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THE CLINIC
DR. INSALACO
FAQ
HAIRLOSS
Hair Anatomy
Androgenetic Alopecia
Additional Hair Loss Causes
Therapies and Treatments
HAIR TRANSPLANT
Fue technique
Cole isolation technique (CIT®)
The phases of a hair tranplant
Hair transplant costs
Long hair transplantation
Additional surgical treatments
Surgical instruments
Tricopigmentation to hide baldness
THERAPIES
TERAPIE
REGENERATIVE
Stem cells
Tricopat
RESULTS
BLOG
CONSULTATION
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Dr. Chiara Insalaco
Virtual contact form
Step
1
of
4
25%
First and Last Name (required)
*
Name
Surname
Address (required)
*
Street/Square/Street and house number
City
Phone (required)
*
Enter your phone number
Date of birth (required)
*
Enter your date of birth
Email (required)
*
Enter email
Email Confirmation
Enter the email address to which you would like to receive the evaluation
Do you use Finasteride ?
*
Si
No
Indicate whether you are using Finasteride (Propecia or Proscar)
How long have you been using Finasteride?
Do you use Minoxidil ?
*
Si
No
Please indicate whether you are using Minoxidil
How long have you been using Minoxidil?
Have you previously undergone hair transplantation ?
*
SI
NO
Specify whether you have undergone hair transplantation in the past
What surgical technique was used in your previous surgery ?
*
Strip - A lozenge of skin was removed from the back of the neck
Fue - Follicles were removed one by one with a punch
BHT - Follicles were extracted from the body/beard.
Year of previous surgery
How many follicular units did you receive ?
*
Please enter a number from
100
to
7500
.
Enter the number of follicular units received in the previous surgery
Doctor who performed your surgery ?
Indicate the name of the clinic at which you had surgery
Have you undergone more than one hair transplant in the past ?
*
SI
NO
Indicate whether you have undergone other transplants in the past
Indicate the number of follicular units grafted in your second transplantation
*
Please enter a number from
50
to
6000
.
Surgical technique used for your second transplantation
*
Strip - A strip of skin was taken from the back of the neck
Fue - Follicles were harvested one by one with a punch
BHT - Follicles were taken from the beard or body.
Other surgeries - Description
Enter year of surgery, number of grafts, and surgical technique of any other transplants performed
What are you interested in?
Specialist examination (1)
Specialist examination via Skype (2)
Regenerative therapies (3)
FUE hair transplantation (4)
In what month would you like to undergo examination/operation?
*
PAGE 3 PHOTOGRAPHIC IMAGES:
. Photographs should be taken preferably barefaced your privacy is guaranteed and the images remain in the clinics archives. It is very important to send photos following the following rules:
DO NOT USE FLASH
.
TAKE IMAGES FROM A DISTANCE OF 80 CM - 1 METER
PREFERABLY USE A DIGITAL CAMERA AND NOT A WEBCAM OR A CELL PHONE WITH LOW RESOLUTION
CARE TO EVIDENCE DIRECTED CALVE ZONES AND NOT TO COVER THEM
.
PREFERABLY TAKE PHOTOS OUTDOOR OR IN NATURAL DAY LIGHT
. Poses are very important the following images are necessary:
FRONT VIEW
- Show at least the eyebrows
COMPLETE RIGHT AND LEFT PROFILE
FULL TOP VIEW
FULL VIEW OF THE DONOR
FRONT VIEW
*
Accepted file types: jpg, jpeg, gif, png, bmp, Max. file size: 256 MB.
Insert a frontal image
RIGHT PROFILE
*
Accepted file types: jpg, jpeg, gif, png, bmp, Max. file size: 256 MB.
Insert a right profile picture
LEFT PROFILE
*
Accepted file types: jpg, jpeg, gif, png, bmp, Max. file size: 256 MB.
Insert a left profile picture
VIEW FROM ABOVE
*
Accepted file types: jpg, jpeg, gif, png, bmp, Max. file size: 256 MB.
Insert full top view
DONOR AREA (NECK AREA)
*
Accepted file types: jpg, jpeg, gif, png, bmp, Max. file size: 256 MB.
Insert an image of the entire neck area
Authorization to process personal data
*
I authorize
By ticking this box I authorize the processing of my personal data according to the EU Regulation 2016/679
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