FUT Hair Transplants

Follicular Unit Transplantation (FUT) is principally the best option for treating hair loss. FUT is, without doubt, a procedure which is tried and tested. By using this method for several years, doctors have continuously been updating it to make it better for those with different types of early-age hair loss.

Nevertheless, in light of the fact that there is a never-ending stream of innovation in this field, and new methods and apparatuses are being part of this surgical process at a regular speed, it’ll be a judicious idea to spend some time to review the latest FUT hair transplant methods, the benefits they have over other types of treatments and the differences between these different forms of FUT advanced techniques.

FUT (Follicular Unit Transplantation) Hair Transplants are performed under local anesthesia. Follicular Unit Transplantation (FUT) is the ‘strip’ approach: the surgeon removes a thin strip of dense-growing tissue hair from the back or sides of the head and divides it into individual follicular units and transplants these one by one into the bald or thinning areas.

The FUT Process Step-by-Step
FOR USE AS DONOR AREA: The area of scalp from which the surgeon will remove a strip of hair and transplant it as naturally as possible. The donor area is normally a narrow strip taken either from the back or sides of the head, since the hairs in these areas are coarser, denser and less prone to balding than the are on the top of the head.

• Local anesthetic: local anesthetic is typically performed on both the donor site as well as the recipient graft site. This can be done while the patient is AWAKE. Yes, awake. What this means is that the patient is fully functioning, fully coherent and able to understand everything that’s going on… yet unable to feel any pain.
• Thin strip: A strip of tissue is harvested from a thin horizontal strip (5 to 15 mm) at the hairline. The grafts are removed from a thin tissue strip that can be 30 cm long and up to 10 cm deep at the side of the head Sutures: The strip is sutured back in place. After sutures, the area is taped for 10 days.
• Follicular Dissection: technicians dissect the strip into single follicular units, naturally occurring units of one to four hairs each, to aid in implantation and facilitate take – making sure the transplant looks natural.
• Recipient Site Creation: The recipient area is prepared and incisions are made in the area where the hairs will eventually be positioned. Its topography is evaluated to be sure of the final density, orientation and direction, so that the hairs appear natural.
• Grafting: Finally, the follicular units are placed into the recipient sites. In the final phase, it’s important to achieve a high density at the back of the head with planted hairs that are placed perpendicularly so as to imitate the density of a healthy head of hair.
• Post-Operative Care: They are given the details of the post-operative hair wash regimen and oral medicines. The recovery after FUT is very quick. There is some pain and discomfort for a few days. All patients can resume their normal work routine within one week.

Advanced Techniques in FUT
Yet while the principles of what’s known as a FUT remain largely unchanged from a decade or even two decades ago, increasing sophistication of technique give the procedure more precision, less scarring, and, with above average hair depth, better outcomes.

Trichophytic Closure
Another enhancement in the FUT approach is the so-called trichophytic closure technique when the incision line in the donor area is closed in a way so that scarred skin will contain the hair follicles and the hair will be actually growing through the scar. The fact, that the wound edges need to be overlapping each other, will force the hair to grow out of the scarred skin in a normal way, as it would do anyway, thus reducing drastically the linear looking scar so typical for FUT in the past.

Microscopic Dissection
Once upon a time, those follicles would have just been plucked from the donor transplant site and hammered into the recipient site (follicles were damaged in the process and the final result wasn’t as good as it is now). Nowadays, they are dissected with a microscope. ‘Technicians’. These are the workers who sit with their scalpels and their microscopes on their high desks all day and all night and day, splitting grafts into their component follicular units under high power. Neurons in the visual cortex are lobbing information into the motor areas, causing neurons there to fire and make hands move in ways that allow them to paint pretty pictures with a knife.

Dense Packing Techniques
Over-maximum coverage is possible, though considered unfavorable, because the thinnest is achieved through dense-packing, either through modern techniques that group the follicular units even closer together than ever in the recipient area, or by planting as many as 40 to 60 grafts per square centimeter under the skin, which results in fuller-looking, or ‘head-looking’, outcomes at one’s hairline and the crown.

