Follicular Unit Transplantation

Follicular Unit Transplantation is a surgical procedure wherein individual hair follicles are harvested in a strip and transplanted from the donor area (at the back of the head) to the areas where balding is apparent. Hair grows naturally in units of 1-4 strands of hairs per bundle, on the average. These hairs, along with their associated structures are known as a follicular unit. These units are transplanted into new openings on the recipient sites. Because hair naturally grows in units of 1-4 strands, the newly transplanted grafts tend to look more natural.

The donor area is usually located at the back and sides of the head, as hair grows abundantly in these areas because the hair follicles are not influenced by the hormone dihydrotestosterone (DHT), which is responsible for most hair loss. During FUT, the hair from the donor area of the scalp is removed in a strip. The donor area is then closed with a fine suture. The strip is 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.

Normally, each session can take up to a whole day to perform. Sessions of 2000-3000 grafts are very common, and some physicians even have sessions in excess of 4000 grafts.

Follicular Unit Transplantation— Surgical Process

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 microscopes
  • 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 of Grafts
  • 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.