10/26/2014
Hair transplantation and Belgium’s little secret
Belgium has a little secret it just so happens to be hair transplant capital of the world. Belgium famous for waffles, chocolate, beer and being the capital of the European Union is also famous for hair transplantation. This unusual little fact is mostly unknown to its citizens. People suffering from hair loss fly in from all over to this small area of the world for a very specialized technique of which only a very small number of doctors worldwide can perform with a very high level of skill.
The market effect of this small concentration creates tight competition within the country’s own borders and the result is that only the best techniques available can be offered. Truly an example of market forces at work. One technique in particular which is extremely difficult to perform is referred to as follicle unit extraction FUE. It requires each individual hair follicle or unit of hair which range in groupings of 1-5 hairs to be extracted with a very small hand punch ranging in size from .7-.9 mm in diameter using special high magnification eye wear.
The hair that surrounds the back and sides of the head referred to as the donor is strategically extracted in a specific pattern and moved into the areas of the scalp where hair loss has occurred. This procedure can often go as high as 3000-4000 individual grafts with procedures sometimes lasting over 12 hours with not only the doctor extracting the grafts but a team of technicians assisting in the placement.
After years of struggle many doctors in the United States gave up on offering the procedure with just a few sporadically scattered here and there eliminating the effect of tight competition and its ability to drive higher levels of skill. Many in the US in fact found the procedure too difficult, time consuming and simply not as profitable and easy as older techniques. The result, many of those older techniques although sometimes ill advised were used on patients who were unaware.
Several doctors in the US have recently tried adopting a robotic type system into their practice as it eliminates the need for skill but the small size punches as performed by hand which are less apt to result in scarring do not work with this type of system. One also needs a range of punch sizes to choose from as the hair groupings change in size and one must be able to change tools as needed. Even more important there is a sense of tactile feel in the finger tips when performing FUE by hand that is very subtle as the punch becomes an extension of the finger tips. This feel developed over many years of repetition becomes second nature for the skilled resulting in a follicle that is not damaged during the extraction process. This damage when it does occur is referred to as the transection rate, the follicle is essentially cut in half near its base rendering it useless.
Hair transplantation is also more of an art then a medical procedure. Understanding the canvas one is working with, the area that needs to be covered and the material one has available to cover that area both short term and long term requires a high level of artistic talent and vision. Each hair or grouping of hairs needs to be placed in an exacting pattern. Not only is where the hairs are placed of extreme importance but the angle at which they are placed in relation to the scalp must be exact and this applies to each and every follicle, very long and tedious work. The real bonus with this technique is that the doctor can choose from a varying array of hairs in caliber and use those that will match the surrounding hairs in the recipient area. This is critical when producing a natural hairline which is mostly comprised of not only single hairs but hairs that are thinner and often lighter in color.
This author in fact has travelled to Brussels after having had extensive hair transplant work in the United States which didn’t quite meet final expectations. Many patients in need of repair once fully informed which can often take years of research, travel the long distance to this special place. My particular situation required hair follicles to be removed from my face around the chin area and from my chest as the normal area of donor the sides and back of the head were depleted. One can imagine the delicate nature of this work and why these tiny instruments are needed to prevent scarring while not placing the patient in a position that is worse off in the end. This procedure was performed by Dr. Christian Bisanga of Brussels.
After over 1000 beard hair grafts were extracted over several years the healing was absolutely amazing. This was done over a very confined area of the chin where the beard hair growth was robust and yet even in this small space there is no appearance of anything having been done.
The competition in Belgium is very tight and the level of skill as stated is unmatched anywhere else. Many of the names familiar to those in the hair loss world include Dr Patrick Mwamba (Brussels) and Dr. De Reys (Berlaar) along with several others all within the borders of Belgium. Names that are consistently repeated over and over again in the world of surgical hair transplantation. We are not sure why they have all decided to congregate in Belgium but we are thankful that they did as they have helped raise the standards of this unique surgical procedure. These are the real diamonds of Belgium truly a treasure to many across the world and one of Belgium’s little secrets.
Petros Michalis
