FUT (Follicular Unit Transplant)


I’m experiencing shock loss in the recipient area after my 2nd hair transplant. I’ve been through this before with my first one. IWhy do some people experience shock loss while others do not?    FYI, I’m only 2 months out from my procedure.

This hair loss question was answered by  Dr. Glenn Charles of Florida who is a member of the Coalition of Independent Hair Restoration Physicians. His professional answer is below.

I wish we had an answer to the question of why shock loss occurs in some patients but not others. That would be like having the answer to how the lions could be that bad every year and not get better like most other teams. Unfortunately, I am also from Detroit and actually still watch them every Sunday. Not sure why. Where has Barry gone?

Any previously transplanted hair will come back. If you still had some original hairs that were very weak and ready to fall out they may be lost, but you will be replacing them with permanent hairs. Good luck.

Dr. Glenn Charles

Bill Seemiller
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum
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One of the most common questions regularly asked on our hair restoration forum is “Who is the best hair transplant surgeon?” Because selecting a quality hair restoration physician is vital to get the best  result, this question demands an answer.

However, determining “who is the best” is as much subjective as it is objective. Thus, awarding a single hair transplant surgeon the gold medal for being the best isn’t always scientifically possible. However, a small group of leading  physicians regularly demonstrates outstanding work and stand out from the pack. Below we’ll discuss how their skill level, experience, and ethics form the characteristics of an elite hair replacement surgeon and how they continue to revolutionize the hair transplant profession.

An elite hair surgeon continually adapts and refines their technique to achieve the densest and most natural looking results. Reputable surgeons will customize individual hair restoration plans for each patient and always do what’s in the patient’s best interest. This includes standing behind their work and guiding patients through any potential questions, concerns, or problems. Continued education, regularly consulting with other leading surgeons, and dedication to excellence are key ingredients to separating the best doctors from the rest.

The Hair Transplant Network specializes in educating patients on available hair loss treatments and recommending only the best hair restoration surgeons. An elite group of surgeons who perform large, densely packed sessions of ultra refined follicular unit hair transplantation when appropriate for the patient are invited to join the ranks of the Coalition of Independent Hair Restoration Physicians. To see our demanding standards for Coalition membership, click here.

This question, from a member of our Hair Loss Social Community and Discussion Forums, was answered by recommended hair transplant surgeon Dr. Mike Vories:

You read all the time on the hair restoration forum to maximize the number of strip hair transplants and then go follicular unit extraction (FUE), in order to max out one’s available grafts. I often wonder how many patients actually go through with all that though. Or what % of patients is it even necessary for?

Dr_VorriesThis is an excellent point. I have always disagreed with the “FUSS first” concept. A follicular unit is a follicular unit, whether it was harvested by follicular unit strip surgery or FUE. One of the several advantages of FUE is that we can spread the extractions over the entire donor area, and so minimizing the impact on any one area. Also keep in mind that strip excision changes the scalp architecture, and harvesting grafts (especially below the donor scar) with FUE is made more difficult after strip excision.

The only questionable benefit I can see to performing FUE after strip excision is the chance to try to cover up the strip scar with FUE grafts. However, the results of this are variable, and in many cases the strip scar does not have the vascularity to support the grafts. For this reason it is much better to avoid the strip scar than to plan on covering it with FUE grafts.

Dr. Mike Vories
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David
Editorial Assistant and Forum Co-Moderator

Rogaine PropeciaToday’s revolutionary surgical hair restoration procedures allow a qualified physician to move individual follicular units (hair groupings as they occur naturally) from the sides and back of one’s scalp to balding areas. The end result is a natural looking head of hair, undetectable to even the harshest critics. And while this miracle hair transplant procedure can restore hair to completely bald areas, it does nothing to stop the progression of genetic baldness. What if hair loss continues? Will a second or even third hair transplant be required? Is there enough donor hair to keep up with the progression of baldness? Should proven medical hair loss treatments be used in conjunction with hair transplant surgery? Why or why not?

Forum member “Roy” is about to undergo surgical hair transplantation with Coalition member Dr. Ron Shapiro and wants to know what risks are involved in proceeding into surgery without taking Propecia (finasteride)  to attempt to slow down continued loss. Visit “Going into Hair Transplant Surgery without Medication” to discuss why non-surgical hair loss products complement a hair transplant and the risks included in not taking them.

Bill Seemiller
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum
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While today’s hair transplant procedures provide naturalness and density that can mimic nature, it often takes more than one procedure to get the best results. This is especially true for men (and women) with extensive thinning hair and baldness. But for those who need more than one procedure, what can they expect from each hair transplant? Will growth yield be similar in subsequent hair restoration procedures as the first? Will results be delayed in following hair surgeries?

In “Do Subsequent Procedures Have Delayed Results“, forum member “Time to Do Something” asks if results take longer in additional procedures. You are encouraged to read what other members have said and to offer your own input on this discussion topic.

Bill Seemiller
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum
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Watch hair transplant videos  on YouTube

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I got a quote from one of the Hair Transplant Network’s recommended clinics of 4000 follicular units. Now, from what I have learned, I think 4000 follicular units = 4000 grafts but the sales executive from this reputed clinic is saying that 4000 follicular units means 2000 grafts. Am I mistaken or taken for a ride?

questionIn response to your question, I’d like to begin by discussing hair transplant nomenclature as it can be somewhat vague.

