Follicular Unit Grafting
Follicular unit grafting is the most widely used method of transplanting hair. It involves moving
small groups of one to three hairs from the donor area (back, side, and temples) to the recipient area or the area where hair has been lost.
Follicular unit grafting accomplishes several goal essential to the successful out come of the surgery.
Maximizes hair growth
Follicular units are distinct anatomic and physiologic entity. Therefore preserving the unit intact during the dissection process is thought to maximize growth. In FUT, after the single strip of hair is removed from the donor area the tissue is dissected under magnification allowing the follicular units to be separated with minimum damage.
In older techniques like micro grafting and mini grafting the hair was harvested in multiple strips. Each time an incision is made there is the potential for the FUTs to be damaged. When doing micro grafting or mini grafting the follicular units were sometimes separated creating the potential for more damage and less growth.
Since your hair grows in follicular units it only makes sense to transplant it that way. It also allows natural distribution of the hair in the grafted area creating the most aesthetically pleasing look.
By using follicular unit grafts instead of larger grafts (some call these multi hair grafts) the larger number of grafts allows the surgeon to distribute the grafts more evenly over the scalp resulting in the most natural look.
The density of naturally occurring follicular units is constant. This helps in the planning of your transplant in two ways.
First: Your surgeon can accurately predict the number of grafts that can be obtained in a single strip of tissue.
Second: The same number of follicular units can be used to cover a specific size bald area regardless of the patients actual hair density
If you have a high density donor area there us usually enough hair to accomplish the patients goals with regard to area covered and density. In patients with low density donor areas the patient must understand that the density in the bald area will not be as great. By transplanting a patient with low density using the same spacing as those with high density the doctor will produce a thinner look, but will allow proper conservation of the donor area for future use.
Minimizing trauma to the scalp.
The key to a good-looking transplant is to have the hair grow from perfectly normal skin. So the less trauma to the scalp is an important aspect of follicular unit transplantation. Trimming away excess tissue from around the unit reduces the size of the wound needed to place the graft.
These small trimmed grafts can be placed into tiny incisions in the scalp minimizing damage to the scalp’s connective tissue and blood supply. Larger grafts such as micro-mini grafts or multi-hair grafts need larger wound resulting in problems that included dimpling and pigment changes in the scalp, depression or elevation of grafts and a thinned shiny look to the scalp. These problems can be avoided by the use of tiny grafts in the scalp.
Small recipient sites create a tight fit for the grafts. These grafts fit into small needle made sites that don’t require the doctor to remove tissue from the scalp thus preserving the elasticity of the scalp and holds the graft tightly in place facilitating would healing and supplying oxygen from the surrounding tissue in order to maximize their survival.
Large Graft Sessions possible
There are four reasons why the follicular unit transplantation allows your doctor to transplant large numbers of grafts.
First: The hair transplant can be completed faster with less down time to the patient.
Second: A larger number of grafts can compensate for the shedding that often comes after a transplant surgery.
Third: Large numbers of grafts help to preserve the donor site by minimizing the number of incisions needed to complete the patient.
Fourth: You get more one and two hair grafts to create a soft natural hairline and enough three and four hair grafts to get the most density.
Follicular unit Extraction
Follicular unit extraction is a newer method of harvesting the follicular unit. In this procedure the doctor removes one follicular unit at a time thereby eliminating the thin scar in the donor area. It doesn’t require sutures in the donor site and is reported create less discomfort after the surgery. The downside to this method is that it takes much longer to do especially larger sessions and can cost over twice as much as the conventional strip harvesting.
Special Considerations for Women
Women seeking a transplant should be aware that their pattern of hair loss may exclude them from
this procedure. While men lose their hair on the top of their head leaving genetically proven hair on the side and back of their head, female pattern loss is indicated by an over all thinning of the scalp. So I you are thinning on top and in the temples beware. Once thinning begins in the temples it can continue around the back of the head. This means that some of the hair in the donor area has been pre-programed by nature to be lost in the future. If this is the case then some of the transplanted hair has already been destined to be lost. Transplanting this hair doesn’t change that. If the hair was going to be lost in the back in say 5 years then it will be lost in the front in 5 years. With this in mind we have to be very careful to make sure that you can get the result you want, or we need to explore other options.