BioEnterics intragastric balloon is introduced besides bariatric surgeries as overweight or obesity treatment. It is a non surgical temporary aid. The procedure is done ambulatory and does not require general anesthesia.
Beside the surgical treatment of obesity there is also less invasive method how to help to loose weight already tested in practice. It represents temporary placement of a silicone balloon into the stomach (BIB, Bioenterics Intragastric Balloon). Soft, expandable balloon is filled with blue colored solution of around 500ml that partially fills the stomach. Patients have then the feeling of fullness even after eating smaller amount of food.
The actual procedure of placement of the balloon in the stomach is less burdening for the patient than the surgery (e.g. laparoscopic gastric banding). It usually does require neither general anesthesia nor hospitalization; it is an out-patient procedure. It is performed through endoscope camera that examines the stomach. The procedure takes approximately 20-30 minutes and the patient can return home after short relaxation and check up by the surgeon. Feeling of fullness and nausea and tension to vomit can occur for a few days after the placement. It is possible to have the intragastric balloon in the stomach only for 3-6 months to avoid its damage and following complications. The leakage of blue colored dye in the solution would cause a change in the color of urine which is the signal for immediate check up by the surgeon who has placed the BIB System. The BIB is removed the same way it was placed through endoscopic way.
This method is based on simplification of weight reduction. The extent of weight loss with the help of the balloon is around 10 to 20 kg. It depends on the level of adherence to the diet – smaller portion of meals, which is caused by BIB System. The time period of maintaining the weight loss after the removal of balloon is essential. It mainly depends on the fact if you maintain diet changes and exercise activities.
BIB is recommended especially for people considered extremely overweight with BMI over 50 as a preparation for gastric banding. It is good to reduce the high risk associated with the surgical procedures in these patients with BIB System prior to the surgery. Intragastric Balloon is also suitable, low invasive and effective aid for overweight treatment even for patients that are not prescribed for bariatric treatment. Although permanent effect can be achieved only in conjunction with specially prescribed diet and behavior modification program. BIB System is not covered by Health Insurance Company.
Obesity is a considerable health, mental and aesthetic problem. If the traditional treatment brings no results, it is possible to use a surgical solution and undergo laparoscopic gastric banding.
Laparoscopic gastric banding is a surgical treatment, in involves strangulation of the upper stomach part with a special bandage. The bandage does not influence the appetite, but enables to reduce the volume of food intake and therefore leads to weight reduction.
The decision to undergo laparoscopic gastric banding depends on your Body mass index (BMI). If it is more than 40 or already 35 and you suffer from diseases caused by obesityand traditional procedures to reduce the weight are not successful, you can be a suitable candidate for laparoscopic gastric banding.
It is absolutely necessary to have good balance of mind and be without any of the contra-indicated diseases. Even a psychiatric diagnosis can be the reason for refusing a laparoscopic gastric banding.
Ideal candidates for laparoscopic gastric banding are people with a high motivation, who are ready to submit to all dietetic specifications required by the operation.
There are two basic techniques of stomach bandage, a rigid bandage and adjustable bandage.
In case of the rigid bandage, the stomach is encircled by a band of woven textile. This bandage can not be regulated.
In case of adjustable bandage, the stomach is encircled by a silicone band. This bandage can be regulated. This bandage has a ball on the inner surface, whose volume can be regulated by an injection through the skin to a special metal cell in the subcutis. The cell is connected with the ball through a tube.
Who shall decide whether you can undergo laparoscopic gastric banding?
Laparoscopic gastric banding is done by bariatric surgeons.
The recommendation for the operation is a result of an agreement between your obesitologist, bariatric surgeon and psychologist.
If the traditional treatment (diet, training of eating habits, exercise, pharmacological measures) does not have an effect, this operation can be recommended. It is desirable to undergo the operation before severe health complications connected with obesity occur.
During the consultation with a bariatric surgeon, your general state of health and mental balancewill be considered as well as the results of medical check and treatment by the obesitologist and psychologist.
The doctor will count your BMI again and consider the type of your obesity. He will inform you about the procedure and all risks, which can be connected with the laparoscopic gastric banding. You will also receive instructions about the necessary regime after the operation.
As a part of the consultation, the doctor shall decide, which type of bandage is suitable for you.
To the preparatory activities before the operation belongs a in-depth pre-operative medical check. You will probably be asked whether you take any medication containing acetylsalicylic acid (Aspirin, Acylpyrin, Alnagon, Mironal etc.). This medicaments can increase bleeding during the operation and thereafter. It is important to inform the doctor if you suffer from any drug allergy.