Often, strip surgery if referred to as “follicular unit transplantation” or “FUT” in contrast to FUE which is follicular unit extraction. However, we prefer the term FUSS or follicular unit strip surgery to describe strip harvesting because, technically speaking, both FUE and strip are forms of follicular unit transplantation.

Follicular unit transplantation in either FUE or strip form refers to state-of-the-art implanting of hair grafts in their naturally occurring clusters of 1 to 4 hairs. These clusters are what we term a “follicular unit” or “FU”.

By that definition, grafts and follicular units are one and the same.

There are instances when a hair restoration physician may opt to use some double follicular units (DFU) combined with FUs to create additional density. In such a case, you would have a difference between the number of grafts and the number of follicular units. However, this is not particularly common.

David
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

This question, asked by a member of our Hair Loss Social Community and Discussion Forums, was answered by Coalition hair restoration physician Dr. Timothy Carman:

Having had multiple hair transplants, I feel my scars over time have become more noticeable and is something I need to address. Do any clinics offer scar revisions/trichophytic closure?

As to revisions, what is the overall success and satisfaction of those that go that route?

Dr_Carman_photoHair transplant strip scar revision can be successful, but that success is individualized and also very dependent upon how many previous procedures have been performed. That option should be available in any state of the art surgical hair restoration practice, given an experienced surgeon.

As for the trichophytic closure, in my opinion, that closure was more of a trend to address poor technique which characterized well-intentioned but less than standard of care donor closures. Adherence to sound plastic surgery techniques when harvesting and especially closing the donor area virtually eliminates the need for any type of trichophytic manipulation.

What’s more, with short, straight hair, the trichophytic method can leave a tell-tale pattern in the hair as hairs along the incision are angled in an unnatural direction due to the mechanics and geometry of hair growth through the scar tissue.

I hope this is helpful.

Dr. Timothy Carman
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David
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

I recently went to a hair transplant surgeon for a consultation and I told him that I wanted to go for FUE but he said that I had curly hairs and so I was not a good candidate for FUE and suggested that I’d go for strip instead. So is there anyone out there with curly hairs who has got an FUE hair transplant?

curly hairVery curly hair such as African American hair is a challenge to harvest via follicular unit extraction (FUE) because the hair continues to curl under the scalp making it difficult for the surgeon to score without transecting the grafts.

Surgeons will sometimes perform a small test procedure on patients with curly hair in order to determine the quality of the grafts. Others may simply turn risky patients away or recommend follicular unit strip surgery (FUSS) instead.

Of course, this can be a serious issue for patients traveling abroad. You could arrive at your destination only to find that you are not a candidate for FUE.

I suggest consulting with a few more FUE specialists before writing yourself off as a candidate. If you haven’t already done so, you may wish view our list of recommended hair restoration physicians.

David
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

To share ideas with other hair loss sufferers visit the hair loss forum and social community.

The following response to a question from the Hair Restoration Social Community and Discussion Forums, was written by forum member “Gillenator”.

I been told by a dermatologist that it is possible to get rid of a scar 100% if you Fraxel it for two years twice a month. He said it’s not a guarantee but he has done it with others before.  Is this true?

I have a bad hair transplant scar from ear to ear from 1 cm wide in the back and 7 mm on the sides. I’m looking to do scalp micropigmentation (SMP) if I can get rid of that scar, I wont get that smiley face on the back of head if this dermatologist is right.

eraserAlthough there are some cases of Fraxel working amazing improvements with the appearance of a scar, nothing will completely get rid of it. That’s a fact.

Anytime flesh tissue is cut, the body repairs itself by forming scar tissue which for the most part does not have blood flow to it or through it.

Probably what the dermatologist meant was that he had a few cases where it was very difficult to see the scar visually speaking after treating it with Fraxel.

Gillenator
Supporting Hair Restoration Physicians: Dr. Glenn Charles, Boca Raton, FL – Dr. Jerry Cooley, Charlotte, NC – Dr. Jim Harris, Denver, CO – Dr. Robert True & Dr. Robert Dorin, New York, NY
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David
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

This question, from a member of our hair loss social community and discussion forums, was answered by Coalition hair transplant surgeon Dr. Glenn Charles:

I had a hair transplant about fifteen years ago using the follicular unit strip surgery (FUSS) technique. It left me with a wide scar. Last December I underwent a follicular unit extraction FUE procedure to increase the density and improve the hairline on top. I could not get my scar filled then using FUE as it would make sleeping a nightmare and I would have probably dislodged some grafts either in the scar or on top.

I would like to proceed before the summer to have my strip scar filled in using FUE. It’s three months since my last surgery. Do I have to wait a certain amount of time before harvesting grafts from my donor area again? Does the donor area need a set time to recover? Could I proceed with my scar repair in the next three months?

Dr. CharlesYou could have more FUE harvesting done at this time.

If there are a few areas that your hair restoration physician did not harvest from during your last procedure, those would be the preferable areas to take from for this next procedure.

Dr. Glenn Charles
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David
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

To share ideas with other hair loss sufferers visit the hair loss forum and social community.

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