FUT (Follicular Unit Transplant)


This question, asked by a member of our hair loss social community and discussion forums, was answered by a representative for Coalition hair transplant surgeon Dr. H. Rahal:

I’m undergoing hair transplant surgery next month. The clinic said to stop minoxidil (Rogaine) one month before the procedure. Why do I need to stop the medication? Is one month before surgery the recommended time period for stopping minoxidil?

RogaineRogaine/Minoxidil promotes blood circulation and flow to the scalp (to promote healthy hair growth to your native hairs). We ask that you stop using it a month prior to your procedure to minimize bleeding on the day of your procedure. Since we’re making several hundreds to thousands of incisions to our recipient area, we don’t want you to bleed any more than you need to. In addition, it makes it easier to continue to make the incisions during the procedure and allows for easier implanting.

-Robert, Senior Patient Adviser
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Blake Bloxham – formerly “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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This question comes from a member of our hair loss social community and discussion forums

I’m interested in hair transplant surgery. When I first started my research, I had no idea two separate methods of the procedure existed. I visit online hair loss discussion forums, and see a lot of people arguing about which technique is “better” – follicular unit extraction (FUE) or strip surgery (follicular unit strip surgery). Now, I’m confused; which procedure is better for me?

FUE v stripThe “fue vs strip” debate does stir up quite a bit of controversy online. Frankly, I think it comes down to two points: accepting more consistent growth yield with strip surgery, but also accepting the linear strip scar; or forgoing the traditional strip scar in favor of less consistent growth.

So, which procedure is “better” for you? Which one should you chose?

In my opinion, there are patients who are better suited for strip procedures and those better suited for FUE. These strip patients MUST understand the reality of the linear scar. But if they do, I think they will simply receive more “bang for their buck” with strip.

The best way to figure this out is by consulting with trusted hair restoration physicians. Discuss FUE versus strip thoroughly with several of these doctors. They should be very comfortable with both methods. Share your goals and what you see as the “pros and cons” of each procedure. Lastly, come up with a solid – and personal – answer to this question: would I rather shoot for increased yield in one pass and deal with a variable linear scar? Or, is the scar a “deal breaker” and I’d prefer more variable yields with less visible scarring?

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

I have a simple question. I have a hair transplant booked at a well regarded clinic in California, but was told by the surgeon that he would have to leave at the break due to another obligation that day. He informed me that the procedure would be complete at that point and standard procedure is for the technicians to finish by themselves, doing the actual graft insertions. The only difference would be that he would not physically be in the office as well.

I would like to commit because it works with my schedule, but I have reservations paying a lot of money for a procedure where the surgeon is only there for half of the day.

doctorisoutWith follicular unit strip surgery (FUSS), the donor area where the strip is excised is indeed closed with sutures, staples, etc., immediately after the strip is taken and before the grafts are inserted. Possibly the doctor was telling you that the techs do all of the graft placement and after they are all placed, the procedure is pretty much completed.

Still, what I don’t like is that it is always possible that the patient may need more anesthesia before the procedure is finished and only a licensed physician should be administering anesthesia. That’s the law in the land.

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

I want hair transplant surgery, but can’t afford it. I found a clinic offering very inexpensive surgery. Should I get the cheap hair transplantation?

dr nickPrice is important; I understand that. I do, however, always share the following “warning” when I hear this question: one quality hair transplant with a trusted physician is usually more cost effective in the end. “Discount” hair transplant surgery sometimes results in touch-ups or, in unfortunate cases, repairs. At the end of the day, this costs more.

Can you get good results at cheap rates? Sure. It happens. Is there any obvious correlation between price and quality? No. And this isn’t what I’m saying.  What I am saying is this: I’ve simply seen too many cases where patients used price as their ONLY determining factor in choosing a clinic and ended up with poor results and repair procedures. I hate seeing this happen to hair loss sufferers,  so I always share the above. I recommend thoroughly reviewing all physicians you’re considering for surgery. Consult with a number of hair loss doctors, review your options, and pick a surgeon who meets all your needs. Be careful, however, selecting a surgeon based on price alone.
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Blake Bloxham – formerly “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

This below response from our Hair Loss Social Community and Discussion Forums was written by recommended hair restoration surgeon Dr. Ali Emre Karadeniz.

I’m about three weeks past a strip hair transplant. Due to tension issues, my hair restoration surgeon had to leave my donor site very open, and also had to loosen a suture a couple of days after the surgery. I’m looking at a 1.5 cm scar on my left temple, and about a 1 cm scar at the back, and a half cm scar on the right. Not quite the 2mm scar I was shown during consultation.

I know it’s early for me, as my scar has to mature, but I have been encouraged to see a plastic surgeon at some point. I’m worried about the lack of laxity at the time of a future scar revision surgery, so I’m also curious about the use of tissue expanders.

Dr_Kardeniz_PhotoHere is my advice on approaching wide strip scars:

The first question to answer is, why is the scar wide? Bad surgical technique (transections along the incision, bad wound closure technique…), too wide strip excision or unlucky tissue character.

The second question is, is there any skin laxity left?

