Surgical hair restoration – Follicular unit transplantation (FUT)

FUT procedure has 4 steps

FUT procedure has 4 steps

Follicular Unit Transplantation (FUT) is a technique which involves harvesting a single strip of follicles from the scalp, separating it into individual follicular units using stereo-microscopic dissection, and implanting them into the targeted area.

Key Features of FUT

Follicular Unit Transplantation accomplishes the following goals:

  • Maximizes Hair Transplant Survival

A follicular unit is a distinct entity which needs to be carefully preserved to enable it to function properly after implantation.  As previously mentioned, during Follicular Unit Transplantation, a single strip is taken from the donor area and then separated into individual follicular units.  Stereo-microscopic dissection allows minimizing the damage to follicular units.  In the past, many follicular units were damaged when the strip was cut into smaller pieces.

  • Creates Natural Hair Growth

Follicular Unit Transplantation allows for the hair transplant to have a natural look due to even distribution of grafts over the targeted area.  Since the surgeon is working with individual follicular units, the surgeon has a large number of grafts with which to work.  This allows creating a more natural distribution of hair.

  • Makes It Easy for the Surgeon to Plan Ahead

The density of follicular units in a scalp is relatively constant which makes it easy for the surgeon to:

    • accurately estimate the number of grafts that can be harvested from the donor strip
    • use the same number of grafts per cm2 when performing the implantation process
  • Minimizes the Damage to the Scalp

The key to having a successful hair transplant is to preserve the structure and the amount of skin on the scalp.  Follicular units are surrounded by a rather large area of skin which doesn’t produce hair and the excess tissues that surround the follicular units have to be removed before inserting them into the scalp of the recipient.  Stereo-microscopic dissection is a technique that allows this to be done without damaging the follicular unit.  After the follicular units are freed from excess tissues, they can be inserted into tiny incisions on the recipient’s scalp while ensuring that little damage is done to the blood vessels and connective tissues.

Since trimmed follicular units are so small, they can be inserted into incisions made by a needle without the need to remove tissue in the recipient area.  This preserves the scalp’s elasticity, while ensuring the grafts are held snugly in place.  This promotes faster healing and better oxygenation of the tissues which maximizes the survival of the follicular units.

By contrast, previous techniques which used plug transplants and mini-micrografting  created various cosmetic problems including pigmentation and dimpling of the skin.  After such a procedure, the skin of the scalp looked shiny and the grafts could be located on different levels.

  • Enables the Surgeon to Transplant a Large Number of Grafts

Since the time between the extraction and implantation of the follicular units is relatively short, a large number of grafts can be implanted in a single session. This creates advantages to the Follicular Unit Transplantation technique such as:

    • Hair restoration can be quickly achieved after only one or two sessions;
    • Using a large number of grafts allows the creation of a soft and full looking frontal hairline after the procedure;
    • The donor area won’t be damaged repeatedly as a large number of grafts can be extracted using only a single session.

Additional Methods of Improving Survivability of Hair Grafts

In order to improve the percentage of surviving follicular units, doctors have started to use a number of additional techniques.  One of these techniques is injection of Platelet Rich Plasma (PRP).

PRP is created using the patient’s own blood after being processed through a centrifuge.  This creates a concentrated mix of platelets and proteins.   A topic anesthesia is applied to the scalp and a special roller is used to administer this platelet-protein mix.  This procedure stimulates the healing and growth of cells which promotes better survival of follicular units.

In some cases, this procedure is used alone without any type of hair transplantation.  The data supporting the efficiency of this method is still scarce; however, creators of this method claim that this procedure can slow down and possibly prevent further loss of hair if the hair loss is still very mild.

In Conclusion

Follicular Unit Transplantation is currently one of the best options available for surgical hair restoration.  It provides a good survival rate for follicular units and leads to less damage to the scalp.  Although not a treatment  for people whose scalp is too tight or who have massive scar tissue as a result of injury, this technique is the first choice for people  who do not have a condition which would contraindicate Follicular Unit Transplantation.