Patient information

1 What is the purpose of this information?

In the following, we will inform you about how our medical treatments PRP hair treatment, medical needling, wrinkle treatment with botulinum toxin and hair transplantation work, what the risks and potential side effects are and for what purposes these treatments are carried out. You will also be informed about how you should behave to ensure that your treatment is as successful as possible.

2. PRP treatment

2.1 PRP treatment, how does it work?

PRP autologous blood treatment Hair treatment is a minimally invasive treatment method. Your own nutrient-rich blood is used: After we have taken your blood, the so-called platelet rich plasma (PRP) is isolated from it and then injected into your scalp.

PRP autologous blood therapy is an outpatient treatment, i.e. you can leave our clinic after the treatment.

2.2 How long does the treatment last and for what purposes is it performed?

PRP autologous blood therapy usually consists of four sessions ("PRP sessions"), each lasting about 30 minutes. The PRP sessions take place at intervals of four weeks, which means that the entire PRP treatment lasts just under four months. During this time you are basically fully fit for work.

Approximately six months after the last PRP session, a hair scan is performed to check the results of the treatment ("follow-up").

The goal of PRP therapy is to boost hair growth, provide your hair roots with essential nutrients, and promote cell renewal and cell regeneration. In addition, PRP therapy can reduce hair loss.

Since each person reacts differently to the treatment, we cannot guarantee your success.

2.3 Behavioral instructions

2.3.1 How do I prepare for the treatment?

From one week before the PRP sessions, it is generally necessary to refrain from taking blood-thinning medications so that platelet formation is not inhibited. Medications containing acetylsalicylic acid (Aspirin, Alca C, Togal, Contra pain, etc.) have a blood-thinning effect. You should also avoid taking other painkillers such as Voltaren or Ibuprofen. Please contact us if you have any questions.

Before discontinuing any medications, be sure to consult with your treating physician as well as your primary care physician and find out whether discontinuing them could cause you serious medical disadvantages and what alternative medications are available.

2.3.2 What should I pay special attention to after the treatment?

If you have had a PRP session with us, you should not go out in the sun, swimming pool, sauna or solarium on the same day, do not wash your hair and avoid sports activities.

If you have any questions about any other specific activity, we will be happy to help you.

2.4 When is a PRP treatment not possible (contraindications)?

PRP therapy cannot be performed in case of:

• Autoimmune diseases
• Blood clotting disorders
• Hepatitis, HIV, cancer or liver diseases
• neurodermatitis, psoriasis or acute herpes
• Thrombocytopenia (lack of blood platelets)
• Pregnancy

PRP therapy is also not recommended for all acute or chronic skin diseases in the scalp and face area.

2.5 Risks and side effects

PRP mesotherapy is a minimal intervention on your body. That is why there are usually no visible scars left behind. The probability of allergies, intolerance reactions and infections is low, but unfortunately cannot be excluded. In exceptional cases, injury to nerves, vessels or organs may occur.

Other possible side effects may include temporary redness, swelling, itching, minor bruising, mild pain with pressure sensitivity and sensitivity disorders on the scalp. Rarely, tissue hardening and inflammatory reactions occur.

3. Hair Transplantation

3.1 Hair transplantation, how does it work?

A hair transplant is the transplantation of your own body hair. At the beginning you will be locally anesthetized at the hairline. After the local anesthesia, grafts (hair roots) are taken with a fine hollow needle and transplanted to the previously marked bald areas (FUE method - "Follicular Unit Extraction"). These bald areas are also anesthetized locally beforehand.

Our hair transplantation is an outpatient treatment, which means that you can leave the clinic after the treatment.

We only offer hair transplantation using the FUE method described above.

3.2 How long does the hair transplantation take and for what purposes is it performed?

We usually perform your hair transplant in a single appointment. This appointment lasts about two to eight hours, and the duration of the treatment depends in particular on the area to be treated (section). The transplantation is followed by up to six follow-up visits within a year. In addition, we enrich your hair roots with essential nutrients after the transplantation through one or more PRP session(s).

It is completely normal for transplanted hair to fall out and grow back after treatment. The new sprouting hair usually becomes visible after about three months. After twelve to eighteen months you will see the final result of your hair transplant.

It can happen that not all transplanted hairs grow as desired, so that a new operation becomes necessary. The success of the hair transplant depends on the quality of the transplanted hair and the aftercare. Unfortunately, we cannot guarantee success.