Now,

  1. Bad surgical technique + skin laxity => Go for a scar excision and trichophytic closure.
  2. Bad surgical technique + no skin laxity, or too wide strip excision with no laxity and unlucky tissue character probably doesn’t benefit from a scar revision.

I’m a youthful 58 year old African-Caribbean woman, London based, who’s losing hair at the front and hating it!

I’m considering a hair transplant but scared! I’m wondering whether some surgeons are better and more experienced than others with Afro hair? And whether FUE or strip surgery would give better results or not for my type of hair? And whether being female has any particular implications? What can go wrong?

I’m at the start of my hair restoration journey, and any observations /comments/stories would be very welcome!

African-American-HairThese are excellent questions. When it comes to hair transplant surgery in general, men are more often better candidates than women due to their typical balding patterns. Male hair loss patterns are described by the Norwood Scale while typical female hair loss patterns are described on the Ludwig Scale.

When hair loss is diffuse and affects the “permanent zone” at the rear and sides of the head, surgical hair restoration is typically not a good option. However, some women may lose hair mostly in the front as you have described and may be good candidates for surgery. The best way to find out is to consult with a skilled and experienced hair transplant surgeon.

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

I underwent hair transplant surgery via the Follicular Unit Strip Surgery (strip) method. The results are good, but the scar needs revision. I want to transplant grafts into the scar to camouflage its appearance. I’m wondering, should I use scalp grafts from the donor region or grafts from my beard (body hair transplantation or BHT)?

hair transplant scar revisionBody hair grafts are generally more fragile and exhibit lower growth rates. One could only assume transplanting body hair grafts, opposed to scalp grafts, into scar tissue would provide lower yield.

Regardless, both are highly variable. Scar tissue is thick and lacks blood supply. This makes it difficult to predict if anything will grow in the scar tissue, let alone determine which type of graft – scalp versus body – will grow better. It’s likely safer to utilize scalp grafts first and then use body hair grafts, if necessary, down the road.
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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:

After wearing my hair in tight braids for years, I now suffer from traction alopecia. I’m wondering, can this be repaired with hair transplant surgery?

traction alopecia before and afterTraction alopecia is defined as a focal (concentrated in one location and non-patterned), non-scarring type of alopecia. It’s generally caused by a prolonged period of pulling – “traction” – on hair follicles. It’s most commonly seen in individuals who wear their hair in tight braids for long periods of time, or individuals who wrap their hair in tight dressings for cultural or religion regions. These situations both put excessive strain on the follicles and cause hair loss over time.

Fortunately, traction alopecia can be repaired with hair transplant surgery. In fact, it usually responds very well to hair transplantation. Interested in what can be achieved with hair transplantation in patients with traction alopecia? If so, please review this excellent case presented by recommended hair transplant surgeon Dr. Tejinder Bhatti: 2,453 Grafts for a Traction Alopecia patient. 

Those interested in a similar repair may benefit from reviewing our recommended hair transplant surgeons and considering a consultation.
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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

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

Several months ago, I underwent Follicular Unit Strip Surgery (FUSS). I’m pleased with the results so far, but worried about the strip scar. How long should I wait before considering revision of my hair transplant strip scar?

FUT staplesMuch like the results of the hair transplant itself, the strip scar takes around 12 months to fully mature and develop. The scar goes through a series of healing phases. During the earlier healing phases, the scar often appears raw and red, and patients assume it won’t heal well. This often is not the case, and the scar simply needs more time to heal.

By month 12, it should be as flat and narrow as it is going to be; at this point, patients can assess the scar and determine if it needs revision. While strip surgery normally leaves a fairly thin and manageable scar, healing is variable and some patients may scar regardless of how well the incision is closed.

Those considering scar revision should consult with an experienced hair transplant surgeon to discuss their options.

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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, Follicular Unit Strip Surgery, , , , hair transplant

This insightful article was written by hair loss physician Dr. Jean Devroye, who is a member of the Coalition of Independent Hair Restoration Physicians.

Dr_Devroye_photoSynopsis
Hair transplantation at the level of the vertex is not an easy to manage technique. This article, after having revised the notions of anatomy, describes the strategic stakes which are necessary to face. It also gives numerous details on the technique to implement in order to obtain the most natural result possible and which also gives the best possible apparent density.

Introduction
The vertex is a complex zone. The hairs are arranged in a radial way. It is of course subject to more or less complete baldness. The progression of this is mostly eccentric, starting from the center and evolving more or less quickly towards the periphery.

It is no easy task to treat the vertex for several reasons that will be developed hereunder.

We are often in an uncertain situation, facing a progression the outcome of which we do not know and the hair loss is often widespread. The thinning often includes the frontal zone, the midscalp and the vertex. It is essential to take into account the Donor-Recipient Area Ratio. Unfortunately this ratio is transformational. It’s never easy to choose the best strategy knowing the vertex is a secondary zone by comparison with the anterior and median zones.

I shall describe exclusively the vertex alopecia in males. Indeed, it is exceptional to treat vertex balding in women. In fact, women almost never have enough graft reserve to treat the vertex.

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