Dr. Amiya Prasad, a NY Hair Transplant Surgeon developed a new technique called Micro Linear Grafting that combines the best features of all of the above methods, while preserving their individual advantages. Hairs naturally grow from the scalp in groups of 2 to 4 hairs called follicular units. Coupled Follicular Units (CFU) describes natural linear groups of 2 or more follicullar units.
Both men and women from around the world are benefiting from the innovation in hair transplant surgery and pioneering research in the utilization of ACell Matristem for the treatment of hair loss.
Follicular Unit Transplantation is the current standard of care for Hair Transplantation in the United States, whereby individual hair follicles are transplanted from the donor area to the areas of balding. Those hair follicles are actually minute and highly specialized organs and we can transplant over 2000 of those in one session.
Hair grows naturally in bundles of 1, 2 3 or 4 hairs per bundle, on the average. These hairs, along with their associated structures are known as the Follicular Unit.
Hair usually grows abundantly at the back and sides of the head as those hair follicles are not influenced by the hormone Dihydrotestosterone (DHT). This horse-shoe shaped area is called the donor area.
During FUT the hair from the donor area of the scalp is removed in a strip. The donor area is closed with a fine suture. The strip in then dissected so that the hair follicles are identified, separated from each other with meticulous microscopic dissection, and then transplanted to the recipient area or areas of balding.
How Many Grafts Will I Need?
I am a male in my early 20′s and live in Texas. I know I’m young, but I do not have a history of baldness on either my father or mothers side. I have had a high hairline (I believe it’s a NW3) my whole life. I’m looking to get FUE transplant this summer. My two questions are these: How many grafts, based on my pictures, do you think I will need? Secondly, I am not looking to spend all of my money at once, but was wondering if I could do it two or maybe even three sessions? Best Regards.
Thank you for your question.
You are in your 20′s and you submitted some very good photos to help me asses the degree of your hairloss. You stated that you’re planning to get a few week grafts and you want to know how many grafts you’ll need and the questions you’re asking are all very reasonable. Now I’m probably going to help you a lot by educating something that we do a lot in our practice that’s a little bit different than the usual answers you will get from a hair restoration specialist. So let’s begin first by defining what your situation is.
You are dealing with unfortunately with a young age with male pattern hairloss. Male pattern hairloss traditionally has been based on a genetic pattern such that different decades of our lives most men will have some time of male pattern hairloss. Now it’s kind of rule of decades in your 20′s 20% of your contemporaries will have hairloss that means at 80% of your contemporaries have lots of hairs when you hit you 40′s and 50′s its starts to even out. 50% have significant hairloss, 50% have mild or moderatebut some degree a lot of men by the 4th or 5th decade of life will have some degree of hairloss.
In the 90′s, specifically in 1997, when drug Finasteride was introduced, we had an understanding with male pattern hairloss based on something called dihydrotestosterone or DHT. And the concept is at a certain point of your life, a protective mechanism turns soft and then dihydrotestosterone literally chokes the hair follicles and causes thinning. Many men mistakenly believe that they have too much testosterone although that is wish full thinking. It’s not true. Most men have normal testosterone depending on whatever age range they’re at but it’s the conversion of testosterone to dihydrotestosterone. And dihydrotestosterone is what causes the hair follicle to shrink. So a drug like finasteride diminishes DHT or dihydrotestosterone.
Now moving the clock forward and in 2011, a research was done in the University of Pennsylvania and it showed that there are certain adult stem cells that are responsible for the hair growth process that suddenly stops working. And they noticed that in the scalps of bald men, the hair follicles are present but the hairs did not continue to grow.
