Hair Transplantation: What is it and How Does it Work?

What is a hair transplant and how does it work?

Simply put, a hair transplant is a surgical procedure where hair is removed from the sides and back of your head (called the donor area) and surgically transplanted into the areas that need hair (called the recipient area) The most current and up to date trend is Follicular Unit Transplantation which  has evolved much since the days of hair plugs, mini-grafts, and micro-grafts.     A follicular unit (FU) is the natural way in which a   hair follicle grows.   Each Follicular unit can contain either 1 hair, 2 hairs, 3 hairs, or 4 hairs.    

Follicular Unit transplantation (FUT) is performed in one of two ways:   Strip surgery or Follicular Unit Extraction (FUE)/Follicular Isolation Technique (FIT).  

Strip surgery is where the doctor and staff will surgically remove a linear strip of scalp from the donor area  typically from ear to ear on the sides and back of your head that contains hair follicles.   The strip is then sown up with sutures or stapled in order for the area to heal.     The hair follicles are removed and cut from the strip of flesh by a staff of technicians and then surgically transplanted into your recipient area (the top of your head).   Because skin with hair follicles are removed from your head, you will be left with a scar.   Many advances have been made and the good news is, in the hands of a skilled doctor, the scar will be minimal.    

The current trend with Strip surgery is to use the trichophytic closure technique to close the donor area. Generally speaking, this method involves closing the wound by overlapping the layers and trimming the edge of one side of the wound to complete the procedure.   There are, however, variations of this technique.  

 A member named JoTronic from our hair loss discussion forums described it as below:

“The Frechet method trims the lower edge so that the top overlaps. The Marzola version trims the top edge so that the bottom overlaps. Rose’s version (referred to as the ‘Ledge’ closure) trims the lower edge but at more of a right angle or “notch” rather than a simple bevel. ”

Ultimately the goal of the trichophytic closure is to minimize the appearance of the wound by allowing hair to grow through it.   While the technicians are cutting the FUs from the strip, the doctor makes incisions using a cutting instrument into your recipient area. The latest and current trend among elite physicians is to use custom cut blades, however, many clinics still use “pre-fab” needles to make the incisions.  

The doctor will make as many incisions as there are follicular units removed.   Once this is complete, the tedious process of placing the grafts into the recipient sites occurs.  

Personally, I had 3 strip surgeries in total.   Click here to view my 3rd strip surgery with Dr. Hasson:

Follicuar Unit Extraction (FUE) or Follicular Isolation Technique (FIT) is a means of using a punch like device to extract one follicular unit at a time from your scalp.   This is not the same, however, as the old punch graft technique.   The standard size of the extraction tool used is typically .6mm to 1.3 mm depending on the number of hairs in the follicular unit.   The doctor uses a cutting instrument to make incisions in your recipient area in order for the follicular unit grafts to be inserted.   Some physicians use custom cut blades while others use other cutting instruments such as needles, etc.   Typically the grafts are inserted into the recipient sites as they are removed from the scalp, however, various clinics may deviate from this.   Here is a link to a guy with alias “Hairroot” on our hair loss discussion forums who had FUE surgery with Dr. Feller.   Results look great in my opinion.

Bill
Associate Publisher

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