Hair Transplantation: How Does It Work?

*Considering hair transplantation? This interview provides essential insights into how the procedure works, what to expect regarding success rates, and crucial advice on choosing the right expert. Peter Zombori speaks with Dr. Alkiviadis Karoutis of the Swiss Luxury Clinic in Switzerland, a specialist in discreet aesthetic surgery and hair transplantation.***Peter Zombori:** Good evening, everyone. Welcome to our medical talk tonight. Our topic is hair transplantation, and I'm very happy to welcome Dr. Karoutis, co-owner of the Swiss Luxury Clinic here in Switzerland. They focus on discrete aesthetic surgery and are highly specialized in hair transplantation. Welcome, Dr. Karoutis, and thank you for joining us.**Dr. Alkiviadis Karoutis:** Thank you so much for having me. It's a pleasure to be here.**Peter Zombori:** The big question we always hear when people ask us about hair transplantation is: "How does it work? How do you perform hair transplantation?" We would be very happy if you could share a little about what you actually do.**Dr. Alkiviadis Karoutis:** I'm pretty sure this is the most common question you find online as well. Unfortunately, this sector is highly commercialized. The very simple basis of hair transplantation is that we take tissue from one area of the body and move it into another. In this case, we take grafts that carry the hair follicle from the donor site, typically the back of the head, and then surgically reconstruct an area that lacks hair follicles. That's the very general aspect of how it works.**Watch the full video here:****Dr. Alkiviadis Karoutis:** Unfortunately, there's a bit of misinformation currently because everyone focuses so much on the surgery itself. On one side, we have surgery that is heavily commercialized, and currently, you don't find a lot of doctor expertise in this. Also, many places aren't providing the necessary post-surgical therapies. So, what you often see are constant procedures after surgery without achieving a result patients are happy with, leading people into these endless loops. In general, the surgical aspect is quite simple. What truly changes is, of course, the artistry of the doctor who performs it, their precision rates, and essentially, the technique of the surgical cut is the most important thing. If you truly study it thoroughly, you can improve many aspects, including recovery times and, of course, the results.**Peter Zombori:** How do you distinguish between a highly skilled surgeon who can perform hair transplantation and, let's say, a less experienced one? Is there any hint you can offer here?**Dr. Alkiviadis Karoutis:** The main issue currently isn't so much about the doctors working in this field, especially in Switzerland, since it's a relatively small country. The problem is that these hair transplants are currently often *not* done by doctors. While you might initially meet a doctor, in most commercial centers—around 90% of cases—a doctor actually does not perform the operation for you.**Peter Zombori:** Who does, then?**Dr. Alkiviadis Karoutis:** It's often a technician, branded as a "specialist" after doing a course over a weekend, who suddenly claims to have medical knowledge. Of course, this is not legal, but this is how you find these very low-cost surgeries. Trusting an individual with no medical background or surgical training to take a scalpel, remove tissue permanently, and then place it elsewhere leads to the quite extreme examples we see online nowadays. So, my first advice as a doctor, specifically for this procedure, is always to ask: "Who will be doing my operation?" This question should be your guide to ensuring as much safety as possible because, in surgery, we can guarantee the execution and the hypothesis. The results come in probabilities, which are heavily dependent on the precise process we follow. That's why we emphasize rigorous training.**Peter Zombori:** The second big question, which you touched upon in your last sentence, is success rates. Many people get their information online, see radical failures, and think, "Okay, I'd like to have a hair transplantation, but I want to make sure the success rate is really good for me." Is there any number you can provide, let's say, between highly skilled doctors and technicians, or how would you tackle this issue of success rate?**Dr. Alkiviadis Karoutis:** The research we have for success rates only comes from studies provided by doctors and medical work. This is how it's graded, and then we get to the numbers. Usually, for purely medical surgical procedures performed by doctors, you get around a 90% success rate. Of course, this success rate only refers to the hair follicle growing into the area where it was transplanted.**Peter Zomboris:** Mhm.**Dr. Alkiviadis Karoutis:** Some other interesting aspects to consider are the damage left in the donor site—the area from which we extracted the follicles—and the amount of operations one can have throughout their lifetime. I would say, when you go with a doctor, based on the research we have from medical boards, the success rate is around 90%. Now, the only ways these operations can go wrong are if the hypothesis is incorrect—meaning we make a completely wrong estimation—or if the execution is not correct. So, typically in the execution phase, because it's surgery, if we have discrepancies in infections or in the amount of tissue we extract, then we encounter side effects that will prevent us from reaching that 90% probability of success. This is a rough way to identify your path.**Peter Zombori:** My last question, because we don't want these interviews to be too long, but you mentioned something I wasn't even aware of: the amount of possible hair transplantations you can have in your life. I'd be interested to know, how often can one do this?**Dr. Alkiviadis Karoutis:** Basically, the information currently available online, which is non-medical, states three times for your entire lifetime. Of course, this is not based on a correct medical protocol or on maximally extracting using the surgical techniques that currently exist. What we do specifically is perform a cut that is much less invasive.The trauma it leaves behind is able to recover much faster, and if we are not 100% precise, the follicle will grow back from the area we left. This, of course, increases the amount of times you can have these operations in your lifetime because our approach is a lot safer. So, instead of going with the famous "graft count," where you count the amount of follicles that go in, we focus on reconstruction cases. The reason we do that is because we've observed that the graft count model—the counting of hairs—is usually related to technical work and a "shock loss effect," which is a negative side effect you have when you focus only on extracting as much tissue as you can. The body goes into a shock, and you end up losing some of your own hair. We avoid that.This is why we, along with some other surgeons we collaborate with, are able to achieve a higher number of these operations throughout one's lifetime.**Peter Zombori:** So, three, four, five, six times?**Dr. Alkiviadis Karoutis:** Yes. Usually, when the approach is commercial and focused on numbers, you often get bad results, or what we call the "Pamela Anderson effect"—something that clearly distinguishes that you've had surgery. We don't aim for that. So, basically, the number is above three, usually over six times, but every approach is specific to ensure a discrete, natural result. That's the basis of good surgery. You want it to be a "silent surgery," not something people can point to and make fun of.**Peter Zombori:** Dr. Karoutis, thank you for your insights. It's been very interesting talking to you, and we wish you all the best.**Dr. Alkiviadis Karoutis:** Thank you so much. Have a great day.**Peter Zombori:** You too. Bye-bye.