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Overview on hair transplant methods

The hair restoration techniques of Follicular Unit Transplantation and Follicular Unit Extraction are performed in our office facilities under local anesthesia. Hair transplant sessions that involve the movement of thousands of tiny follicular unit grafts may take a whole day, but the time goes by quickly as patients rest comfortably during the procedure; either watching TV, taking a nap, or chatting with the staff.

The perception that people may have of a hair transplant, where patients leave the office with their heads wrapped in bandages and have significant bleeding and pain, is from the older, plug techniques. In modern follicular unit hair transplantation, patients leave the office with only a hat and headband and are able to shower and shampoo their hair the day after hair restoration surgery. After the procedure there is only some discomfort that is treated with oral medications, and there is literally no bleeding.

In Follicular Unit Transplantation (FUT) a thin strip of hair is taken from the back and/or sides of the scalp and the area where the strip was taken from is sewn closed. The hair from above the incision covers the area so that it is not visible. The donor strip is placed under a series of special dissecting microscopes where the individual follicular units, of one to four hairs, are carefully dissected into tiny grafts. These grafts are stored in a special holding solution and refrigerated while awaiting placement in the bald or thinning scalp (the recipient area). Meticulous stereo-microscopic dissection is a crucial part of the hair transplantation procedure, if one is to get full yield from the donor hair.

Recipient sites (tiny incisions) are then made in the bald scalp where the grafts are to be inserted. The sites are created with a thin instrument, or very fine needle, no larger than the one used to draw blood from your arm. If there is some hair in the area, the hair transplant doctor can work within the existing hair, so that it doesn't need to be cut. The depth, angle, and distribution of these recipient sites are a critical aspect of the hair transplantation if the results are to look perfectly natural. Their proper placement is a special art and skill of the experienced hair transplant surgeon.

Once the recipient sites are made, the follicular unit grafts are carefully inserted into the scalp. The 1-hair grafts are placed at the hairline, the 2's immediately behind them and the larger 3- and 4-hair units are placed in the central, forelock area. The recipient site sizes are matched to the different size follicular unit grafts, so that a snug fit is created. This facilitates healing, enhances growth of the follicles and permits a very easy post-op course.

In Follicular Unit Extraction (FUE) a relatively large area in the back and sides of the scalp is shaved to approximately 1-mm in length. Instead of removing a single strip, as in FUT, a tiny circular incision is made around each follicular unit. The follicular units are then extracted, one-by-one, directly from the scalp. The tiny wounds are small enough to be left open and heal on their own, which takes about a week. The remainder of the procedure is similar to Follicular Unit Hair Transplantation.

In either procedure, the hair transplant is visible for about a week. Some patients cover the area with their existing hair and others choose to wear a hat when they are in public. Patients can resume normal daily activities the second day following their hair restoration surgery, although there are some restrictions on strenuous exercise, smoking and drinking. New hair growth starts to appear in 2 to 3 months and is generally complete in 10 to 12 months.
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