The procedure consists of resurfacing bald areas of the scalp with hair. Plugs of bald scalp are removed and then filled with plugs of scalp containing several hair roots taken from hair-bearing areas. Thеse grafts root themselves into their new locations and hair follicles start to grow eventually.
Тhe number of grafts needed and the length of treatment sessions depend on the degree of baldness. Several operations may be necessary. The technique may leave many small scars on the donor sites, but are usually not noticeable.
Follicular Unit Extraction (FUE) Hair Transplant
Follicular unit extraction (FUE) is a hair transplant technique in which a small round punch is used to extract follicular units from a patient's bald resistant donor areas. These hair follicular unit grafts are then transplanted into a patient's balding areas.
Given the time consuming and tedious nature of this procedure, a physician is often limited to transplanting 500 to 600 follicular unit grafts in one day. The cost per graft of FUE is also typically twice the cost of the standard follicular unit hair transplant procedure in which a strip of donor tissue is removed from the back of the head and trimmed under magnification into individual follicular unit grafts.
Comparing Follicular Unit Extraction (FUE) to the Standard Strip Procedure
While the FUE procedure has grown in popularity, largely due to the minimally invasive way in which follicular unit grafts are removed, the standard strip excision method is still the most popular hair transplant procedure. It involves surgically removing a strip of scalp from the bald resistant donor area of the patient. The donor area is then sutured together.
These sutures (either stitches or staples) are then removed about ten days after surgery. Some physicians use dissolvable sutures so that no removal is needed. When the linear incision is fully healed the patient is left with a thin scar in the back of the head. This scar is typically hard to see once the surrounding hair grows out and conceals it.
Scalp Flap Transfer
This is done when the sides of the scalp (above the ears) and the back of the scalp is hair-bearing. A long, thin "flap" of scalp that is hair-bearing is removed and placed across a bald section to create a band of normal hair growth. As part of the treatment, parts of the bald scalp may be removed. The donor site is closed by stretching the opposite side of the scalp. This procedure replaces hair across a large area of bald scalp. The hair growth looks normal, and the narrow scars are hidden between the hair follicles.
Scalp Reduction (Serial Excision)
This is the removal of as much of the bald section as possible and done in the first operation. The adjacent hair bearing areas of scalp are pulled in close to the bald section, with the understanding that some bald areas will remain. This technique is repeated one or more times at a later date to eventually reconstruct the bald area.
A device called a tissue expander is placed under a hair growth area situated adjacent to a bald area. After several weeks, the tissue expander causes skin to grow new skin cells. Then another operation is necessary to place the newly expanded skin over the ajoining bald area.
Almost everyone believes that follicular units are the best size grafts for hair transplantation, but reality is a bit different. In our clinic we use 3 sizes of grafts: single hair follicular units, follicular units, and modified follicular units. We use single hair follicular units mostly for the hairline, while follicular units could be the basic size for the rest of the grafts.
Ideal candidates for hair replacement must have a healthy growth of hair at the back and sides of the head. The hair on the back and sides of the head will be the donor sites where the flaps and grafts will be surgically removed.
To achieve the desired fullness, several surgical sessions are needed. There is a healing period of several months recommended between each session. The final result with a full transplant series may take up to 2 years.
A month or 2 after surgery, the grafted hair falls out (which is normal and temporary). It takes another month or more before hair growth starts. To create more natural-looking results, a surgical touch-up procedure may be necessary. This may consist of using a combination of mini grafts or slit grafts to fill and blend in the hairline.