You should not fall ill with a contagious disease (virus disease, cold etc) during three weeks before the operation.
If you smoke, plan to stop smoking approximately two weeks before the operation and do not start it sooner than three weeks after the operation.
You should organize your transport home after the operation and assistance for one or two days, if you need it.
Laparoscopic gastric banding is done in a very gentle mini-invasive way through some little incisions.
First, the abdominal cavity is filled with carbon dioxid to uplift the abdominal wall and make it easy to inspect. An optical device with a camera is inserted through sections which are 1-2 cm long. This device provides the surgeons with a projection of abdominal cavity on a screen. The bandage is fixed to the stomach with the help of other special tools, inserted through short sections. The gastrointestinal area will not be opened during the operation.
The sections are closed with stitches, one stitch is usually enough for one section. The small wounds are then covered with a sterile plaster.
The operation always requires general anaesthesia, it means you shall sleep during the whole operation and will not feel any pain. If you have already experienced general anesthesia, you can inform the doctor about your reaction. You will have to spend some time on the clinic after the operation.
You can feel little pain immediately after the operation at the place of the sections, as well as pains connected with the absorption of carbon dioxid. It is mostly an unpleasant feeling in the place of clavicle and arms. This pains will stop very soon an can be reduced with the help of analgeticprescribed by the doctor.
The stitches will be removed in few days.
The doctor provides you with complete instructions concerning dietary measures and other necessary regime details. You will be informed about possible short and long-term post-operational complications, which are however very little in comparison with risks connected with obesity.
In case of unusual symptoms, do not hesitate to contact the doctor anytime.
The strangulation of the upper stomach part with a special bandage causes the client to feel full even after first bites at the meal. It does not reduce the appetite but the daily volume of food intake decreases without unpleasant feeling of being hungry.
In case of adjustable bandage, the volume of the ball can be adjusted during an ambulatory visit in the surgery under the control of x-ray.
The client´s weight reduces and his/her general state of health improves.
The complications connected with obesity improve as well: the amount of blood sugar in case of diabetes drops, high blood pressure decreases and joints are relieved. The general mobility improves as well, this leads to an increased expenditure of energy and other possible loss of weight.
Together with the reduction of your weight, it is your look which improves. In case of massive weight loss, you may suffer from excessive skin volume. The doctor will recommend you how to deal with this problem. He will probably suggest undergoing a treatment of plastic surgery, which removes the excessive skin.
The weight loss is connected a good mental balance of the client, connected with general improvement of state of health and general look.
The loss of weight after the operation is approximately 2 – 10 kg in a month, more than 20 kg after a year and 30 – 40 kg after two years.
The weight reduction after laparoscopic gastric banding has a long-term effect, it lasts more than 5 years.
The stomach bandage can be removed anytime, without the risk of persistent effects. The intestins return almost to their original state.
Leading cosmetic surgery provider The Hospital Group have seen an immense growth in the number of men striving to achieve a supple body shape, with the number of liposuction operations growing largely during the last year. The procedure, which contours parts of the body by removing fat, has rocketed in popularity by 117% since August 2009.
Last year, soccer ace Ronaldo was reported to have undergone liposuction to remove fat from his stomach and in line with this revelation, The Hospital Group have seen a massive increase in men wanting fast, dramatic results to achieve a trim and toned body shape.
Previously British men were keen to slim line their chests and avoid the Simon Cowell man boobs look. However surgeons have recorded a fall in demand for the gynaecomastia operation this year. Now men want to lose those love handles and get a washboard stomach instead.
Medical Director of Aesthetic Surgery at The Hospital Group, Mario Russo, said cosmetic surgery procedures are no longer such a taboo with men and that increasing pressure in the job market could be one of the reasons why men want to banish flabby tummies during 2010.
He said: “We are seeing an increasing number of men who don’t have the time to achieve such amazing body results by just hitting the gym. This, combined with increasingly tough workplace environments means men want to be looking and feeling their best, so they can perform at their best.
“Lots of celebrities are turning to cosmetic surgery to fix imperfections, with amazing results and men are no longer scared to strive for the same body shape.
“Liposuction and liposculpture provides the perfect way for men to feel good about their bodies again.”
The Hospital Group offers a number of cosmetic surgery procedures to restore body confidence, including rhinoplasty (nose job) abdominoplasty (tummy tuck) teeth whitening and bariatric procedures, as well as rejuvenating non-surgical treatments such as dermal fillers and chemical peels to turn back the clock.
