HAIR TRANSPLANTATION TECHNIQUES
Hair transplants are done by FUT and FUE methods.
Follicular Unit Transplantation (FUT) is a surgical procedure where hair is transplanted from the permanent zone, the area in the back and sides of the scalp where hair is more resistant to balding, to the bald or balding areas of the scalp. This is accomplished using naturally-occurring groups of 1, 2, 3, or 4 hairs, called follicular units. After the patient’s scalp is anaesthetized, the doctor removes a strip of tissue from the donor area, an area within the permanent zone, and, once extracted, the donor strip is cut into many individual follicular units using microscopic dissection techniques. As these follicular unit grafts are being prepared, the doctor makes tiny holes in the scalp, called recipient sites, where the grafts are placed.
The arrangement and positioning of these follicular unit grafts determine the aesthetic qualities of a hair transplant, and so this arrangement must be decided on a case-by-case basis, depending on the patients’ history of hair loss and the likelihood of future hair loss. Since follicular unit transplants mimic the way hair grows in nature, the results, in expert hands, will look completely natural and be indistinguishable from one’s original hair.
One of the most important aspects of FUT hair transplant surgery is stereo-microscopic dissection. This allows follicular units to be isolated from the donor strip without being broken up or damaged. During graft dissection, it is critical that the whole follicular unit is kept intact as this will maximize its growth. Intact follicular units will also give the most fullness to the hair restoration, as they contain the full, natural complement of 1-4 hairs.
In the FUT technique, once the local anaesthesia has been applied to the donor area, grafts are taken as a section from the region, and then it is closed with a suture. With this technique, the healing period takes longer and it leaves a visible scar in the donor area.
Follicular Unit Excision (FUE), formerly called Follicular Unit Extraction, is a method of extracting, or “harvesting,” donor hair in a follicular unit hair transplant procedure. In FUE hair transplant surgery, an instrument is used to make a small, circular incision in the skin around a follicular unit, separating it from the surrounding tissue. The unit is then extracted (pulled) directly from the scalp, leaving a small open hole.
This process is repeated until the hair transplant surgeon has harvested enough follicular units for the planned hair restoration. This process can take one or more hours and in more than one session, may be accomplished over two consecutive days. The donor wounds, approximately 1-mm in size, completely heal over the course of seven to ten days, leaving tiny white scars buried in the hair in the back and sides of the scalp.
This method of donor harvesting, removing follicular units one-by-one directly from the scalp, is what differentiates the FUE hair transplant from a traditional Follicular Unit Transplant (FUT), where the donor’s hair is removed from the scalp in one thin, long strip and then subsequently dissected into individual follicular units using a stereo-microscope.
Before the grafts are harvested, tiny “recipient sites” are made in the balding area of the scalp using a fine needlepoint instrument. The follicular units are then placed into the recipient sites where they will grow into healthy hair-producing follicles. The creation of recipient sites and the placing of follicular unit grafts are essentially the same in both FUE and FUT procedures. The difference lies in the appearance of the donor area and in the quality and quantity of grafts obtained with each technique.
In the FUE technique, grafts collected and transplanted into the needed area one by one. It does not leave a scar on the donor area because it does not require stitches. So the FUE technique has become quite popular in recent years. After seven days of recovery, the procedure is complete without any trace on the skin.