3.3 Instructions

3.3.1 How do I prepare for the treatment?

From one week before the hair transplantation, it is generally necessary to refrain from taking blood-thinning medication, so that there is no increased risk of bleeding. Medications containing acetylsalicylic acid (Aspirin, Alca C, Togal, Contra-Pain, etc.) have a blood-thinning effect. You should also refrain from taking minoxidil preparations (Reagine, Spectral, Rogaine, etc.) during this period. Please contact us if you have any questions.

Before discontinuing any medication, be sure to consult with your treating physician as well as your primary care physician and find out if discontinuing could cause you serious medical disadvantages and what alternative medications are available.

You should refrain from cutting or shaving your hair from 5 days before the treatment. From this time on, you should also refrain from drinking alcohol or taking other drugs.

On the day of the treatment, it is also necessary to refrain from using hair products (gel, wax, etc.) and drinking beverages containing caffeine.

3.3.2 What should I pay special attention to after the treatment?

The time after hair transplantation is planned individually for each client by our doctors. We will instruct you in detail about the further procedure.

Whether you need to wear a headband after the transplantation or the treatment is otherwise recognizable also depends on your individual treatment. Swelling, which can also occur on the forehead and face, should be counteracted by cooling. However, cooling of the area where the hair was transplanted should be avoided.

Please note that you are not allowed to drive a vehicle after the treatment on the same day.

In principle, you are able to work on the first day after the treatment, as long as you do not do any physical work. Physical work is defined as any activity that requires light to heavy exertion.

We recommend that during the first week after transplantation you do not engage in any physical activities that require light to heavy exertion, and do not expose yourself to extreme weather or the sun. Visits to saunas, indoor swimming pools or solariums should also be avoided. During the first week after treatment, you should also sleep with your upper body elevated (e.g. with the help of a neck pillow), avoiding any pressure on the implantation zone. If you have any questions about a specific activity, we will be happy to help you.

For an optimal result, the scalp should be spared as much as possible during the entire treatment. In particular, you should avoid rubbing or scratching the scalp and use the shampoos we recommend.

3.3.3 How do I wash my hair after the hair transplantation?

After the hair transplantation, gentle and high quality products should be used for washing your hair and taking care of your scalp. Please use the products recommended by your attending HAIR & SKIN doctor.
On the day of the hair transplantation and the first two days after, you are not allowed to wash or rinse your hair. Washing your hair is generally possible again from the third day after the treatment. Please follow these recommendations:

• Wet the grafted area, apply HAIR & SKIN foam gently with the fingertips, leave for 30 minutes and then rinse with warm water. After washing, dab the head with a paper towel. Do not use a towel.
• Wash hair gently with the HAIR & SKIN shampoo. Then rinse with a light stream of water. Dab with a paper towel.
• From the 8th day, you can add circular movements to the washing process to masssage the remaining crusts. There should be no more crusts at the 10-day check-up. If there are still some left by then, the doctor will treat the crusts carefully.
• From the 11th day, the hair can be washed as usual again, the shampoo can still be used. The foam is no longer needed.

3.4 When is hair transplantation not possible (contraindications)?

Hair transplantation cannot be performed in the case of:

• Autoimmune diseases
• Blood coagulation disorders
• Hepatitis, HIV, cancer or severe diabetic disease
• Neurodermatitis, psoriasis or acute herpes
• pregnancy
• cardiovascular diseases, uncontrolled high blood pressure

Hair transplantation is also not recommended for all acute or chronic skin diseases in the area of the scalp and face, as well as for circular hair loss.

3.5 Risks and side effects

Hair transplantation is a relatively minor operation on your body. Therefore, as a rule, no visible scars remain. The probability of allergies, intolerance reactions and infections is low, but unfortunately they cannot be excluded. In exceptional cases, injury to nerves, vessels or organs may occur.

Other possible side effects may include temporary redness, swelling, itching, minor bruising, secondary bleeding, blood crust formation, numbness, mild pain with sensitivity to pressure, and sensitization disorders. Rarely, tissue hardening and inflammatory reactions occur. It is also possible that hair may temporarily fall out (tissue trauma) in the areas where hair was harvested for transplantation (hair crown).