The purpose of overall anaesthesia is to put the patient to artificial sleep and thus, to prevent unpleasant perception of pain caused by surgery. Up-to-date anaesthetic medicaments influencing brain activity are used for this, while the required anaesthesia depth is achieved by correct dosing. For monitoring and evaluation of overall anaesthesia depth and its quality, we use also monitoring of blood pressure, pulse frequency, relaxation quality, blood oxygen saturation and ventilation values besides the check of the clinical status of the patient. The experienced anaesthesiologist decides from these parameters, whether anaesthesia is so that the patient is in optimum stabilised status with respect of the surgery type.
Recently, the above mentioned ways of patient monitoring have been extended by a new method of monitoring overall anaesthesia quality, the so called bispectral index monitoring (BIS). This method consists in continuous scanning of electrical brain activity during surgery, signal processing and graphic and numerical evaluation on the BIS monitor screen. This non-invasive monitoring starts by sticking a special patch strip with electrodes on the patient’s forehead and connecting it with the monitor itself – without any punctures. It is very similar to monitoring electric activity of the heart (EKG) with the difference that BIS monitoring concerns electric activity of the brain, which changes in dependence on patient’s consciousness status. It is different in a completely conscious person compared to a person falling asleep, being medicated into artificial sleep or getting up from overall anaesthesia.
Plastic surgery similar to other surgical disciplines cannot exist without anaesthesia or desensitization. For the surgeon to be able to perform a surgery, it is necessary to secure painlessness of the surgery and the patient’s comfort during and after it. In principle, this can be achieved either by local anaesthesia of the treated area or by putting the patient to sleep (by overall anaesthesia).
Local anaesthesia results in absence of pain in the area subject to surgery at full consciousness of the patient during surgery. It is mostly used in operations of smaller extent and anaesthesia is applied by the surgeon by an injection in the treated area.
“Now it will bite a little bit and then you will not feel anything more”. This is the information heard by the patient from the surgeon at the operating room. Really, you will not feel anything during surgery and after its end the local anaesthesia injection continues to be effective for some time. Thus, the patient can leave for home almost immediately after surgery end.
Perfect comfort during surgery with local anaesthesia can be even enhanced by administration of medicaments influencing the overall status of the patient. They decrease the patients’ fear of the surgery, restrain pain in a complex way and result in a status of fatigue and the need of closing one’s eyes and having a nap. This combination with local anaesthesia is called analgosedation. Its administration in our Clinic already belongs into the hands of an anaesthesiologist. This type of anaesthesia is very pleasant, but it requires a longer stay at the clinic and a person for accompanying the patient home as the effect intravenously applied medicaments fades out only slowly. It is ideal for those who do not want to see, to hear and to feel anything, are not in a hurry and fear overall anaesthesia (narcosis). Analgosedation can be used only in selected surgeries of smaller extent where the patient’s stay at the bed department of the Clinic is not necessary.
„As a surgeon, I appreciate top technology used for anaesthesia in the LAUREA clinic. On the BIS monitor screen I can see that the patient is exactly in the narcosis depth necessary for the surgery being performed.” says Dr. Josef Hrbatý.
Surgical interventions of bigger extent, with the necessity of a stay at the Clinic, are performed in overall anaesthesia (narcosis). It is an artificially introduced status, during which the patient is in artificial unconsciousness, feeling no pain and with muscles relaxed. The patient gets intravenously medicaments with pronounced, immediate effect and falls asleep within a few seconds. These medicaments “switch off” consciousness, interception of pain, but also breathing (an apparatus breathes for the operated patient). Their administration belongs into the hands of an experienced physician – an anaesthesiologist carefully following basic life functions of the patient, his/her consciousness status and/or depth of artificial unconsciousness, parameters of artificial ventilation and the bloodstream status during the surgery itself. One can say without exaggeration that the life of the patient is in the hands of the anaesthesiologist during surgery. The anaesthesiologist has, besides knowledge and experience, the monitoring devices showing graphically all vital functions of the sleeping patient’s body in order to maintain the patient in a stabilised status with sufficiently deep narcosis. Thus, the anaesthesiologist can react immediately in case of any deviations. This is the reason why it is not necessary to fear overall anaesthesia any more. Thanks to up-to-date anaesthesiologic devices, perfect monitoring technique, advanced medicaments (anaesthetica) with minimum side effects, overall anaesthesia is very safe at present. We in our Clinic focus very carefully on providing our patients with the best of what the present medicine can offer.
