit well. So finally today’s method of Follicular Unit Extraction was reached. It can so far imitate nature in the best way – at least the cut circle from the nape fits to the circle cut in the forehead.
It is one year after the first surgery and half a year after the thickening procedure. I stand in front of the mirror with a picture of my old self, a reflection of today’s reality in front of me. I look back and forth from the picture to my current look – there is a change! And very visible! How is it possible that no one has noticed it? To put it right, one of my friends, a girl, noticed the other week that my hair is becoming grey. Although it looks charming. But how could the sexy blond at the next table that I literally stripped with my eyes the other day during lunch miss my hair? She didn’t wear glasses! Is it true that women don’t notice these things? So what, to hell with them! The important thing is that inside of me I feel much better, more complex, and hairier. The time I spend every morning in front of the mirror in a useless effort to fix my old-new disobeying hair with extra strong gel raises my self-confidence. And my new self-confidence must shine from me – two days ago I got an offer from a radio. I won’t fly to San Francisco! And concerning women…in any case Internet dates are very trendy today.
P.S. Hairy 35-year-old man looking for…