Advantages of FUT Over Other Hair Transplant Techniques
Follicular Unit Transplantation (FUT) is often compared with Follicular Unit Extraction (FUE) – another widespread procedure for hair-transplants. Both can achieve excellent results but FUT has a set of particular advantages.

Higher Graft Yield
Another advantage of FUT is that more grafts can be harvested per session. Because the surgeon is removing a strip of tissue, he is able to take more follicles than one could in FUE, where hair is extracted individually one follicle at a time. For those who require a lot of hair, this effect can be more dramatic and, consequently, more aesthetic.

Better for High-Density Transplants
In those cases – when you have a patient with a lot of high density transplantation or a lot of coverage – FUT is the method of choice. Because you can harvest thousands of grafts in a single session, you can achieve thick fullness and natural results a lot quicker.

Less Donor Site Trauma
Here the difference is that, while FUT is a single linear incision, in FUE at least several hundred and potentially thousands of little ‘core’ holes are punched into that donor area. All things being equal, each individual ‘core’ from a FUE donor area intervention has less donor trauma than the FUT method of extraction and exit point. FUT always has much less total donor scarring, and the patient heals much more quickly in the donor area after each intervention, should they be doing multiple transplants (which is often the case in several-year intervals to ‘finish’ the unit implantation required).

Cost-Effectiveness
In general, FUT is a less expensive procedure than FUE because the same number of grafts can be harvested in a smaller number of sessions, and many men needing large numbers of grafts have fewer, less expensive procedures as a result.

Graft Quality
Consequently, transplants from FUT will typically have higher-quality grafts, because follicular units are dissected off under the microscope with far greater accuracy and efficiency than randomized harvesting, allowing for much cleaner and healthier follicular units. In the case of FUT, stages one and two eliminate the dead tissues surrounding the follicles at the donor site, while preserving the integrity and survival of individual follicles at their new recipient sites.

Recovery and Results
An FUT procedure requires downtime to recover, though it’s easy to do so:

Immediate Post-Operative Care
The patient is normally discharged, taking analgesic tablets for the postoperative pain, and antibiotics (to prevent infection) which they will need to take for a week or 10 days. The donor area can be a little sore for a few days; the patient should avoid disturbing the sutures. They are able to go back to normal office work within a few days and to full activity after about a week.

Donor Area Healing
The donor site linear scar will fade into a very fine white line. If a trichophytic closure is performed – that is, if the tissues have been re-approximated in such a way that the hairs seem to ‘grow through’ the linear closure – then the scar often becomes imperceptible, and certainly so when the hair that surrounds it has grown long enough to overhang the scar line. Sutures are normally removed between 10-14 days postop.

Shedding and Regrowth
In the weeks following the procedure, the transplanted hair will simply fall out – this is perfectly normal, and part of the normal hair cycle. Sometimes this is called ‘shock loss’. New hair will begin to grow back within three to four months, with actual hair growth visible at around the six-month point, and full visible results taking 12 to 18 months.

Long-Term Results
This is because the FUT donor follicles resistant to the effects of DHT come from the back (occipital scalp) and sides (parietal and temporal scalp), known as the ‘permanent zone’ due to its innate resistance to hair loss and need for medical intervention to do so. An FUT hair transplant, therefore, results in permanent outcomes, with hair transplanted growing in, taking root, and growing for many years to come.

Potential Risks and Complications
Like any surgical procedure FUT is not completely without risk, but serious complications are uncommon and most possible side effects are minor and only temporary:

• Scarring: although scarring can be reduced when there is trichophytic closure, some patients on certain skin types can end up developing a more visible scar. Rare, but if the post-operative installation instructions are not observed, then what you could get is infection. Otherwise known as shock loss, this can affect the hair that has been transplanted, as well as the surrounding hair in the donor area. This hair will usually regrow within three to six months.
• Pain/Discomfort: Patients may describe discomfort in a donor or recipient body site for a length of time, which can range from a few days up to several months post-surgery.

How to Choose Between FUT and FUE
It is superior to hair restoration either from FUT or from FUE, and the choice depend on many factors. Capacity For Large Sessions: In cases where a higher yield per session is warranted due to large graft requirements, FUT is the better option.

Donor Area Characteristics: Patients with limited donor hair may