To gather all necessary data on the patient’s health status for the anaesthesiologist, the patient must pass the pre-surgery examination. Its aim is to detect his/her overall health status and/or find hidden problems that could influence anaesthesia course and the surgery result. Thus, all our patients pass such an examination before surgery as well as a detailed interview with the anaesthesiologist before surgery. Sense of such thorough prevention is unequivocal. In this way, we exclude anything that could adversely influence smooth narcosis course. Only if this thorough pre-anaesthesia examination has satisfactory results, the patient gets an injection for overall calming and inner stabilisation (pre-medication) and leaves for the operation room. After surgery end, the patient wakes up in the operation room within a few minutes. As soon as his/her status is stabilised and signs of overall anaesthesia fade out, he/she leaves for the bed department of the Clinic where all his vital functions continue to be monitored in the same way as during surgery and medicaments mitigating pain, if any, are administered.
Dr. Radoslav Hujňák: „BIS Monitoring means safety, quality and certainty for the patient.“
Anaesthesia at the LAUREA Clinic is a team work of experienced physicians and erudited nurses. Our aim is top quality of our work, as the life of the patient is in our hands. We cannot allow anything below absolute top quality.
… Is it necessary to pas the pre-surgery examination before overall anaesthesia?
Yes, it is. The patient gets medicaments (anaesthetica) during overall anaesthesia that influence all the functions of his/her body. The pre-surgery examination aims at detecting all disorders that – combined with overall anaesthesia – could expose the patient to failure of vital organs. It is a thorough check of your body before you lie down on the operating table.
… Why am I not allowed to eat and drink before surgery in overall anaesthesia?
Overall anaesthesia puts out defence reflexes of the patient’s body. The stomach content (fluids and food) could return to the oral cavity and be inhaled into the lungs. Here they would cause a serious damage to the ventilation functions. Thus, it is necessary to observe the safety interval between last meal and start of overall anaesthesia. Usually I recommend a light supper with sufficient liquids and complete abstinence from eating and drinking starting with midnight.
… I am afraid that I will not fall asleep, recently I have problems to fall asleep and I repeatedly wake up at night.
Your fear is unsubstantiated. For overall anaesthesia, we use anaesthetica that put every patient to sleep within a few seconds. To the contrary of your domestic natural sleep that can be influenced by a series of spurious factors, the artificial sleep (overall anaesthesia) is deep and continuous and is influenced only by the type and amount of administered anaesthetica.
… I always feel thick after anaesthesia and suffer of vomiting. Will this repeat again?
Vomiting after anaesthesia occurs in a small percentage of our patients. The exact reason has not been unequivocally determined yet. It can occur, even if you carefully observe the pre-surgery prohibition of eating and drinking. Partly it can be influenced by the neuro-vegetative instability of the patient, by the scope and place of surgery, by administered anaesthetica and by other factors. Partly it can be influenced by medicaments limiting the occurrence of nausea and vomiting in relation to overall anaesthesia. Thus, it is necessary to inform the anaesthesiologist about this problem in the anaesthesiological interview in the morning before surgery.
… Can it happen that I wake up during surgery?
No, it cannot. The depth of the artificial sleep is determined in relation to nature and scope of surgery. It is carefully followed by the anaesthesiologist during surgery and overall anaesthesia and all vital functions of the body are monitored and shown on screens. We use up-to-date, reliable dosing devices in our operation room to secure continuous dosing of anaesthetica to the patient’s organism in order to achieve the necessary anaesthesia depth during all the surgery.
… Will I get an injection to the vein or will I have to breathe in something?
We use intravenous administration in our clinic. After arrival at the operation room, the anaesthesiological nurse shall inject a cannula to the vein in the arm of the patient and shall connect an infusion solution to it. The cannula application is the only pain that the patient has to undergo. Afterwards, the patient gets medicaments introducing artificial sleep (anaesthetica) already without pain through this cannula. The cannula with the infusion remains applied usually to the next day.
… How long after surgery will I wake up?
Vital functions influenced (put out of operation) by overall anaesthesia will restore within a few minutes after surgery end.
First, ventilation and defence reflexes are restored and after a few minutes, consciousness returns. After a while, the patient is able to open his/her eyes, to breathe in deeply and/or to grasp his hand when asked to do so. This is the normal course of fading anaesthesia. The patient is able to follow these instructions already a few minutes after the last stitch in his/her operation wound. Restoration of full consciousness and the usual communication comfort is then influenced usually by the length and scope of surgery and takes several hours, before the body metabolises and eliminates last remainders of the anaesthetica.
… Will I have the ventilation tube in my throat during narcosis?
Yes, you will. This tube (intubation cannula) is necessary for artificial ventilation during narcosis when the patient does not breathe, but an apparatus (ventilator) breathes for him/her. The cannula is introduced to the patient’s throat after his/her falling asleep and is removed after narcosis end. The patient is not aware of it at all and has no unpleasant memories.
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…
The migration of cells
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…