4 Medical needling

4.1 Medical needling, what is it?

In medical needling, certain components from your blood are used specifically for skin rejuvenation. The plasma you use is rich in platelets, regenerating proteins and growth factors. These growth factors stimulate skin regeneration and stimulate collagen production. The focus here is not only on injecting severe wrinkles, but on natural skin regeneration. The blood plasma is injected into your skin using our needling pen and their finest needles between 0.5 and 2 millimetres. These clean micro-injuries are fundamental to medical needling. This triggers the above-mentioned cell renewal, so that your skin becomes firmer and fresher. In addition, the skin appears visually rejuvenated and the skin structure also improves.

4.2 How long does medical needling take and for what purposes is it performed?

Medical needling with autologous blood usually consists of four sessions in combination with a skin scan, which is performed about 1-2 months after the last session so that the results of the treatment can be checked ("follow-up"). Each session, including preparation and follow-up, lasts about one hour, although there may be individual time variations. If you wish, annual follow-up treatments are possible so that the results last longer. The aim of autologous blood needling is to stimulate cell renewal, blood circulation and collagen production, so that the skin becomes more vital and healthy.

4.3 Instructions for use

4.3.1 How do I prepare for the treatment?

From one week before the medical needling, you should always refrain from taking blood-thinning medication so that the formation of blood platelets is not inhibited. Medications containing acetylsalicylic acid (Aspirin, Alca C, Togal, Contra pain, etc.) have a blood-thinning effect. You should also avoid taking other painkillers such as Voltaren or Ibuprofen. Please contact us if you have any questions. Before discontinuing any medication, it is important to consult with your doctor and your family doctor to find out whether discontinuing any medication could have serious medical disadvantages for you and what alternative medications are available.

4.3.2 What should I pay special attention to after the treatment?

After PRP medical needling, the skin is initially still red. This usually disappears after a few days. To avoid swelling and bruising, the treated areas should be cooled. Therefore, you should temporarily refrain from sports, sauna and solarium visits and not use any cosmetic products for the first few days after the treatment. These can further irritate the skin. Our doctors will advise you in detail and explain to you individually what you should pay attention to.

4.4 When is medical needling not possible (contraindications)?

PRP medical needling cannot be carried out in the case of: Autoimmune diseases Blood coagulation disorders Hepatitis, HIV, cancer or liver diseases Neurodermatitis, psoriasis or acute herpes Thrombocytopenia (lack of blood platelets) Pregnancy Medical needling is also not recommended for any acute or chronic skin diseases in the area of the scalp and face.

4.5 Risks and side effects

Medical needling is a particularly pleasant and well-tolerated form of therapy. Thanks to its exceptionally gentle procedure with ultra-fine special needles, it causes hardly any pain. However, anaesthesia is of course possible if desired. Redness and swelling also remain the absolute exception. If the patient follows the general recommendations of the doctor after the treatment, the micro-injuries on the skin usually disappear quickly and smoothly. Allergic reactions and intolerances are just as rare with PRP therapy. The reason: since the body is administered its own blood, it usually reacts positively to the nutrient-rich blood plasma. After all, it is not a foreign fluid that the body is trying to reject. A little tip: In order to be able to completely rule out allergic reactions and intolerances, it is worthwhile to have a clarifying discussion with your doctor before the procedure. Together you can get to the bottom of possible weak points.

5. Wrinkle treatment with botulinum toxin

5.1 What is botulinum toxin?

In medicine, mainly biotechnologically derived botulinum neurotoxin type A is used as a highly effective prescription drug - both for the effective and safe treatment of wrinkles and for the treatment of severe neurological movement disorders and extreme sweating under the armpits (hyperhidrosis).

The active ingredient for the treatment of wrinkles has become known under the brand name "Botox", but we use a product from a different manufacturer.

5.2 How does botulinum toxin work in wrinkle correction and how long does its effect last?

Due to constant activity of the mimic muscles, wrinkles can appear in the overlying skin over the course of a lifetime, for example frown lines above the nose, forehead wrinkles or laugh lines at the corners of the eyes.

Botulinum toxin reduces muscle contraction by blocking the messenger substance needed for this action. Therefore, botulinum toxin injections into the affected muscles lead to muscle relaxation.

As a result of this muscle relaxation, the overlying wrinkles also smooth out or disappear completely if they were not too deep yet. Botulinum toxin is continuously broken down by the body after injection, and its effect lasts for 4-6 months, depending on the patient, the injection site, the dose and the specific formulation of the botulinum toxin used.

