What Is Surgical Hair Transplant?
Have you heard of the word ‘mesotherapy’ before? Most of us haven’t. Mesotherapy is defined as a ‘non-invasive non-surgical technique that uses micro-injections of pharmaceutical and homoeopathic preparations, plant extracts, vitamins, and other ingredients into subcutaneous fat’. What this means is that it administers superficial injections into the skin surface (transdermal injection), which typically contain diluted drugs such as vitamins, nutrients, and growth factors. When used on the scalp, it helps to stimulate hair growth, hair thickening, and inhibition of hair loss.
Regenera Activa is one such innovative treatment. The Regenera Activa procedure injects the scalp with a special suspension containing stem cells, growth factors, and progenitor cells with powerful regenerative properties. It has zero downtime and no side effects! The unique and most interesting part about Regenera Activa is that it relies on your body’s own ability to produce new functioning hair follicles by ‘activating’ the inactive areas in your scalp, using the most updated regenerative medicine protocol to date – the ‘Stromal Vascular Fraction’.
Is it safe? – Absolutely!
Regenera Activa has gone through extensive clinical trials across the world and is listed as US FDA and CE-certified. The medical devices used – N4SA and Rigenracons – are listed as Class A medical devices by the Health Science Authority (HSA), Singapore and have also been approved by the HSA. These ratings assure patients of its safety and effectiveness. Pioneered in Barcelona, Spain, this procedure has since seen widespread acceptance as a stand-alone or combination treatment option for male or female pattern hair loss.
Is this new? – In Singapore, yes!
Regenera Activa, Regenera-AMT (Autologous Micrograft Transfer) is a technique that has been used to treat hair loss for decades in Europe. We are the proud first users of Regenera Activa and Regenera-AMT in Singapore. With over 400 hundred cases performed to date since its introduction in 2018, Dr Chong has been selected to be the Key Opinion Leader for this treatment.
Dr Chong has given lectures and workshops on the use of Regenera Activa across South East Asia and delivered International Webinars to other Regenera professionals, including those organised by Regenera Science and at 2022 Aesthetic and Anti-Aging World Congress.
How Does Regenera Activa Work?
How Does Regenera Activa Work?
When hair loss happens, especially in male or female pattern hair loss, the hair follicle itself is affected. Hormones that travel in the bloodstream to the hair follicles are converted into di-hydrotestosterone (DHT), which causes the hair follicle to undergo something called ‘miniaturisation’. During miniaturisation, the hair follicles that once were producing healthy hairs start generating thinner hairs with fragile shafts. When hairs become thinner and less dense, the scalp becomes more visible.
Those with hair miniaturisation will also experience a disruption in the hair growth cycle. Hairs that are growing are in the ‘anagen’ phase of the hair cycle. A healthy hair follicle that grows strong hair will have stem cells which ‘communicate’ with the part where the hair grows out of – the follicular bulge and dermal papilla – and activate those follicles to grow. When there is a disruption in this communication, it results in hairs being unable to grow as thick and strong as before, and has a higher chance of being in the ‘telogen’ phase where shedding happens.
How Regenera Activa works is by reintroducing the necessary cells and cell communication molecules into areas of hair thinning. This helps hair follicles to regain their normal growth characteristics again.
How do I know if I am suitable for Regenera Activa?
Many options for hair restoration can result in confusion as to which procedure is the optimal one for you. To identify if you are suitable for Regenera Active, we always start with an initial consultation with one of our hair loss professionals.
- What goes on in the initial consultation? – A subjective history-taking will be done where you will answer questions about your personal journey with hair thinning, past medications or medical procedures, family history of baldness, and lifestyle factors (such as diet, exercise, and stress). After that, an objective assessment will be done where your hair is examined under a high-powered microscope specially for hair diagnoses, called ‘trichoscopy’. This diagnostic tool helps to confirm the suspicions of hair loss causes, and provides our hair loss specialists with an accurate picture of your hair and scalp condition. This paves the way for accurate treatment.
- Who are those typically suitable for Regenera Activa? – This treatment will greatly benefit both men and women who want to avoid undergoing a surgical procedure like hair transplant where possible, but are already experiencing areas of hair thinning.
If you are deemed suitable for the Regenera Activa procedure, your doctor will inform you of the areas that can be restored with Regenera Activa. The areas that are likely to do better with other forms of treatments (e.g. hair transplant surgery or medications) will also be explained.
How is the procedure performed?
Step 1 – Hair Analysis
Our dermatologist will do an in-depth hair analysis, which is the initial consultation part. [Read above: “How do I know if I am suitable for Regenera Activa?”]
Step 2 – Sample Extraction
Samples, or ‘grafts’ are extracted from near the back of the scalp. This area chosen is important, as sample extraction may form deep punctures that possibly heal with some scarring. The extraction is performed in a sterile operating theatre in-clinic. While lying on your side, local anaesthesia is injected to the donor sites, and a small area (roughly the size of a fingernail) will be shaven down to skin. The shaving allows for extraction of hair and skin grafts.
