How it Works
by Ramtin Kassir, M.D., F.A.C.S.
The hair restoration techniques of Follicular Unit Transplantation and Follicular Unit Extraction are performed in our office facilities in New Jersey under local anesthesia. The most state of the art techniques involve automated FUE Hair transplant sessions like the Neograft or Artas 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 hair loss surgery; 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, hair surgery 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 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 2 to 3 months after hair surgery and is generally complete in 10 to 12 months.
Q: What’s the difference between FUE and FUT?
FUT (Follicular Unit Transplant)
The FUT/strip technique is currently the most widely practiced form of hair restoration surgery. It involves the excision of a strip of scalp from the back and sides of the head. This strip is then dissected into smaller units and then further subdivided into individual follicular units under a microscope. Meanwhile, the open wound is closed with sutures or staples. Strip harvesting has existed, in various forms, for several decades. In the 1990’s, the technique was much improved with the use of a single blade becoming normal practice.
Despite its prominence, there are several drawbacks to the strip method. Most notably, this method leaves a long linear scar in the donor area. It is difficult to predict the width of the scar you will be left with; contributing factors include scalp laxity, the skill of your physician and personal healing characteristics. With a strip scar, you no longer have the option of wearing your hair short without the tell-tale linear scar being visible. Additionally, a strip procedure will cause irreversible changes in the donor area’s hair growth angles so, even with a longer hair cut, people may be able to tell you have had a hair transplant procedure.
The strip method of hair transplantation is also a more invasive procedure than FUE because it involves the use of a scalpel to remove a portion of tissue from the back of your head. Recovery can be uncomfortable with numbness, tightness and/or soreness for up to two weeks. Another drawback of this method is that it, logically, results in a scalp reduction in the donor area. This reduction in laxity can be uncomfortable, is irreversible and can prevent you from being able to harvest more donor hair if your hair loss persists in the future.
Follicular Unit Extraction (FUE) is a method of follicular extraction by which follicular units are removed individually from the donor area. With this technique, there is no need for a linear incision and, therefore, no linear scar.
FUE is less invasive than the strip technique, as it does not require a large scalpel incision or sutures. This greatly decreases healing time in the donor region and greatly decreases any post-op discomfort. Patients can resume even strenuous activities the very next day following a procedure.
FUE provides an extended donor region from which your physician can graft from because they are not limited to a single strip of hair. With this method, your surgeon can extract hair from the nape of your neck or even extract body or facial hair. This ability also allows the physician to “cherry-pick” follicular groups which will yield the most optimal and consistent results.
FUE is a particularly good option for those with increased risk of donor scarring (Asians, for example). It also serves as an alternative for those who do not have enough scalp laxity to undergo traditional strip excision. FUE can even be used to repair linear donor scars (from previous strip procedures) that cannot be excised.
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