The treatment consists of a consultation, cleaning and disinfection of the area to be treated, and the actual injection.. The duration of a treatment is about 15 minutes, although there may be variations in time. The treatment effect usually appears after 2-3 days, the maximum effect is reached after about 2 weeks. Rarely, however, the onset of the effect can be delayed.

If you wish, you can have any number of follow-up treatments. It should be mentioned at this point that the body gets used to botulinum toxin and that the duration of effect decreases with repeated treatments and therefore only lasts 2-3 months with repeated treatments.

5.3 Instructions for use

5.3.1 How do I prepare for treatment?

Avoid caffeine, niacin supplements, high sodium foods, high sugar foods, refined carbohydrates, spicy foods and cigarettes 24-48 hours before treatment. In addition, alcohol should be avoided for a fortnight prior to treatment as it can increase the risk of bleeding and bruising at the treated area(s). Avoid waxing, bleaching, plucking or using hair removal creams in the areas to be treated.

Inflammation of the facial skin such as eczema, active psoriasis, atopic dermatitis, acne, etc. may prevent treatment with botulinum toxin depending on the extent of the condition. If you suffer from one of these diseases or other inflammations of the scalp/facial skin, it is essential that you inform the doctor treating you. Eating and drinking is allowed both before and after the treatment.

5.3.2 What should I pay special attention to after the treatment?

You should not massage the injection sites for the first four hours. Avoid saunas, sunbathing, heavy exercise and sports on the day of treatment. Showering, gentle facial cleansing and the application of light make-up, on the other hand, are possible immediately without any problems. You should refrain from drug consumption (including alcohol and nicotine) for two days after the treatment in order not to impair wound healing. You should also avoid sleeping on your face for the first night.

5.4 When is treatment with botulinum toxin not possible (contraindications)?

Absolute contraindications include the following conditions:

Body dysmorphic disorder, dependence on facial expression as a livelihood (e.g. actors, singers), Skin lesions in the area to be treated, Inflammatory skin disease that cannot be controlled with medication, Dermatoses (e.g. psoriasis, eczema), Gross motor weakness in the treatment area (e.g. Bell's palsy), Neuromuscular disorders (e.g.. (e.g. amyotrophic lateral sclerosis, myasthenia gravis, Lambert-Eaton syndrome, myopathies), immunosuppression, active infection, localised (injection area) or systemic (especially urinary tract), history of keloids or hypertrophic scarring, use of medications that impair muscle function, e.g. muscle relaxants, muscle relaxants, muscle relaxants, muscle relaxants). e.g. muscle relaxants, taking medications that can increase the effectiveness of botulinum toxin (calcium channel blockers, quinine, aminoglycoside antibiotics), pregnancy and breastfeeding, hypersensitivity or allergy to components of botulinum toxin (e.g. Cow's milk protein allergy in the case of abobotulinumtoxinA [Dysport], human albumin, saline, lactose, sodium succinate), changes in health status for which a diagnosis has not yet been made, and unreasonable expectations or ignorance of short- and long-term results.

Relative contraindications include:

Coagulation disorders (haemophilia, von Willebrand disease, thrombocytopenia), use of anticoagulant or antiplatelet drugs such as warfarin (Marcoumar), dabigatran (Pradaxa), rivaroxaban (Xarelto), Apixaban (Eliquis), Edoxaban (Savaysa), Betrixaban (Bevyxxa), Acetylsalicylic acid (Aspirin, Asaphene, Entrophene, Novasen), Clopidogrel (Plavix), Prasugrel (Effient), Ticagrelor (Brilinta), and in epilepsy disorder.

5.5 Risks and side effects

Side effects of botulinum toxin include the following reactions. It is important to note that all side effects - like the effects of botulinum toxin - are temporary. There are no long-term side effects.

The following side effects have been observed with the use of botulinum toxin:

• Swelling or bruising at the injection site.
• Itching
• Mild headache
• Flu-like symptoms
• Undesirable impairment of muscle function
• Focal facial paralysis
• For upper face injections: drooping eyebrows or eyelids (brow ptosis or blepharoptosis), lateral elevation of eyebrows (Mephisto/"Mr. Spock" eyebrows), diplopia, ectropion, drooping of lower eyelids, epiphora (excessive tearing), decreased strength of eye closure, dry eyes, tension or heaviness in forehead or eyebrows, muscle spasms in forehead
• Rarely: Shortness of breath, cardiac arrhythmias, seizures, allergic reactions.

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