Step 3 – Solution Preparation
These ‘graft’ samples are then placed in a ‘regeneracon’ unit to be processed, which helps to isolate the cells with regenerative capabilities. This breaks the larger tissue down into 50-micrometre sized fragments called ‘micrografts’. This micrograft suspension now contains viable hair follicles, mesenchymal stem cells, and cell-signalling growth factors. It should look extremely dense and non-see through, which indicates an adequate concentration of regenerative cells and molecules.
Step 4 – Solution Application
This rich solution is reintroduced on areas with hair loss to begin initiating the regenerative process of hair follicles. The depth of injection is important to ensure that the follicular bulge and dermal papilla (areas which contain stem cells that signal hair growth) are targeted.
Hence, to make sure that you are in good hands, the doctor that performs this procedure needs to be familiar with hair follicle anatomy and practice their speciality in the field of hair loss procedures – this ensures safety, treatment efficacy, and greater results satisfaction for you.
Regenera Activa – Zero Downtime
The Regenera Activa treatment procedure offers a lot of great benefits, which makes this therapy an effective and safe one. One such benefit is that it has zero downtime! Unlike hair transplant surgery where you may need to set aside 5-7 days before being able to continue most of your daily activities, you will be able to walk out the door right into the next thing on your schedule after a Regenera Activa treatment.
It is also a relatively fast procedure that you do not need to clear your entire day’s schedule for, involves fast tissue preparation, and has minimal discomfort. Aside from being a one-time procedure, it is also minimally-invasive and uses stem cells from the patient’s body for the treatment which makes it a safe choice.
Another plus side is that if you are a suitable candidate, Regenera Activa acts almost immediately to activate dormant hair follicles. Results can be seen within 30 days, compared to medications like finasteride and minoxidil which may take up to half a year to show tangible results. Some results you may see from Regenera Activa are:
- Thicker hair growth
- Hair grows faster
- Density improves, covering sparse areas of your scalp
Can Regenera Activa Be Combined With Other Treatments?
It is completely safe to combine the Regenera Activa procedure with other treatments. In fact, combined with the right treatment, Regenera Activa can be even more effective. The types of treatments that can be combined with Regenera Activa are:
- Low-level laser light therapy (improves circulation and activation of hair follicles)
- Topical hair growth solution (stimulates the hair to enter the anagen/growth phase)
- Hair growth supplements (increases antioxidant levels in the body for hair health)
- Anti-hair fall shampoos (provides a healthy scalp environment)
Another great side effect of Regenera Activa treatments is that it may actually help reduce the dosage of some other hair growth treatments, like DHT-blockers. DHT-blockers help to prevent miniaturisation of hair follicles in male or female pattern baldness.
What happens after the procedure?
- Duration of procedure – The duration of Regenera Activa takes between 45-60 minutes to be completed, with no downtime after.
- Immediately post-procedure – The dressing on the area of extraction should remain there for 24 hours to allow the wound to heal and prevent any entry of bacteria. After 24 hours, you can then shampoo your hair and remove the dressing on your own.
- 1 week post-procedure – The wounds over the extraction site will heal on their own and some hairs will start growing out from them by the end of 1 week.
- 3-4 weeks post-procedure – You will notice shedding of the ‘miniaturised’ or weak hairs around this period. Do not worry if there is shedding happening! Those stem cells are signalling the hair follicles to enter into a new anagen/growth phase. The shedding may last for 2-4 weeks or even up to 6 weeks if you have been started on minoxidil. This shedding typically will not make your hair appear thinner.
- 1 month post-procedure – A review appointment will be scheduled to follow-up on the degree of improvement by using clinical photography. A programme of low-level laser light therapy will be performed on the day of the review to optimise growth and increase activation of the hair follicles.
- 3 months post-procedure – New, stronger hair would have grown over the treated area. Another review will be scheduled for clinical photographs to be taken again, for hair growth comparison. Another session of low-level laser light therapy will be performed at that point, as part of the new revised protocol based on latest Regenera research.
It is important to note that results do vary between patients and treatments. Other than avoiding any pool activities or submerging yourself in the sea for a week after the treatment, there are no major cautionary restrictions to follow. However, lifestyle changes post-treatment are also important. If you want to ensure good scalp health in general for strong and healthy hair, take care of your diet and nutrition. Certain foods are shown to be better for a healthy scalp, especially those rich in zinc, vitamin A, and omega-3 fatty acids. Managing your stress levels will also go a long way in preventing any long-term hair loss.
What happens after the procedure?
The initial assessment is very important for women experiencing female pattern hair loss.
Some female pattern hair loss patients may NOT be immediately suitable for the procedure. Taking a holistic approach, all other factors will need to be addressed first (addressing concurrent medical conditions, nutrition optimisation, etc.) before considering a hair transplant surgery where needed.