So essentially, with dealing inactive follicles, in our practice the past 2 years, we have had the remarkable opportunity to develop and injection using a wound healing model to stimulate and reverse thinning hair. If you will imagine that these adult stem cells are responsible for the protection of the hair follicle from DHT or dihydrotestosterone. Imagine that we have applied a material that causes healing in a cellular level that protects the hair follicles. We refer to this as progenitor cells as was referred to in the University of Pennsylvania studies. These progenitor cells, think of it as protecting the hair follicles. So essentially, what we are able to do is literally create a wall in conceptual way because this is a test to proven in a laboratory studies but conceptually this is what appears to be the case. And by doing this, thinning hair is being reversed in our practice with this injection and this is a very important point particularly to somebody in their 20′s. And when you’re in your 20′s and you could imagine by the time you’re in your 30s 40s, your hairloss will otherwise progress. And even if you take DHT blocker like finasteride, you can still progress.
So traditionally in hair transplant, we were always hesitant to perform transplant on a 20 yr old because somebody who are in their 20′s continuously loss their hair while the transplanted hair the genetically resisted hair would stay and it would force them to keep doing more and more so my suggestions for you is to actually consider this kind of hair regeneration technology. And if in our practice, just to give you perspective of what we do when we use hair regenerative technology we’ll do that first. We’ll do the injection first then after a year and see how much re-growth you had. We then decided if you want more hair. We can then do a transplant and even with the transplant we can use this regenerative healing technology that allows are donor area to heal beautifully and our hair grafts to take very well.
So to answer the question about the number of grafts, that’s very straight forward. The number of grafts depends on the area that you want to cover. And in typically the hair transplants zone are frontal middle and back. And generally in a given transplant we will transplant anywhere from 15hundred to two thousand hairs and we’ll do that usually towards the front because the hair frames the face and if you want to frame the face, you want to do it towards the front. Now that may not be adequate to cover as much as you desire that were additional transplantation may be recommended but in summary, before you consider a transplant, think about investigating both of the DHT blocker although currently finasteride does have a lot of controversy about long term side effects. And in addition, that’s new hair regenartive technology that we have been fore front of and then consider a transplant. So I know that’s a lot to learn and i hope that was helpful and thank you for your question.
Hair follicles can also be extracted individually for patients who prefer a virtually scarless donor area by Follicular Unit Extraction (FUE).
By meticulously dissecting and trimming the Follicular Units, the doctor and the medical team ensure that the grafts are comprised of healthy intact hair follicles as they naturally occur in the scalp. The ultimate goal is to achieve natural looking results.
In simple words, there are 4 steps in Follicular Unit Transplantation.
Step 1 – Graft Removal
- The donor area is anesthetized using local anaesthetic. Hair bearing tissue is removed painlessly form the back and/or sides of the scalp.
Step 2 – Slivering
Hair grafts are prepared using binocular microscopesStep 2 – SliveringStep 2 – Slivering
- The hair bearing tissue is divided into slivers approximately 1mm thick.
Step 3 – Microscopic Dissection
- The slivers are dissected using stereoscopic microscopes and/or loupes into Follicular Unit Grafts (FUG’s) containing 1,2, 3 and 4 hairs per graft, on the average.
Step 4 – Placement
- Tiny openings are made in the recipient area. The Follicular Unit Grafts are transplanted into these openings. Grafts containing 1 hair are placed in the frontal hairline. Grafts containing 2 or more hairs area placed behind the hairline as needed to achieve the desired density in those areas
- Old techniques of Hair Transplantation used 4mm diameter cylinders of hair bundles which cut through the healthy hair and usually led to a ‘doll’s head’, ‘corn crow’ or ‘toothbrush’ effect. These old methods are now obsolete.
- Follicular Unit Transplantation is an excellent procedure to repair the ‘dolls head’ effect of old punch graft techniques.
- It is important to note that Follicular Unit Transplantation does not create new hair but re-distributes existing healthy hair from the back and sides of your scalp to the thinning or bald areas. This hair grows naturally and for life, as it was programmed to grow in the donor area.
Schedule An Appointment Today!
To schedule a consultation with Dr. Prasad to determine the best procedure for you, submit the form below or call our Manhattan office at (646) 461-8547 or Garden City Long Island Office at (516) 535-9479. Our phones are open 24 Hours a Day / 7 Days a Week. Patient Financing options available for qualified candidates.