What is Follicular Unit Extraction and Transplant??

For contemporary hair transplants, there are two basic methods of harvesing donor hair. The conventional strip technique and follicular unit extraction. In Follicular Unit Extraction (FUE) technique donor hair are harvested one by one and is therefore more labour intensive. During this technique a small micropunch usually sized 1mm or smaller is used to isolate a group of hair from its skin attachments. These groups having one to four hair, called follicular units, are then gathered (pulled out) from the head. This leaves a pin point wound from the area of harvest.

In this way the hair are taken out one after another, until adequate number of hair required for that session have been harvested. This surgery is done at a "micro" level and requires 8X magnification and expert hand control. Since FUE procedure requires careful and delicate handling, it is possible to harvest only 1200-1500 follicular units per session. An average session may last 8 hours and may need to be repeated, if balding area or graft requirement is extensive. The donor wounds heal over the next of seven to ten days with barely visible scars. Stiches are not required

In contrast, in FUT (strip) technique all the required hair are removed in one long strip of hair bearing skin. These hair are then isolated from the strip and implanted. To close the gap after strip harvest, stiching is required.

After the grafts are harvested, micro slits are created in the bald area where these follicular units are implanted with help of fine instruments. Once they develop their blood supply they will grow into healthy growing hair. The angulation of hair, density in key areas and hair design remais different from surgeon to surgeon and depends upon his experience and expertise.

At the end of the day the difference is only in harvesting technique, but what a big difference is that.

I will try to post a video of FUE soon and may be a pictorial comparison of two techniques.

FAQs about Hair Transplant

What is Hair Transplant?

Word "Transplant" can be seen as  made of two  words, Transfer and Implant. So, hair transplant is simply transfer of living hair. These hair can be transplanted in any hairless area such as balding scalp or area of stable scar, eyebrow, moustache etc. Currently, this is the only technique that can give natural, permanent, growing hair in bald area.

Who Needs It?

Hair transplantation is used predominantly to treat the hereditary balding condition known as androgenetic alopecia ( Male pattern baldness). Patients with male pattern hair loss tend to loose hair from the front and top of their head. Since baldness is often ridiculed in society, it can undermine one's confidence and performance, especially if it comes at a young age.

Women with diffuse alopecia, selected patients with burn alopecia, eyebrow and facial hair loss patients are other candidates who can benefit from the procedure.

What Causes Hair Loss?

Although there are many causes of hair loss, the commonest cause is male pattern baldness. this is due to a combination of two factors. First, the hormonal byproduct Di Hydro Testosterone (DHT) and second your hair follicle's susceptibility to DHT, which is genetically determined. Both the factors should be present to cause hair loss.

How is Hair Transplant done?

Patients having baldness still have good density of permanent hair on the sides and back of the head. These good quality hair that naturally last a lifetime, are used to fill up the bald region. The hair are taken out from the scalp one by one (as single units called FUE)  and are implanted individually in the bald area. This highly sophisticated procedure replicates the natural hair growing pattern.

Is There Pain?

Hardly if any at all. I customise local anesthesia solution to gently numbs the area of procedure. You will not feel anything at all. even in post operative phase when anaesthesia effect wears off, only mild painkillers may be required. Some people do not require any painkiller after FUE method.

How Long Will It Take?

Hair transplant is a one day  procedure in office setting. No admission is required. An average surgery of 1500-2000 grafts takes 5-6 hours. Megasessions of 3000 or more grafts may take 8-10 hours. You can go home the same day after procedure.

Are Results Permanent?

Yes. Since transplanted hair come from permanent hair zone (the back and side of scalp) that is unaffected by DHT, these hair do not fall after implantation. They will have same texture, colour, growth and quality as your back hair and the results will last you a lifetime.

Why Shouldn't I go for Artificial Hair?

Entirely too many reasons. The biggest reason that my patients tell me is that they feel artificial. There is always that fear of losing face in public if the hair piece comes off. Then, of course, there is price for maintenance, price for replacement and price for touch ups. After some time the cost of maintaining a good hair piece crosses that of transplant and you still have nothing to show. Last but not the least is health reasons. The glue can cause allergy, the clips can cause headache,even wounds if they are too tight, weaving may pull and damage your existing hair

Can I afford it?

The initial cost of a good hair transplant may be high but it does not require any maintenance. It is a kind of investment that will keep you giving good returns for times to come. An average a transplant session costs 5-7,000 US $ for FUT and 15-20,000 US $ for FUE hair transplants, but it is much cheaper in India.

Hair Transplant Basics: Who is the Right Candidate?

Did you know that by the time you start noticing hair loss, approximately 50% of the hair are already gone. So, as soon as you notice hair loss, you should consult a doctor. Remember that consulting a doctor is not same as going for transplant. In early stages of baldness, medicines can help you retain your hair and may postpone the need of transplant. However, medicines can not bring back the lost hair and to grow new hair in a bald area, transplant is the only option..

You should plan a transplant if,

      You have Androgenetic alopecia stage III to stage VII.

      Your hairline is not appropriate for age or you wish to achieve younger looking hair line

      You have burn alopecia or traction alopecia.

      You have eyebrow, eyelash or facial hair loss.

You should wait if,

You are in your teens or early twenties with unstable hair line.

If you have rare genetic conditions like DUPA, extensive alopecia areata etc.

If you are medically unfit for surgery (uncontrolled blood pressure, uncontrolled diabetes, heart failure etc)

Even in these conditions, it is best to consult a qualified plastic and cosmetic surgeon; because he can help you chalk out a plan for future and may offer you alternative therapies. An honest expert advice can save you lot of grief and money.

Hair Transplant Basics: What is Follicular Unit hair transplant?

Baldness and thinning of scalp hair are conditions that affect almost one-third of all men in their thirties and, fifty percent by their fifties.  Infrequently, some women also experience noticeable hair loss. There are many causes for temporary hair loss including systemic diseases, severe infection, anemia, thyroid disease, protein, vitamin and mineral deficiency, certain drugs, cancer treatments, childbirth and birth control pills. In this type of hair fall the root of hair is not destroyed. Therefore hair loss is temporary and corrects after the offending agent is withdrawn.

However, when hair root is destroyed, the loss of hair is permanent. The causes include direct trauma such as accidents, burns, operations and inflammatory or infectious diseases of the scalp. But, the most common type of permanent hair loss is Androgenetic alopecia, the exact cause of which is not known. However a hormonal byproduct called DHT has a significant role to play. It is postulated that people who have hair roots with increased genetic susceptibility to DHT suffer more severe hair loss. Since DHT is present in very small quantities in women, they do not generally suffer this type of hair loss.In Androgenetic alopecia, hair loss occurs typically from front and top portions of head, while sides and back hair are retained. 

Artificial coverage of bald area can be done with hairpieces and fibers, but many people find them unnatural looking or difficult to maintain. There are some medicines and oils in the market that claim to restore hair growth with limited success. Although medicines like Finasteride (Propecia) and Minoxidil (Rogaine) may stop hairfall to an extent, no amount of medicines can bring lost hair back. Follicular unit hair transplant is the only predictable, natural and permanent solution for those who are bald or have thinning hair. Hair transplants or grafting is a procedure which produces natural growing hair in bald areas.