FUT (Follicular Unit Transplant)


This question comes from a member of our hair loss social community and discussion forums:

Several years ago, I underwent Follicular Unit Strip Surgery (FUSS). The result is good, but the strip scar is noticeable when my hair is trimmed short. I’m interested in “buzzing” my hair shorter on the sides, and would like to revise the scar. Is it possible to revise or camouflage my hair transplant scar with Follicular Unit Extraction (FUE) grafts?

FUE scar repairCamouflaging a strip scar with FUE grafts is an option. Unfortunately, FUE grafting into strip scarring isn’t always reliable. Scar tissue is dense, tortuous, and avascular (no blood supply). This makes growth rates highly variable. If your scar is thick and raised, you may have low blood supply in the region. This could really affect growth. If you can, consult with one of our recommended hair restoration physicians. This will help clarify the level of scarring and how well grafts could grow in the tissue.
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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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Technorati Tags: hair loss, Follicular Unit Strip Surgery, , , , Follicular Unit Extraction, , hair restoration physicians

This common question comes from a member of our hair loss social community and discussion forums

I want to undergo hair transplant surgery. I can only undergo surgery once, however, so it must be with the best. So, who is the best hair transplant surgeon practicing today? Help me find the “best” hair transplant surgeon.

first place ribbonMembers frequently ask this question at our hair loss discussion forums. We pride ourselves on researching, reviewing, and recommending the most talented hair restoration surgeons practicing today; however, identifying one surgeon as the “best” practicing today is difficult. This is true for several reasons:

First, surgeons specialize in different aspects of hair restoration surgery. For example, say a surgeon specializes in follicular unit extraction (FUE). He may be considered the “best” FUE surgeon practicing today, but he wouldn’t be the first name mentioned for a female hair loss sufferer seeking strip surgery (Follicular Unit Strip Surgery).

Second, terms like “the best” are subjective. Hair transplant surgery is as much an art as it is a science. Many patients desire a specific hairline design or reconstructed whorl pattern in the crown, and connect with a surgeon using these designs. This surgeon may be the “best” for this patient. Another, however, may find this doctor’s hairline and crown design too aggressive and desire a different approach. For this patient, the second surgeon may be “the best.”

This question comes from a member of our hair loss social community and discussion forums

I’ve been losing my hair for several years. I initially thought I suffered from androgenic alopecia or male pattern hair loss; however, members of online forums now say it may be diffuse unpatterned alopecia or DUPA. What is DUPA? Can it be fixed with hair transplant surgery?

DUPAI’m not 100% sold on the idea of “DUPA” or it’s cousin “diffuse patterned alopecia” (“DPA”).

Traditionally, non-scarring alopecia is broken down into several categories: focal, patterned, and diffuse. Focal alopecia includes conditions like alopecia areata; patterned includes androgenic alopecia and female pattern hair loss; and diffuse covers conditions like telogen effluvium, anagen effluvium, loose anagen syndrome, atrichosis, and hyoptrichosis. However, it does not – traditionally – include “DUPA” or “DPA.” Maybe the categorization is out of date, but I generally try to stay away from these terms – or at least from DPA. I do understand that “DUPA” is a good description for one clinical picture – which I will explain below.

I would classify hair loss fitting this diffuse pattern as follows:

Either: diffuse androgenic alopecia that is best described by the Ludwig and not the traditional Hamiltion-Norwood hair loss scale; OR you could call it diffuse unpatterned alopecia if you are experiencing thinning in the donor region (which is the only time I really think this term is appropriate).

This question comes from a member of our hair loss social community and discussion forums: 

I recently underwent hair transplant surgery. I’m happy with the results, but I’m afraid they will not last. Are the follicles transplanted during hair restoration surgery permanent, or will they thin and fall out over time?

For all intents and purposes, the follicles transplanted during a hair restoration procedure are permanent.

Barry post opAndrogenic alopecia (male pattern hair loss) is caused, initially, by diyhydrotestosterone (DHT) hormone. Hair follicles in the frontal scalp, mid-scalp, and vertex are sensitive to this hormone, and contact with DHT causes the follicles to miniaturize and stop producing hair. There are some follicles in the scalp, however, that are “highly resistant” to DHT. These follicles are located on the sides (temporal/parietal) and back (occipital) of the scalp. When transplanted, these follicles retain their resistance to DHT and do not shed or thin – even when exposed to DHT in new regions of the scalp.

These follicles are “highly resistant” to DHT, but they are not completely immune. This means, in theory, they could still shed if exposed to very high levels of DHT over a long period of time. However, the thousands of successful cases of hair transplantation performed over the past 60 years prove the resistance and permanent nature of the DHT resistant follicles. Many of the “10 year plus” hair transplant cases shared on our Hair Restoration Discussion Forums reinstate this point; hair transplantation is permanent, and patients should not expect their results to thin or shed significantly over time.
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Blake – aka Future_HT_Doc

I had a follicular unit strip surgery (FUSS) back in 2003. My hair transplant result is okay but I want to shave off my hair. Will my scar be visible? If so, how can I hide it being bald?

FUSS-scar-fixedUnfortunately, once you have undergone follicular unit strip surgery, shaving your head will expose the resulting scar. You may have success camouflaging the strip scar via scalp micropigmentation (SMP) or scar revision through follicular unit extraction (FUE) hair transplantation.

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David (TakingThePlunge)
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.

