Follicular Unit Transplantation / FUT hair transplant derives from the traditional strip harvesting method in which, the micro-grafting technique is utilized to harvest hairs by its follicular units by surgically removing a strip of skin from the patient’s back of the scalp, the strip of hair is to contain numerous hair follicular units that is dissected and sorted under a microscope and replaced to the bald area to achieve an evened density of hair all over the scalp.

The FUT hair transplant procedure depends mainly on two factors: Donor Supply and Scalp Elasticity. The donor hair is examined under due techniques and equipments and scalp elasticity means how flexible the scalp is to accommodate the 2cm skin stripping.

The final result and the factor of a “head full of hair” may depend on the amount the donor supply however, a fuller appearance is intended by artistically planting the hairs following some intelligent patterns.

FUT Procedure

A hair transplant procedure works with the naturally occurring groups of 1,2,3,4 or 5 hairs referred as hair follicular units. In the FUT procedure the hair follicular units are harvested by examining the patient’s back of the scalp for the densest area where the hair is strongest being immune to baldness or have androgenic-resistant characteristic.

The surgery takes place after a formal consultation wherein the patient is examined and made aware of the all details of the hair transplant surgery that is right for individual condition and the actual course of the procedures. Patients are encouraged to make their decisions with complete independence and confidence, and once they have done so, they are provided a printed hard copy of pre-operative instructions to be maintained at least for two weeks till the surgery.

This pre-operative instructions list includes:

• Refrain from smoking and nicotine consumption (including nicorette)
• Refraining from medications like blood thinners; anti-coagulants; aspirins, Vitamin E supplements
• Slowing down on caffeine intake

The pre-op list is made individually depending on weather the patient smokes at all, takes anti-coagulants at all, and depending on the habits and drug usage the patient keeps is the pre-op list made.

The surgery is done under local tumescent anaesthesia which is injected to the scalp subcutaneously. The anaesthesia plays the part of numbing the scalp so that the patient doesn’t feel any pain or discomfort and also constricting and hardening blood vessels and collagen which limit blood loss and bruising. The patient feels a little drowsy but don’t fall asleep unless they want to.

The hair in the pre-determined donor area is clipped short and the donor strip is cut following a depth till the erector pilli muscle and a length of 2cms excising a linear strip from one end of the scalp from behind the ears to the other around 20cms. As with the factor of scalp elasticity, if the patient’s scalp is too tight the overall size of the strip has to be reduced limiting the total amount of donor hair.

Hair Graft Dissection

Once the donor strip is excised off the back of the scalp of the patient, it is collected by the assistant surgeons to be put under microscopic dissection. The FUT hair transplant procedure facilitates open dissection wherein the surgeon can see the follicular units stuck to the skin strip and dissect those follicular units from the skin strip with a little tissue to surround the follicular unit and provide the essential moisture and support to hold the hairs. The whole thing of the hair follicular units bound under a fatty tissue is called a hair graft which is immediately placed on a saline solution which mimics the body fluids the hair follicles are accustomed to and save them from surgical trauma and dryness and keep them fresh and health to sustain normal growth once they are implanted to the bald area. As the graft dissection is taking place the hair transplant surgeon will be busy closing the donor scar and preparing the recipient site to implant the hair grafts.

Closing the donor area and creating the recipient site

The donor scar is closed and sutured the two ends together by staples or dissolvable threads and cleaned of the blood and fluids.

The recipient site is prepared with tiny pinprick holes or slits where the hair grafts can be plunged much like planting wheat making a certain pattern for a fuller and naturalistic appearance. Once the process is done the hair grafts are used according to their number to follow the pre-marked artistic pattern, where usually the lower graft numbers of 1-2 hairs are planted to the front and larger number grafts of 3,4 and 5 hairs are placed to the central area for an ultimate coverage yet look completely natural.

Final Results

The FUT hair transplant procedure makes up 7-10 hours under one session and can complete planting up to 3,000 hair grafts successfully, which can suffice the coverage of a big bald scalp. Once the surgery is completed the patient’s scalp is cleaned and a bandage is wrapped around the head covering the nape of the neck and the forehead but keeping the recipient site open. The patient can immediately go home as soon as they feel comfortable, yet still it is necessary that the patient is escorted home attended by someone on the first 3 nights of the surgery.

A printed hard copy of post-operative instructions is handed to the patient to maintain. The patient might feel varying amounts of pain in the first night and 2-3 consecutive days that can be bearable or unbearable depending on the patient’s tolerance, and the patient is required to sit their elevated for 3days post-op. Surgical downtime can be resumed within 1-2weeks depending on patient’s condition, and final results gradually emerge by 10-12months.