- Female pattern hair loss is a far more complex condition than male pattern hair loss. While genetics and hormonal factors play the main role in male pattern baldness, it may not be so in female pattern baldness. In females, hormone levels may be identified as normal but hair loss may still occur. Hence, we need to look at lifestyle, nutrition, stress, and perhaps even conduct a blood test to identify what is contributing to hair loss.
- Even the classical signs of balding will differ from men and women! In females, it may resemble a ‘Christmas tree’ pattern at the top of the head where the middle parting lies. This means that a diffuse form of hair thinning starts to occur there, eventually getting wider and wider with more scalp visibility.
- However, other conditions may also result in this patchy thinning – things like telogen effluvium, or even hair loss from medical conditions like PCOS (polycystic ovarian syndrome). As such, the clinical diagnosis may be challenging and may require further testing to identify if Regenera Activa will produce optimal results for the female candidate.
If you ARE a suitable candidate, you may need to consider that:
- Regenera Activa may need to be repeated on a more frequent basis than men. This will be affected by your age, hormonal profile, family planning status, and genetics. There are, however, some combinations of treatments that can be used to prolong the effects of this regenerative treatment, which will be discussed with you.
- Regenera Activa may not be able to target the entire area of thinning. This is because a large area of diffuse thinning often occurs in female pattern hair loss, and attempting to spread the ‘micrograft suspension’ across all areas will just dilute the effects of the cell growth factors. For optimal aesthetic benefits, this regenerative concoction will be utilised in areas that have the most obvious thinning only.
Of the hundreds of cases that have been done in Terra Medical Clinic, a patient-centric approach to this treatment based on considerations of the aesthetic profile and client expectations provides higher patient satisfaction for women!
This depends on the severity of the hair loss and whether other hair loss treatments have been prescribed in combination with Regenera Activa. Generally, the effects of Regenera Activa last about 1 year and it is recommended that repeat treatments are done yearly to give the best chance for the hair to develop fully. A combination of treatments targeting the various causes of pattern hair loss can help to extend the lifespan of the procedure.
The duration of Regenera Activa takes between 45-60 minutes to be completed. During the procedure, a local anaesthetic injection will be given over the scalp areas, which may sting slightly. The graft extraction is completely painless due to the anaesthetic, and when the micrograft suspension is injected into the scalp, it may sting for 3-5 minutes only. After the procedure is done, there will be minimal to zero residual pain and you can go ahead with your daily activities!
Over the extraction area where the grafts are taken to formulate the regenerative micrograft suspension, some hair follicles may be lost. However, it is not a permanent hair loss and the hairs will grow back eventually. Usually by the end of the first week, you will start to feel the hair stubs appearing from the scalp again.
It is not known how many times this procedure can or should be repeated. At Terra Medical Clinic, we review our patients for clinical photography frequently, and by comparison of the photographs, we will be able to advise if a repeat procedure is warranted; likewise, if scalp coverage is still good, then we would advise to hold off the Regenera Activa procedure.
Minoxidil (oral OR topical) should be stopped for 1 week before the procedure. Finasteride (oral) can and should be continued.
The Regenera Activa procedure is done by collecting stem cells from the patient’s own body (autologous transplants) and no harmful chemicals are used for treatment. Hence, the treatment involves no risk of harming your health. There may be slight tenderness of the scalp after the treatment, but you are able to rinse your hair and shower after. You will be ready to return to work and exercise the next day.
With the graft extractions, there is a small risk of scarring, bleeding, or infection; however, we have not yet encountered such complications among the hundreds of cases done successfully.
Another risk that you have to keep in mind is that the effectiveness of Regenera Activa depends from patient to patient. Despite being a suitable candidate for Regenera Activa, if your body does not respond accordingly to the micrograft suspension, you may not see the results that you expect.
You should mention all medications that you are currently taking to the doctor, which include blood thinners (NSAIDs, aspirin, warfarin, etc.). If you are a suitable candidate, you will have to stop those medications 1 week prior to the procedure. Stop all multivitamins, fish oil, ginkgo biloba and garlic extract supplements 5 days prior to the procedure.
You should thoroughly shampoo your scalp as you will not be able to shampoo it for 24 hours after. Do not make an appointment for a haircut within 3 days of the procedure. We will also perform an antiseptic scalp cleanse during the procedure as part of the sterile precautions.
Yes! You can use Regenera Activa to strengthen and maintain the areas of thinning that were not transplanted. However, this is on a case-by-case basis – depending on how thin the native hairs are as well as the capacity for your donor area to undergo graft extraction, you may be advised to optimise your hair via a different method.
At Terra Medical Clinic, our hair restoration team takes great pride in providing a holistic approach to treating hair loss. We will advise you on what will deliver the best results to match your expectations, and each person’s prescribed treatment will differ based on hair conditions. If you are feeling emotionally distressed over your hair loss, we also encourage you to seek counselling help. This, coupled with effective hair loss treatments, can really work wonders in bringing about a happier and healthier you.