 

Technorati Tags: , , , , scalp micropigmentation, , follicular unit extraction, ,

This common question comes from a member of our hair loss social community and discussion forums:

I want hair transplant surgery now, but don’t have a lot of disposable income. This means I’m looking for the most affordable hair transplant surgeon. Does anyone know where I can undergo cheap hair transplant surgery? Should I take cost into consideration when choosing a surgeon? Is it wrong to pick a doctor based solely on price?

piggybankThough it is tempting, most advise against “price shopping” for hair transplant surgery. In some cases, it results in sub-par work; when this happens, it is almost always MORE expensive in the end. I’m not saying completely discount cost, but a single quality procedure with a trusted doctor will be most efficient with respect to both cost and use of your finite grafts. This does not mean you can’t take cost into consideration when selecting a physician. However, it probably should not be the sole deciding factor, nor should it be placed above quality, skill, and results.

You can always wait and “save up” for a hair transplant as well. Hair loss (androgenic alopecia) is a progressive disease, and many physicians actually recommend waiting and using preventive medications – finasteride (Propecia) and minoxidil (Rogaine) – before taking the surgical plunge. Consult with several recommended hair restoration physicians and discuss your cost concerns. Some likely have payment plans outlined for this situation; others may recommend saving up while stabilizing the hair loss with preventive medications.  However, I don’t think any will recommend seeking the “cheapest hair transplant” available as quickly as you can.
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Blake – aka Future_HT_Doc

This question comes from a member of our hair loss social community and discussion forums

Several years ago, I suffered from an unrelated medical issue. A physician prescribed a medication and the pills essentially fixed the problem. However, I’m beginning to experience symptoms again and wanted to restart some left-over medication. But, I just underwent hair transplant surgery several days ago and I’m concerned restarting the medication could affect the results. What should I do?

pillsI recommend the following:

First, speak with the physician who originally prescribed the medication. Ask him – or her – whether or not you should restart the medications, and if an appointment, exam, or further testing is required first.

Next, speak with your hair transplant surgeon. Explain the situation and ask whether or not the medications could affect the newly implanted grafts. Make sure both physicians understand the importance of your prior medical condition and your new hair transplant. Follow the advice of both doctors closely. If possible, ask if the two doctors could speak directly and create a treatment plan together.

Questions about medications should always be answered by trained physicians.
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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

Follow our community on Twitter

Watch hair transplant videos on YouTube

Technorati Tags: hair loss, hair transplant

This question comes from a member of our hair loss social community and discussion forums: 

I recently underwent hair transplant surgery. Everything went well, but I’ve experienced this strange “spasm” in my forehead since the procedure. I am wondering if it was from the local anesthetic; my doctor said he performed a “supraorbital and supratrochlear nerve block.” Is this normal? Do patients experience muscle spasms after hair transplant surgery?

First, and foremost, I think you should discuss this issue with your hair transplant surgeon. The doctor may have experience with this issue and offer an explanation to help put your mind at ease. 

facial nerveMuscle twitching in your forehead would likely be related to activity of the facial nerve (cranial nerve VII). During the procedure, it sounds like your doctor performed an anesthetic “block” of the supratrochlear and supraorbital branches of the trigeminal nerve (cranial nerve V). These nerves exit the skull directly above the midline of the eyebrow. The temporal branch of the facial nerve, which controls the muscles in the forehead (and would likely cause the spasm), is a bit deeper and further lateral compared to the trigeminal injection site. This means it would be difficult to accidentally inject or damage this nerve during the anesthetic block.

The other concern could be nerve issues during the strip extraction process of a Follicular Unit Strip Surgery (FUSS) procedure. However, the facial nerve exits the skull near the bottom of the ear, and this position makes it unlikely to be damaged during the strip extraction process.

This question comes from a member of our hair loss social community and discussion forums

I recently underwent hair transplant surgery, and need to return to work. Part of my job requires me to wear a hat. I spoke with my hair restoration physician and he said I could wear a hat after the grafts were fully anchored. How long does it take for the grafts to anchor and become permanent? Can I wear a hat after hair transplant surgery?

bad hatIt takes approximately 7 to 10 days for the newly implanted follicular unit grafts to fully “anchor” and become permanent. Before this time, manipulation or compression of the grafts may cause permanent damage and affect growth. Due to this fact, most hair transplant surgeons recommend waiting 7-10 days before wearing any type of cap that could compress, move, or dislodge a graft.

After the 7 – 10 day mark, the grafts should be permanently connected; at this point, no amount of manipulation should cause any damage. Wearing a hat after this period should be perfectly safe. It is, however, important to discuss issues like this with your hair restoration physician. Many doctors have specific rules about activity post-surgery, and it is important to follow these closely.
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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

Follow our community on Twitter

This common post-operative concern was recently discussed by Coalition hair transplant surgeon Dr. Carlos Wesley

post-op-pimpleA common observation among patients during the early phase of hair growth following surgical hair restoration (either Follicular Unit Strip Surgery or Follicular Unit Extraction) is ingrown hair follicles. The “pimples” that some (but not all) patients experience generally represent focal inflammation (folliculitis) where a newly-ingrowing hairs are beginning to surface.

Patients can often feel reassured knowing that these generally precede more apparent hair growth over the following weeks and months. They can be seen in both the recipient area (where transplanted hairs are coming in) or donor region (especially in FUE where any residual hair fragments may be coming in). They may be more commonly observed in zones where the angle of hair implantation is the sharpest angle (e.g. the vertex or crown).

In general, a simple cotton ball soaked in rubbing alcohol can be used to rub on each pimple. The microabrasion allows the nearly-ingrowing hair to surface and resume growth. It’s relatively rare that an antibiotic is required, but even a one-week course of antibiotic can have a positive impact. The ultimate appearance is not impacted by the presence absence of a few “pimples” and patients should simply be aware that they generally represent an early phase of growth. 

-Dr Carlos Wesley
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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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